S01.E04: Boundaries

[CooperTV]

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When Max volunteers New Amsterdam to take over for a short-staffed hospital nearby, things get chaotic quickly. Iggy has a crisis of conscience after receiving the news that funding for a garden has been granted and an eager resident learns a secret about Dr. Bloom.

10/16/2018

[Brian Cronin]

It felt so great to see Reynolds FINALLY trust Nottingham. That was huge for Nottingham. You know, the guy we just met briefly last episode.

Seriously, this was a good episode, but it was just funny to see them toss in some of these new characters and expect us to care about them right away. 

I liked their angle on Doctor Helen in this week's episode. This is the real drama of Doctor Helen. She became a celebrity doctor, in part, to keep from dealing with all the sadness that comes from being the person directly dealing with these cancer patients. Now that she's back, she's having a hard time dealing with it. Good stuff. Better than, "You are on TV, we don't want you to be our doctor because of that even though we knew that before coming to you"/"I must not be a good doctor, these morons didn't like me!" from the last episode. 

Edited October 17, 2018 by Brian Cronin

[catrice2]

I know this is based on a true story but if they wanted us to care about the lead actor's wife and child they could have cast an actress that he has chemistry with and they need to do something about the chemistry that he has with the Freema agyeman character. I'm just tired of people at the hospital having to be involved in a relationship and why are these medical dramas always have to have some big episode like one hospital being shut down or something

[Kelda Feegle]

A better episode than all the previous ones, still flawed but definitely improving. 

[themadman]

So all the cardiothoracic surgeons that dude hired (the three black women) in the last episode just disappeared, eh? 

[Good Queen Jane]

31 minutes ago, themadman said:

So all the cardiothoracic surgeons that dude hired (the three black women) in the last episode just disappeared, eh? 

No, they were in San Diego for the conference with all the other cardiothoracic surgeons in NYC.  Dr. Reynolds said that he was the designated survivor for New Amsterdam. Must have been a helluva conference.

[doodlebug]

12 hours ago, catrice2 said:

I know this is based on a true story but if they wanted us to care about the lead actor's wife and child they could have cast an actress that he has chemistry with and they need to do something about the chemistry that he has with the Freema agyeman character. I'm just tired of people at the hospital having to be involved in a relationship and why are these medical dramas always have to have some big episode like one hospital being shut down or something

The whole premise was ridiculous. Every cardiac surgeon in NYC  goes to the national meeting every year?  That there aren’t staffing minimums?  These docs are not in private practice, they work for the hospital system, they are employees.  I work for a large hospital system and there is a rule that, on any given day, including  Christmas Eve, at least 50% of the practitioners in a given specialty must be present and working, no exceptions.  Even if 90% of the cardiac surgeons wanted to attend the national meeting (believe me, they don’t), there would be a limit on how many could go.  It was laughably stupid as a plot point.

Every year, a couple months before the annual meeting, we get an email reminding us of the limits, telling us that docs who are giving talks, on national committees and the like will be given preference and that anyone else is subject to the numbers game.

There was also absolutely no reason that the other hospital’s ER should’ve been shut down either.  99+% of ER patient don’t need a cardiovascular surgeon, and, if they do,  there are literally dozens of other hospitals in NYC that could take the patients.  All the baloney about them being too far away was ridiculous.  There are many places in the US where it can take hours to call in a doc or transfer a patient; it wasn’t going to be anywhere near that in NYC.

[sempervivum]

I only watched this because Hulu refused to let me look at 'The Rookie' (Nathan Fillion!) last night. I had seen-and mocked- the New Amsterdam pilot, but not been back since.

It's just as stupid as I remembered. Hasn't EVERY hospital drama had one of these 'super crowded ER' episodes? And did I understand that the ambulances were bringing in mental cases?-was that why the Angsty Teen was pouting about the crowds milling around 'her' psych ward? And of course St. Max the Super Doc had to spend several hours treating some random hoboes while his ER was blowing up.

And in a fitting match to the idiotic 'Farmers Market' plot point in the pilot, here we get the 'Rooftop Serenity Garden' plot point. Whoever writes these clearly idolizes gardening without ever having done any. As I recall, supposedly the Super Doc needed to have a Farmers Market because they were in a food desert (or something), but now somehow has access to a garden center? You'd need a pick up truck at minimum to transport all the plants, containers and soil to set up that garden, to say nothing of tying up the elevators to get it up to the roof. And I don't suppose there's a water source up there either. And of course all the nurses and docs know how to garden and are willing to use their off time to work on this.

Sticking with The Resident, I think.

[Biggie B]

I would like to see Max and the oncologist as a couple. They've got a good rapport. Since all TV shows insist on pairing off their characters, at least there should be a good connection between the two people involved, unlike Max and his wife. 

Speaking of the wife, will Max ever tell her that he has cancer and is about to undergo a rigorous course of treatment? Hello? It will pretty damn hard to keep that a secret, especially if he experiences any sort of skin discoloration or burning from the radiation, and if he has a port put in for chemo. 

I like Dr. Reynolds, but I don't care for Dr. Bloom, so it's hard for me to envision them together. 

