Season 4 of Transplant is finally here and creator and showrunner Joseph Kay spoke with Fangirlish about what to expect for the two-hour season premiere and the final 10 episodes.
Transplant tells the story of an ER doctor Bashir “Bash” Hamed, played by Hamza Haq, who fled his native Syria to come to Canada. Along three seasons he’s faced numerous obstacles in his efforts to resume a career in the high stakes world of emergency medicine. And Season 3 ended with Bash returning from working overseas in a Lebanon refugee camp.
In this final season, creator Kay previews what we can expect, and it’s a mixture of heartache, joy, closure, and new beginnings. And this is exciting but also sad as fans have fallen in love with this show in a time and age where everything gets cancelled left and right. But Transplant was always meant to have 4 seasons. And that means there’s an opportunity to tie things off in a way that feels satisfying for Bash, Mags, and the rest of the cast.
FANGIRLISH: Hi, Joseph. Nice to see you again. So I’m just going to jump right into it. What can you tease for this double-season four premiere?
KAY: Well, I can tease for the double season four premiere that we, as always on Transplant, leave everybody at the end of season three in a bit of limbo with some big cliffhangers. And so there’s a lot to orient the audience around.
We’ve taken a different structural approach to the premiere this time. We played with point of view a little bit, and we kind of just hit the ground running in ways that are going to get people caught up to where everybody is since we were last on the air. It’s slightly disorienting, but we think it’s really fun.
And we use these first two episodes to, you know, as always, to kind of let the audience catch up to where the characters are and set the stage for what’s going to happen in the rest of the season. We’re going to introduce a couple of the big things – it’s the final year of Bashir’s residency. So that means he’s looking at an uncertain future which is hard for a lot of us but even harder for him and the way he perceives that uncertain future. [That] kind of sets the stage for a lot of the stories we’re gonna be telling this year for all the characters.
MORE: Transplant showrunner previously spoke with us about Season 3 of the series. Here’s what he had to say.
FANGIRLISH: Speaking of Bash, I wanted to touch on Bash and Mags’ relationship. I’m just curious, particularly with some of the conflicts of Mags’s health and her kind of hyper-independence, her need for “I’m fine, I can take care of everything,” versus some of Bash’s tendencies to avoid his trauma. What can we say about their relationship and the conflicts that might come?
KAY: I mean, they had split up at the end of season three over many things. Still, maybe in an emotional sense over the fact that Mags could understand that Bash has this inability to allow himself to be happy. And that comes part and parcel with so much of what he’s been through.
And he’s made progress, looked at himself, and faced some things that are hard to face, but it’s just hard for a person to drag another person over that line. It’s too much pressure on her, and he sees that too.
And so there’s a significant weight to that, and it has defined their breakup. Also, she is, of course, as you said, she’s got this massive health situation. She’s a candidate for a heart transplant. She’s been told that she needs one.

And she hasn’t shared that with him. And she’s carrying it herself. And she knows, ‘cause he’s got such a hero complex, that if she tells him the truth, he will try to protect her. And she doesn’t want that. She doesn’t want that. She doesn’t think he needs that.
So there’s a lot of weight. So, what we do to dispel that weight is create a competition for them at work. That’s the last year of residency. There’s some unstable footing about who will get an opportunity to be a full-fledged doctor next year, and maybe they both have to go head-to-head around it.
It allows them to have fun with that and step back from all of this emotion, which, in a way, resets them over the first couple of episodes.
MORE: Just starting out Transplant? Read our review of the pilot.
FANGIRLISH: Very healthy for their personality types, I’d say with sarcasm. So, speaking of some of our other dynamic quads, Theo is suspended, handling that outcome, and we’ve seen Theo’s progression from season one to now.
He used to be a very timid guy, but things started going awry for him, and we started to see more of it come out. First, obviously verbal. So, what are we looking at when it comes to him dealing with the suspension? Is he going to get help?
KAY: Yeah, I mean, I love the way you characterize that. His arc is there. He’s pretty unmoored right now. He lost his hospital privileges because he violated doctor-patient confidentiality.
He thought he was helping a woman who had been a victim of assault, and it wasn’t his place to violate that confidentiality. And as a result, his privileges have been taken away.

And so suspended, he doesn’t know if he’ll get them back. When we meet him, he’s doing like Zoom medicine, you know, and you can feel in him this like, like you said, this anger, like, like he wants to, he wants so badly to make a difference in the world that he wants to like jump through the computer screen at these people that he’s trying to help—one patient in particular in episode two.
And he just, he’s a man who’s lost his place in the world. And he, you know, yeah, he hasn’t got help, but we are tracing the origins of a romance for him, the first one since his marriage ended with a fellow doctor at the hospital, and we’re asking if maybe opening himself up to that will help him in some way.
But Theo, you know, Transplant has always been a story about new beginnings, about how it’s never too late to start again, and Theo needs to start again. He just doesn’t know how, and that’s where he is when we meet him.
FANGIRLISH: Of course, can’t leave out June. What is June’s kind of—it’s funny, almost—Theo started in this stable place in season one, and slowly as the seasons came over, he became unstable or unsure about his life.
In contrast, June has been closed off in season one, and we’ve seen her reverse. We’ve seen her let people into her life. We’ve seen her go through traumas. We’ve seen some of her story and her history. What can you tease about how June will continue to grow and evolve?
KAY: Again, I love the way you characterize it. That’s fantastic.
She’s—yeah, we used to say she wanted to become a surgeon because she preferred her patients unconscious. She was the most closed off of the bunch, but we’ve seen her go in the other direction.
And now, when we meet June in season four, she has everything she’s ever wanted. She’s got like, she’s a full-fledged surgeon. She has a lot of autonomy for someone her age and no inexperience level.

But like, when you get what you want, something’s not quite right. And it’s just about that. That June, you know, it’s like, she has love to give but doesn’t know how to give it. And that doesn’t necessarily mean romantically, it might mean that, it might mean to another person, it might mean to herself.
But she’s, you know, that’s kind of what she’s wrestling with. And we explore it in her relationship with Mags and their friendship. We explore it in her professional relationship with Dr. Novak, this surgeon with whom she has a very kind of contested sort of platonic work romance in a way.
And we explore it in her constant need to self-actualize, which I’ve always found admirable in her. Like she’s never good enough, she’s always looking internally and how she can better herself, but she’s run out of ways to do that, so yeah.
FANGIRLISH: Yeah, so last question to you before I gush about all of the loveliness this season, ’cause as a Canadian, I have already seen it, already love it.
Because this is the final season, what few words can you tease—give me three words that will sum up the season.
KAY: Great big emotion.
FANGIRLISH: Great big emotion. I love that. I love that. Well, thank you so much.
KAY: Thank you. I appreciate it.
Transplant airs on Thursdays at 8/7c on NBC.