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S04.E20: Rise


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Max discovers the extent to which Dr. Fuentes’ cuts are severely damaging New Amsterdam and decides it’s now or never. Iggy takes an unconventional approach to reach a young patient in need. Reynolds and Wilder perform a risky, life-saving surgery on unborn twins.

Original air date: Tuesday May 10 2022

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(edited)

There’s a scheme in place…..not sure what it is.  ….. I just realized that I missed last night’s episode.  
 

Not sure if they  covered the boy who was resuscitated tonight.  So, he has no brain function?  Is that right?  So, is the show saying people with no brain function should be kept on life support?  I don’t get it.  

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So Helen, if you hadn’t resuscitated a brain dead child his parents wouldn’t have gone through that additional trauma. And I must have missed something: why was she trying to get him sent to NA? Who was going to pay for his treatment there? The treatment in Britain was, according to Helen, a one in a billion shot. 🤦‍♀️ 
Non-compete clauses in the medical field are generally to keep docs from taking patients with them. In that case, why would NA care if Max went to the UK to practice? 
How could Bloom just take over the ED again? Not her decision to make.

On a positive note, nice to see Karen again.

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I have no idea what was heroic, wise or helpful about a doctor encouraging the parents of a child with no brain activity to prolong him being on life support.  Wouldn’t it be better to help explain to them what the realty of the situation was.  The mother who insisted she knew better that the medical tests…..I think a lot of family members say that, but it doesn’t make it so.  Denial is understandable under those circumstances, so dealing with the truth would have helped.  For a doctor to scheme a plan to transport a patient in that condition to NA for the purpose to keep him on life support boggles the mind.  I can’t imagine  any doctor doing that.  No part of it makes any sense.  

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Disappointing that Max could never thwart Veronica but now--after Max's listens and treats a few of the workers, which encourages them to "fight their oppressor",--the (lackey) essential workers usurp Veronica who caves and leaves🙄.  For this torturous, long, villainous "Veronica arc" to have drug on as long as it has, this was a rather lackluster and unsatisfying ending to her demise, imo.  I would have much rather seen Max and the other doctors take her down.

The remainder of this episode was just discombobulated from Helen to Floyd Bloom and Iggy.   It seems the writers have definitely and certainly lost their way this season, imho.   There are now throwing too many obstacles and twists for the characters when the show will end with an abbreviated S5.  There is no way in hell they will resolve all the issues that need to be resolved.

Without spoiling too much for those who maybe have not read what the showrunner has said about E20-21, there will be more obstacles, challenges, heartbreak & heartache for Sharpwin.

Why the writers/showrunner decided too ruin a once brilliant show is beyond me.  Since they have, it is best it end with S5 (although 13 episodes are a real disservice to the fans).

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14 minutes ago, LittleIggy said:


Non-compete clauses in the medical field are generally to keep docs from taking patients with them. In that case, why would NA care if Max went to the UK to practice? 

Yeah, the idea an American hospital had its doctors under some kind of worldwide non-compete clause was kind of ridiculous. 

I was a little confused about Iggy's treatment of the gamer.  I would think it's unethical, at best, to try and trick someone into therapy.  And wasn't this a kid?  Who gave Iggy the okay to do any of this?

 

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2 minutes ago, cathmed said:

Disappointing that Max could never thwart Veronica but now--after Max's listens and treats a few of the workers, which encourages them to "fight their oppressor",--the (lackey) essential workers usurp Veronica who caves and leaves🙄.  For this torturous, long, villainous "Veronica arc" to have drug on as long as it has, this was a rather lackluster and unsatisfying ending to her demise, imo.  I would have much rather seen Max and the other doctors take her down.

 

It's shocking just how terribly pathetic it was handled. Like, wow, holy shit, this? THIS? THIS?!?!

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I was trying to recap this episode for a friend but eventually we just got so confused about the hodgepodge of storylines and bad writing that it was an exercise in futility. 

I seriously can’t believe that they’re going to have Helen drop a bombshell on Max before they get married (per the promo). Can’t they just let them BE? Unless she is pregnant, then that’s fine. We really don’t need anymore ridiculous obstacles or nonsensical crisis storylines.

I really was wondering if Floyd was going to tell his mom about his poly baby. Now that would be a reaction to see! 