[doodlebug]

51 minutes ago, Biggie B said:

I would like to see Max and the oncologist as a couple. They've got a good rapport. Since all TV shows insist on pairing off their characters, at least there should be a good connection between the two people involved, unlike Max and his wife. 

Speaking of the wife, will Max ever tell her that he has cancer and is about to undergo a rigorous course of treatment? Hello? It will pretty damn hard to keep that a secret, especially if he experiences any sort of skin discoloration or burning from the radiation, and if he has a port put in for chemo. 

I like Dr. Reynolds, but I don't care for Dr. Bloom, so it's hard for me to envision them together. 

Heck, I’m still trying to figure out why he has to sleep on the couch while his wife sprawls out on a huge bed.  She supposedly has a placenta previa so sex is off the table anyway, why can’t he sleep platonically with her in their bed? Once he starts radiation, he’s going to be exhausted and sleeping on the sofa won’t help.

The actor has so much more chemistry with the oncologist than he does with his wife; a romance with her could only help the show.

[Texasmom1970]

Im trying; maybe my expectations are too high. But the only character I like is the oncologist. Hard to watch a show where I am not even midly interested in the characters. 

[Pepper the Cat]

Is a roof top garden really a good place for people with a mental illness?  

[txhorns79]

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Heck, I’m still trying to figure out why he has to sleep on the couch while his wife sprawls out on a huge bed.  She supposedly has a placenta previa so sex is off the table anyway, why can’t he sleep platonically with her in their bed? Once he starts radiation, he’s going to be exhausted and sleeping on the sofa won’t help.

My thought is his wife will hopefully throw him out once she finds out that he hid his diagnosis and treatment from her, so the couch won't even be an issue.  

Quote

The whole premise was ridiculous. Every cardiac surgeon in NYC  goes to the national meeting every year?  That there aren’t staffing minimums?  These docs are not in private practice, they work for the hospital system, they are employees.  I work for a large hospital system and there is a rule that, on any given day, including  Christmas Eve, at least 50% of the practitioners in a given specialty must be present and working, no exceptions.  Even if 90% of the cardiac surgeons wanted to attend the national meeting (believe me, they don’t), there would be a limit on how many could go.  It was laughably stupid as a plot point.

This.  Even if this conference is essentially a three day sex orgy where people do cocaine chasers off each other's naked bodies, the idea that not only would 99% of the hospital's cardio thoracic surgeons go, but that every hospital in New York City would have a similar staffing pattern is laughable and completely insane.  Literally all it took was one doctor becoming ill, and the entire system collapsed.  No hospital would purposefully expose itself to that kind of liability, much less all of them.  

And seriously, all the doctor had to do was ask the patient what she was doing when she became dizzy and he wouldn't have wasted the entire day trying to make her answer a stupid question.  

Finally, do you think the show is contractually forbidden from calling the emergency department the "ER," lest people make unfavorable comparisons?   

Edited October 18, 2018 by txhorns79

[starri]

36 minutes ago, Pepper the Cat said:

Is a roof top garden really a good place for people with a mental illness?  

I am not 100% sure about this, but I have a vague memory that Bellevue actually has some kind of rooftop area for recreation.

I am making myself vulnerable here, and I feel ashamed of myself, but Helen's interaction with her patient, which caught me at the end of a pretty bad day, got to me in a way I didn't expect.

[Brian Cronin]

Helen's scenes were great, so I could totally see them having an effect on you if you were in a vulnerable mood. 

[txhorns79]

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I am making myself vulnerable here, and I feel ashamed of myself, but Helen's interaction with her patient, which caught me at the end of a pretty bad day, got to me in a way I didn't expect.

I think her storyline was the best one this week.  It probably helps that the actress is good in the role, and is better at making her character seem less one note than some of the other cast members. 

[Efzee]

12 hours ago, txhorns79 said:

And seriously, all the doctor had to do was ask the patient what she was doing when she became dizzy and he wouldn't have wasted the entire day trying to make her answer a stupid question.  

I interpreted this as a lesson to viewers not to be idiots when going to see a doctor and try describing the pain/condition/whatever you have properly instead of just saying "dizzy". And it's not like the doctor was wasting time (maybe a bed but they managed in the end, didn't they?) with his occasional check in, it was the patient who was wasting her time and being an idiot.

[doodlebug]

7 minutes ago, Efzee said:

I interpreted this as a lesson to viewers not to be idiots when going to see a doctor and try describing the pain/condition/whatever you have properly instead of just saying "dizzy". And it's not like the doctor was wasting time (maybe a bed but they managed in the end, didn't they?) with his occasional check in, it was the patient who was wasting her time and being an idiot.

