S04.E08: Paid in Full

[secnarf]

Quote

Max is faced with a wrenching decision when New Amsterdam falls prey to a massive ransomware attack.

Original air date: Nov 9 2021

[CarpeFelis]

Good grief, is this the only medical drama that hasn’t already done the ransomeware thing?

[karenc3]

The thought crossed my mind that Fuentes was the one that actually started the ransomware attack to get Max to sign the budget.  It seems like a strange coincidence that this would happen just as the budget needed to be signed, and all of a sudden she got the money and it was fixed after he signed the budget. If this is what happened she really is pure evil.  Maybe that's part of what they were talking about in the preview if this actually is what happened.

 

I think it would have been better if they brought the guy with the pacemaker to another hospital, and then removed and replaced it.  I'm not sure what they expected to happen when they removed it without being able to replace it.    

[OLynn33]

Pharmacies, the places that give out drugs, also have your prescription history. 

The kid who is now "less" than he was, is still smart enough to get his doctors to nearly kill him.

Pond scum, that algae like foul smelling sludge that floats on stagnant water is still better than people who engage in ransomware attacks on hospitals. It just happened up here.

Edited November 10, 2021 by OLynn33

[Cloud9Shopper]

So if the board terminates Fuentes and Max and Helen go to London, who’s going to be the medical director? Maybe Sharpwin will stay after all? I certainly don’t think any of the other main cast deserve it even temporarily. I’d rather Karen run the hospital than any of those fools. (So happy to see her in next week’s promo!) 

I cheered Casey on for putting Lauren in her place about Leyla. I can’t believe he was one of the fired ones. It’s only a matter of time before her cover gets blown. She wouldn’t even be straight with Floyd and Iggy in the opening scene.

Watching Agnes and Casey get fired hurt. I get that they weren’t going to can the main stars but why two of the more likable side characters? It should’ve just been Max saying he cut other jobs and refer to three nobodies the audience doesn’t know. 

Overall just a boring episode, although I won’t complain if Veronica gets fired.  

 

[LittleIggy]

So how did Max get likable people like Dr. Kao, Casey, and Gladys (plus all those others) canned in place of his buddies? Did he get Fuentes to fire more people to save them? And was that Dr. Baptiste who was fired, too?

I liked Casey going off on Bloom. But why did it just dawn on him that they had one more resident than usual? At least that’s how it appeared to me.

 

Edited November 10, 2021 by LittleIggy

[statsgirl]

Iggy: "Why would anyone deliberately as for a medication that they're allergic to?"  Me: I don't know, you're the psychiatrist, maybe you can figure it out. You know, like the suicidal patients you treat.

Max continues to be the worst ever. The worst. He saved his friends' jobs and fired a bunch of competent and useful people.  Iggy cannot run that department without that admin assistant because she's the smart one in that department, She and Casey put together would make only a quarter of what Bloom earns. Firing Kao isn't going to save money, the department still needs a head of the department and Kao being young would get paid less than a more established doctor.

38 minutes ago, LittleIggy said:

So how did Max get likable people like Dr. Kao, Casey, and Agnes (plus all those others) canned in place of his buddies? Did he get Fuentes to fire more people to save them? And was that Dr. Baptiste who was fired, too?

Yes, I think it was Baptiste. So now Max's friend Floyd is free to continue his affair.

Firing nurses and admin people instead of doctors isn't going to balance the budget because they are paid so much less than a senior doctor or head of department like Iggy and Bloom. And they will need to be replaced because they do jobs that enable the doctors to do more important things, or is Iggy going to do his own paperwork now or Bloom start IVs and hand out medication?

1 hour ago, karenc3 said:

I think it would have been better if they brought the guy with the pacemaker to another hospital, and then removed and replaced it.  I'm not sure what they expected to happen when they removed it without being able to replace it.    

You are a better doctor than Bloom.

This show just gets more and more ridiculous.

Edited November 10, 2021 by statsgirl

[LittleIggy]

Yeah, seeing Helen packing those plastic containers made me go 🙄. I don’t even think they were Tupperware. More like the containers you can buy at Kroger or Target. I was like “They do have those where you are going!”

[Frisky Wig]

I’m 21 minutes in. Hey, maybe send all incoming patients to other hospitals? Contact EMTs/ambulances/NYPD/whoever and let them know they can’t send people to NA until this ransomeware crap is figured out? 
 

Also, my job (I work for a county library in CA) requires all employees to undergo security training to learn to identify virus-laden emails and we each occasionally get test emails that we have to report. Maybe NA needs to implement something like this. 
 

Max pulling Floyd from surgery and nearly firing him in the doorway!? Only to get interrupted by the beeping monitor? Is this for real!? 

Edited November 10, 2021 by Frisky Wig
WTF is this show?

[babyrambo]

The funniest part of this episode was Max barging into Reynolds’ surgery, fully prepared to tell him that he’d been fired. Like could he have picked a worse moment? How was Reynolds supposed to stick his hands back into someone’s body cavity and fix them after being told he no longer had a job lol

For all the ridiculous moments, though, I actually enjoyed this episode. 

 

IGGY: he actually gave some solid advice to the suicidal patient, I wish they weren’t so inconsistent with him and his therapeutic work. And between him and Gladys, I say toss him and keep Gladys. 

 

BLOOM: she’s made quite the mess for herself. And now Casey, the person I’d argue was her closest ally at work has seemingly given up on her. She really didn’t need to do this and Casey reprimanding her was very necessary. Bloom’s rationalized her decision and I even get why, but at this point, she needs to come clean and let the cards fall where they may. By trying to hold on so tightly to Leyla, she’s ended up doing the very thing that will inevitably push her away. And really, her fixing things so Leyla would stay just seems all the more unnecessary in the age of FaceTime and flights. 

