“The Pitt” has a diagnosis for what’s wrong with America

Like a lot of people, I lost my primary care physician to the pandemic. He didn’t die, it’s nothing like that. From what I can tell he was done with it all, same as so many other healthcare professionals. Extreme burnout among medical professionals isn’t as rampant as it was when COVID-19 was tearing across the world unchecked, but it’s still a major concern. Have you tried to find a PCP lately? The next one I landed quit within the year. The doctor I’m currently looking at has a nine-month wait.

But these are champagne problems; at least I have health insurance. We all might have it by now if the concept of universal healthcare hadn’t been politicized into nuclear toxicity. Then again, most of us couldn’t have imagined that a lethal virus or vaccines or wearing masks would become political hot zones.

All of these and more converge in “The Pitt,” where creator and showrunner R. Scott Gemmill invites us to have a seat to witness one frantic 15-hour shift at the emergency room of the fictional Pittsburgh Trauma Medical Hospital.  

“The Pitt” is medical fiction that isn’t designed to make us feel better about how badly our excuse for a healthcare system is failing patients and healthcare professionals. If the pandemic pushed many generation practitioners to quit, imagine the toll it took on emergency medicine. In a 2023 survey conducted by Medscape, emergency medicine reported the highest rates of burnout, at 65%, followed by internists and pediatricians.

At the same time, Gemmill staffs his emergency unit with figures who keep showing up despite the grueling caseload and brutal psychological impact, which makes watching it a hopeful experience.

Since the drama stars Noah Wyle as Dr. Michael “Robby” Robinavitch, the attending physician on the day shift, associating it with NBC’s “ER” is understandable. Wyle, that classic’s longest-tenured cast member, is an executive producer alongside “ER” creator John Wells. It also minted a cinematic superstar in George Clooney, who, for better or worse, defined much of its legacy.

Robby, as his colleagues at The Pitt call him, is not John Carter. Neither is he the flinty survivor or gruff hero playing God that other medical dramas love to hold up. Years after the world has resumed some version of normal, the crushing wave of dying and dead that overwhelmed Robby’s emergency room during the pandemic has left him wracked with PTSD. As one of the most senior and skilled in the hospital’s emergency unit, he’s expected to be caring, nurturing and encouraging. Robby is not allowed to break, even when a nightmare drops into his midst.

Taylor Dearden, Noah Wyle and Shawn Hatosy in “The Pitt” (John Johnson/Max)

Robby is our guide through a too-long workday, where he and his fellow doctors and nurses are overworked and strung out. Flanking Robby are his trusted senior residents, Dr. Collins (Tracy Ifeachor) and Dr. Langdon (Patrick Bell). They may view him as their captain, but their charge nurse, Dana (Katherine LaNasa), is really who’s keeping the place afloat.

As for the technical parts, doctors who watched “The Pitt” each week between January and mid-April praise the producers for mostly getting the diagnostic and surgical details right. But the message hitting the rest of us squarely between the eyes is that our emergency rooms are where the nation’s broken policies wreak havoc.

“The high rates of physician burnout are being caused by a myriad of factors stemming from our broken health care system,” says a 2023 report by The Century Foundation. It goes on to list a few of the factors, including for-profit motives, politicization of healthcare decision-making, systemic inequities, and lack of physical and psychological safety.

This pretty much captures the gist of the show’s debut season.

By the end of the Pitt team’s marathon day, they have endured the worst of what people can do to each other. They’re also committed to healing all the open wounds around them, even at the expense of their own well-being.

When a dropped scalpel impales a surgeon’s foot during a procedure, she can only groan and keep cutting and sewing as the blade sticks out of her foot. Later, she sews herself up. When a green resident faints, her fellow physicians wait for her to revive before tossing her back into the fray. When the place floods with gunshot victims and a doctor crumbles under the despair of a loss, there isn’t time for that person to rest. They can only accept an extended hand that pulls them back to their feet.

Isa Briones, Katherine LaNasa and Gerran Howell in “The Pitt” (John Johnson/Max)

The Pitt is a teaching hospital where the residents learn lessons medical schools don’t teach. It’s also inadequately resourced, thanks to a management that refuses to pay nurses a decent wage and, instead, sends its top representative to pester Robby about raising satisfaction scores. The bean counters expect their doctors, who yank people back from the brink of death and care for ailing folks screaming epithets at them, to do it all with a smile.

But it’s the fresh meat that makes spending one of the worst days in this ER riveting, even uplifting at times. Broadcast dramas lean into the classic lures of personal conflict and romance more than accuracy. “The Pitt” puts that to the side in favor of showing viewers who these people are in the face of the worst possible scenarios, either for one person, or family, or for a city. Residents Mel King (Taylor Dearden), Trinity Santos (Isa Briones), Dennis Whitaker (Gerran Howell) and Victoria Javadi (Shabana Azeez) receive a baptism by fire on their first day of the job — or, to us, the first season.

Start your day with essential news from Salon. Sign up for our free morning newsletter, Crash Course.

During a single shift, the doctors confront mental health crises, drug dependencies, unwanted pregnancies, and one unexpectedly early and swift delivery. They see and treat heart attacks and strokes, or don’t see them, learning that sometimes the people they think are fine to leave waiting on gurneys aren’t.

We learn the emergency room also doubles as an elder daycare or shelter for people who have been forgotten by their families or communities, while its waiting room is a repository for frustration, entitlement and anger. The world’s changed, as Dana exhaustedly observes. Tempers are shorter. People are angry. “And we’re still just trying to help,” she concludes.

The first season ended in April and dropped weekly, but waiting to gulp down episodes in a couple of sittings may be more rewarding than taking it in over a couple of months.

Binging “The Pitt” allows us to remember that we’re watching one day, and one place, where a whole lot of short-sighted and greedy legislative decisions flock, leaving it to a group of dedicated people to patch up the victims — us — and keep going. That also acknowledges that our collective sickness is one of broken hearts and spirits, leaving it up to us to either address that diagnosis or accept the risks of allowing it to run its course.

All episodes of “The Pitt” are streaming on HBO Max.