I don't know, I see patients every day who have vague symptoms and it is my job to try to put them into a workable context in order to move forward with the diagnosis.  'Dizzy' is an infamous one and any decent doctor should be able to ask a couple of questions to figure out what she was experiencing.  Asking people if they can describe symptoms differently, what exactly was happening when the symptom appeared, etc is part of the task I undertake when I walk in the exam room.  BTW, when your doctor interrupts you, sometimes it is because he/she is trying to clarify and understand. Telling the doctor that something happens 'all the time', or that it lasts 'a while' isn't really very helpful.  I think differently about a symptom when 'all the time' means twice a month than when it means 10 times a day.  'A while' might mean a month, it might be a minute; I need to know.  As for 'dizzy', is the room spinning?  Does it affect your vision?  Do you faint? Do you fall?  There's a lot of nuance that needs to be revealed to get to the proper differential diagnosis and order the right testing and treatment.  Many articles that lament that doctors don't let patients talk long enough and that is very true, but, let me say, that sometimes a little direction from the doctor can get to the heart of the issue faster.

Anyway, I don't think the lady was wasting time or being an idiot; I think her caregivers missed the boat.

[vibeology]

1 hour ago, doodlebug said:

Anyway, I don't think the lady was wasting time or being an idiot; I think her caregivers missed the boat.

This! Why not ask a probing question or two? I have no medical training but if someone told me they were dizzy, I'd ask them what they were doing when they first felt dizzy, what helped make it stop, if they felt anything else while they were dizzy like nausea or pain at the very least to help them focus on what exactly the problem might be. It was like the doctor knew all along what her problem was but wanted to make her figure it out. It bugged.

[sempervivum]

14 hours ago, Pepper the Cat said:

s a roof top garden really a good place for people with a mental illness?  

I'm guessing you mean 'safe'? I think any of the patients who were feeling suicidal would have to be able to climb like monkeys to get up the walls, or be as flexible as a cat in order to squeeze through the grates.

[txhorns79]

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This! Why not ask a probing question or two? I have no medical training but if someone told me they were dizzy, I'd ask them what they were doing when they first felt dizzy, what helped make it stop, if they felt anything else while they were dizzy like nausea or pain at the very least to help them focus on what exactly the problem might be. It was like the doctor knew all along what her problem was but wanted to make her figure it out. It bugged.

This.  It felt like the doctor was just playing games with her, when all he had to do was ask follow up questions. 

[Evagirl]

20 hours ago, doodlebug said:

Heck, I’m still trying to figure out why he has to sleep on the couch while his wife sprawls out on a huge bed.  She supposedly has a placenta previa so sex is off the table anyway, why can’t he sleep platonically with her in their bed? Once he starts radiation, he’s going to be exhausted and sleeping on the sofa won’t help.

The actor has so much more chemistry with the oncologist than he does with his wife; a romance with her could only help the show.

I don't even know why they gave him a wife.  I think the show would have been much more interesting without a wife.  There's so much going on at the hospital and even outside the hospital (Faye, the homeless lady), that the show doesn't need the drama that this wife is bringing to the show.  She says she loves him with all her heart, but not ready to recommit to him yet.  She says she wants him but not ready to want him 100% yet.  What's up with this nonsense?!!  She can't bring herself to love a guy who's a committed doctor, who clearly adores her (in the script anyway) and his child that she's carrying and she treats him like a dog on a lease.  Geesh!  The woman's gotta go!

[txhorns79]

Quote

She says she loves him with all her heart, but not ready to recommit to him yet.  She says she wants him but not ready to want him 100% yet.  What's up with this nonsense?!!  She can't bring herself to love a guy who's a committed doctor, who clearly adores her (in the script anyway) and his child that she's carrying and she treats him like a dog on a lease.  Geesh!  The woman's gotta go!

In fairness to her, his main priority appears to be the hospital, not her.  He is also is hiding a potentially fatal illness and associated treatment from her.  I can see why she might not be eager to give him the benefit of the doubt. 

[doodlebug]

1 hour ago, txhorns79 said:

This.  It felt like the doctor was just playing games with her, when all he had to do was ask follow up questions. 

I really like the particular actor and have generally liked his character, but, it makes no sense in any context to do what he did.  It was like he was punishing her for not using different terms.  Like a parent to a naughty child, 'Now, SIT here and think about what you said, I'll be back when you're ready to talk properly'.  WTF?  Also, the ER was inundated with patients, they were running on fumes; tying up a bed for hours rather than obtain a useful medical history was terribly unfair to his coworkers.  I think we were supposed to admire him for his amazing medical talents, but he seemed like a jerk to me.  Also, if her feet were numb, a decent neurologic exam should've picked that up and the guy was supposed to be a neurologist. Did he refuse to examine her until she was properly repentant and submissive? And, as I am sure everyone realizes, Guillain Barre is not the only possible cause of the problem she was having and diagnosing her off the cuff after she finally utters the magic  words was dumb.

[doodlebug]

49 minutes ago, Evagirl said:

I don't even know why they gave him a wife.  I think the show would have been much more interesting without a wife.  There's so much going on at the hospital and even outside the hospital (Faye, the homeless lady), that the show doesn't need the drama that this wife is bringing to the show.  She says she loves him with all her heart, but not ready to recommit to him yet.  She says she wants him but not ready to want him 100% yet.  What's up with this nonsense?!!  She can't bring herself to love a guy who's a committed doctor, who clearly adores her (in the script anyway) and his child that she's carrying and she treats him like a dog on a lease.  Geesh!  The woman's gotta go!

