New Amsterdam (2018–…): Season 2, Episode 15 - Double Blind - full transcript

When tasked with turning the Opioid epidemic around, Max shuts down the ED and proposes a massive change. Meanwhile, Sharpe goes great lengths to prove a point.

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*NEW AMSTERDAM (2018)*
Season 02 Episode 15
Episode Title: "Double Blind"

Oh...

- Morning.
- Morning.

So you know Evie's taken a job
in San Francisco.

- I do.
- Yeah, and, um,

seeing as we're, uh,
gonna get married soon...

Mm-hmm.
You're leaving.



- Yeah.
- Yeah.

Um, I really didn't have
a choice here, Max.

I'll help you fill
the position, of course.

You know,
sort through resumes.

Not necessary.
Congrats.

Tonight's the big night
isn't it... dinner with mom?

Oh, God, thank you
for the reminder.

You know why
she reached out to you?

Well, because she is sober
this week

and wants to make amends
for the thousandth time.

I'm only going
because I like the restaurant.

Holland.

I know, I know.

I was really hoping

I wouldn't see you
back here again.

Yeah.

Now I have to send you home.

I just misjudged the dose.
I'm not gonna OD again.

- Can someone help us?
- On it.

I'm already taking less
than I was before,

and I have a whole new plan.
Okay, we talked about this.

Addiction is not something
that you can tackle alone.

You need support.

Trust me.

I know the dance all too well.

Please.

Lauren?

Valentina?
Do you have a minute to chat?

Sure, I'm just late
for a meeting.

I saw Fatima Abassi
yesterday.

Her eyes were glazed.
She mumbling to herself.

I'm just curious if any other
patients in your trial

had these symptoms.
What are you suggesting?

- Nothing.
- I'm just concerned.

When she was receiving
traditional chemotherapy...

She's no longer
your patient.

- Understood.
- But I care about her...

Under the guise of concern
you're implying that

I'm withholding my drug's side
effects to protect my trial.

Right?

Stay in your lane.
I have a department to run.

Altered mental state.
Diaphoresis.

I must say
your husband's symptoms

are rather confounding,
but they are not from

stroke
or dementia.

Our tests have ruled out

liver failure, diabetes,
and drug ingestion.

He's never taken a drug
in his life.

- What about alcohol?
- Joe doesn't drink.

Are you certain?

Sweating, delirium...
Could be alcohol withdrawal.

Yes.
I'm certain.

I've lived with the man
over 40 years.

Okay,
based on Joe's symptoms,

I'd like to start him
on high-dose benzos.

And when he recovers, perhaps
we will all know him better.

- A sip?
- No thanks.

I just added something
like that to my mulch pile.

Okay, well, you have no idea
what you're missing.

That's supposed to cure
your sugar cravings?

Yup, no more junk food
for me, Gladys.

My body deserves better.
I deserve better.

- Dr. Frome.
- Who's gonna tell that

to the pastry landfill
in your desk?

You know, I'm sending in
a hazmat crew today

- if you must know.
- Mmm.

Well, the cleanup
will have to wait.

There's a cute couple
eager to see you.

Dr. Steiner's referral.

Yes, the refreshing break
that is couples counseling.

See?

Healthy choices
are being rewarded Gladys.

Take heed.

Chris and Jenny, right?

Uh, yeah.

Thanks for fitting us in.

Dr. Steiner told us you were
one of his favorite students.

One of?

Well, if that isn't a blow.
Jeez.

And you two are both from
Long Island, as well, right?

- Yeah, we both grew up there.
- Okeydoke.

So what are we doing here
today?

Uh, Jenny and I have been
together for nine years,

and we'd been planning on
getting married

at the end of the month,

but we've been having
some problems.

- It happens.
- We're fighting, all the time.

We haven't had sex
in over a month.

We're not even living together
right now.

Jenny moved in with a friend.
I'm sorry-is this...

Is this seriously
what you're opening with?

Well, Jenny,

what do you think
he should be opening with?

We, um, we got a...

An early wedding present
from my uncle.

It was a... a DNA kit.

One of those things that tells
you how French you are,

if you're related to George
Washington... you know.

- Um...
- Did you guys send it in?

We did.

And?