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44 minutes ago, LittleIggy said:

 And I must have missed something: why was she trying to get him sent to NA? Who was going to pay for his treatment there? The treatment in Britain was, according to Helen, a one in a billion shot. 🤦‍♀️ 

I think it was because the parents were not ready to let the boy go, but the UK government was forcing them to.  Helen knew if they went to NA they would be able to decide themselves what they should do.  I'm not sure how they would have paid though because they wouldn't be insured, though maybe Helen knows how to get them in anyway.  

 

The point of the whole thing might be that Helen decides to go back to the US to practice medicine if she doesn't like the government control that was shown here. 

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So Veronica was making all the doctors stay to punish them for Max trying to throw her in jail? Ok, but I can't believe that there is a non-compete so strong that it would legally hold up in another country. Or even another state. I looked it up and there are limits on what can go into a non-compete in the state of New York.

After all Max's effort, all it took to get rid of Veronica was all the support staff going on strike? And then everyone thanks Max and acts like his ridiculous schemes saved them? And they have a party but don't invite the support staff? Real nice.

The storyline with the brain dead boy in England was very sad. The parents shouldn't be forced to take him off life support before they are ready,  but I may have missed how long he had been on life support.

Why is Floyd telling everyone he is going to be a dad? Didn't he tell whats-her-name to go to Colorado and let her husband be the father? 

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Iggy talks to his secretary about playing the video game and entrapping his patient. 
 

Iggy: “why do I feel like I’m doing something wrong?”

Me: “uhhhh… cuz it’s creepy and wrong?” 

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5 hours ago, Rammchick said:

WTF, Floyd is a pediatric surgeon now?!

Well Lyn was taking a blood clot out of Helen’s lung a couple weeks ago and she’s an OBGYN. So I guess anything is possible in this universe. 

Medical shows are notoriously bad about specialties. When I watch ER, their docs seem to deliver babies in the ER constantly and know everything about OB practice. Then the actual OB was seen as a bitch when she interfered with…her department. That she was the head of. Made no sense. 

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Karen's back!

Although not very satisfying, the doctors not being the ones to take Veronica down, I like that in the end, it was the essential workers who took Veronica down. Nice to see them get a little recognition. The workers credit Max for their protest, and Max credited them when the doctors were celebrating. 

Veronica's not understanding how the support staff put the hospital at a standstill was probably not too unbelievable. You see what can happen when management focuses more on making money than on the the entire staff it takes to make that money.

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I was happy to see Veronica brought down by the essential workers. Also finding ‘new’ Bloom a hoot. Once again Iggy makes another stupid decision that somehow turns out great. How could you ever build a trusting relationship on a lie? What if the gamer turned out to be underage? I appreciate that Iggy tries to meet people where they are in a way but he still works for a hospital and has to adhere to rules. I don’t understand why they thought up the whole London storyline and none of it works.

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Just when I think this show couldn't get more stupid, it does. Since the show has effectively been cancelled I am assuming that the writers are busy sending out resumes and attempting to get jobs for next year instead of actually attempting to write a coherent show.

On the simplest level any kind of non-compete clause is very narrowly construed because the law doesn't favor preventing people from earning a level. There is no way any of these doctors were be viewed as having unique knowledge or even be able to take business from their old employer.

The English child segment is VERY loosely *inspired* by Alta Fixsler who was a two year old who had spent all of her 2 years in an English hospital in a vegetative state while having to undergo intrusive and presumably painful or very uncomfortable procedures to keep her alive. The case was litigated for a LONG time and ultimately even by some European court of human rights who all decided that the English medical authorities were correct and that continuing to sustain her *life* was doing medical harm without any benefit.