I still don't understand why she cannot bring herself to allow him to sleep in their huge king sized bed until she decides whether she wants to stay married or not.  The guy should be making a very comfortable living, their apartment is beautiful and looks very large for NYC, but there is apparently no guest room or even a futon.  She seems like a selfish unpleasant person to me, I have no idea why he thinks she's so wonderful.

[rwlevin]

Wow, a doctor opens the door to a surgical suite without a face mask? Two doctors in the middle of a surgery without surgical caps on? Talk about all the OSHA violations. 

Regarding the surgical resident, did they say he was a first year? No first year surgeons ever perform surgery unassisted and the surgeries they do are very simple, like removing fat pads. That type of surgery would be reserved for a 4th or 5th year. Not to mention, unless you're a fellow, cardiothoracic surgery is a one month rotation during your residency. Fou may have the rotation multiple times during residency but injury once per year. Yeah, I a hundred percent agreed with Reynolds. Letting a non-senior resident perform on his own is begging to be taken to court. 

[Evagirl]

34 minutes ago, doodlebug said:

I still don't understand why she cannot bring herself to allow him to sleep in their huge king sized bed until she decides whether she wants to stay married or not.  The guy should be making a very comfortable living, their apartment is beautiful and looks very large for NYC, but there is apparently no guest room or even a futon.  She seems like a selfish unpleasant person to me, I have no idea why he thinks she's so wonderful.

Ditto Doodlebug!

[Guest]

4 hours ago, Evagirl said:

I don't even know why they gave him a wife.  I think the show would have been much more interesting without a wife.  There's so much going on at the hospital and even outside the hospital (Faye, the homeless lady), that the show doesn't need the drama that this wife is bringing to the show.  She says she loves him with all her heart, but not ready to recommit to him yet.  She says she wants him but not ready to want him 100% yet.  What's up with this nonsense?!!  She can't bring herself to love a guy who's a committed doctor, who clearly adores her (in the script anyway) and his child that she's carrying and she treats him like a dog on a lease.  Geesh!  The woman's gotta go!

I agree with this. I get it- before the show started, he wasn’t a great husband. But either get over it or end it if you can’t even non-sexually share a bed with him.

I find her to be really annoying.

[Loves2Dance]

21 hours ago, Pepper the Cat said:

Is a roof top garden really a good place for people with a mental illness?  

Did they bother to bring out the company who built the building to determine whether or not the roof area can hold the excess weight? I did notice metal bars in front of the windows, but seriously---plants are not light! It could cave in. 

Edited October 18, 2018 by Loves2Dance

[catrice2]

Yes I meant to say I don't understand why every drama has to pair off couples . I see no chemistry between the lead surgeon and I guess his resident( I'm not quite sure the one who he told that he couldn't date her because she wasn't black). 

Is she supposed to have a problem? They showed her popping pills in one scene. The only two people I see as potentially romantic are Max and Helen reading these comments. The fact that I can't remember the character names is not a good sign. Since they saddled him with a boring wife I don't see that happening 

And who knows what stupid backstory they're going to give her.

[doodlebug]

11 hours ago, catrice2 said:

Yes I meant to say I don't understand why every drama has to pair off couples . I see no chemistry between the lead surgeon and I guess his resident( I'm not quite sure the one who he told that he couldn't date her because she wasn't black). 

Is she supposed to have a problem? They showed her popping pills in one scene. The only two people I see as potentially romantic are Max and Helen reading these comments. The fact that I can't remember the character names is not a good sign. Since they saddled him with a boring wife I don't see that happening 

And who knows what stupid backstory they're going to give her.

The cardiac surgeon is supposedly attracted  to the doc who runs the ER.  She is ‘popping pills’ because she is stupid and doesn’t know how ADHD meds work nor does she understand the importance of keeping controlled meds properly labeled and locked up even if they’re yours.

Adderall is an amphetamine taken by people with attention deficit disorders.  They don’t just take it randomly, they don’t just pop one when they’re feeling out of it.  There are varying dosages, but taking a single pill once or twice a day is the way it is taken.  If she needs to keep a few around because she might get stuck at work, then keeping a labeled bottle in her locker would be appropriate.  Carrying a bunch of Adderall around with her in an ibuprofen bottle and constantly complaining of headaches throughout the day and popping one reeks of abuse of a controlled prescription med.  Maybe she is going to turn out to be a speed freak.

[doodlebug]

18 hours ago, rwlevin said:

Wow, a doctor opens the door to a surgical suite without a face mask? Two doctors in the middle of a surgery without surgical caps on? Talk about all the OSHA violations. 

Regarding the surgical resident, did they say he was a first year? No first year surgeons ever perform surgery unassisted and the surgeries they do are very simple, like removing fat pads. That type of surgery would be reserved for a 4th or 5th year. Not to mention, unless you're a fellow, cardiothoracic surgery is a one month rotation during your residency. Fou may have the rotation multiple times during residency but injury once per year. Yeah, I a hundred percent agreed with Reynolds. Letting a non-senior resident perform on his own is begging to be taken to court. 