 

HELEN: the whole mentor thing with Agnes fell flat to me. Helen keeps not knowing what’s going on at this hospital and that’s never been her. Is her relationship with Max really that all mind consuming? It’s nice that they’re finally together, I guess. But I wish they’d let her be as interesting as she was back in season 1, again. 

 

MAX: What a fool. He’s done a lot of stupid stuff but this takes the cake. Trading in hundreds of jobs to keep three? Seriously? I thought he was kidding at first. Not only is that unethical, but they will need to rehire people to do those same jobs again so talk about  redundancy.

 

And poor Agnes Kao. Just as the writers remembered she exists, she gets axed. Also Casey, I’ll miss him; he’s lively and brought some much needed balance to the ED. Hopefully this is a temporary decision. 

[circumvent]

4 hours ago, statsgirl said:

Firing nurses and admin people instead of doctors isn't going to balance the budget because they are paid so much less than a senior doctor or head of department like Iggy and Bloom. And they will need to be replaced because they do jobs that enable the doctors to do more important things, or is Iggy going to do his own paperwork now or Bloom start IVs and hand out medication?

Firing staff is never a solution for a place that makes money by procedure but here is the reality: Fewer doctors means fewer admissions, procedures. Fewer nurses and administrative staff (except for billing staff) means that patients will be badly served and that the bureaucracy will be even slower. Welcome to health "care" in the US of A! That's exactly what hospitals do in this country. Now, NA is a public hospital, so I am not sure of the implications of such actions Usually this happens when a private hedge fund buys a public hospital - they fire people and literally sell the hospitals for parts.

[cathmed]

On 11/8/2021 at 12:43 PM, CarpeFelis said:

Good grief, is this the only medical drama that hasn’t already done the ransomeware thing?

Yes - it was done on Chicago Med in Season 2 (Dr. Latham paid) and on The Resident on the  S5 premiere (Devon had a black-hat IT extraordinaire college friend who hacked the hackers).  At least there was resolution to both of those whereas this was left "open".   I still believe Fuentes was responsible and/or had something to do  with it

[cathmed]

Max should have known Fuentes wouldn't be forthright and couldn't be trusted.  I wish he had not signed until AFTER HC paid.  I truly believe Fuentes was responsible and/or had somethi9ng to do wit the ransomware attack.   I hope Casey and Dr. Kao will return.

Floyd & Claude bonding as buddies 😂🙄😉 Since Claude is now one, does that leave  clear path for Flyn--I hope not🤢🥵

Poor Helen & Max - both trying to reassure each other that everything's going to be OK 💔

Previews for E9 next week - will they truly fire Fuentes?  Has she done something so despicable that it will finally be her swan song?  She needs to go, NOW

[cathmed]

7 hours ago, Cloud9Shopper said:

So if the board terminates Fuentes and Max and Helen go to London, who’s going to be the medical director? Maybe Sharpwin will stay after all? I certainly don’t think any of the other main cast deserve it even temporarily. I’d rather Karen run the hospital than any of those fools. (So happy to see her in next week’s promo!) 

I cheered Casey on for putting Lauren in her place about Leyla. I can’t believe he was one of the fired ones. It’s only a matter of time before her cover gets blown. She wouldn’t even be straight with Floyd and Iggy in the opening scene.

Watching Agnes and Casey get fired hurt. I get that they weren’t going to can the main stars but why two of the more likable side characters? It should’ve just been Max saying he cut other jobs and refer to three nobodies the audience doesn’t know. 

Overall just a boring episode, although I won’t complain if Veronica gets fired.  

 

ALL OF THIS ^^   I thought the exact thing thing as I watched this episode and preview for next week.  I think Karen may, indeed, be the interim Med Dir IF they actually fire Fuentes (good riddance).  I too, believe, she was responsible for the ransomware as another poster mentioned.  It was all too coincidental and "timed" perfectly.

Hoping Casey & Dr. Kao return and that was just for dramatic effect.  I know fans have been begging for Casey to be a regular rather than recurring character.  Guess time will tell.  I hadn't heard anything about him leaving the show; guess I better research that!  And yeah, Lauren should have had her comeuppance a while ago.  Glad Casey put her in her place.

Not the most exciting episode.  Ransomware story has been done on 2 other medical shows (Chicago Med, S2 & the Resident, S5 premiere)

 

[Sweet Tee]

Unbelievable.  I normally just roll my eyes at Max's antics but he fired 148 people just to protect three of the worst doctors in the hospital?  Well, two of the worst doctors.  I actually think Floyd is a good doctor.  I just don't like him as a character the longer he continues with this Lynn thing.  Casey was the only competent one in the hospital.  Lauren, who's always just on the edge of a cliff, will fall over without him.  As others have said, they'll just need to rehire those positions anyway, so what was he really accomplishing?  The only thing I can hope is that Lynn will decide to fully commit to her husband now that he's been fired and break it off with Floyd.  That was just so selfish on Max's part.  He cost nearly 150 people their jobs so he could protect his friends.  I really hope Casey, Dr. Kao, and Gladys come back.  They're far more likeable than most of the main characters.

At least Casey got to call Lauren out on her crap.  No, Lauren, you didn't have to do it.  You wanted to do it.  Maybe if Leyla hadn't gotten a spot anywhere, I would have understood a little bit.  But, she did get a residency.  One that she earned.  Lauren just couldn't handle not being around her 24/7.  Lauren is rich.  She could have visited as often as she pleased.  I really hope Leyla finds out soon and sends her packing.