It is ridiculous to have made Helen into a doctor who pursues "life" at any cost because there is absolutely nothing in her prior history that would have her do anything except try to get the parents to understand why hopeless medical intervention was just inflicting useless suffering. The legal justification for the English court is that the best interests of the child are not to proceed with more painful intervention - it is basically the same as when courts intervene in order to get medical treatment for parents who aren't allowing their kids to get appropriate chemotherapy or other medical treatment. 

https://www.bAlta Fixslerbc.com/news/uk-england-manchester-58820309

In the US there is the case of Jahi McMath who was declared brain dead after surgery but the parents would not consent to removing her from life support even though panels of doctors had confirmed that she was in essence a corpse and death certificates had been issued. In that case she was taken to New Jersey which is one of the few states that allows parents to override medical panels on the basis of religious beliefs. She remained in a vegetative state for a few years but eventually died after about five years. There are some cynics who *allege* that a motivation for keeping her alive was to increase the amount one could get in a lawsuit since there is a cap on amount for a death of a child versus almost unlimited amounts if the child remains alive.

https://en.wikipedia.org/wiki/Jahi_McMath_case 

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I fail to see how New Amsterdam, as the employer, would be significantly harmed if these people went to work for another hospital. It’s not like there are “trade secrets” involved, and none of them are winning the Nobel Prize in medicine any time soon. Plus weren’t they all just fired a few weeks ago?

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IT'S TIME FOR...

THE SECOND WORST DOCTOR OF THE WEEK? THE SECOND EDITION OF THE WORST DOCTOR OF THE WEEK?

let's just get on with it

time to hit play

let me guess, on this episode Fuentes builds a giant hot air balloon out of all of the money she has had the hospital spend, max asks the balloon how he can help, and she just drops a bag of sand on him

PREVIOUSLY ON NEW AMSTERDAM

please drop the reynolds plot

when is fuentes going to start wearing all black, have a pointy hat, and call hospital employees her pretties?

oh hey, orientation for the new employees, some of whom never should have been fired because they were actually decent and were just fired for being close to their former bosses

wait who has been running the ER since Bloom got canned

also I hope Dr. Head Of Neuro Who Was Just A Resident realizes that she should not get that position back

um a noncompete that says they cannot practice medicine is illegal

I mean even if it specified a wide range it might be illegal in NY due to how compact the tri-state area is

also, Max, Fuentes is right - you did make it personal. But I don't think she would have gone to prison for acquiring the money launderers - just canned by the board for a realllly bad decision

i hope we see awesome deaf doctor in this episode

oh no is max's spirit crushed and will we see that by him snapping at this janitor

oh, no, it's just that Max isn't going to look at the man's arm

um, wait, iggy are you doing therapy with a patient without their consent

wait wait little person resident is now the chief? god this hospital is messed up, making residents into chiefs like they're highlanders or something

um I don't think this system will work in the event of something serious, since you need more than a doctor and a single nurse for some things

ok, at first glance this patient made me think "hey this guy looks vaguely like robin williams" and I was like "damn i miss robin williams"

I am gonna guess he has either appendicitis, heart attack, or aortic dissection

CALLED IT, HEART ATTACK

wait, is this locker room different from the last time we saw it or am I mixing it up with a locker room from another medical show

sharpe couldn't you tell by Max's voice that he is not happy

DR DEAF DOCTOR!

wait wait so a cardiothoracic surgeon and a oncologist (I think an oncological surgeon?) are going to operate on 18 week olds?

oh are they going to have to get floyd's lover involved too?

oh god we're getting an english patient? why, and I bet it is going to turn out that the kid actually has brain function and the doctors must have been wrong all along

sharpe, the defibrilator just resets the rhythm, it is not a magic heartstartybox

hey sharpe, listen to british doctor, he's right

um max are you passing out prescription steroid cream without a prescription

um former-resident-now-chief, potassium being high by 0.1 isn't instant notify worthy

iggy who even hired you to be this gamer's therapist, I don't know how old this gamer is... but this could easy be seen as you doing something baaaaaaaaaaad if it's a kid

see iggy, your actions have consequences! you're the only one this patient trusts because the patient thinks you are a friend

WHY ISN'T THERE A FETAL SURGEON IN THERE?

and that is what happens when you don't have the proper people in there - now the babies won't fit where they used to. Now you have to play fetal tetris

oh god please no more english patient

good, british doctor did go to the court

so uh what is max's job here, is he just Locker Room Doc or something? Sounds like a crappy medical show

of course max is interviewing everyone

hey iggy you feel like you should! Weird!

