New Amsterdam (2018–…): Season 4, Episode 10 - Death Is the Rule. Life Is the Exception - full transcript

As Max and Dr. Sharpe prepare to depart for London, a deadly super big hits the hospital.

Are you wondering how healthy the food you are eating is? Check it -

Previously on
"New Amsterdam."

I see now why they created
a fifth spot for you.

You know the last time
that happened,

Dr Nottingham's family
had to donate

a whole building
to the hospital?

And I'm sorry

for caring so much about

both of you.

I know how difficult it was
for you to sign that budget.

These people are
not your friends, Max.

They're your employees.

Believe it or not, you did what
was best for this hospital.

Today I protected you,

but I can't protect you


Don't most people start
the day with good morning?

Yeah, but today is
no ordinary day, Sandra Fall.

Today is my last day.

Well, since this is our big,
emotional farewell--six feet.


You can call me Sandra.
Oh, wow.

That means a lot
coming from you.

So listen, I wanted
to thank you

for all your hard work
and your hot lists,

and me running you
all over this hospital

to give me information you

just as easily given me
from your office.

So excuse me,

I'm just going to grab
a quick something.

I got you this little gift,
and by little--

♪ Sweetpea

♪ What's all of this about

Please don't tell me
your cat died.

It's a first edition--rare,
first edition of "Gitanjali"

by Rabindranath Tagore.

Remember Vijay
used to have the book?

He would read you poems
from it,

and sometimes you'd kind of
get a little teared up.

Look at that.


Peter Lugar's
steak dinner spectacular

for two
with all the fixings.

Yeah, I know it's one
of your favorite restaurants,

and I do have to say because
I care about your health

and the sustainability
of the planet,

not to mention the cruel
treatment of animals--

I'm a vegetarian now.

Oh, great.

Oh, but then this is--

Very kind.

Very thoughtful.

Your heart was
in the right place.

Now that stethoscope
belonged to

Vivien Thomas,
one of your heroes,

who used that stethoscope

to help pioneer
modern day heart surgery.

Appreciate it.

Appreciate it?
What is with everybody today?

Why is everybody so--


I'm just trying to do
something nice for the people

that I love the most
in the place

that I love the most
one last time.

Max, look, I'm going
to level with you.

The gift is beyond beautiful.

It's just that the only gift

that anyone really wants

is for you to stay.


Hi--Trevor Vaughan?

Reporting for duty,

Right, right.

I am so sorry that I kept you
waiting like this.

It's not my style,
but my organization

and my scheduling in general

has gone off the rails
since I lost my head nurse.

No problem at all.
I kept myself busy.

I hope you don't mind,
I saw this on your desk.

The--oh, yeah/

Yeah, the entire department's
a little fanatical

about the caption contest.

You got any brilliant ideas
I can pass off as my own?

Hope this isn't
a deal breaker,

but witty captions
are outside of my skill set.

Drats, Trevor Vaughan.

Now if you want to talk
keeping behavioral health wards

from going off the rails,
though, I'm your guy.

Okay, good, let's talk.
All right.

Trained at St. Vincent's
Hospital in Melbourne.

Rose up the ranks at Tufts.

Managed behavioral health
at Baptist.

this is really impressive.

Thank you.
Yeah, so I guess

the biggest question
I have right off the bat

is you come
from private institutions.

Do you foresee any problems

working in a public hospital
system like New Amsterdam?

The only problem I see having
is getting any work done

while staring into those
amazing blue eyes of yours.


Yeah, so--

He actually said that?

Oh, he lobbed it at me

like we were
at a rave on Fire Island.

Was he cute?
Was he cute?

In a sent from Asgard
kind of way.

Chiseled by the gods
sort of way, you know?

And he totally knows it.

Deadly combo.

Yeah, well,
it takes one to know one.

I think we can both agree
that four kids has humbled me.

Perhaps a touch, my love.

But you know,
you got to hand it to him,

the kind of confidence
it takes to go all kamikaze

with the moves
in a job interview?

It's just completely

Oh, oh, yeah, completely.

Completely, no doubt.

Although he just so
happens to be

the best candidate I can afford

under Veronica's new budget
cuts--I'm just saying.

Yeah, well, I'm sorry
you have to keep looking, babe.

Yeah, I know.
Me too.

You know, I've got to say that
the whole thing has left me

feeling kind of charged,
like the thrill of it

left me feeling great,

if not a touch guilty.

Iggy, don't feel guilty.