At least the Max/Helen scenes are getting better. Helen actually seems into Max again and I like how he turned to her for support and she gave it to him.  That's all I wanted from them.  Just to be a happy couple.

[statsgirl]

3 hours ago, cathmed said:

Yes - it was done on Chicago Med in Season 2 (Dr. Latham paid) and on The Resident on the  S5 premiere (Devon had a black-hat IT extraordinaire college friend who hacked the hackers).

I think it was the neurosurgeon on Chicago Med, not Latham. Grey's Anatomy also did it a few seasons ago, resolved by the vet intern. ( I wish that they would bring him back.) Curiously none of the Canadian medical shows (Saving Hope, Transplant ) have done it while ironically Newfoundland's medical system was cyberattacked last week.

2 hours ago, Sweet Tee said:

That was just so selfish on Max's part.  He cost nearly 150 people their jobs so he could protect his friends.

Just when I think that Max couldn't be any worse as an administrator, the writers find a way to prove me wrong.

How much money did Max spend last week buying a fleet of ambulances, the equipment and the people to run them? That bit of cash would have saved a few jobs.

[LittleIggy]

10 hours ago, Frisky Wig said:

I’m 21 minutes in. Hey, maybe send all incoming patients to other hospitals? Contact EMTs/ambulances/NYPD/whoever and let them know they can’t send people to NA until this ransomeware crap is figured out? 
 

I believe Bloom said to put the ED on diversion.

So Max is so dumb he doesn’t know not to click on attachments from unknown senders? 🙄

[perkie1968]

14 hours ago, OLynn33 said:

Pharmacies, the places that give out drugs, also have your prescription history. 

This.  So much this.  Also, ask the patients to bring in their med bottles.  So stupid.   

[Cloud9Shopper]

5 hours ago, Sweet Tee said:

Unbelievable.  I normally just roll my eyes at Max's antics but he fired 148 people just to protect three of the worst doctors in the hospital?  Well, two of the worst doctors.  I actually think Floyd is a good doctor.  I just don't like him as a character the longer he continues with this Lynn thing.  Casey was the only competent one in the hospital.  Lauren, who's always just on the edge of a cliff, will fall over without him.  As others have said, they'll just need to rehire those positions anyway, so what was he really accomplishing?  The only thing I can hope is that Lynn will decide to fully commit to her husband now that he's been fired and break it off with Floyd.  That was just so selfish on Max's part.  He cost nearly 150 people their jobs so he could protect his friends.  I really hope Casey, Dr. Kao, and Gladys come back.  They're far more likeable than most of the main characters.

At least Casey got to call Lauren out on her crap.  No, Lauren, you didn't have to do it.  You wanted to do it.  Maybe if Leyla hadn't gotten a spot anywhere, I would have understood a little bit.  But, she did get a residency.  One that she earned.  Lauren just couldn't handle not being around her 24/7.  Lauren is rich.  She could have visited as often as she pleased.  I really hope Leyla finds out soon and sends her packing.

At least the Max/Helen scenes are getting better. Helen actually seems into Max again and I like how he turned to her for support and she gave it to him.  That's all I wanted from them.  Just to be a happy couple.

I’m on the NA subreddit and what kills me about Lauren is that some people there say “others should show empathy for her” and “give her a break” or “but her abandonment issues.” Lauren knew what she was doing last season, full stop. I mean, it didn’t even take Veronica that long to know her connection to Leyla and wanting to know if she was involved. It’s not like someone reached into her wallet and stole the money to give Leyla a spot. Lauren runs an emergency room at a major NYC hospital. If she can’t handle all this pressure and needs to be coddled because of her Mommy issues she needs to step down or go back to rehab. Attend more NA meetings. Something. I have hated this trope on other shows and I don’t like it here. Plenty of TV characters or real-life healthcare professionals have had difficult lives but don’t act like she does. 

Edited November 10, 2021 by Cloud9Shopper

[HerkyJerky]

13 hours ago, Frisky Wig said:

Also, my job (I work for a county library in CA) requires all employees to undergo security training to learn to identify virus-laden emails and we each occasionally get test emails that we have to report. Maybe NA needs to implement something like this.

Agreed!  I work at a local hospital and they have us so scared of ransonware that I got an e-mail telling me about an award I had won (which I didn't open) and three days later TPTB asked me why I wasn't more appreciative!😁

Hard to believe that Max was that cavalier about opening his e-mail (or maybe not?)

[Ohiopirate02]

27 minutes ago, HerkyJerky said:

Agreed!  I work at a local hospital and they have us so scared of ransonware that I got an e-mail telling me about an award I had won (which I didn't open) and three days later TPTB asked me why I wasn't more appreciative!😁

Hard to believe that Max was that cavalier about opening his e-mail (or maybe not?)

The main city in my county had a ransomware attack back in 2019 that shut down their computers for a couple of weeks.  They were able to pinpoint the time and computer where the malware was downloaded, but that did not happen to well after the attack.  Because city IT and the state task force employed to help the city were too busy working on getting the system back up.  No way Fuentes could possibly know Max was the cause of this attack from one email unless she had a hand in this.  That is not the top priority of IT and forensic FBI computer guys at that point in the attack.  

