The Pitt has the remedy for what ails so many medical dramas

Very early on in the first episode of The Pitt, Max’s hospital drama that reunites some of the band of ER (including executive producer John Wells, showrunner R. Scott Gemmill, and star-turned-producer Noah Wyle), Wyle’s character, Dr. Michael “Robby” Rabinavitch, seeks out Jack (Shawn Hatosy), a colleague from the emergency department—only to find him leaning along the very top railing of the hospital’s very high roof. 

In any of the myriad of scrubbed-up weepies that picked up ER’s scalpel, from Grey’s Anatomy to Chicago Med and New Amsterdam to The Good Doctor, series that veer from high drama to arguably unintentional camp, the ER chief’s colleague/friendly rival making even a casual show of suicidal ideation would dominate an entire Very Special Episode about caregiver burnout. But The Pitt is no such program.  

Instead, Robby sighs, and in a warm yet weary baritone that crackles with the wisdom and ache of his years, says, “This is the job that keeps on giving. Nightmares. Ulcers. Suicidal tendencies.” It’s enough to bring Jack on the right side of the railing and it also serves as a careworn mantra for a show that is trying to answer the inevitable question left in the slight hitch at the end of Robby’s voice: Is it worth it, though? 

While the conceit of the show might be somewhat novel compared to other medical soap operas—each hour-long episode follows one hour of the 15 hours comprising a shift at the fictional Pittsburgh Trauma Medical Center—this first installment, covering 7–8 a.m., hits some of the standard tropes viewers might expect. It’s the first day on the job for an assortment of doctors in training, including Whitaker (Gerran Howell), a farm boy making good in the big city; Javadi (Shabana Azeez), the prodigy living in the pressure cooker of two doctor parents who happen to be bigwigs at the hospital; Dr. Santos (Isabel Briones), a snarky hotshot; and Dr. King (Taylor Dearden), who’s sweetly quirky yet intense in ways that are hinted to signify neurodivergence. 

Serving as our fresh-faced squad’s guides into the neon-lit underworld of a bustling ER, there are Dr. Collins (Tracy Ifeachor), who is concealing a pregnancy; Dr. McKay (Fiona Dourif), the single mom with a secret of her own; Dr. Langdon (Patrick Ball), whose good looks have him nicknamed “ER Ken”; and Dr. Mohan (Supriya Ganesh), known for a compassion that gets good results—but runs her afoul of Robby, or, more specifically, the demands put upon Robby from a caricature of a hospital administrator (an underserved Michael Hyatt) to move patients in and out faster. 

If that sounds like a massive cast of characters, well, it is. And The Pitt sometimes struggles under the heft of its obligation to all of them, especially in this first episode. The show is best when it’s in motion and when it uses patient encounters to provoke more meaningful character moments and growth. One of the central patient throughlines of this hour involves a woman who may or may not have been pushed onto the train tracks and the good samaritan who hit his head saving her life. Confronted with the grisly reality of the woman’s degloving injury, which essentially turns her leg into a pulp of muscle and bone (kudos to the special effects team), Javadi, who has experienced everything in books, passes out. Her status as the golden child born to a life in medicine suddenly challenged, she’s forced out of the trauma bay to attend to the huddled masses in the waiting room with Dr. McKay. It’s her first foray out of the bell jar of her privileged life, and Azeez is more than capable of playing it with the revelatory flourish of a young woman discovering her true calling.  

Meanwhile, Whitaker encounters a gregarious older gentleman, who seems to be exhibiting signs of gallstones after a night out on the town celebrating his anniversary, and the broke med student must resort to stealing sandwiches off the food cart to survive. Howell is effective at conveying Whitaker’s silent anxiety that he doesn’t quite belong here—in the ER, in the city, in the profession, in the tension between the bristling, tremulous tautness of his posture and the naked hangdog fear in his eyes. Yet when the chatty patient asks him about his background and opines that his parents must be proud of him, Howell releases a pressure valve in his body, allowing himself to relax and light up. 

