‘Transplant’ Creator Joseph Kay Previews ‘Very Big Format Jump’ for Season 4 (Exclusive)

The long-awaited fourth and final season of Canadian medical drama Transplant is hitting NBC this week, and creator and executive producer Joseph Kay spoke to PopCulture.com about what’s in store.

In Season 4, Hamza Haq’s Bashir “Bash” Hamed is “on the precipice of finishing his residency at York Memorial and officially requalifying as a doctor.”

“With his future uncertain once again, Bash and his sister, Amira, are Canadian citizens now, but are still trying, with everything they have, to build a life in their adopted country,” the official logline continues. The new season will have a two-episode premiere starting this Thursday at 8 p.m. ET. Season 3 left fans wondering about what’s going to happen with Bash, Laurence Leboeuf’s Mags, and Jim Watson’s Theo all for different reasons, so there will be a lot to look forward to. Kay, who also serves as showrunner, told PopCulture what to expect. (Interview has been edited for length and clarity).

PopCulture: What can you preview for the two-episode Season 4 premiere of Transplant?

Joseph Kay: We always end our seasons with pretty good cliffhangers. So we kind of leave Season 3 with all of our characters in a pretty big disarray. For Bash, he had become a citizen in Season 3 and decided that he wanted to kind of change his career track.And so, he was going to be a surgeon, but he decided not to be. For Mags, she learns at the end of Season 3 that she probably needs a heart transplant. Theo loses his hospital privileges. And so we kind of leave everybody with their lives in turmoil, and we hit the ground running in Season 4 from an exposition, kind of getting the audience caught up. We kind of come in at full speed in an episode that it takes a very big kind of structural departure from how we normally do it and kind of shifts point of view in a slightly disorienting way.

But we get there, we catch up on what everybody’s doing. So we take a pretty, like, drop you into the deep end kind of fast-paced approach to letting you know what’s happened since we’ve been gone and how everybody is kind of adjusting to their new reality and trying to figure things out. And we set the tone over those two episodes again and again, which is something that we do by sort of reframing how Transplant has always been a show about new beginnings and how it’s never too late for any of us to start again. And that’s what these two episodes are definitely doing by continuing to reset everybody’s story and frame some new questions and some new challenges for them and to keep on giving you portraits of these characters and saying, ‘Okay, now how are they going to respond from this and reset and start again in Episode 1?’ Like I said, a very big format jump.

In Episode 2, we do a pretty big medical field set stunt episode where we have a sinkhole open up and actually swallow a van entirely whole. And we set a lot of the action in there.

PC: Going off of that, as you were saying, Season 3 left fans with a lot of questions. What story were you most excited to expand on for Season 4?

Kay: I mean, I love all my children, but I’m always most excited about Bash’s story because it’s the one that really grounds the theme and sort of centers the show. We’ve seen Bash through the three seasons of the show. We’ve seen him kind of encounter his past while trying to become a doctor in the present. We’ve seen things he’s gone through: a war back home, being arrested, kind of losing the love of his life, escaping the Mediterranean on a lifeboat. We’ve seen him go through a lot of things. Season 4 asks what was life like for him when he first landed in Canada, in North America?

And it contrasts that story to what’s happening to him in the present tense, which is that, once again, his future as a doctor is in jeopardy because it’s the fourth and final year of his residency, and he has a hard time seeing ahead. He has a hard time visualizing a future for himself. So we have a new way of kind of engaging with Bash’s past this year and sort of setting the stage for his future. And it’s a good reset for the show, and it leads to some really interesting stories.

PC: Mags got news in Season 3 that she would have to take things down a notch with her job or get a heart transplant, be out of commission for a year. She obviously is not one to back down, and we’ve seen her try to slow down, but it never ends up working out for her. What can you tease about what kind of place she’s at now in Season 4?

Kay: She has as big a choice as any of us could ever possibly have. If she doesn’t accept the heart, she could die. If she does accept the heart, exactly like you said, it could mean a year or more away from work and never an ability to return to the form she was in. And also, any kind of transplant is a huge risk. And so it forces her to really ask herself what she cares about, what’s first in her life. And some of us don’t choose work, but her identity is really caught up in her job, and some of us do choose work. Some of us do see our lives that way.

And so, I guess I won’t spoil the decision that she makes, but I will say that we don’t shy away from drama around it, and it defines her as a character. And it affects everyone around her and especially Bash, because they had left things between them, in limbo, kind of romantically. He doesn’t even know what she’s going through when the season starts. And it gives us a really great way to reset their relationship and tell it anew without some of the weight they have both been carrying to this point.

PC: Throughout Season 3, we saw Theo struggle a lot after the crash. He doesn’t always think clearly before doing something. That was pretty evident in the Season 3 finale when he was suspended after going to the police about a patient. How is he dealing with everything when the new season comes around?

Kay: When we meet Theo in Season 4, he’s not dealing well. When we first met him in Season 1, he seemed like the most boring, most milquetoast guy in our company. But it turns out he’s actually the biggest rule breaker among them. And he has kind of learned that, like a slow-motion car crash, as his life has fallen apart. We meet him in Season 4, his hospital privileges have been suspended because he violated doctor-patient confidentiality. He thought he was doing that to protect a woman who’d been assaulted, but it still caused him to lose his hospital privileges. He’s being investigated by the board, and he’s practicing medicine remotely, like over Zoom.

And he’s really restless. He wants to make a difference in people’s lives, and he wants to jump through that computer screen. And I would say that his troubles aren’t over, and Theo really feels like he doesn’t fit into the world anymore. He can’t quite understand it, and he’s got some work to do before he finds what his place actually is.

PC: Is there anything else you can tease for the premiere or the rest of the season?

Kay: I would say that the premiere is a really fun ride, and it tells the story of kind of a group of people who started out on what seems like kind of a hiking adventure in the wilderness that takes a very dark turn, and we have a really fun time exploring what that was. And the rest of the season is the most emotional season for challenging Bash. It brings us to the culmination of our story in the most emotional possible way and puts all of our characters through the wringer before launching them out into the world on their own.

Transplant Season 4 premieres on Thursday at 8 p.m. ET on NBC, streaming the next day on Peacock.