I also question how thorough this attack was.  Networks are supposed to be built in ways to silo all of these functions so what happened in this episode does not happen.  The Da Vinci robot should have it's own network as well as the pacemaker and whatever software Helen was using for her chemo patient.  And while Max is the one in charge, his computer should never have access to all of these networks.  I know the writers were going for shock, but their scenarios come off as New Amsterdam having the worst IT ever.  

[Frisky Wig]

1 hour ago, perkie1968 said:

This.  So much this.  Also, ask the patients to bring in their med bottles.  So stupid.   

I believe they were referring to the inpatient clients meds. When you’re inpatient, staff give you your meds at certain times (ie, breakfast, before bed), you don’t have any bottles. All the meds are locked up, actually. 
 

On this topic, I was surprised that Dr Fromme suggested calling patients old doctors because often, when a patient is admitted to a hospital, medications and/or dosages change. Heck, diagnoses can change as well, which requires med changes. During that scene, I thought “ok, but how current is the info you’re going to get?” But I guess he was desperate. 

[perkie1968]

32 minutes ago, Frisky Wig said:

I believe they were referring to the inpatient clients meds. When you’re inpatient, staff give you your meds at certain times (ie, breakfast, before bed), you don’t have any bottles. All the meds are locked up, actually. 

Ok, I must have missed that it was the in patients.  

[KaveDweller]

19 hours ago, LittleIggy said:

So how did Max get likable people like Dr. Kao, Casey, and Gladys (plus all those others) canned in place of his buddies? Did he get Fuentes to fire more people to save them? And was that Dr. Baptiste who was fired, too?

Did Max really fire 148 people to replace the three in the main cast, or were some of them already going to be let go. I can't believe Max would trade 148 people for his friends, or that anyone would let him.

Also, Lauren and Iggy DESERVE to be let go. Lauren previously worked while high and then paid a bribe to bring in her girlfriend. Iggy has been the worst doctor ever since the beginning and doesn't even want the job of seeing patients anymore. Floyd seems like a good doctor except that episode where he was hallucinating about gunshot victims. He is an idiot for dating his boss's wife, but an okay doctor. He's the only one of the three that didn't deserve to lose the job. But no one we saw leaving deserved it either.

9 hours ago, statsgirl said:

I think it was the neurosurgeon on Chicago Med, not Latham. Grey's Anatomy also did it a few seasons ago, resolved by the vet intern. ( I wish that they would bring him back.) Curiously none of the Canadian medical shows (Saving Hope, Transplant ) have done it while ironically Newfoundland's medical system was cyberattacked last week.

The Good Doctor did it last season as well, Leah magically fixed it with her computer skills. It is really irritating that no one can be original. 

[txhorns79]

12 hours ago, Sweet Tee said:

I normally just roll my eyes at Max's antics but he fired 148 people just to protect three of the worst doctors in the hospital?  Well, two of the worst doctors.  I actually think Floyd is a good doctor. 

In fairness, I think the 148 were going to be fired no matter what, but Max arranged it so three other people got fired instead of his three friends.  I'm not saying that makes him better, but just saying the vast majority were already being fired.  I also have no idea how Agnes was able to become the full time Chair of Neurology.  From what I recall, she went from a fellowship to acting Chair last season, even though she would be chairing a department that nominally would have doctors with decades more experience than her.  And that wouldn't even get into her lack of administrative experience. 

And I'm sorry, are we supposed to see Fuentes as a bad actor for wanting to *gasp* balance the hospital's budget?  I'd tell Max if he found her budget so awful, then come up with his own that similarly balances.  If he cannot do that, then stop complaining. 

[judyri]

Casey and Cao and Agnes need to come back, they were the voice of reason, professionalism and competence.  So of course they get fired.

[bros402]

okay guys it's time for WORST DOCTOR!

shooting from the hip I am going to guess it will be Reynolds

ok for a second there I thought Bloom was gonna tell Iggy and Reynolds she did a donation that might've gotten her girlfriend a slot

you three have only known max for three years, how are you his people - well, maybe Reynolds is since Max made him rise to prominence

since Reyndols was the only member of the cardiac surgery department to stay when everyone else walked off, but Iggy and Bloom were already there and in charge of their departments

"It's gonna be okay" - Max and Sharpe (Me: It's not gonna be okay)

so uhhh Fuentes wants to fire at least two department heads? I can understand Reynolds, he's not a department head, he just came back within the last year, so he could be replaceable. But firing the head of your ER and psychiatric unit (especially since he is in charge of pediatric inpatient, it seems) at the same time seems.... unwise - especially since I doubt she has replacements lined up

umm max the second you saw that stuff appear on the computer you should've been "hey look at your computer do you see this stuff too?"

unless Max brought the ransomware into the hospital which lol

um why would Dr. Neurology be taking over an oncology patient's treatment

wait did they just claim that intrathecal MTX is a *new* option? that's been around since at least the 70s! I would be shocked if it weren't standard operating procedure for CNS lymphoma!