Well, we're not French.

We're brother and sister.

- How can I help?
- Are you aware that your ED

just discharged another patient
who overdosed on opiates?

No, but I'm not surprised.

We're up to about
ten a day now.

Do you know how
much the opioid epidemic

cost this country last year?
$500 billion.

700 billion.

We've seen a massive increase
in patient overdoses,

most of whom are
simply treated and released,

only to return days later
if they're lucky.

And most of these
folks are uninsured,

so we're operating at a loss.
Is that your issue?

It certainly is one of them.

Well, Karen, I assure you
that we spend a lot of time

talking to our patients about
the dangers of opioids,

but when you have massive
pharmaceutical companies

delivering a very different
message...

I know what
they're delivering.

- Then what have I done wrong?
- Nothing.

Which is precisely the problem.

I thought you wanted me
to do

- nothing.
- Not today.

Today I want you to turn
this epidemic around.

All the crazy ideas,

all the impulsive, rash
tantrums you want to throw...

Throw them, break the law,
I don't care.

You'll have my full,
unwavering support.

Is this, um...
Are there... are there cameras?

Max.

I want to see
how much damage you can do.

Challenge accepted.

This is one dose, one pill,
of the opiate oxycodone.

The pharmacy asked me
for a prescription,

and seeing as how I was only
looking for a visual aid,

I didn't have one.

So I had to drag our chairwoman
here to the dispensary

where we each
had to sign wavers

affirming our
educational intent.

But if I sold you this pill,
or even just gave it to you,

it's a loss of medical license
for me

and actual jail time for her.

1%.

That's how many doctors at New
Amsterdam are in this room.

Yet, you prescribe 79%
of the opioids here.

And given that we are hooking
patients by the thousands

on drugs that are a molecule
away from black tar heroin,

can anyone tell me why you all
shouldn't be arrested?

You know they have
a legitimate use.

Not at the levels
you're prescribing them.

None of us
prescribe them lightly.

Standards of care suggest
they're the best choice

- for our patients.
- Not true.

The SOC says they're
the most efficient choice,

and if you're looking
to drop a few pounds

amputation
is pretty efficient too.

Our patients want them,
Max.

They ask for them
by brand name.

They also do that
with cigarettes.

And our funding is tied to
patient satisfaction scores.

Well, it's kind of hard
to be satisfied if you're dead.

- Max.
- Nope, this changes now.

All right?
Since you all prescribe

79% of our opioids,

I'm giving you one year
to prescribe 79% less,

and anyone who does not meet
that mark will be fired.

Thank you for coming.

You may get some calls.

This is war, Max.

And your solution
is to berate our staff?

- Yeah... and threaten.
- Hell, I could've done that.

I want a macro solution.
I want the full Max.

But that down there...
Very disappointing.

- What's wrong?
- No pulse.

V-fib.
All clear.

- Still not there.
- Going again.

All clear.

- He's back.
- Thank God.

- Vijay.
- ST segment elevations.

Active ischemia.
I'll page Reynolds.

I'm afraid
I owe you an apology.

Your husband is not going
through alcohol withdrawal.

He had a heart attack.
Before he got here?

No, just now.

Which speaks to
an underlying condition.

Meaning?

We have
a far greater problem.

Approaching the right
coronary artery.

You see that narrowing?
Proximal section?

Yes, that blockage
is causing his ischemia.

So I'm just gonna put
a stent in there,

open up the artery,
and he should be good to go.

What's that?

In the left anterior.
It also looks like a narrowing.

That's weird.
That wasn't there a second ago.

Okay, Lana,
placing a second stent.

Floyd, another area's
constricting in the circumflex.

The hell is going on?

Every time I open up an artery,
another one closes.

And if you stop?

He'll die.

So, you're situation,
to put it mildly,

is a little more complicated
than most.

You are half-siblings.

All right, what about, um,

let's start with
a little context.

How did you two meet?

It was the second day
of freshmen year at NYU.

I was in a philosophy class.

Which I almost
immediately realized

was the worst decision
I'd ever made...

Until Jenny walked in.

She was 20 minutes late, and
when the professor apologized

for having such an early class,
she just said, "No problem."

Then she sat down next to me.

