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New Amsterdam, Old Tropes

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“How can I help?”

These are perhaps the most four most powerful words in all of medicine and ones that every consultant should know well. It’s also a phrase that runs through the pilot episode of New Amsterdam, the new medical drama on NBC that debuted on Sept. 25.

The word hero is tossed around a bit too much early on in the show. So is the phrase “a new kind of medicine,” which based on my viewing is referring to the blatant refusal to do any sort of documentation (or something we could all get behind).

To give you a sense of what’s happening in the show, New Amsterdam is the name of the “first public hospital” in the U.S. That apparently means anyone without insurance can come there for care, which in the U.S. is known exclusively as a “hospital.” Although we are told it’s massively underfunded, New Amsterdam looks more spectacular than any hotel I’ve ever stayed at, let alone any hospital I’ve been in.

The pilot episode starts by enrolling a new medical director—an impossibly young doctor whose only fault is “just caring too damn much.” He is some sort of quasi-CMO/VPMA type that apparently has the power to fire anyone at any time, which is odd given current labor laws and the fact that New York is not an at-will state. But…hey, drama…am I right?

Despite its chronic underfunding, the newly minted medical director asks for everyone’s wishlist (everyone who wasn’t already fired that is) regardless of cost. Somehow, an ED attending (the ED chief… maybe… like much of the show, it’s unclear) suggests getting rid of the waiting room with no mention or understanding of its throughput or where people will go once all the ED beds are full since the waiting room has now been banished.

In a later scene, a string of scary infectious diseases that aren’t at all related or present at all the same show up in a young Liberian (don’t ask how they know he is from there since he was unconscious at the time he was being assessed) patient. Before you can look up the capital of Liberia (spoiler: it’s Monrovia), the kid is in isolation for Ebola.

The hospital has a unit where several ambassadors are admitted, making New Amsterdam’s inpatients a strange amalgam of prisoners (don’t ask), the indigent, the middle class, and…well, the diplomat class. This comes in handy as the ambassador exists for another patient’s needs.

Deus ex machina anyone?

The ED attending wanders around haunting the halls of the place, running into other doctors, telling them of patients that they know they need to see rather than staying in the ED, caring for said patients, and paging the appropriate doctors. (They did warn us that this is “a new kind of medicine.”) Apparently, the ED didn’t just banish the waiting room but attending supervision as well.

The last major scene of the pilot is where they run a code of sorts where the ED attending (who somehow now sees patients that are admitted—perhaps a natural progression in this “new kind of medicine”) thinks not bagging an intubated patient for less than ten seconds is more important than epinephrine. She gives “10 ml” (no dosage needed apparently) for some reason (because the medical director/CMO/VPMA told her to do so?) even though the patient wasn’t in PEA or asystole.

For the sake of brevity (thanks a lot cruel cruel editors!), I completely skipped two other subplots which were more fleshed out than the others, but still problematic. Still, I have significant problems with the show as you can see, but the pacing is fast, the dialogue is snappy, and I like some of the characters (and yet want to slap others). All told, despite all of the above, this show is intriguing enough that I’ll be back for more…if for no reason, but to deliver snark upon it.

Dr. Harish Kakarala is a Pulmonology/Critical Care/Sleep Medicine physician who has been accused of being a TV and film junkie (which is pretty good considering all the other things you can be a junkie of).

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