WHY DO THEY WANT TO DRILL INTO HER HEAD? INTRATHECAL MTX IS DONE SIMILARLY TO A SPINAL TAP! IT IS DONE IN THE SPINE! NOT THE BRAIN! WHAT THE HELL!

a neurologist is not a neurosurgeon

oh no, iggy needs some air and it's gonna be ransomware - is he gonna be locked somewhere with someone who needs his help, then he gets his therapist mojo back?

uh oh, robotics and ransomware - i bet it's gonna start in the middle of surgery

uh oh, remotely accessed pacemaker is gonna get locked up

is pacemaker man gonna spread ransomware around the city of new york like a digital typhod mary

um shouldn't diagnosis of a pacemaker be something you are at least on the phone with a patient for

why is a nurse doing the ER scheduling for residents

damn, iggy didn't get caught with someone while he was away

um if this is ransomware, it doesn't make things disappear, it just locks up the files

they would have to make so many different viruses for so many different machines, and have to know the specific machines and model numbers in order to do things like "hack pharmacy to send fatal dose of mtx to the patient"

and why would the pump (which isn't connected to the internet) push all of the MTX right away

it's also why they have a buddy system where someone brings the medicine, checks the dosage, checks with the patient (or at least with me, in my experience), and then checks the doctors order - they don't just go "lol let's hook this patient up"

um with the robot surgery, see previous comment about knowing the specific machines, but adding THEY WOULD HAVE TO KNOW THE EXACT SURGERY AND THE EXACT POINT THEY ARE AT AND KNOW EXACTLY HOW TO HURT THE PATIENT

so how did at least one medical director and one department see that stuff on their screen and not call IT immediately, since it seems like it took a bit to spread through the hospital

ha ha max is the reason they got the ransomware - i bet he clicked a link in the email

i doubt cutting the 30 doctors or so would give them the 10 million they need

um max now that you know about it why not shut down the hospital intranet and all affected machines

oh well now it's too late

 

it's so helpful of these hackers to show the stuff on their screen until they click the mouse

I have to imagine they have paper backups of what medications their patients are on, even if it is just their patient notes

so they claim she got 5x the dose of MTX - for intrathecal, they tend to give a high dose, so 5x would most likely be in a range where a pharmacist would be like "hey, you made a mistake here, are you sure this dose is right, doc?"

hey, they got the drug right, leucovorin does help with MTX, 

um reynolds shouldn't you have known where the robot was from the start in case you had to go in

um bloom how are you gonna dig a pacemaker out of him

iggy why weren't you watching the patient who you gave medications that might've been incorrect

uh oh they're saying it's gonna be ok again, I don't think it is gonna be okay

wait WHY DO THEY HAVE THE PATIENT WHO JUST WENT INTO ANAPHYLAXIS IN A ROOM BY HIMSELF HE SHOULD BE IN THE ER

iggy, he might want to hurt himself because he's suicidal, he is inpatient psych, after all.

also it takes like 2 days for mtx toxicity iirc

um bloom how did you get that out so quickly

oh casey, I love you "His heart's crappin out!"

ok I am guessing Iggy is going to get his mojo back by helping suicidal patient

max you do not tell reynolds in the middle of surgery that he is being let go

HOW IS EVERYTHING CONNECTED TO THE NETWORK

max, that's why you wait until after it is secured before you sign it

um reynolds
did you just macgyver a piece of surgical equipment

 

i thought dr. neurology was going to tell Sharpe that she already had a mentor and was just humoring her for the day

 

bloom do not confess your potential crime to casey
bloom, you did not have to do it, you wanted to do it

why did bloom have the biggest surprised face at potenitatlly being let go, Reynolds should've - since he has nobody supporting

 

HOW COULD YOU LET GO DR. NEUROLOGY? SHE IS PROBABLY ONE OF THE LOWEST PAID HEADS BECAUSE SHE PRETTY MUCH WENT FROM RESIDENT TO DEPARTMENT HEAD

ok so if iggy's assistant is on the list it's a purge of every potential max loyalist

Casey too????
fuentes must go for this offense

ok how do 148 people line up with the like ~30ish or whatever Fuentes wanted fired at the start, i think that would more than exceed saving his three friends

ok I did the math, let's say they need to get the 10 mil - the 148 would have to be earning 67.5k a year each in order to hit 10 mil

 

i doubt all of them earn that

so, uhhhh, who is the worst doctor?

ok so Sharpe didn't check her patient's MTX dose

but Iggy relied on patients knowledge of what pills looked like from a potentially suicidal patient (WHY NOT CONTACT HIS FAMILY OR WHOEVER DID INTAKE TO ASK WHY HE WAS THERE FIRST) and caused an allergic reaction

so I would make it a tie between Max and Iggy - since Max let 148 people go so three of his friends could keep their jobs. I could understand if maybe he did somethin so Reynolds could keep his job, but Iggy and Bloom have cushions to land on. Reynolds doesn't

Iggy because yeah

[circumvent]

8 hours ago, txhorns79 said:

And I'm sorry, are we supposed to see Fuentes as a bad actor for wanting to *gasp* balance the hospital's budget?  I'd tell Max if he found her budget so awful, then come up with his own that similarly balances.  If he cannot do that, then stop complaining. 

That's a fair point. The reality is that public hospitals are always in the red because of the system in this country that incentivizes care for profit only. The problem is that TV shows only like some realities, and not others, so they find a villain to take the blame for things that are systemic in real life. A real Fuentes would either be struggling to provide good care, unable to balance the budget and fighting to get grants or whatever funds they are allowed to pursue, or she would be just another capitalist trying to deliberately sink the hospital to force the board to privatize it. 

Hellen packing skills match her sandwich making skills. When you move to another country you only pack the essential, maybe some books, but not kitchen utensils. And Max, Luna will not miss all her toys. Pick two or three favorites, the rest is donation, storage or garbage.

Iggy being all cry baby because Fuentes is "forcing" him to see patients, and being enabled by Lauren and Floyd is ridiculous. "Does she know you were attacked by a patient?". He is traumatized and does not seek therapy? So he should definitely resign.

 

[judyri]

4 hours ago, circumvent said:

Hellen packing skills match her sandwich making skills.

Seriously, who packs empty tupperware to move to London???