THANKS AWESOME NURSE/SECRETARY/WHATEVER YOUR TITLE IS, TELLING IGGY LIKE IT IS

um reynolds an ectopic pregnancy is bad, don't intentionally create one

yes sharpe, they could've always transferred to another hospital. are you going to pay the like 100k it will cost for them to bring their kid to the US in a plane that would have to pretty much be a PICU?

hey look, this is why residents shouldn't become chiefs overnight

good  thing bloom was right there

if you have been so alone for so long, VR patient, WHO HIRED THIS THERAPIST FOR YOU

wait wait wait so you volunteer to force therapy on people? isn't that against some kind of ethics for being a therapist? I could understand if it were deprogramming... but ?????

WHY ISN'T SOME KIND OF FETAL SURGEON IN THIS OR

oh no, max gives up and janitor is dismayed - i bet he is going to organize a staff strike to bring back max because it will be inspirational

hahahahahahah oh god this british stuff is just making me laugh with how cartoonishly british that guy was

let me guess, right before they turn off the life support he'll suddenly have a spike in brain activity because magic

oh hey they killed the kid

wait so the VR patient managed to get over his agoraphobia and get an appointment in a matter of hours? what

okay, so 10 minutes left, english kid is dead, heart attack guy is fine, fetus is outside of the womb.. time for a revolution against Fuentes I guess? or are we going to have Floyd telling his mom about the poly couple

oh hey the resident realizes he shouldn't be chief, but it is not a title you can pass on to someone like a crown - you cannot just say it and it is so

i wonder who Floyd's dad will be played by

wait sharpe's ex girlfriend has an unwinnable case because she has changed addresses? She has a stable job and probably has a lease on her apartment, and Bloom wants her to commit immigration fraud?

yes of course she can move back in, the magic cups have healed you of your addictions Bloom

oh hey look it is a rebellion

wait how did the hospital break down in a matter of hours? they should still have toilet paper (unless it was removed by the janitors) and HOW DID THEY RUN OUT OF CLEAN SCRUBS?

wait does board lady want fuentes to yell out the window that max is back or something? nobody will hear her

oh look he's magically the medical director again and they are partying on the Roof(?)

having the hospital rely on max for morale is not the best, what if he croaks tomorrow?

 

So, who is the worst doctor of the week?

It's... you guessed it...

 

DR. SHARPE! FOR TORTURING THOSE PARENTS!

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What I don't get is why Max and the others just didn't go to the media when this all began. The oldest public health institution in the country failing at-risk communities and abusing public trust in NYC wouldn't just be front page of the NY Times and every national TV newscast, but there would be governmental hearings/etc. Not just Fuentes, but every board member would be investigated.

The other part of this that I don't get is how were they able to take the hospital private without massive investigations? Again, if this was J. Random Hospital in Nowheresville I could see it, but no way NotBellevue could fall like that without notice.

Also, you don't shock asystole!

Next step will obviously be that Sharp will be so disgusted with NHS rules she'll go back to NY.

Gawd this show is hot garbage. You'd think with all the millions of dollars NBC is throwing at shows like this they'd have some execs who would step in and fire the writers.

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Just now, NJRadioGuy said:

What I don't get is why Max and the others just didn't go to the media when this all began. The oldest public health institution in the country failing at-risk communities and abusing public trust in NYC wouldn't just be front page of the NY Times and every national TV newscast, but there would be governmental hearings/etc. Not just Fuentes, but every board member would be investigated.

That would be a good way to make it bigger for everyone although in real life the media is controlled by big corporations that censure and erase everything that needs to be of interest of the public because dissent in the US of A is treated like a crime. The corporate media is not only part of the problem, they are the problem, and they would side with Fuentes and her bosses. We live under corporate totalitarian rule

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Everything in this episode was upside down. Why is Iggy's game pal a freak? I thought they would reveal some facial deformity that would make people stay away but that wasn't it.

The story in England is one of those cases where there is never a full agreement and was badly done. Helen said the kid was in a semi-vegetative state and the parents wanted him alive, so the whole let's turn off the machines was just capitalism saying that his right to live has reached a cap and he needs to go. Those stories are always badly done by TV and they are simply bias confirmation. The nuances and specifics are lost and in the end, 99% of the time, it is about money and how much life cost. And sending the kid to the US made me laugh in despair. We are bad at caring for people here. Besides, Helen would not be able to arrange the transfer in a few hours. Those things involve the State Department and takes longer, no one doctor can get it done on their own.

