HBO Max’s medical drama The Pitt has struck a chord with both healthcare workers and general audiences. One of the platform’s five most-watched debuts, it has already been renewed for a second season and widely discussed on TikTok and other social media.
The show was created by R. Scott Gemmill and executive produced by John Wells and Noah Wyle, among others, all of whom previously worked on ER, another medical drama that aired from 1994 to 2009. Unlike its predecessor, however, The Pitt from the start aims to convey and denounce the real conditions health workers face in the US.
Lead actor and co-producer Noah Wyle explained in an interview:
Our initial intention was to put a spotlight on this community of frontline workers who have worked tirelessly for the last 5 years without a break since Covid. We’re really focusing on the toll that it has taken on the practitioners and the workers.
The genre of hospital dramas typically suffers from escapist tendencies, featuring godlike physicians who manage to save the day against all odds, romantic intrigues, rare mystery diseases and satisfying emotional resolutions in the closed-off, alternate reality of a hospital, where other laws exist and society and politics feel distant. Despite dialogue that leans toward the quippy and occasionally implausible, The Pitt feels “real” not just in medical terms (visual effects, accuracy of procedures and jargon), but because it reveals a crisis-ridden society in which individuals, despite their best efforts at addressing each major challenge, come up against a system that places private profit over lives–capitalism.
Wells explained that one of the major reasons to make the show was to discuss the trauma from the Covid 19 pandemic:
We are in a stage in which everyone’s trying to forget the pandemic, because it was a strange, surreal, horrible experience for everybody, with tremendous ramifications on the economy and other things, but for the people who were there, who were having patients die left and right, who are risking their lives, who had their co-workers dying, that trauma and PTSD remains. There are lots of reasons for the nursing shortage, which is severe, but the biggest reason is that so many people left. They were just exhausted, burned out, had PTSD, died, had illnesses from dealing with this tragedy that we had for months and months and months.
The series follows senior attending physician Dr. Michael “Robby” Robinavitch (Wylie) and his team at the Pittsburgh Trauma Medical Hospital’s emergency room, referred to as “The Pitt.” Each episode chronicles one hour of a 15-hour shift in the understaffed and underfunded ER. We learn in the first episode that Robby is still dealing with grief and PTSD from the loss of his mentor and colleague during the early days of the pandemic. When he arrives to start his shift at 7 am, he finds his colleague Dr. Jack Abbot (Shawn Hatosy) on the rooftop, contemplating suicide after having failed to revive a patient. This is apparently a frequent occurrence, as they both joke about it and Robby finds himself in Abbot’s position in the final episode.
The show is filmed with handheld cameras, which gives it a documentary feel. We follow a patient’s journey across multiple levels of care (triage, diagnostics, treatment) and multiple handovers between nurses, residents and attending physicians. We witness the full decision-making process under pressure, including the moments when staff rush to use the restroom, wolf down a sandwich or have an emotional breakdown mid-shift.
The cause of the crowded waiting room, the lack of time and resources are explained right at the beginning in a confrontation between Robby and hospital administrator, Gloria Underwood (Charlene “Michael” Hyatt). A key issue is “boarders,” i.e., patients stuck in the ER while waiting for beds elsewhere. While Gloria claims there are no beds, Robby argues the beds exist, but the hospital will not hire enough staff to make them available. The hospital only staffs beds when there is guaranteed revenue and relies on predictive models to estimate when beds will be needed. The ER becomes a buffer zone, absorbing the backlog to avoid staffing unused beds. Gloria attempts to blame the issue on “staff shortages around the country“ and Robby retorts that if they were paid a living wage, there would be no shortage.
One scene that particularly resonates is the passing of Mr. Spencer (Madison Mason), an elderly man brought in by his adult children. Spencer suffers from dementia, pneumonia and sepsis. Dr. Robby steers his children away from pursuing further treatment as it goes against the patient’s own wishes and would likely only cause further pain. He helps the family through the dying process with great sensitivity while juggling other patients. In the aftermath of a pandemic that robbed millions of dignified goodbyes, Mr. Spencer’s death shows the heavy emotional toll it exacts, even under comparatively “comfortable” conditions. It stands as an indictment of the forever COVID-policies of both the Biden and Trump administrations and their treatment of the elderly as expendable.
In addition to highlighting the self-sacrifice of healthcare workers and affirming the value of human life, The Pitt includes moments where the showrunners seek to educate viewers and challenge fear-mongering and disinformation.
In one episode, a child is rushed to the ER with a measles-related brain infection, and the staff quickly realize he was never vaccinated. Dr. Robby becomes increasingly frustrated with the parents who have been misinformed and are putting their son’s life in danger by delaying care. In another scene resident physician Dr. Mel King (Taylor Dearden)—who is neurodivergent and cares for her autistic sister—directly addresses a patient’s claim that vaccines cause autism.
Finally, there is the instructive moment when two women are brought in after having a physical fight in the waiting room. After determining that one woman who opposes wearing a mask needs surgery, Dr. Frank Langdon (Patrick Ball) declares: “Well, those of us who save lives for a living believe strongly that masks minimize risk when it comes to spreading disease and infection. But I want to respect your beliefs so what do you think? With or without for surgery? Without?” The patient reconsiders.
The series clearly reveals the explosive social climate in the US. Hospital staff are regularly assaulted and the final episodes revolve around a mass shooting at a music festival.
One weakness of The Pitt is that while it portrays the hospital workers as hostile towards management there are no indications of resistance. The most combative moment is when one worker threatens Gloria to “talk to our union rep“ after a colleague is attacked while on shift.
If the mission of The Pitt is to put a realistic spotlight on hospital workers, then its creators might consider, in a second season, dealing not only with the workers’ suffering but also their struggles. One website records over 100 strikes by nurses alone in the US over the course of the past five years (www.nursetogether.com/nurse-strikes/ ). The current series was shot and filmed during the Biden administration and demonstrates in dramatic fashion the responsibility not only of the Democratic Party, but also the trade unions, for the neglect and decline of the country’s health system.
Meanwhile the crisis in American hospitals has only been compounded by the measures introduced by the anti-science quacks appointed by the Trump administration to run down public health and the Medicaid system. In the space of just a few months, there has been a systematic dismantling of the infrastructure of public health and scientific research in the US. Over 20,000 scientists and public health workers have been purged, entire branches of the Centers for Disease Control and Prevention and National Institutes of Health defunded, and access to scientific data erased from public view. Programs tracking chronic illness and pandemic response are being destroyed, while gag orders silence those who tried to warn the public.
There is more than enough material for a second season of The Pitt.