 

And... how can a public hospital just love 150 workers overnight? Besides people, what services are they cutting forever?

[Jillybean]

This episode failed to hold my interest. My takeaway was that the unprofessional staff got to keep their jobs and the ones who conduct themselves professionally were fired.

[circumvent]

2 minutes ago, Jillybean said:

This episode failed to hold my interest. My takeaway was that the unprofessional staff got to keep their jobs and the ones who conduct themselves professionally were fired.

And as soon as Max takes back his job he will hire them back because to the writers, they just need to go round and round until the last episode of the season.

[Lovecat]

 

On 11/10/2021 at 12:21 PM, LittleIggy said:

So Max is so dumb he doesn’t know not to click on attachments from unknown senders? 🙄

Yes.  Yes he is.

21 hours ago, Frisky Wig said:

I believe they were referring to the inpatient clients meds. When you’re inpatient, staff give you your meds at certain times (ie, breakfast, before bed), you don’t have any bottles. All the meds are locked up, actually. 
 

On this topic, I was surprised that Dr Fromme suggested calling patients old doctors because often, when a patient is admitted to a hospital, medications and/or dosages change. Heck, diagnoses can change as well, which requires med changes. During that scene, I thought “ok, but how current is the info you’re going to get?” But I guess he was desperate. 

I did like the one patient that was trying to describe how his meds felt.  "It used to be like...wah-wah-wahhhhh...and now it's like...pshhhhhhh!"  I half expected Iggie to nod vigorously, say "Yes, of course, thank you!" and write down some meds just based on those descriptions.

13 hours ago, judyri said:

Casey and [Agnes] Cao and Agnes Gladys need to come back, they were the voice of reason, professionalism and competence.  So of course they get fired.

I think at this point I'm only watching this show for Casey and Gladys.  I'm neutral on Dr. Kao, because I really miss Kapoop.  Uh, Kapoor. :) 

[judyri]

Just now, Lovecat said:

Casey and [Agnes] Cao and Agnes Gladys need to come back, they were the voice of reason, professionalism and competence.  So of course they get fired.

Sorry I got the names mixed up, I could see them in my head!  but yeah, most of the 'regulars' are pretty insufferable right now.

 

[statsgirl]

17 hours ago, txhorns79 said:

In fairness, I think the 148 were going to be fired no matter what, but Max arranged it so three other people got fired instead of his three friends. 

I seem to remember Fuentes saying that 140 people were going to be let go from departments that are "top-heavy". So basically Max get an extra 8 people fired so that he could save his friends.  The problem is that Fuentes picked people based on their perormance and ability to bring money in to the hospital and Max based it on friendship. Iggy and Lauren both draw large salaries as longtime heads of departments. I don't know if Lauren is worth her pay in terms of treating patients but Iggy certainly isn't right now even if he is starting to see patients. Gladys is the smart one who runs that department and it's really going to suffer with her gone, just as the ED will with Casey gone.

When Iggy waxed lyrical about how it feels when therapy is going good and he's in the zone, I got squicked out. I know psychiatrists who feel like that and it's usually when the psychiatrist is forcing his thinking on to the patient. Real therapy is much messier and much less easy.

[Sweet Tee]

22 hours ago, txhorns79 said:

In fairness, I think the 148 were going to be fired no matter what, but Max arranged it so three other people got fired instead of his three friends.

Ah, that makes sense.  But still, Max didn't do anything noble to save his buddies by laying off three other people that basically prop said friends up and keep their departments running.  And obviously, this wouldn't make a big dent in the budget, but maybe if they didn't have that extra resident to pay, Lauren....just saying.  

 

As others have said, Iggy really needs some therapy of his own.  Was he expecting to never have to see patients again?  Not that he should be seeing patients because, once again, he is a terrible doctor.  Just one episode ago he was ready to resign rather than see patients so he should be let go.  And Lauren deserves it too because of what she did for Leyla   herself.

Edited November 12, 2021 by Sweet Tee

[bros402]

19 hours ago, circumvent said:

That's a fair point. The reality is that public hospitals are always in the red because of the system in this country that incentivizes care for profit only. The problem is that TV shows only like some realities, and not others, so they find a villain to take the blame for things that are systemic in real life. A real Fuentes would either be struggling to provide good care, unable to balance the budget and fighting to get grants or whatever funds they are allowed to pursue, or she would be just another capitalist trying to deliberately sink the hospital to force the board to privatize it. 

Hellen packing skills match her sandwich making skills. When you move to another country you only pack the essential, maybe some books, but not kitchen utensils. And Max, Luna will not miss all her toys. Pick two or three favorites, the rest is donation, storage or garbage.

Iggy being all cry baby because Fuentes is "forcing" him to see patients, and being enabled by Lauren and Floyd is ridiculous. "Does she know you were attacked by a patient?". He is traumatized and does not seek therapy? So he should definitely resign.

 

Yeah, there's three options for the toys - donation, storage, or drop some off at the grandparents if they still in touch with them

and Iggy needs to see a therapist, but everyone knows that a doctor is the worst patient.

9 hours ago, statsgirl said:

I seem to remember Fuentes saying that 140 people were going to be let go from departments that are "top-heavy". So basically Max get an extra 8 people fired so that he could save his friends.  The problem is that Fuentes picked people based on their perormance and ability to bring money in to the hospital and Max based it on friendship. Iggy and Lauren both draw large salaries as longtime heads of departments. I don't know if Lauren is worth her pay in terms of treating patients but Iggy certainly isn't right now even if he is starting to see patients. Gladys is the smart one who runs that department and it's really going to suffer with her gone, just as the ED will with Casey gone.