Now, the most twisted story of all: the essential workers "helping" Max because he is their savior. No, people. You are essential, you help yourselves. Unionize and demand more. It is typical bourgeoisie elitism of the liberal crowd (not liberal as opposed to conservative, but in neoliberal supportive of the elites and imperialism as opposed to progressivism). If the workers in this country stopped serving the elites for a few hours every week, they would be able to get more for their work. And getting rid of Veronica, while satisfactory, will not solve anything. The hedge fund still controls the hospital, they will just send another one. The whole story is just a silly, too long, boring plot to elevate Max even more. For a moment I thought he would save the kid in England all the way from NY, and then he would be given whatever the thing is that the queen likes to give people - OBE? MBE? Lordship? Not sure

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Wow, what a miraculous recovery Helen made post stroke!  No speech impediment, no memory issues...nothing.


My dad had one 3 and a bit years ago and whilst he can speak, memory is a bit iffy at times and he struggles to find words.

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My big question regarding Iggy's gamer patient - who was paying for that appointment time slot? Per Gladys it was on the official schedule but as the gamer wasn't even aware of anything happening other than playing a game, was Iggy just donating his time?

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4 hours ago, SnarkySheep said:

My big question regarding Iggy's gamer patient - who was paying for that appointment time slot? Per Gladys it was on the official schedule but as the gamer wasn't even aware of anything happening other than playing a game, was Iggy just donating his time?

Isn't New Amsterdam a public hospital? Excuse my ignorance (I'm not American nor have I ever lived in the US) but where I'm from a patient doesn't pay in a public hospital. 

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5 hours ago, christie said:

Isn't New Amsterdam a public hospital? Excuse my ignorance (I'm not American nor have I ever lived in the US) but where I'm from a patient doesn't pay in a public hospital. 

Here in the US we don't really have much in the way of public hospitals. I have to imagine NA would be like any other hospital and try as hard as they can to get someone to pay.

iirc in this episode Iggy said he was working with some organization?

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27 minutes ago, bros402 said:

Here in the US we don't really have much in the way of public hospitals. I have to imagine NA would be like any other hospital and try as hard as they can to get someone to pay.

iirc in this episode Iggy said he was working with some organization?

Yes, I know there's not a lot of public hospitals in the US but I thought that it was mentioned in one episode that New Amsterdam was public.

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On 8/4/2022 at 1:21 AM, christie said:

Yes, I know there's not a lot of public hospitals in the US but I thought that it was mentioned in one episode that New Amsterdam was public.

It was - it is modeled after Bellevue, which is a public hospital. 

Bellevue has an insurance plan of its own, but only to people who meet specific requirements. https://www.nychealthandhospitals.org/paying-for-your-health-care/

I have to imagine it is similar to EMTALA - which is where hospitals are required to treat you in the emergency room until you are stable, then you can be kicked to the curb. I am guessing Bellevue goes a bit further than that, maybe they do the bare minimum required to treat someone if they are under a certain amount of money - they probably are tied to the federal poverty level

https://www.nychealthandhospitals.org/bellevue-patients-visitors/ - they aim for "affordable" - which in the US, means still bankrupting, just less. QUick googling shows it is "only" 6k for a birth with no complications (average cost in america is 13k)

 

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2 hours ago, bros402 said:

It was - it is modeled after Bellevue, which is a public hospital. 

Bellevue has an insurance plan of its own, but only to people who meet specific requirements. https://www.nychealthandhospitals.org/paying-for-your-health-care/

I have to imagine it is similar to EMTALA - which is where hospitals are required to treat you in the emergency room until you are stable, then you can be kicked to the curb. I am guessing Bellevue goes a bit further than that, maybe they do the bare minimum required to treat someone if they are under a certain amount of money - they probably are tied to the federal poverty level

https://www.nychealthandhospitals.org/bellevue-patients-visitors/ - they aim for "affordable" - which in the US, means still bankrupting, just less. QUick googling shows it is "only" 6k for a birth with no complications (average cost in america is 13k)

 

Thanks for the information. So, not really public then? Not as bad as a private hospital and not a real public hospital.

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21 hours ago, christie said:

Thanks for the information. So, not really public then? Not as bad as a private hospital and not a real public hospital.

Surprisingly, here in the US most of our hospitals are non-profits

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22 hours ago, christie said:

Given what I've heard about the US medical system, that's staggering. 

