‘New Amsterdam’ Recap: Season 4, Episode 21 “Castles Made of Sand”


Life at New Amsterdam isn’t as planned after Veronica’s resignation. The hospital, now without a medical director, receives a sudden influx of patients.

Lauren’s Sex Ed Class

An elder care facility in the area gets shut down leading to New Amsterdam having to take in its patients. Max questions them taking them all in and it’s explained that all the other hospitals in the area turned them down and New Amsterdam doesn’t have a medical director to make a choice on the matter.

Lauren goes through all the patients and splits them between doctors depending on the care they could be receiving but aren’t. All of them can’t be in the ED, so she moves as many as possible. Lauren bugs Max about being the medical director or at least acting in the interim role between doing this. Max declines but agrees to help her under the guise of a concerned citizen.

When checking all the elderly home patients out and placing them, Lauren learns one of them has an STD. She tells Lauren that she thought she had strep throat and lists other people that also have the same symptoms. After learning this, she needs to ask and check other patients from the home to see how far the STD spread and to get them treatment as it’s curable.

She runs into a patient that is offended by Lauren asking her and swears she hasn’t had sex but later almost dies from symptoms of the STD. When questioned on why she lied, she explains that the way she was raised, you don’t talk about sex, and people who had sex out of wedlock were made fun of. Even in the care home, they were, which raised concern for Lauren.

Lauren gathers all the patients from the nursing home and runs through safe sex practices. She starts answering questions the patients have. They have a good time while doing it. Lauren makes it fun so the patients want to engage in it all. Her patient from before asks a question to Lauren’s surprise.

Surgeries, Surgeries, and More Surgeries

When Lauren passes Floyd the folders of patients who need surgeries, he looks into them and sees many have been denied surgeries solely because of their age. He decides they’ll all be getting those surgeries because if they need and want them, they should be able to get them. He schedules all of the surgeries for that day and passes them to the surgeons of each department.

Floyd is performing a surgery when problems arise in all of the other ORs. He steps out to help where he can. Elizabeth has complications with her surgery and fights that this is probably the reason it was denied. Floyd disagrees and tags in to finish the surgery. They end up working together until Floyd gets pulled out of the room. Floyd questions his decisions at that moment.

The surgery requires immediate time-based help. They barely get it in time. When Floyd asks the surgeon why he didn’t push back if he thought the surgery was too risky, the only reply he gets is Floyd is the chair of the department.

Floyd gets interrupted when helping with another surgery and he snaps only to learn that it was his patient that was in need of help. He gets there and finds Elizabeth had fixed the issue.

When talking to the surgeons, Floyd apologizes for doing all of this. He opens them to a line of communication because he wants their input to fix the things that are broken. Elizabeth points out that it is the right call and none of them would have agreed before, but they see it now.

Life Crisis

Iggy has a nurse, Gene, come in to help out with the influx of patients. While helping patients out, Gene starts struggling to breathe. When Iggy tries to help, he claims it’s asthma but Iggy notices quickly it’s actually a panic attack and brings him to his office.

In Iggy’s office, Iggy gets Gene to open up about the stressors in his life. He starts by saying he and his wife have been fighting a lot because she feels he’s not showing up as he should be. When Gene doesn’t want to keep talking about this, the conversation shifts to how much he loves his job. As he talks, Iggy listens and his ultimate response is that his panic attacks are caused by his job.

The patient pushes back and Iggy lays out the reality of his job to him. Jobs are overworking nurses and keeping them understaffed because they can make the money off it and the nurses love their job too much to leave it. He keeps pointing it out to Gene further before Gene goes.

Gene is waiting for Iggy later and he explains to Iggy how he’s suffering because of his job. He can’t quit his job, though, because it’s important work. He breaks down in tears as he asks Iggy what to do. Iggy struggles to comfort him as he continues to cry about how this job is what he loves doing.

A Wish To Play Again

In Lauren’s patient shuffle, she passes a patient from the elderly home to Max. The patient tells Max about all the different medications he’s on and what they’re for. It’s a long list of medications and Max also picks up that he has arthritis. The patient tells him about how nothing stops his hands from swelling.

Max comes back and tells him that he thinks he can cut down the number of medications the patient is taking. He’s going to so many different doctors for so many different things but Max is asking about all of them and looking at the bigger picture. The patient hopefully asks if his hands will stop swelling up as well and Max sadly tells him no.

In response, the patient asks if Max has a phone and can look up a specific performance at Carnegie Hall. Together they watch a man play the piano and it’s revealed the man in the video is Max’s patient. He tells Max that he hasn’t been able to play for over a decade because of how his hands are. He tells Max that playing was the love of his life and every doctor treated all his other symptoms but never helped with his hands.

Later, Max returns to the patient and lets him know that he found a way to help with his hands. The risk is there’s going to be more side effects with other things because of the other medications he’s taking. He’s happy to accept this if he can play again.

Max finds his patient attempting to be resuscitated. As he reaches them, the patient’s time of death is said. He explains that he changed his medicine and Lauren explains that it was a brain aneurysm and a change in medicine wouldn’t cause that.

Wedding Planning

Virginia Sherwood/NBC

Max calls Helen and offers to help with the wedding planning. He tells her that after how their relationship has been, he’d like to have this be something that’s more planned out. She suggests they get married in a castle because she wants a big production. Max gets busy at work and has to leave the call.

Mina messages Helen and tells her she can’t come to help her with wedding planning that day. Not wanting to go alone, she calls her mom to go with her. They go and look at a castle together. Helen and her mom fight a bit as her mom has some comments about the location. After fighting more, her mom explains that places like this were built by slaves.

Helen’s mom tells her that if she wants to have this here, then she should do it. She says it genuinely and Helen tells her she doesn’t want a wedding here. She continues to say she doesn’t know if she wants a wedding at all.

Max and Helen talk later. Helen tells him that she doesn’t want to get married in a castle and Max told her that he was thinking the same. He tells her that he’s not getting on that plane back to England. He tells her that he doesn’t want to wait any longer and he’s not going to London because she’s going to come home to him. He wants to get married to her tomorrow in New York. Helen happily agrees to it all after he romantically rambles about what they’ll do.

Iggy and Martin’s Marriage Issues

Martin gives Iggy a shirt that reminds him of their first date. He tells Iggy that he’s noticed all the work he’s been putting into their relationship from therapy to fancy coffees for him. He continues to say he thinks they’re getting back to where they started.

At the end of the day, Iggy comes home and talks to Martin. He tells him that he’s been spending their whole marriage trying to make up for his shortcomings. The sweater made him realize he’s been doing it since the night they met. He breaks himself down so Martin can save him because that’s the way Martin loves him. He continues to say that because of this, Martin is the problem rather than him.

Finding Floyd’s Father

Virginia Sherwood/NBC

Floyd stops by an auto shop named “Floyd’s” looking for his father. He asks the new owner about his dad and learns the last address on file for him. The new owner mentions that she heard his dad was sick and she never knew if he recovered or not.

Later, Floyd stops by the address and talks to the super. When he asks about his dad, the man says he can’t give information out like that but also that no one by that name lives there. Floyd calls his sister when he walks away and tells her that he found their dad.

Couple Reunited

Barbara Nitke/NBC

Lauren and Leyla awkwardly try to exist in the same apartment as each other without stepping on each other’s toes.

Later, the two come home together and joke around because of the sex talk in the hospital. Leyla tries to kiss Lauren, but Lauren fights it saying it’s a bad idea before giving in.

New Amsterdam will be back next week with the season finale on May 23 on NBC at 10 p.m. ET. In the meantime, check out our other coverage of New Amsterdam!

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