When Iggy waxed lyrical about how it feels when therapy is going good and he's in the zone, I got squicked out. I know psychiatrists who feel like that and it's usually when the psychiatrist is forcing his thinking on to the patient. Real therapy is much messier and much less easy.

I believe 30 was said at first - then when Max saved his friends, 148 people got fired?

Lauren seems worth her pay - just look at how she was in the pilot, it seemed like the ER was competently run.

Yeah, Iggy wanting to be "in the zone" for therapy was weird - it sounded like he didn't want to really help patients, just make them... less of a pain for him by making them seem better, which seems like he would have patients bound for episodes of decompensation.

[Johnny Dollar]

Max didn’t fire 148 people so his three friends could keep their jobs. That was the total number of staff that was fired to balance the budget. But Max did decide to save his three friends’ jobs at the expense of others that were not on the initial list. All the while knowing that he will be jetting off to London without having to deal with the consequences. What a great guy!  Not sure why Bloom’s girlfriend wasn’t among those let go. Anyway, I’m sure Casey and Agnes and probably Kao will be back after the mid-season break. They’re some of the few likable characters left on this disaster. 

[KaveDweller]

On 11/11/2021 at 7:25 PM, Sweet Tee said:

As others have said, Iggy really needs some therapy of his own.  Was he expecting to never have to see patients again?  Not that he should be seeing patients because, once again, he is a terrible doctor.  Just one episode ago he was ready to resign rather than see patients so he should be let go.  And Lauren deserves it too because of what she did for Leyla   herself.

When Iggy declared he wasn't seeing patients anymore last season, I thought he meant he was quitting his job. He could do other things like teacher or writing that would still use his "skills." It makes no sense for him to stay at the hospital but expect to never have to see patients. 

22 hours ago, bros402 said:

I believe 30 was said at first - then when Max saved his friends, 148 people got fired?

Originally Max mentioned 3 dozen doctors, but some of the people let go weren't doctors. So it was probably a much bigger number and just a couple extras got added to balance out keeping his favorites.

[bros402]

1 hour ago, KaveDweller said:

When Iggy declared he wasn't seeing patients anymore last season, I thought he meant he was quitting his job. He could do other things like teacher or writing that would still use his "skills." It makes no sense for him to stay at the hospital but expect to never have to see patients. 

Originally Max mentioned 3 dozen doctors, but some of the people let go weren't doctors. So it was probably a much bigger number and just a couple extras got added to balance out keeping his favorites.

Ahhh, so it was 3 dozen doctors and the 100+ support staff weren't mentioned until the end. jeeez that seems like a bad way to fire so many people. Googled it and Bellevue has 1200 physicians and 5500 support staff, so they fired ~3% of their doctors and ~2% of their support staff in one day?

 

that does not seem good

also them claiming that intrathecal MTX is a new thing is still bugging me

they could literally just google "how long has mtx been used intrathecal cns lymphoma" and you find articles going back to the late 70s, early 80s on it with a super quick google search

it isn't just something that started recently

they don't just drill a hole in your head, they inject it into your spine, no trepanation needed!


also MTX is such an annoying drug, makes me super nauseous - I hated when I was using it for treating my cancer. Now i'm on another med with no side effects!

Edited November 13, 2021 by bros402

[babyrambo]

1 hour ago, bros402 said:

Ahhh, so it was 3 dozen doctors and the 100+ support staff weren't mentioned until the end. jeeez that seems like a bad way to fire so many people. Googled it and Bellevue has 1200 physicians and 5500 support staff, so they fired ~3% of their doctors and ~2% of their support staff in one day?

 

This makes so much more sense. Having the initial number be 36 and then having Max say he saved his friends jobs and then say 148 people got fired confused me and made it seem like it was a direct correlation which made no sense. Because even if Iggy and co. are paid top dollar, which I doubt because that hospital is broke, their pay wasn’t adding up to all those extra employees. Max still shouldn’t have switched his friends out for the other doctors though, but I doubt it’ll come back to bite him in the ass. He hardly faces consequences and he’s outta there soon anyway. 

[Court]

Lately, I've been watching halfway and then reading here. Now, I'm officially done. I enjoyed everyone laid off and they were way better Drs. Bloom and Iggy should have been fired. 

[bros402]

22 hours ago, babyrambo said:

This makes so much more sense. Having the initial number be 36 and then having Max say he saved his friends jobs and then say 148 people got fired confused me and made it seem like it was a direct correlation which made no sense. Because even if Iggy and co. are paid top dollar, which I doubt because that hospital is broke, their pay wasn’t adding up to all those extra employees. Max still shouldn’t have switched his friends out for the other doctors though, but I doubt it’ll come back to bite him in the ass. He hardly faces consequences and he’s outta there soon anyway. 

I have to imagine that at most, Iggy and the other heads are paid 200-300k a year, based on how much the medical director of Bellevue is paid. Head of Neuro would obviously be paid the least - so there is literally no reason to cut her. I could understand if Fuentes had NYC Health or whatever the board that oversees New Amsterdam is offer older staff members a bit of a retirement incentive to get those older doctors off of the payroll, since it'd just be a one time expense to get those pricier people off - but this show is all or nothing.

You'd also think Fuentes would want to keep Bloom on staff, given that she can continually pump he for donations to the hospital - maybe her job was never had risk and Fuentes just wanted Max to beg for a job for someone that wasn't going to be terminated

[Nessa]

On 11/10/2021 at 4:44 PM, LittleIggy said:

Yeah, seeing Helen packing those plastic containers made me go 🙄. I don’t even think they were Tupperware. More like the containers you can buy at Kroger or Target. I was like “They do have those where you are going!”