Yeah, the vast majority are run by 501(c)(3) non profits - but just because they are non profit doesn't mean they cannot charge a lot. IIRC it works by them investing the money over their expenses (which usually involves paying their executives quite a good amount) into their hospitals and communities. One hospital system in my area used to have a few gyms (that charged like $75 a month) before COVID.

IIRC something like 20-25% of hospitals in the US are for profit

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(edited)
On 5/10/2022 at 11:29 PM, txhorns79 said:

Yeah, the idea an American hospital had its doctors under some kind of worldwide non-compete clause was kind of ridiculous. 

I assume that was just an evil plan to punish the insurrectionists, not the usual contract. We've seen other doctors leave and get jobs elsewhere.

That said, Power to the People! I actually like that the revolution only succeeded when it included everybody. Top down action is great for the ego of the people on top, but actions are stronger when they come from empowerment on multiple strata. Max kept saying he asked everybody for help, but he didn't ask Floyd before, and then he didn't ask the non-elite staff now. But that's what it took. Top to bottom, not one class or the other, is the best kind of movement and the most likely to effect lasting changes.

I'm surprised this show has lasted as long as it has, with its anti-corporate philosophy.

On 5/11/2022 at 12:17 AM, KaveDweller said:

And they have a party but don't invite the support staff? Real nice.

Yes, that's incredibly rude and ungrateful and snobby. They don't seem to have learned anything from this experience.

On 5/12/2022 at 12:30 PM, amarante said:

It is ridiculous to have made Helen into a doctor who pursues "life" at any cost because there is absolutely nothing in her prior history that would have her do anything except try to get the parents to understand why hopeless medical intervention was just inflicting useless suffering.

I agree with you but they tried to explain Helen's attitude by saying "she's a mum now"[to Luna] and that's why she changed her attitude.

I think she acted impulsively, and not from a skillful, informed place. Though, it's true that there ought to be a review process and a court order and not just one doctor deciding over the wishes of the parents.

On 5/12/2022 at 10:23 PM, Johnny Dollar said:

I fail to see how New Amsterdam, as the employer, would be significantly harmed if these people went to work for another hospital. It’s not like there are “trade secrets” involved, and none of them are winning the Nobel Prize in medicine any time soon. Plus weren’t they all just fired a few weeks ago?

I think it was just a vindictive move by Veronica, not a general policy they've always had. We've seen other doctors leave and get medical jobs elsewhere in previous episodes.

On 5/13/2022 at 3:41 PM, circumvent said:

Unionize and demand more.

I like that idea, but aren't they already in a union? I totally forgot about that. Sometimes there are laws barring essential workers from striking, though. I know that there used to be laws like that in NYS. I don't know if there still are. Either way, I hope the work stoppage gets them better contracts, not just a return of Max the Savior. I like that they showed that Max and his few Dept had pals and hand-picked favorite 2nd in command people couldn't do it alone.

I am still in shock that Iggy got away with his behavior in the previous episode, where he thought it was okay to say he can't work with the person he hired because he's attracted to him, rather than figuring out how to deal with his feelings. Travis was unprofessional, but when he realized it and tried to stop, Iggy insisted he go back to flirting. I mean... wow. And now when Iggy decides he can't handle it, what did he want HR to do? It's his problem, and Travis shouldn't be punished for it. So I was not surprised Iggy was being unethical this week, and that the show gave him a pass by showing the lied-to-gamer miraculously benefiting. But... wow. Yikes.

I generally have been regarding the show as half full rather than half empty, i.e. I'm hand-waving the bad stuff because I like some elements. But sometimes even I get really upset by what they're selling.

I don't even know what to say about the Wilder and Reynolds patient.

I find Bloom's relaxed demeanor really funny. I also don't really understand why it's illegal for Leyla to have borrowed money to pay her immigration lawyer, and why she can't find a sstable address or leverage her ability to manage her residency even without one into some kind of testimonial to her good behavior as a resident. Also, if she's here on a refugee type program, that is really different than being in the country on other types of status, I thought? But I realize they are just trying to show how horrible the immigration system is, and also get Leyla and Lauren back together, so I'm willing to handwave that, um... for the greater good?

I'm always amazed that the clear masks don't fog up. If my eyewear fogs, why don't the masks do that, too? I

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