How long before you two
went out?

We got coffee
after class.

But immediately I knew
we were meant to be together.

Even before we both learned
we were from Port Jeff.

Port Jefferson,
that's a population of...

8,000.
Pretty small.

Especially
if both your mothers

used anonymous sperm donors.

Right.

Have you told your parents?
No.

No, we haven't told anyone.
We're not going to tell anyone.

Well, they are expecting us
to get married in 16 days.

Right.

Well, let me ask you this.

What are you both hoping
to get out of this session?

You know, processing this.

Finding our way back
to each other.

God, Chris, there's
no finding our way back.

We are... we're related.

Well, Chris, why do you
think this can be fixed?

Because the day I met Jenny
was the best day of my life...

And every day since
has been better.

Look, I know that this
is insane, okay?

Believe me.
And I can understand

why you
can't see a way through it,

but I can't imagine
not going back to how we were.

Not coming home to you...

If you think it's impossible,

and you can look me in the eye
and tell me right now

that you don't love me
anymore,

then I will call off
the wedding.

You know I love you...

But love just isn't enough.

It isn't enough, is it?

Hi, so, uh, I'm here
to end the opioid epidemic.

Okay.

So half the ODs occur

within three months of a visit
to the emergency room,

but if we prescribe suboxone...

We could manage the symptoms
of opioid withdrawal

- without the risk of fatality.
- Exactly.

We'll need a Treatment Act
Waiver by the DEA,

and even then, each licensed
doctor's only allowed

to treat 30 patients at a time.
So who's all licensed?

- You're looking at her.
- Really?

Well, that has to change.
Today.

To get everyone licensed,

they'll need to go on
an all-day training course.

Sure, okay, grab all
the doctors, attendings,

and residents and have them
take that test,

and nobody comes back
until they pass.

That would mean
shutting down ED.

Yeah, so shut it down.

- No, Max.
- Yes.

You want me to call the
department of public health,

re-route all ambulances,

suspend our Level I
Trauma status,

and potentially move
a multitude of patients

who are already being treated?

- That's a great plan.
- Max!

That's unheard of.
It would make the news!

And Brantley...
Will love it! Go!

A secret rendezvous
on the pier?

Are we catching up or
practicing our spy craft?

Audra.

I'm sorry for all
the cloak and dagger,

but I have a dilemma,
and I'm afraid it is a secret.

- What's up?
- Um...

It involves the NIH trial
that Castro's running

out of New Amsterdam.

- What's your dilemma?
- I'm not entirely sure.

Not yet.

Are you concerned there's
been a protocol deviation?

Because that could jeopardize

all NIH funding
at your hospital.

We're talking hundreds
of millions of dollars.

Which is why I needed to
speak with you off the record

without your NIH hat on.

I don't have a lot of details.

I'm simply trying to help one
of my patients that's involved.

Have you heard of any
significant side effects

from Castro's trial?

She hasn't reported anything,

but she's supposed to document

any adverse reactions
immediately.

Is your patient on
the protocol or the placebo?

- I don't know.
- Well, you have to find out.

It's the only way to verify.

But that would mean
violating the double-blind.

You can Castro directly.

Yeah, that would be,
um... awkward.

Then go around her
if you have to.

You need to know
if the patient

is on the placebo
or the drug.

And if it's the drug...

We have a bigger
conversation.

Uh, not sure if you've heard,

but both NPR and New York One
are buzzing about us.

- Because you shuttered the ED?
- That's right.

Both lead stories, both focused
on the opioid epidemic.

You know, we're gonna have
more licensed suboxone doctors

in this hospital than any other
hospital in the country.

Wonderful.
You want a cookie?

What?

I didn't ask you
to raise awareness,

I asked you
to solve the problem.

But instead
you're handing out detox drugs

while millions of people

outside the hospital
are suffering.

I don't work outside
the hospital.

Yes, you do.
When you want to.

Blood pressure testing
in barber shops?

Chasing down insurance agents
in their offices?

Come on, Max!
It's me you're talking to.

People are dying.

Do better.

Casey, Casey.
Get him situated in Urology.

Don't let them pawn him off.

Incoming!

Carolyn Werner, 20,
fell in Times Square.