OMG said the same thing to my sister!  It's not like they're going to the middle of nowhere!

[circumvent]

I came across an article today and just to show that the firing of staff, plus the "selling hospitals for parts" is not far-fetched at all, here is a real life example

For example, Ed Gadomski worked at Waterbury Hospital in Connecticut, in the IT department, for 32 years before Leonard Green & Partners, a Los Angeles–based private equity firm, took over. “In the first year, layoffs became a household word,” Gadomski said. “Longevity employees were particularly targeted.” He lost his job in July 2020 and was offered it back at just $13.46 an hour, just one-third of his previous salary, without health insurance or retirement accounts. He declined the offer; now an outside contractor has his job. “The fear among the current hospital workers is that Leonard Green will outsource department by department and there’s nothing we can do about it,” he lamented."

From The American Prospect website

[bros402]

On 11/30/2021 at 6:59 AM, circumvent said:

I came across an article today and just to show that the firing of staff, plus the "selling hospitals for parts" is not far-fetched at all, here is a real life example

For example, Ed Gadomski worked at Waterbury Hospital in Connecticut, in the IT department, for 32 years before Leonard Green & Partners, a Los Angeles–based private equity firm, took over. “In the first year, layoffs became a household word,” Gadomski said. “Longevity employees were particularly targeted.” He lost his job in July 2020 and was offered it back at just $13.46 an hour, just one-third of his previous salary, without health insurance or retirement accounts. He declined the offer; now an outside contractor has his job. “The fear among the current hospital workers is that Leonard Green will outsource department by department and there’s nothing we can do about it,” he lamented."

From The American Prospect website

Waterbury Hospital is not a public hospital, though.

Sadly, there are very few left - https://en.wikipedia.org/wiki/List_of_public_hospitals_in_the_United_States

[circumvent]

3 hours ago, bros402 said:

Waterbury Hospital is not a public hospital, though.

Sadly, there are very few left - https://en.wikipedia.org/wiki/List_of_public_hospitals_in_the_United_States

Yes, that was one of my criticisms of the storyline, that to sell a public hospital for parts is possible but not in the way the show is doing, with all the decisions made by one person, or by a small board in a meeting without minutes or rules. But the take over by corporations is affecting how public hospitals function, since the few left get overwhelmed by the "rejects" of the new private companies

[bros402]

18 hours ago, circumvent said:

Yes, that was one of my criticisms of the storyline, that to sell a public hospital for parts is possible but not in the way the show is doing, with all the decisions made by one person, or by a small board in a meeting without minutes or rules. But the take over by corporations is affecting how public hospitals function, since the few left get overwhelmed by the "rejects" of the new private companies

and tbh with the recent mayors of NYC, I doubt they would let any major chunk of Bellevue get sold off. Now if it were the 2000s, sure it would be a believable plot

[NJRadioGuy]

On 12/2/2021 at 1:03 AM, bros402 said:

Sadly, there are very few left - https://en.wikipedia.org/wiki/List_of_public_hospitals_in_the_United_States

Just as an aside, the third entry on that list, Harbor-UCLA, was the fictional "Rampart General Hospital" on Emergency! in the 1970s! Good to know it's still a public hospital.

[possibilities]

On 11/10/2021 at 1:43 PM, perkie1968 said:

 Also, ask the patients to bring in their med bottles.  So stupid.   

In-patients wouldn't have any medication bottles, would they? They'd be given their meds one dose at a time when they need to take them. And their meds would come from the hospital's own pharmacy, which surely is on the same network that was affected by the ransomware attack. But wouldn't the hospital have back ups of their records? And insurance to pay the ransom rather than needing to find an independent source of funds to appropriate them on the fly? And for sure HCC would not say: "oh well, let the hospital be offline for months, this is not a necessary expense". That said, I knew Veronica would extort Max to get her way. What I didn't understand is why she thought she had to. In the past, when he refused to sign something, she said she'd just wait til he left and then do it without him. So whatever Max did or didn't do this episode, she was just going to fire everyone in 2 weeks when he was gone anyway.

I am very confused about Iggy. I thought he resigned last week. Clearly I must have spaced out and missed a scene somewhere.

I don't really understand how they planned to run the hospital if they had fired the department heads who ran the emergency department and the psychiatry wing. Likewise, having no one in charge of neurology is just not practical. But the show goes for the emotional gut punch more than the logical story.

I enjoyed seeing Reynolds and Baptiste working together as a team instead of fighting.

I love Casey and I applauded him all episode. I also really like Gladys and Agnes, because they are basically rational adults and drama-free. It might be a low bar, but that's where I'm at lately. I like to watch competence more than histrionics.

Hire movers, Helen and Max! You don't have time to pack everything, not even the stuff you're leaving behind. They need to clear stuff out, even if they're not taking it with them, I assume. Though I doubt the move will be permanent, they are telling themselves it is, so I figure they are either going to sell their housing if they own it, or rent it to someone else in their absence. Or if they rent, they'd be giving up their leases. But they can hire movers to do the packing.  I get that it's hard to make decisions, but you don't need to take everything, especially not tupperware. Or, if you really can't face the decisions, just put it all in storage for now. I wonder what happened to everything in that enormous place Helen lived before she moved in with Max and Luna a few weeks ago. Donate what you don't want, put in storage what you're not sure about, and take as little as possible any time you move overseas.