Your eyes are gorgeous.

Thank you, husband.

You'll find someone.

I know, I know.

Dr. Malvo, wait up.

Whew, man, you are a hard woman
to catch-up to.

I did do the 400
in high school.

Yeah, I can see that,

but can you just stop
for one moment?

That's generally not
how one wins a race.

Look, I've been texting you
and leaving you messages.

And can you just talk to me?

I know you want to apologize
and say you had nothing to do

with Claude getting the axe.
I believe you,

you're not vindictive.
That's not how you roll.

Okay, but look, what happened
to Claude was messed up.

But, hey, we've been through
too much to just end it.

But it's just--it's, um--

it's too complicated now.

I'm sorry.

I know that we stopped
eating meat and fish,

but what do you say to

20 side orders of spinach?

How much did you spend?

Oh, that's the best part.

Zero dollars, a gift from Max.


How much did you spend
to buy my residency?

Where did you hear that?

Answer the question.
How big was your bribe?

AI didn't bribe.
I didn't bribe anyone.

I didn't, I...

All I did--all I did was
make a donation.

A donation that happened
to get your girlfriend

a non-existent residency
at New Amsterdam?

Come on, we both know
it's a joke that you had

to do your residency at all,

but when the dean saw
an application from a doctor

who trained in Pakistan

at a hospital he never
heard of, he stopped reading.

I mean, you could
have cured cancer

and you wouldn't have
gotten that spot.

All I did--all I did was
open up the dean's eyes

to see that--that you were
the best candidate.

How much?


Leyla, I did this for you.

For us.

Oh, hey, guys.
Hi, I'm glad I caught you.

Um, did you guys hear about
the blue-eyed hottie

that got hit on today
in the psych ward?

Did you?
Did news reach the ED?

It was me!

Well, did they
love your gifts?

Oh, yeah, they--
they loved them.

If by love, you mean
dispassionate indifference

in a thinly veiled apathy,

with just a hint of anger.

Go easy on them.
It's hard to say goodbye.

You seem cool as a cucumber.

I am going to miss
this place, you know I am,

but we are getting ready
for a brand new chapter

of our lives
together in London.

Tell me you're not excited
about that?

I'm excited, I am excited.


Okay, so Luna's all settled
for a week in Connecticut

with Glenn and Calvin?

We have handed over the keys
to the subletter?


We've checked in
for our flight?

Check and check.

Well, then it's time to go.

It doesn't feel real,
does it?

Come on.

Sorry, uncheck.

Forgot to return it.

I'll be right back.

BP dropping, 60 over 20.

Septic shock, hypotension.
We're losing him here.

Patient came in for
a routine cardiac stent.

What the hell happened?

Yeah, that makes sense.

That's why we try to reframe
these feelings of anger,

you know?
New context--Kaelen.

Hey, what's the matter?


Kaelen, Kaelen--
okay, you're okay.

You're okay, you're okay.
Ka--help, help!

I need some help.

No pulse.
No pulse, call a code team now.

What is it?

Still no pulse.

Going again.


What the hell just happened?

We just had nine code blues
at the same time.

How is that possible?


We need to shut down
the hospital.

Dead, in the hallway.

All right.
Everyone listen up.

I've alerted Veronica,
but she's still in Chicago,

so this is on us,
and here are the facts.

Nine patients died
this morning.

They were all colonized
by a bacterium infection,

Klebsiella Pneumoniae

I'm sorry, but what is that?

A superbug that's resistant
to most of our antibiotics.

Now the good news is

KPC isn't airborne
like a virus or COVID.

It's spread by direct contact
through an open wound

or ingestion,
but that's the only good news.

From there, the bacteria
quickly spreads to the lungs,

where our patient's died
of either bacterial pneumonia

or pulmonary embolism.

Where are they
all getting it from?

Well, all the infections came

from different departments.

I mean, it could be anywhere
in the hospital.

Ten more patients
just tested positive.

So what do we do now?

Well, we have
to call the NIH.

I mean, this could be
in other hospitals.


I'll call the top people
at the CDC.

We'll get their infection
control team here,

we'll find a treatment
for the infected,

Dr. Sharpe can conduct
a hospital-wide search

for the source.

Max, you've got
a plane to catch.

I know, but there's no way

I'm going to leave
this hospital in crisis.

this is more important.

There's no easy way to say
what I'm about to say.

Your son...

Was there
another manic episode?

No, it's not that.
Where's our son, doctor?

