How the Break-the-System Fantasy of NBC’s New Amsterdam Offers Hope in Dark, Revolutionary Times
The show uses its fairy tale powers to reflect the systemic injustices and bureaucratic failures endemic to the American healthcare system.Photo Courtesy of NBC TV Features New Amsterdam
“How can I help?”
When New Amsterdam, NBC’s break-the-system medical drama, first premiered as part of the network’s Fall 2018 prime-time slate, this simple question was repeated so often, and with such unflagging sincerity, by Ryan Eggold’s pot-stirring Medical Director protagonist that you couldn’t throw a digital media stone without hitting a critical review gleefully ready to mock it. Even Paste’s own former TV editor, Matt Brennan (a self-proclaimed New Amsterdam apologist!), declared its “metronomic refrain” absurd.
And yet, as anyone who’s watched the series grow into itself over the past two years might tell you, Dr. Max Goodwin’s How can I help? has evolved from the kind of cheesy catchphrase my fellow critics derided as prime-time pabulum, to the kind of bullishly anti-cynical mission statement it’s hard not to find inspiring—not least coming from a blockbuster broadcast medical drama. Because here’s the thing: As many unbelievably sweeping, pie-in-the-medical-sky changes as Max seems to make at New Amsterdam in those first few episodes that critics were sent for review, the systemic injustices and bureaucratic nightmares baked into American healthcare are so deeply rooted that even a white savior complex as well-meaning and robust as Max’s has proven not nearly enough to dismantle it all in one go. Or two. Or three. Or a hundred.
How can I help, as repeated ad nauseam in an exhausting Episode 2 walk-and-talk montage set to the series’ signature percussive soundtrack, reads out of context as a middling baby medical drama trying way too hard to accomplish nothing, so much as the sense that Mac is patronizing an entire hospital full of medical professionals. How can I help is repeated by Max even when the system knocks him back seven paces; even when New Amsterdam lose patients to bad insurance, state violence, and rotting city infrastructure; even when the Board of Directors sends a babysitter to force him to cut important programs from a bloated budget; even when a barely disguised Sackler family pulls support from the entire hospital in retaliation for him tearing up their blood-money opioid contract; even when he loses to the implacable forces of racism, classism, sexism, capitalism, opportunism, and just plain human intransigence again and again and again. Yet in each it reads as something entirely different. How can I help, as picked up and repeated by the various department chairs and administrative staff who make up the rest of the series’ ensemble cast (Freema Agyeman, Janet Montgomery, Jocko Sims, Tyler Labine, Anupam Kher, Zabryna Guevara and Debra Monk among them) changes it all the more.
Or, to return to Matt Brennan’s metaphor: Sure, a metronomic refrain, given nothing to do but repeat, can ring absurdly hollow. Given context and a bit of meditative grit, though, the same metronomic refrain can instead be deeply grounding. And context—now that we’re two 22-episode seasons, one global pandemic, and a long-awaited national reckoning on systemic racism and state-sanctioned police violence in—is something we’re not short on. Watching New Amsterdam right now, that one simple question, How can I help?, asked cheerfully, exhaustedly, resignedly, blackly, openly, honestly, over and over and over again, feels like nothing so much as a vital reminder that there is real value in always being willing to fight.
To be fair, the pillories my fellow critics ran against New Amsterdam when it first premiered weren’t without merit. They didn’t have to be so tart about it all, but from the start, the series—which was loosely adapted for television by David Shulner from Eric Manheimer’s memoir, Twelve Patients: Life and Death at Bellevue Hospital—really was trying to do way too much, to way too little effect. In the pilot alone, Max surprises the cynical, mostly Hispanic janitorial staff by addressing them as equals in perfect Spanish, fires the entire cardiothoracic department (but one) for prioritizing billing over patient care, pulls Agyeman’s talk-show-hopping Dr. Sharpe from her gig courting public attention for donations to come back to New Amsterdam to Be A Doctor(™), institutes a fresh produce market in the hospital’s lobby, begs his pregnant wife to come back and try once more to make their marriage work in spite of the all-consuming job he took without telling her, solves (?) Ebola (?), and reveals (at least, to Sharpe) that he has throat cancer. As many critics happily clowned on, Max isn’t just shown to be The Best Doctor Ever through starry-eyed policy changes and stirring motivational speeches alone (e.g., “We all feel like the system is too big to change, but guess what? We ARE the system. And WE need to change. Let’s get into some trouble. Let’s be doctors again.”)—he is literally named Max (ultra) Good (yes) Win (victory!).
There are valid criticisms of the fact that New Amsterdam seemed to be suggesting healthcare’s deeply rooted problems might be solved by One Good Dude just caring enough. But none of the critics I read seemed to take into consideration the fact that, as a prime-time broadcast drama, the show is both built to sprawl and obligated to deliver intelligible, emotionally satisfying individual episodes to a massive audience that may or may not be tuning in on a weekly basis. To be fair, Brit Trogen, a pediatrics resident from Bellevue Hospital, addressed this failure to some extent in a piece she wrote early in the show’s first season for The Atlantic, where she noted that “prime-time procedural dramas venerate the quick fix at the expense of substance, [relying], by necessity, on simplified, stylized versions of difficult medical problems.” Taking similar criticism a step further, THR’s Dan Feinberg lamented that those simplified, stylized versions of difficult medical problems, in New Amsterdam’s hands, were so rote as to be entirely forgettable.