Yes, he was a surgical intern, 3 months out of med school who said he had scrubbed on exactly 4 bypasses, which is actually pretty good for that point in his career, but not nearly enough for him to even think about doing any of it.  Even letting him close the skin incision would be a big deal at that moment.  

Once again, that is not how residency works. General surgery is a 5 year one. A hospital would have multiple residents at each level, at least 3, but probably more. That means New Amsterdam would have at least 15 surgery residents, with at least a dozen of them far more experienced than that intern.  Where were they?  Why wasn’t a resident with 4 years’ experience in that OR?

TV shows have surgeons scrubbing without masks all the time, then stepping into the OR where a nurse/handmaiden puts it on for him/her.  Surgical masks are uncomfortable, they need adjustment when they’re worn to get them fitted and less annoying.  It is not possible for someone to adjust it properly if they’re not wearing it. TPTB on ER said they did it this way so the actors’faces could be seen while they said their lines.

Even more ridiculous was the gowning of the intern. We see him at the sink, no mask on, scrubbing with soap and water, then walking directly into the OR where a nurse meets him at the door with a gown because his arms have magically dried in 2 seconds.  In real life; the resident would approach the table where the scrub tech would hand him a towel to dry his arms. Once he discarded that, she would put the gown on him. Techs do not wander around the room putting gowms on surgeons, way too much risk of contamination.

[Efzee]

I forgot to mention this earlier, but what are these department heads' qualifications? Initially, I thought they were all 'just' surgeons but after watching all 4 eps in one go, I realized they were all supposed to be the department heads. But wasn't the cardio guy a resident in the pilot, when he got fired along with the rest of his department? And he's the one hiring attendings? It was my understanding that department heads are (at the very least) attendings with usually quite a few years of experience as attendings, but this guy seems to have gone from resident to department head hiring other attendings? And don't he, the ED doc and Oncology/PR doc look a bit young for department heads? And why don't we see any other attendings/residents/interns working under them, aside from the trio of new cardio attendings and Tall Guy or whatever he was called. The guy stealing the onco chair was a nurse, I thought.

[doodlebug]

5 hours ago, Efzee said:

I forgot to mention this earlier, but what are these department heads' qualifications? Initially, I thought they were all 'just' surgeons but after watching all 4 eps in one go, I realized they were all supposed to be the department heads. But wasn't the cardio guy a resident in the pilot, when he got fired along with the rest of his department? And he's the one hiring attendings? It was my understanding that department heads are (at the very least) attendings with usually quite a few years of experience as attendings, but this guy seems to have gone from resident to department head hiring other attendings? And don't he, the ED doc and Oncology/PR doc look a bit young for department heads? And why don't we see any other attendings/residents/interns working under them, aside from the trio of new cardio attendings and Tall Guy or whatever he was called. The guy stealing the onco chair was a nurse, I thought.

Yes, department heads are not residents, they are attending physicians in the area where they lead, and most department heads have years of experience before becoming the boss.  Nowadays, in a huge teaching hospital in a big city, most department heads would also need to have managerial experience, often an MBA is required. 

In the first episode, the amazing Dr Max asked who was in the cardiovascular department and fired them.  He can't fire residents, so he must've been firing attendings (he cannot really fire them either, they have employment contracts and there are rules about stuff like that).  He then decided that the one cardiovascular surgeon must be good because he didn't do as much surgery as the other docs in the department (because that's what you want running your department, a heart surgeon who doesn't actually like to operate on people).  That's the guy who was doing all the surgery this past episode so he has apparently overcome his aversion to the OR.  And, BTW, does anyone think it is a good idea for any surgeon, but especially one doing life or death procedures to keep operating on patient after patient without a break? That this would be safe for the patients?  My mom was scheduled for a vascular surgery years ago and it was postponed until the next day because a patient came in with a leaking aortic aneurysm (same surgery being done at the beginning of the episode) and her surgeon didn't want to do a second major procedure the same day due to being tired and the OR team also being exhausted.  Imagine that!

Yes, the Emergency Medicine chief looks really young but, on ER, Kerry began running the department on ER just a couple of years out her residency, so that seems to be a TV thing.  After all, older docs like the Chiefs of Psychiatry and Neurology aren't young enough or pretty enough for network TV romances; so the show has to have docs who are a good decade too young running things.

The ER person who took the Adderall because it was mislabeled as ibuprofen was either a nurse or a medical assistant or physician assistant. 

BTW, here are some photos of various Adderall type meds.  You will notice that most of them don't look like an ibuprofen and many of them actually say 'Adderall' right on the pill or capsule, which makes it hard to understand why a medical professional would take them thinking they were ibuprofen:

https://www.google.com/search?q=Adderall+pill&tbm=isch&source=iu&ictx=1&fir=i5tYDvuqvmeXWM%3A%2CBDSwuSqFpPg78M%2C_&usg=AI4_-kQEHFQ_8W6RQiWk4ctfUiiTVNK3nw&sa=X&ved=2ahUKEwicvtr2l5PeAhWr64MKHcP1CRsQ9QEwDXoECAUQBg#imgrc=i5tYDvuqvmeXWM:

[thuganomics85]

Yeah, I don't care how important any conference is: I really doubt every hospital would go down to just one surgeon and call it day.  Because all it takes is one major emergency or accident and.... well, we apparently saw what happened.