Looks like
a radial/ulna fracture.

BP 120 over...
Okay, let me stop you

right there... she is stable with
an isolated injury to the arm?

- Yeah.
- Turn her around

- and take her to Baptist.
- Are you serious?

Uh, we thought dispatch
was mistaken.

No.
We are closed.

What the hell am I supposed
to do with all these?

I don't know, Dr. Skein.

They are patients admitted to
your care, so... tend to them?

20 people?

You've clogged every bed in my
department with this... this...

Uh, whatever you're doing.

We are trying to solve
the opioid crisis.

A crisis you helped cause.

I'm a dermatologist.

I will admit that your
situation is difficult.

Um, but is not my job to judge

whether your relationship
is right or wrong.

What is very apparent to me

is the love between you two
is very real.

And if you want,
worth fighting for.

There is one
inconvertible truth.

Biological children
can never be an option.

You think kids are what
we're worried about?

I can't even look at him.

Because this new information
has changed the way you see him?

Well, good news there.

Relationships
can survive change.

In fact, almost all of them
have to.

This isn't like he's suddenly
gained 20 pounds.

No, um...
Look, I get it.

But life goes on,
and you adjust.

Relationships adjust too,
or they end.

If change is insurmountable
in the heart, then that's it,

show's over.

But that is not
the case with you two.

Is it?

So the real question becomes:

can we change
what's in your heads?

How?

Jenny, will you sit
on the couch with Chris?

Good.

Jenny, will you take
Chris's hand?

Jenny.

I can't.

I can't.
I can't.

I'm sorry.

Floyd.

His test level shows

extremely high levels
of creatinine kinase.

It's already damaged
his kidneys.

That means his muscles
are breaking down.

Vasospasm, delirium,
muscle breakdown...

It all adds up to one thing:
decompression sickness.

The bends?

Joe has never gone
scuba diving in his life.

I tried to get him to go
on our honeymoon,

but he's afraid
of the water.

That may be true, but
I'm certain of this diagnosis.

You were certain before,
but you were wrong.

Joe doesn't drink,
and he's not a water guy.

Even on vacation, he is a good,
decent, no nonsense,

stay-in-the-room-and-watch-golf
guy.

But with
the symptoms exhibiting,

if we do not put him in
hyperbaric chamber right away,

I'm afraid he will be
a dead guy.

Who knows him better,
Dr. Kapoor?

His wife of 40 years or you?

Hi, I'm looking
for Dr. Castro.

She'll be back
in about 15 minutes.

Perfect.

Satisfied?

I've tried to be
the bigger person here.

Valentina...

If you focused a bit more
on the patient

instead of trying to nail me
to the wall,

you might have noticed that
Fatima has aggressive arthritis

in her left wrist.

It was caused by
an enterobacter infection

which then relisted
as a thiamine deficiency.

That's what led
to her delirium.

Not my drug.

You're welcome.

Dr. Morris, I apologize that
your hospital is overflowing,

but I will see you very soon,
okay?

Uh, Max Goodwin.

Dr. Farnum, yes,
I, um, did close the ED

and I look forward
to explaining why shortly.

- Max Goodwin.
- Hi.

Alice.

I'm sorry to bother you
at work.

Did you get my text?

Yeah, no... I did,
I've been, um...

I know you're busy,
but are you free tonight?

Tonight?

Uh.
Tonight, tonight?

I got this gig,
and I can't find a sitter.

I hate asking.
I feel terrible.

Oh, right.
No, of course.

Yes, I can.
Yes.

I thought... great.
Yeah, Luna's gonna love that.

- Thank you so much.
- Sure, sure.

Happy to help.
See you tonight.

Everybody told me
that it would be impossible

to get the city's top
medical directors

together in one room,
but then I reminded them

how much medical directors
enjoy a free lunch.

Yeah, so, um...

earlier today, I put
New Amsterdam on diversion.

I know that closing our ED

caused problems
for many of you.

To those of you
who are still annoyed,

I just want to say
it's about to get worse.

This is how much money New
Amsterdam spends on opioids

every year, and every hospital
network in the city

is spending the same.
Just the 15 of us,

sitting here in this room

are spending $1 billion a year

on a product that we know
is killing people.