Your son contracted
a bacterial infection

here at the hospital, and...

He passed away.

I am so sorry.

Okay, are
the cameras in here?

Excuse me?

I don't know how much
you know about our son, doctor.

Maybe you're part of this?

He pranks us all the time
for that TikTok thing.

He's obsessed.

He's 17.
He gets his friends to help.


No, I-I assure you, I'm not--
All right.

Maybe you're a part of this,
maybe he's playing you.

I really don't care.
But I want to see him now.

Mr. and Mrs. Mancini,

I am very sorry,
but your son is dead.

All right.
Enough fooling around.

I want to see Kaelen now.

Dr. Goodwin?
Simon Holgate, from CDC.

Yeah, where is Julie Framm
or Dr. Wu?

Sorry, we just had
a major bacterial outbreak.

We've already lost patients
and our ICU's

completely overwhelmed.
We need the A team here,

and you seem
a little Gen Z-ish.

Dr. Goodwin,
I started at the CDC

straight out of Johns Hopkins.

I've resolved crises
in Ghana, India,

most recently at the NIH
in Bethesda,

where I identified
the frame shift mutation

in their KPC outbreak.

I am the A team.

Everyone, listen up.

All non-trauma patients
have been diverted,

but we are still up
and running.

Everything needs to be cleaned
and disinfected.

If in doubt, toss it.

Years of medical school,
but they can't make

a decent pot of java
to save their lives.

The coffee.

This stuff like's mud.

You got to ice it down
to make it drinkable.

I'm actually
a latte guy myself--

There is a superbug
infection running rampant

in the hospital,

and you're talking
about coffee.

Why do I even try?

Addison Stadler,
24-year-old male.

motorcycle accident,

head trauma,
unresponsive in the field.

Trauma one, Shinwari,
you're with me.

Let's go.

Addison, can you hear me?

Pupils are fixed and dilated.

GCS score of three.

He's becoming hyperthermic.

Complete brain stem

We've got to keep
his temperature under control.

Wrap his body in ice and
I'll grab a cooling blanket.

Check his license.
See if he's an organ donor.

He's not coming back from this.

How's it going on your end?

Any connection
between the patients?

None that I can find,

but I need you
to take over the KPC ward.

How bad?

It's getting worse
by the minute.

Okay, go.
I'll head up there now.

I heard your patient's lungs

are stiff
and difficult to ventilate.

Yes, and I paged
for a general consult.

The chair of surgery
doesn't need to swoop in.

If it's a possible
KPC infection,

I need to know about it.

And, Lyn, you should know

that I'm in for complicated.

And being with you has shown me

that I might even
like complicated.

Course rhonci throughout
with diminished breath sounds.

Left lower lobe.

That's how my last patient
with KPC started.

X-ray tells the same story.
All right.

Well, there's no treatment
for this,

but if we can remove
the infected lobe

before it spreads
to the rest of the lungs,

we might be able to stop
the infection in its tracks.

That's a long shot.
It's all we got.

tell me you got good news.

I put the CDC's strongest
antibiotics in each dish--

Cipro, Colistin, Vancomycin.

Bacteria should not be able
to survive in this environment.


New Amsterdam's KPC strain

not only survived,
it flourished.

Nothing worked?

This is what antibiotic
resistance looks like.

New Amsterdam is
the third hospital this year

to get an infection like this.

And what happened to patients
at the other hospitals?

They died.


There must be a common link,

but all the infected
came from different floors.

They were admitted
to different departments,

and given various treatments.

From arrival
to first symptoms,

looks like roughly a 48-hour
incubation period

for the bacteria.


let's go back
to hour one for every patient.

Where did they enter?

All but three went in
through the ED.

Okay, then what?

Six went through radiology
for imaging.

And five went to cardio.

Okay, then those
are our common links.

We need to put the ED
on full diversion

and lockdown cardiology
and radiology.

We have to test
every square inch.

Don't we need the medical
director to authorize that?

Well, when she returns, you
can tell her to give me a ring.

Okay, guys, let's go.

So you're telling me
the strongest antibacterial

the CDC has won't work?

It doesn't even make a dent.

Well, then we need to think
of something else, and fast.

Our supplies are pushed
to the brink.

I mean, the ward you just put
me in charge of is almost full.

Okay, what about something
other than antibiotics,

like phage therapy.

I've already tried it.

Nothing in the phage trials
works on this train.

like pegfilgrastim?