Sharpe's storyline was decent at least and I like that she is becoming better with interacting with patients.

So, I guess Bloom taking pills for ADHD is going to come back into play, somewhere down the line.

Concerning Kappor and the dizzy patient: I felt like we were suppose to find her overtly-rude to him, and this was his way of getting back at her.  But I would think a doctor his age would be much better at handling impatient and rude patients.

Still could care less about Max and his wife, since I suspect it is going to be a doomed relationship.

[kgg]

On ‎10‎/‎18‎/‎2018 at 9:26 AM, doodlebug said:

'A while' might mean a month, it might be a minute; I need to know. 

When I get blank stares after I ask people to clarify, I've started adding, "Does it last as long as a commercial, a TV show, or a movie?"  Someone once told me, "A long commercial.  Like...a Nationwide commercial."

[starri]

On 10/18/2018 at 1:10 PM, rwlevin said:

Wow, a doctor opens the door to a surgical suite without a face mask? Two doctors in the middle of a surgery without surgical caps on? Talk about all the OSHA violations. 

I can't take too many points off, because save for ER, which I think actually explained how scrubbing in works in an episode, every medical show gets it wrong.  On the gleefully stupid Night Shift, the ORs had sliding doors, which, good luck opening that when you're sterile.

13 hours ago, doodlebug said:

The cardiac surgeon is supposedly attracted  to the doc who runs the ER.  She is ‘popping pills’ because she is stupid and doesn’t know how ADHD meds work nor does she understand the importance of keeping controlled meds properly labeled and locked up even if they’re yours.

Don't they have cardiothoracic fellows?  I can't imagine a CT fellow couldn't pitch in and help with a general surgery attending monitoring.

13 hours ago, doodlebug said:

Carrying a bunch of Adderall around with her in an ibuprofen bottle and constantly complaining of headaches throughout the day and popping one reeks of abuse of a controlled prescription med.  Maybe she is going to turn out to be a speed freak.

I'm looking forward to the story where we find out she's an addict, because otherwise, if the show thinks that's how amphetamine salts work, we're going to see Iggy having to evaluate her for drug-induced psychosis.

[eel2178]

On ‎10‎/‎19‎/‎2018 at 4:40 AM, doodlebug said:

Adderall is an amphetamine taken by people with attention deficit disorders.  They don’t just take it randomly, they don’t just pop one when they’re feeling out of it.  There are varying dosages, but taking a single pill once or twice a day is the way it is taken.  If she needs to keep a few around because she might get stuck at work, then keeping a labeled bottle in her locker would be appropriate.  Carrying a bunch of Adderall around with her in an ibuprofen bottle and constantly complaining of headaches throughout the day and popping one reeks of abuse of a controlled prescription med.  Maybe she is going to turn out to be a speed freak.

I think that is where they are going with this. She will turn out not to have ADD and has been self-prescribing her meds just because she enjoys the side effects. She'll have some major crisis that effects her ability to do patient care and disciplinary action ensues after she recovers from her near-death experience. 

P.S. They did the same thing on St. Elsewhere.

[eel2178]

On ‎10‎/‎18‎/‎2018 at 10:54 AM, doodlebug said:

I really like the particular actor and have generally liked his character, but, it makes no sense in any context to do what he did.  It was like he was punishing her for not using different terms.  Like a parent to a naughty child, 'Now, SIT here and think about what you said, I'll be back when you're ready to talk properly'.  WTF?  Also, the ER was inundated with patients, they were running on fumes; tying up a bed for hours rather than obtain a useful medical history was terribly unfair to his coworkers.  I think we were supposed to admire him for his amazing medical talents, but he seemed like a jerk to me.  

He has always seemed like a jerk to me, which I've found to be pretty typical of neurologists in real life.

[starri]

57 minutes ago, eel2178 said:

I think that is where they are going with this. She will turn out not to have ADD and has been self-prescribing her meds just because she enjoys the side effects

Then I'm really going to laugh.  There's no way a pharmacy would fill a self-prescription for a controlled substance.  New York doctors are really restricted on prescribing them in general:  no more than a 30 day supply, can only send prescriptions electronically, have to use a two-factor identification that's tied to your NPI and/or DEA number, and you have to check the state database before you do.

[Princess Lucky]

On 17/10/2018 at 6:29 PM, Kelda Feegle said:

A better episode than all the previous ones, still flawed but definitely improving. 

Agreed. I had almost written it off, only sticking around for the likable cast, but the show has really been improving, to the point where I am actually looking forward to new episodes. I agree that it's far from perfect, but it seems like the writers are making an effort, and they are identifying what works and what doesn't, so that gives me a little bit of hope.