We're hospitals.
Killing people should be

pretty high on the list
of things we try not to do.

Opioids work
incredibly well.

That's right, Florence.
They do work.

But they also worked in 1996,
and back then they worked

without causing an
international addiction crisis.

That was before the Nylers

started launching
propaganda campaigns

and buying off hospitals...
Including yours.

That's right.
Including mine.

Raise your hand if your
hospital has a Nyler Wing.

I'm not saying
that New Amsterdam

is better than anyone else.

I am saying it's time
to return to ethical behavior.

So instead of giving the Nylers

another billion dollars
this year,

I'd like to propose
a new number.

I'm ready to cancel New
Amsterdam's opioid contract

right now,

and I want you all
to do the same.

We have to hit them hard,
we have to hit them together,

and what we need is unity.

Unity
is an anti-trust violation.

There is blood

on all of our hands.

I think it's time
to wash it off.

So who's with me?

Florence?
Pass.

We could change things.
Dr. Farnum!

John.

Yes, well, can you...
Can you expedite it?

Yeah, I mean is there a fee
that I can pay for a faster...

Mm-hmm.

Okay, well call me back.

Yep.
Thank you.

Our pacemaker supplier
can't make shipment.

No big deal,
they're just people's hearts.

Stents are being held up too.

Not to pile on,
but several of my chemo drugs

won't be coming in tomorrow.
Or ever.

It's the Nylers.
They're retaliating

because I ripped up
their opioid contract.

Their companies make more
than just opioids, Max.

Most of my drugs
are under their patent.

No one besides Nyler
can make them.

Look, I love that we're finally
taking a stand against them,

but this could jeopardize
the lives of our patients.

Can someone please tell me

why my supplier just killed
my order for acne cream?

His wife said he's afraid
of the water.

I know.

What if he has an endocrine
disorder or something?

I mean, isn't your whole thing
about listening to the patient?

I am listening.

To Joe.

Despite everything
his wife believes,

his body's saying
decompression sickness.

You better hope you're right.

Jenny, this is your DNA,

and Christopher,
this is your DNA.

- They're the same.
- Not quite.

There's a .1% variant
between the two of you,

but yes,
they are 98.5% identical.

What more do we need?

But this is my DNA.

Also 98.5% identical
to both of yours.

Because that
is the genetic similarity

between any two human beings.

Scientifically speaking,
we are all very much the same.

Jenny...

What?
I should carry a DNA chart

to the market
to explain to everybody

why it's okay
I'm married to my brother?

Why do you feel the need
to explain anything to anyone?

Look, I'm sorry.
I'm sorry, but there's just...

There's nothing
that you're gonna say

that's gonna make me forget
who Chris really is.

Okay.

Okay, fair enough.

Is there anything
that you could say?

You were planning on
being married in 16 days.

You must've written your vows.

Okay.
Good.

Chris.

"As I sit here in our
half-painted living room

"that you promised to finish,
listening to the, um,

"Spin Doctors Album
that we bought for $1.00

"at a yard sale because
the lady who sold it to us

had no idea who they were..."

"I can't believe
how happy I am

or how lucky I am..."

"I never thought
I would find somebody...

"Somebody who laughs
at all my stupid duck jokes.

"Or likes my grandma's
baked spaghetti.

Or picks up all of our
bath towels all the time."

"So of course I said yes
when you asked me to marry you.

"Nobody's ever
loved me like you,

and I've never wanted
to be with anybody..."

Okay.
Good.

Jenny.

Can you see that Chris?

The Chris you wrote
those vows for.

That is the only Chris
there is.

And if you ever forget that,

all you need to do is go back
to those vows.

Just like every other couple.

Feeling pretty whooped,
huh?

The Nylers took you good.

That they did.

Do you have their new contract?

You know,
I don't know what's worse.

People addicted to their drugs,

or the system addicted
to their money.

Celeste.

- My little sister.
- Hmm.

She had this stupid surgery,
gum grafts of all things,

but it hurt a lot,
so they gave her Oxy.

She's gone now.

Two years.

May I?

Hey, we're closed.

I know, just taking an OD
down to the morgue.

Oh, no.

You knew her?

It's a funny thing, you know,

when you don't know anything.
I mean, I knew I was with you.

