I guess you could look at this as interesting worldbuilding: What do we do when the meds run out. But that's not the part that interests me the most, in the larger context: It's that all of this -- the pain and the shame and the violence, and the lying -- is a matter of perspective, that doesn't cross generational lines. For Rafe and Nicky and Pilar, the Old World was what mattered, and it's gone. You can't expect Quentin -- or Christie, or Alak -- to feel the same way. You work with what you've got; it's one of the reasons Datak is so fascinating, because he escaped the cage of the Old World and managed to bring the worst parts of it out with him. Pilar was taken out of one world and put into another one, and it broke her, but these kids were just born here.
Connor: "A good thing to do would be to pull over for one second and administer the cure to yourself so that you no longer have the plague."
Nolan: "I am not thinking clearly due to I have the plague, so forget it."
They are carjacked at this point by Nizar and the shaman, who have decided to hold the cure hostage until such time as the Irath are released. Nizar doesn't know it's too late for his brother, who just got shot; he wastes only a little time on the obligatory "you pretend to be the Little Wolf's father and then cage her up" stuff before they start roughing up our boys.
Stahma watches, sad, as Alak slides a ring onto Christie's finger and weeps over her; Rafe holds onto the boy tightly while he cries. When they get the call from Nolan, Stahma brings the full force of her liro around on Amanda's Casti assistant, threatening without threatening, under the guise of taking care of Rafe and leaving him to care for their children, Tarr and McCawley. And just like that, it's done: "Mayor Rosewater has taken ill, my husband is in charge now."
She thinks fast once the Irathient gets on the phone: Nizar's personal demand, for Rathus's freedom, is not doable. (There's a subtle moment where the miners on the phone cover for each other, all about how Gail the Asshole was actually endangered somehow and that's why they had to kill him.) They have to get the cure so Alak can marry into the gulanite mines, but it would be nice to dick the cure around so Amanda and hopefully Rafe can die of the plague. She whispers, without time to explain, that it's time for Datak to free them. We don't see the rest of her plan until it happens, but it is a Stahma Doozy of the first degree.