One thing I appreciate is how non-soapy this is. The male lead is shirtless around (his doctor, sure, but also) a gorgeous woman, and a) the camera never lingers on his body b) neither of them makes a salacious or "funny" comment c) the scene is actually played in earnest, with the focus on the anxiety of the lead/patient who is going through something serious. I was impressed. Same for the Bloom/Reynolds "drama" which is theoretically the soapiest aspect of the show. They have their scenes together which are mostly about their jobs, but the actual moments where they discuss their relationship are brief and to the point and drama-free. That's refreshing.

 

On 17/10/2018 at 6:42 PM, themadman said:

So all the cardiothoracic surgeons that dude hired (the three black women) in the last episode just disappeared, eh? 

Right? Couldn't one of them have had the big moment this random tall white guy had?

 

On 17/10/2018 at 10:19 PM, doodlebug said:

The actor has so much more chemistry with the oncologist than he does with his wife; a romance with her could only help the show.

On 17/10/2018 at 7:06 AM, catrice2 said:

I know this is based on a true story but if they wanted us to care about the lead actor's wife and child they could have cast an actress that he has chemistry with and they need to do something about the chemistry that he has with the Freema agyeman character.

This is true. The wife role is pretty thankless, sure, but the actress is doing nothing to bring any kind of warmth to it, or any personality. I agree with the comments above; what's so great about her? We are constantly told that Max loves her, but we don't know her, or him, really, so it's hard to share the sentiment. That's why it's not often that the lead of a show starts off married (especially if they're young). The audience wants to see the build-up, otherwise it won't resonate.

And Ryan Eggold and Freema Agyeman really do have chemistry, in the best of ways. I think this might be intentional, because Dr. Sharpe is the only one who knows the truth about Max, so he's able to connect with her on a different level, past the bullshit jokes and smirks and puppy dog eyes he pulls around everyone else. Also, Dr. Sharpe doesn't seem like she'd have that many connections in life either, and Max seemed to get under her skin since they met, in a way most people would be too afraid to do, so it seems that she's opening up to him more than she usually might. All that is fine, and subtle (if that is in fact the writers' intention), and wonderfully acted, but what about their actual, physical chemistry? It pops. The best part is that it's happening organically, and neither actor is playing "flirty" at all (which they shouldn't, in these circumstances). It's just there. And, I agree, the show needs to do something about it.

Speaking of, I also wonder what the show will do with the wife. I suppose that her leaving Max would be the easiest to get over, but maybe it won't be dramatic enough. But what's the alternative? If she dies and the baby lives, Max will be a cancer-struck widowed single parent of an infant, which, even for this show, would be too much. If both her and the baby die, it'll be way too glib. A divorce would probably be the easiest to work in. Either way, I don't know what it is, but I see a lot of comments (with which I agree) about the wife situation feeling temporary. I don't know if it's the casting or the writing, but I find it hard to care about the whole thing too. I hope that when he tells her about his cancer (or when she finds out) the situation might be resolved.

[eel2178]

54 minutes ago, starri said:

Then I'm really going to laugh.  There's no way a pharmacy would fill a self-prescription for a controlled substance.  New York doctors are really restricted on prescribing them in general:  no more than a 30 day supply, can only send prescriptions electronically, have to use a two-factor identification that's tied to your NPI and/or DEA number, and you have to check the state database before you do.

I knew a nurse who stole one of the doctor's prescription pads, wrote out prescriptions for her patients who were currently in ICU, then went to the pharmacy and said she was picking it up to do the family a favor. She got away with it a couple of times before the pharmacy questioned it and called the doctor to verify it, then she got arrested. 

I can see an Adderall addict coming up with a similar plan, only she'd be the doctor who got called and okay the prescription if the pharmacy questioned it.

[eel2178]

8 minutes ago, Princess Lucky said:

Speaking of, I also wonder what the show will do with the wife. I suppose that her leaving Max would be the easiest to get over, but maybe it won't be dramatic enough. But what's the alternative? If she dies and the baby lives, Max will be a cancer-struck widowed single parent of an infant, which, even for this show, would be too much. If both her and the baby die, it'll be way too glib.

The baby is named after his dead sister. There is no way the baby will die; however, I wouldn't rule out a near-death scenario in the delivery room. Probably something like he is in the middle of a cancer treatment when she goes into labor, so all three lives are suddenly in jeopardy.

[Dowel Jones]

On 10/17/2018 at 9:31 AM, doodlebug said:

There was also absolutely no reason that the other hospital’s ER should’ve been shut down either.  99+% of ER patient don’t need a cardiovascular surgeon, and, if they do,  there are literally dozens of other hospitals in NYC that could take the patients.

That's the Code Black treatment, in which a major US city (in that case LA) apparently has only one trauma center that receives virtually every single major trauma or difficult medical case in the city. To use the mnemonic, it's the Only Surgical Hospital In Town.

[Lunula]

I honestly thought my eyes were going to stick permanently into the back of my head with the serious eye-rolling I was doing during this episode. Every story in the silly plot was so unbelievably stupid and unrealistic, with the exception of Helen and the young cancer patient (which I found very sweet and moving), that my husband and I were actually pausing the show throughout to complain about how dumb it was. 