Or heavy doses of probiotics
for microbiota modulation?

They're good as
preventative measures,

but it's too late
to help those already infected.

What about CRISPR?

We could alter the Cas9 enzyme

and turn the KPC gene function
against itself.


It's experimental and time
consuming, but it could work.

Let's do it.

Can you believe this, Thora?

You believe what this kid
puts us through?

Don't yell at him.
I'm not going to yell at him.

He's gonna know I'm over this.
Okay, okay.

The denial of death,
of our own mortality,

of the mortality of the people
we love, it is essential.

If we were constantly aware
of our own fragility,

of the emptiness
that we are this close

to all the time,
we would be filled with terror.

Right now your brain
is trying to protect you.

I am trying to protect you
from that terror,

but if I open that door
and I show you your son--

Open the door, doctor.


Oh, my God.




Mr. Mancini, I know
the pain you must bein--

This ward is
KPC patients only.

That's why we're here.

Don't you dare be nice
to me now.

Walsh hasn't been anywhere
near radiology all week.

And we've cross-checked
his whereabouts

with all other departments.

Which leaves us with this.
Here's our epicenter.

Full resection of the left
KPC-infected lobe complete.

I see pus on the right lung.

Oh, damn it.
That is KPC, all right.

We can probably
resect the right lobe too.


Won't matter.
It's spread.

It's everywhere.

So our only option
will be a transplant?

Yeah, I guess we can
put her on ECMO.

That'll buy her 36 hours
to find a donor.

And if we don't find one?

Time of death, 2:14 p.m.

I've checked
everyone's results on CRISPR.

It's not working.
We just lost another one.

It was immediately degraded
in the body.

Okay, then we just have
to think of something else.


Test every nook and cranny,

trash can, table,

chair, catheter bag,

stethoscope, suture tray,

and I hate Mondays mugs
in this department.

Something is infecting people

and we've got to find out
what it is.

There's too many

I hope you pushed your flight
to next month.

Well, it'll take
as long as it takes.

All right, let's try target
signaling and regulation.

Unless you have
a time machine,

that's theoretical.

Okay, then we can change
the patient's microbiome,

and we can do
a fecal transplant--

And risk more infection?

Then how about you
give me an idea

instead of
just shooting them down.

I have tested every drug,
modeled every outcome,

and all these roads
lead to the same place.

I'm sorry, Max, but there's
no antibiotics on the market

that can fight this infection.

That could work.

Wait, what?

You're saying test
old antibiotics

that aren't in the market.

Definitely not
what I'm saying.

It's brilliant.
But it's not what I'm saying.

But it's genius.

Max, antibiotics get pulled
from the market

for specific reasons--
namely for killing people.

And I've got over 14 patients
upstairs with a superbug

decimating their bodies,

so I think we're
in hail mary territory.

So please,
can we start testing?


This isn't our fault.

No, I know.
No one is saying it is.

Yeah, but how could he
be here one minute,

and just--
the next minute, he's--

Our son is dead.

You know what, Dora,
let's go.

We don't have to stay here.

Our baby is dead, Dominic.

I'm not going back
into that house.

That emptiness.

We can find you
somewhere quiet to grieve here.

What, in this hospital?

This place that killed my boy?

This isn't the hospital's
fault, Dominic.

It's yours.

Kaelen was never good enough
for him.

He never gave that boy an inch,
so of course he acted out,

and ended up in here.

Yeah, yeah, listen to this.

Perfect mama's boy,
could never do anything wrong.

You know, I saw this
coming for years,

but she would
never listen to me.

All she could do
is protect him.

You screamed at him
every day.

I did not scream--
No, stop!

You can't--
you cannot blame each other.

All she ever did
was blame me, always.

Oh, Kaelen.



Without our little boy,

what do we have?

They're sick because of us.

This is a hospital.

Some people get better.
Some get worse.

Yeah, but ideally we're
not the ones making it worse.

My sister died here.

From an infection
just like this.

I remember you telling us
that on your first day.

All the doctor
said to me was,

"I'm sorry,
there's nothing we can do."

I felt helpless.

How can I leave this hospital

when it's happening
all over again?

Then don't.

Guys, I know you're all
exhausted and frustrated,

but people are--
are counting on us.

Walsh is counting on us.

Okay, look, everybody,
take a coffee break.

That might help give us
a second wind.

The iceman cometh.

What does that mean?

Oh, it's just an inside joke

all the residents
have with Walsh.