I just couldn't get
the words out.

It's okay, honey.

I'm just grateful
that you're all right.

Now, your wife said you'd
never been scuba diving before,

but...

Since our
anniversary's coming up,

I wanted to surprise you
by taking a few lessons.

You wanted to go
on our honeymoon,

but I was too scared.

I wanted to show you
I could do it.

But you're not a water guy.

Which is why I knew
it would be a surprise.

I didn't think
you could ever surprise me.

But you did.

- So adorable.
- Mmm.

Aren't they?
Mmm.

[Broken Heart's
"Spiritualized"

You don't own me.

Mmm.

Oh.

I wasn't sure
if you were gonna come.

I mean, not that I blame you.

I'm sober now.
I don't wanna hear it, Mom.

You wanna know
my earliest memory?

Was Dad's friend
calling you an alcoholic.

But Dad said no you weren't.
No, you were a drunk.

After that, I did everything
I could to slow you down.

The first time I got wasted,
I was seven.

♪ There's a lot of things
that need to be done ♪

I chugged half your martini

thinking the more I drank,
the less you could.

You know what you did?

You licked the glass,
and you made yourself another.

That night you shouted at me,
not for being drunk...

For being sick on the rug.

♪ Lord, I have
a broken dream ♪

- Lauren...
- No, I am not done, Mom.

I have spent years
being angry at you.

Hating you.

Feeling sorry for you.

Then doing it all over again.

♪ There's a lot of things
that I gotta do ♪

And I don't know
when it happened,

but I can't really feel
anything for you anymore.

♪ Lord, I have
a broken dream ♪

I was a little kid.

♪ And I'm wasted
all the time ♪

I was a little kid

who was killing herself
trying to get close you,

and you were an adult,
and you did not even try.

So I am sad
because I got cheated.

And it sucks.

It really sucks,
because I didn't deserve it.

♪ I've been told
that this will heal ♪

Oh, do you know what? Just
tell me you're sorry so I can go.

I wish I could.

I want to.

I am sorry.

That you feel so sad.

♪ I have to keep it
covered up with a smile ♪

But, sweetheart,
I... I just don't...

I don't remember
any of that happening.

♪ And I'll keep on moving on
for a while ♪

♪ Lord,
I have a broken heart ♪

Max.
Yo, you got a sec?

Look, I don't feel good about
our conversation this morning.

- Okay.
- No, it's not okay.

Look, I'm sorry
I didn't tell you sooner,

but you're just
gonna ice me now?

My fiancée moved
to San Francisco.

It's either her
or this hospital.

Look, Floyd.

I just can't lose
anyone else this year.

Dr. Brighton.

Did you ask people
to do this?

- No.
- Mmm.

Everyone's talking about

how the Nylers
retaliated against you

and against your hospital.

By shutting you out,

this company put patients'
lives at risk,

and that's not business,
it's a shakedown.

A shakedown that could happen
to any of us.

So what do you propose?

Unity.

This should counter
the infection, Fatima.

Alleviate all your symptoms.

Thank you for figuring out
what was wrong.

Mmm.

It wasn't me.
Dr. Castro made the diagnosis.

You're very fortunate
to be in her trial.

Hmm.

Okay.

Lauren, call me
as soon as you can.

I was wrong about
the side effects

Castro's drug might be causing,
but I was right about her.

She altered her patients'
numbers before treatment

so their tumors
would look worse

so her drug will appear to be
performing better

than it actually is!
Castro altered her trial.

- Hey.
- Hi.

Wow, you look serious.

Yikes.

That's not exactly
what I was going for.

No, no, I meant...
I just meant you look great.

Uh, come on in.

Hey, how'd it go?

- Really well, yeah.
- Good.

- Thanks for asking.
- Hey, yeah, sure.

- How're the babies?
- They're exhausting.

- Adorable.
- Sleeping?

Yes, sleeping.
She, uh,

jammed on this bad boy
quite a bit.

- She loves this.
- Yeah.

- You... you have a...
- Oh.

- A sweet potato?
- Oh.

I think yam actually.

It's a good look for you.

Yeah, it's kind of
becoming my go to.

There's more.

Here.

Thanks.