I started this show only because of Ryan Eggold, but they are making his character seriously unlikeable by trying to make him too nice. I can suspend reality for television, but when stories do not make sense and characters do not make sense, I can't see myself in this for the long haul. 

Because I like Helen's character, and because I like Eggold, I'm going to give it two more episodes. Hopefully the writers will stop assuming everyone watching is a complete doofus and give us some intelligent content. 

[doodlebug]

22 hours ago, starri said:

Then I'm really going to laugh.  There's no way a pharmacy would fill a self-prescription for a controlled substance.  New York doctors are really restricted on prescribing them in general:  no more than a 30 day supply, can only send prescriptions electronically, have to use a two-factor identification that's tied to your NPI and/or DEA number, and you have to check the state database before you do.

It is against federal law for any doctor to write a controlled substance prescription for a family member, let alone for himself/herself. The DEA would pull her prescriptive authority immediately and notify the state medical board which would probably prohibit her from practicing pending a hearing at which she could lose her license to practice medicine entirely.   And any pharmacy that knowingly filled it and/or didn't report it would jeopardize their licensure, too.  Adderall is a Schedule II controlled substance, just like most opiates.  Schedule I are medications like LSD which don't have any known medical use but can sometimes be licensed to be purchased by researchers, etc.  Schedule III and down are less addictive medications which still have abuse potential.

Every state has a database accessible to practitioners and dispensaries which is supposed to be reviewed anytime a controlled substance is provided to a patient.  There is a check-off that is to be completed when the prescription is written attesting that I, the doctor (or pharmacy) have checked and found no evidence of abuse.  So, if a doctor is going to use a patient's name to write prescriptions for Adderall, she'd better be darned sure that patient isn't already on that or another controlled substance or it will be picked up and reported the next time someone wants to write for that patient.  Also, since she is an ER doc and Adderall is a long-term med with absolutely no medical indication for short term use, she is going to have a very tough time explaining to the DEA why she is providing a long term maintenance med to a patient.

The 30 day rule is universal, too, and, these days, most ER's will only provide a patient with enough medication to tide them over for a day or two until they can see their regular doctor.  No ER doc is giving 30 days worth of a Schedule II medication to anyone.

The state where I practice doesn't permit electronic prescribing of schedule II's.  The idea is that the doctor should be seeing the patient regularly and assessing the need to continue the medication.  The patient has to have a paper prescription with a real signature, not a stamp which also has to have the date it was issued as well as the patient's name and date of birth and the practitioner's address and phone number.  It also requires a diagnosis right on the prescription.  No diagnosis, no meds. A patient can only fill 30 days' worth at a time although prescriptions for up to 90 days worth of meds can be presented to a pharmacy which will then fill it 30 days at a time.  I don't prescribe Adderall except for inpatients who took it prior to admission and the only narcotics I write are for postop patients for 3-5 days' worth. When I check the database, I can find out what other controlled substances have been prescribed and the diagnosis for each.  Ideally, this prevents patients from getting meds for back pain from 4 different docs at once.

[txhorns79]

Quote

That's the Code Black treatment, in which a major US city (in that case LA) apparently has only one trauma center that receives virtually every single major trauma or difficult medical case in the city.

Ah yes, Code Black.  The show that tried to argue it made total sense that one hospital in Los Angeles would be entirely overwhelmed and understaffed nearly every day of the year without any real negative health outcomes or backlash because the staff was magical.  Also, it had that really weird observation deck area in the middle of the ER where medical staff would just come and watch emergency procedures for no real reason.    

[IDreamofJoaquin]

I can't believe they are threw this episode together 4 weeks in.  Ummm......you are going to run out of dramatic circumstances by episode 10!

@doodlebug stay on this board forever,  we need you. 

[eel2178]

23 hours ago, doodlebug said:

 

The state where I practice doesn't permit electronic prescribing of schedule II's.  The idea is that the doctor should be seeing the patient regularly and assessing the need to continue the medication.  The patient has to have a paper prescription with a real signature, not a stamp which also has to have the date it was issued as well as the patient's name and date of birth and the practitioner's address and phone number.  It also requires a diagnosis right on the prescription.  No diagnosis, no meds.

That's interesting. The state I live in prefers electronic scripts on the theory that they are harder for the patient to forge. Also, with a written script, the patient has to present photo ID at the pharmacy to have it filled. It has to have patient's name, DOB, patient's address and phone number on it, but a diagnosis is only necessary in the chart to justify it to the insurance company.

[martha21]

As someone who was briefly married to an Adderall addict, it is extremely easy to get from a doctor. He had his doctor completely fooled and went through a month's worth of medication in less than a week, repeatedly. I met with his doctor to report this but if I hadn't it would have continued. It did result in psychosis and it was a horrible experience. If I had to guess I would say he probably found a new doctor and is getting it prescribed again. IMO, it should not be repeatedly prescribed without checking with loved ones to ensure it's not being misused. I'm hoping for a resolution to this issue in the show and that it is handled properly.