We nicknamed Walsh
the iceman

because he always complains
that our coffee is too strong.

He always has to dump
a ton of ice in his mug

to water it down.

Drives him crazy.

How old is this ice machine?

It's older than all of you.

Thank you.

We found our infection point.

Now what else was
this machine used for?

I hate feeling lucky.
Well, our patient is lucky

that Mr. Stadler
was an organ donor.

You and I can feel grateful.

Transplant team ready?
Yeah, they're coming in now.

They'll harvest both lungs
to give Maru the best shot.


Is that Addison Stadler,
motorcycle MDA?

Yeah, are you assisting
with the transplant?

You need to call it off.

That patient's lungs were
exposed to the KPC bacteria.

The ED wrapped him in ice

to control
his body temperature.

That ice harbors the bacteria.

My patient needs these lungs.
She only has hours left.

I understand that,
but you can't use these.

They'll be a death sentence.

We've got something,

an antibacterial solution
that worked against the KPC.

What did I tell you?

Hospital spent way
too much money training you.

No way we're
gonna let you die.

Your bedside manner
is a thing to behold.

So what's the drug?

From the 1950s?

Wasn't that taken
off the shelves

because it decimated
people's kidneys?

Technically yes,
but as we give people the drug,

we'll simultaneously
administer dialysis.

So we keep them alive

but we risk destroying
their renal systems?

Is that really
our best solution?

At the moment,
it's our only solution.

We're not quite ready
to press go.

We haven't tried it
on a patient yet.

I should hope not.

Try it on me.


How's he doing?

He's gonna make it.

We've done all we can.

He has to make it.

I know.




Blood vessels are degrading.

How much longer do you
give the patient?

Fifteen minutes, tops.

Dr. Reynolds, you're a go
on your lung transplant.

New donor?
New antibiotic.

We can treat the infected lungs
of the motorcyclist.

Now you can feel lucky.

All right, everyone,
you heard Dr. Sharpe.

Let's get to work.


would you come over here
and sit down with your wife?

Thank you.


Can you two look at each other?

Right now you're both in shock.

You are both
in unimaginable pain.

You are angry.

You are lost.

But that doesn't mean
that this is the end.

It doesn't have to mean that.

An event this traumatic

can actually bring you
closer together.

Because right now...

you are the only one
who truly knows

what the other one
is experiencing.

You are the only one
who knows what the other one

is going through,

and what comes next
is going to be a challenge,


Things are not going to go
back to the way they were.

They will never be the same,

but don't you dare
turn on one another.

Instead, turn to each other.

Lean on each other.

You embrace
your grief together.

And above all else, you talk.

You really talk to each other,

because that is how
you will survive this.

♪ Lying on my back

♪ Dry your smoke-stung eyes

♪ So you can see the light

♪ Staring at the sky

Thank you for sticking around.

Of course.

How are you gonna
break it to Helen?


That you're not going
with her.

♪ Watching stars

♪ If you leave

♪ When I go

♪ Follow me

♪ In the shallows

♪ If you leave

♪ Find me

Hi, this is Trevor.
You know what to do.

Hi, Trevor,
this is Dr. Frome--

Iggy from New Amsterdam.


listen, about the job,

could you start on Monday?

Okay, get back to me.
Thank you.


♪ When the time comes

♪ On the last day

I thought about
what you said earlier.

And I'm glad that you're up
for complicated because...

I'm pregnant.

♪ Will you run away?

♪ Will you run away?

♪ And let it all rain down

That was good work today,
Dr. Shinwari.

Hey, stop.

You lied to me.

I asked you if this residency
was on the level,

and you said yes.
You said it was all me.

It was all you.
Okay, you earned it.

I just made sure
that everyone knew it,

and if I hadn't,

I mean, you'd be half way
across the country.

You'd be gone.

We'd be over.

♪ If you leave

Leyla, I would write

a million dollar check
to keep us together.

So you got a deal?

That's not what I meant.

That's the only
honest thing you've said.


You bought me clothes, food,

and I went along with it,
and that's on me.

But the one thing
I thought I had earned

was just paid for
like everything else.

You didn't do this for us.

You did this for yourself.

Leyla, I love you.



You tried to own me.

You bought me.

That's not love.

♪ Lying on my back

♪ Lying on my back

♪ Lying on my back

♪ Watching stars collide

♪ Watching stars collide

♪ Watching stars collide

Burden me.

♪ Watching stars collide

JFK, terminal four.