NBC's new medical drama, " features a medical director who tries to "change the system" at his new hospital. But can the new series also avoid the wild medical inaccuracies so common in the genre? In this exclusive 51˶ video, , of McGovern Medical School at UTHealth in Houston, takes us through the pilot episode to discuss three major plot points he found most interesting.
Also see 51˶'s interview with Eric Manheimer, who wrote the book on which the show is based.
[This review contains spoilers for the "New Amsterdam" series premiere].
Following is a transcript:
The new NBC series, "New Amsterdam" [clip].
It's supposed to be a fantasy world where real doctors actually treat patients like doctors. So, the main protagonist in the show is Dr. Max Goodwin. His sister, when she was about 9 years old, actually got an infection in this New Amsterdam hospital and died. So Max is now coming in and he wants to both literally and physically clean house in this hospital.
[Clip] Will everyone in the cardiac surgical department please raise your hand? Don't be shy. Just get them up there. Great. Great. Thank you. You're all fired.
Now, this is certainly unrealistic, because let's face it, if we want change in our hospitals, we got to meet with the doctors, we've got to meet with the administration, and figure out what is the right path and then move on from that. So firing doctors doesn't work in our system. And also, you know, we will run out of doctors if we just fire all the doctors. Now, he also tries to communicate with all of the important people in the hospital, so you see him talking to nurses, talking to janitors, talking to the other doctors. So he is trying to make a change, but I think he's a little bit unrealistic in the way he is trying to change the system.
I'd like to now discuss the boy that came from Liberia. He was traveling from a country that is known for specific infectious diseases like Ebola and Lassa fever and others.
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That was bad. I mean they should have isolated him and got him in quicker in the emergency room. He was in the waiting room for about an hour and he could have potentially infected other patients. Anyway, they get him in, and then they realized that, okay, this might be Ebola, so they get him into isolation, and Dr. Laura Bloom, who's the main ER doctor, is kind of taking care of him, and she's got a hazmat suit on, taking blood samples and all of that. So this is all correct. They're doing a good job. A little bit later, the boy takes a turn downhill and he codes and he's got hemoptysis, he's got blood coming out of the mouth, and first error -- Laura Bloom panics and she doesn't get her full hazmat gear. Just goes into the room. She's half dressed. So you know, again, if this was a truly Ebola, that would've meant potentially her life and the patient's life. So that's bad.
Second thing was during the code, she's about to push the epinephrine. Now the typical dose is one ml of one in a thousand epinephrine or one milligram and Max Goodwin who's outside now watching, he says, push 10 mils, 10 mils, and she says no, and he says push 10! So that's 10 milligrams and that's what we call high-dose epinephrine. And that, my friends, is wrong! The studies have been done and the number of people that have return of spontaneous circulation is half that of giving the standard one milligram dose and they have worse neurological outcomes. So on the Ebola patient, Laura Bloom should have gone into the hazmat gear, would have only taken another 20, 30 seconds. That was very important. And secondly, no to the high-dose epinephrine. That was a mistake.
The next case is a neurological case and it involves Dr. Neil Kapoor, who is the neurologist onsite at New Amsterdam. First of all, they bring this lady in, EMS brings her in, and they tell them, oh, you know, she's dead on arrival. And then the ER doctor kind of listened to her, and it's like, no, she's not. So I thought that was a bit odd. I mean these well-trained EMS technicians actually said that she was dead, and she wasn't! So I don't know, I wouldn't be getting those EMS guys, you know, to deal with me, that's for sure.
Anyway, the neurologist does a little bit further digging and finds out she was misdiagnosed with depression, first of all when she was on haloperidol, which made her deaf. Now that is a known complication of haloperidol, but it is very uncommon. Only about 1 in 10,000. But you know, he was right. Then she got Parkinson's as a side effect of some other medications and was put on alpha methyldopa as well as hydroxyzine and she got some muscle rigidity and other side reactions from that. Now, one of the things that he did mention, if those medications were continued, she could have even had a cardiac arrest and died. And he was correct, because some of those medications in particular are associated with prolongation of the QTc interval, which what that basically means in terms of cardiology and the ECG is that it makes her more likely to go into ventricular fibrillation and ventricular tachycardia and die. So that was correct. So overall, good diagnosis, good workup of the case. And it ended up, unfortunately, the lady ended up actually having a thymoma, so she already had 1 year to live, but they did sort her out very well. So two thumbs up to that neurologist.
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Finally, I would like to discuss Dr. Hannah Sharp. Now I really like her. Why? Because she is a little bit like me! She does a lot of the media opportunities for the hospital. So she goes on the local television. She does the radio interviews and she also presents to other doctors. And Max Goodwin tells her that she can't do it anymore. He's going to shut it down. So I was very upset with that because you know what, when we do things like this for the media, we reach out to a lot more people about health and wellness. So I believe that good education of the public is critical to a doctor's mission, and particularly a medical institution's mission, which is why, you know, we do a lot of media, to get the message out about health and wellness. So Max, I don't like you shutting down that great media doctor and shutting down her good message! And she was really famous, because she was even on "Oprah" and "Good Morning America." So keep it up. I hope Max doesn't shut you down.
So what is my final evaluation of the new show, "New Amsterdam"? Well, I'm going to give it one thumb up and one thumb down. Why? Well, I think the concept of putting patients first is a good concept, and I liked the fact that Max brought in the farmer's market, so he's got good healthy food going on there, and he's trying to get the doctors to focus on what is important, which is patient care. I will give it one thumb down, because I picked up a couple of medical errors in the show. They use the high-dose Epi, which we don't do. And they also didn't take proper precautions on that case. That could have been Ebola. And finally they didn't work with all of the stakeholders to make change. So I think if they can kind of work on those aspects of the show, they will be more realistic and they can make better change in the community.
And finally, don't shut down your media guy or girl!
Also watch: Dr. Higgins' review of the pilot episode of "The Good Doctor"