What both of these criticisms miss—and what the series’ other critics, who wrote their reviews after screening the first two episodes, were obliged to overlook as a whole—is the fact not long after shaking off the growing pains of those early episodes, New Amsterdam proved itself to not actually be all that interested in the traditional medical-mystery-of-the-week stories that most medical dramas rely on, nor even on the genre’s other bread-and-butter feature: interpersonal social dramas of the central ensemble cast. Certainly, every episode is centered around one or two cases that Max and his team wrap up unrealistically neatly by the end of the hour, and absolutely there are compelling interpersonal stories that have developed over the course of 40-odd episodes. (Though thankfully, the wedged-in affair between Montgomery’s ED chair and Sims’ heart surgeon, which multiple critics called out as a particularly exhausting cliché, burned out within a few episodes.)
No, at the end of the day, what New Amsterdam is most interested in, as a medical drama, is all the red tape and bureaucratic conservatism that prevents doctors from actually solving the problems that bring them so many patients in the first place. There are a number of episodes devoted to Max finding ways to shift money around an already tight budget, or to sidestepping the Board of Directors to use the resources they do have in a way that actually makes sense, or to shake out people on the payroll whose jobs are obsolete so that they might be given better jobs that would benefit the hospital as an organism for care. Honestly, the fact that a prime-time medical drama has been able to execute that mission so successfully, while simultaneously developing central characters and one-off plotlines compelling enough to keep mainstream audiences tuning in week after week, is genuinely impressive.
This is not to say that New Amsterdam has turned into a perfect shining beacon upon a progressive storytelling hill. While there have been a plurality of thoughtful episodes about the indefensible disparity in health outcomes between white and non-white (especially black) patients, and even more about those between patients with good insurance and those without (the purpose of a public hospital is, after all, providing care for everyone regardless of cost), the diversity of producers, writers and directors tasked with building those stories is lacking. Of the forty-two episodes that have aired, only fifteen were directed by women, and only five by people of color—only two of whom are black. On the writing side, of the fourteen people credited, five are women, and only four aren’t white. Most notably, the number of black writers on staff appears to be equal to the number who are named David (two each). Moving over to production, the only real change to the overall balance, it seems, is that the number of Davids increases by one. And so on down the list: At the top of the heap, a lot of mostly older white men; below them, a fewer number of mostly white women; further down still, even fewer black or other non-white folks.
This is only a glancing survey of the creative team’s most superficial characteristics, but for a show so committed to telling the stories of all kinds of people, living so many different kinds of lives, marginalized and unmarginalized alike, the diversity of people working behind the scenes to tell them could be much better. This becomes especially apparent when you look at something like Netflix’s new community hospital docuseriesLennox Hill. In following four individual doctors practicing at New York’s storied Lennox Hill hospital—two white neurosurgeons at the pinnacle of their respective careers, one Latina emergency doctor, and one black OB-GYN resident (the latter two who are both pregnant)—feels more like a scripted, narrative-driven medical drama than whatever non-fiction comp titles might come to mind. The diversity of the experiences New Amsterdam is reflecting on screen—especially in Bloom’s (Montgomery) ED—is clearly a considered reflection of the population real New York hospitals like Bellevue and Lennox Hill serve. So, too, though, must there be a similarly diverse talent pool available to staff up behind the scenes, the better to give those reflections accurate and specific dimension.
Thankfully, when NBC renewed New Amsterdam earlier this year, it did so for a nearly unprecedented three seasons. Three! Three whole seasons, all at once! NBC had given a similar renewal to This is Us in a previous year, so the size of the order isn’t entirely unheard of. But for any broadcast drama to be given such a sense of long term stability—especially in this Peak TV economy—is, especially from a storytelling perspective, incredibly exciting.
Of course, due to industry shutdowns caused by the ongoing pandemic—which, pertinently, forced New Amsterdam to shelve its pandemic-themed penultimate episode at the last minute and on which, just as pertinently, new cast member Daniel Dae Kim contracted COVID-19 (he has since recovered, and no further cases have been recorded from set)—production on New Amsterdam’s next season is unlikely to start anytime soon. That’s okay. With more than 40 episodes already available for new viewers to catch up on—and with the likelihood that many of those same viewers will find themselves caught up in the shards of America’s broken healthcare system, the longer both the pandemic and current historic rates of unemployment persist—there’s more than enough of Dr. Max Goodwin’s brand of break-the-system fantasy not just to hold us for the moment, but to inspire more of us to turn to our communities and take up the metronomic refrain, How can I help?
New Amsterdam is currently streaming on the NBC app. Once Peacock launches, it will also be available streaming there. Lennox Hill, also worth your time, is available to stream on Netflix.
Alexis Gunderson is a TV critic and audiobibliophile. She can be found @AlexisKG.
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