Of all the pairings, the laconic Langdon and sensitive, eager-to-succeed King, seems to possess the most compelling friction. Dearden distinguishes herself among the ensemble for taking a character who could grate in her obsessive quest for perfection and endowing her with a spirit of deep, driving empathy that rumbles underneath her every action, threatening to separate the tectonic plates of her professional composure and release a magma of righteous anger. After the team has attended to the good samaritan, and sent him to a room where he may or may not wake up, she plaintively asks whether anyone has found the man’s next of kin. 

Yet The Pitt is, ultimately, Wiley’s series, a showcase for him to shade layers of brilliance, fatigue, anger, compassion, and despair into a lead performance that feels truly lived-in. For this shift happens on no ordinary day: It’s the anniversary of the death of Robby’s predecessor, mentor, and father figure, Dr. Adamson, one of the COVID pandemic’s earliest casualties. The weight of that sorrow suffuses Robby’s every movement and inflection with a heaviness that he can’t quite shuck off —even in his moments of casual victory, like when he catches the potentially life-threatening injury of a man in a bar fight or goes against hospital protocol to do a procedure to save a young athlete from crashing. 

Wyle is remarkable at giving empathy a dramatic alacrity, making the act of listening rich with purpose and potential. When Robby gives space to a concerned mother who has literally faked illness to get her son (who has written about harming girls in his class) into the ER for help, it elevates what could be a garden-variety, topical case-of-the-week into something more poignant. But when Robby pursues the boy into the lobby, he’s hit with the crushing mass of suffering patients. There’s so much suffering, and no way to help everyone. And the first hour ends in a flashback of one of the worst days of Robby’s life, one of the early days of the pandemic, the day he was informed that his friend and mentor was slipping away. 

Photo: Warrick Page/Max

If the first hour of The Pitt was concerned with introducing a broad cast of characters, the second settles more into the daily routines of patient care, where heartbreak and redemption can often dance hand in hand. After opening in flashback, in which a dazed and helpless Robby stands clad in the PPE that can’t protect him from what is about to be one of the worst moments of his life, he shucks off the memory before returning back to his patients. 

One of the patients of the day is an older man brought in from assisted living. His DNR order is very clear that he doesn’t want measures like ventilation used to keep him alive. However, his two adult children, who have medical power of attorney, are too afraid to let him go. They tell Robby they want him to ventilate their father. Though The Pitt has already delivered a rather harrowing flashback to the chaos of the pandemic, the real impact of COVID (its creeping vampiric hand of a shadow) is most acutely felt when Robby tells the duo what exactly they’re condemning their father to. As Robby describes the pain of ventilation, especially for someone with Alzheimer’s, Wyle offers a tour de force in miniature. 

The pain of putting patients on ventilators knowing that they’ll never come off of them again cracks through his voice. Despair seems to expand and catch fire inside him, like all the parts of him that had to turn into steel to do his job have melted into the tip of a dagger. In this moment, Robby’s natural gift of empathy for his elderly patient taps into the roots of a darker, more wounded aspect of him, and it’s a masterful evocation of the very real trauma many health-care workers experienced at the peak of the pandemic. 

Hour two of The Pitt is concerned with the power and limitations of empathy, with a major focus on a young Black woman brought into the ER howling in agony.She was kicked off a bus and assumed to be in a drug-related fit until Dr. Mohan correctly identifies her as a sickle-cell patient enduring a hellacious flare-up. Whitaker, who is paired with Mohan, marvels skeptically at the amount of pain medication the woman requires, quipping at her “not to go crazy” with the self-administered dosage. 

After playing the saint for the better part of two episodes, Ganesh gets to unleash a righteously arctic fury, unloading on the farm boy for his lack of empathy. He’ll learn to discover the fakers, the people who are trying to hit him up for drugs. And what he’ll also learn is that even these people deserve his kindness, since most of the time, they simply want someone to listen to them as much as they want the narcotic. Howell is wonderfully responsive, seeming to retreat into himself with shame. 

Meanwhile, two different sets of parents and sons swing into the ER. Robby takes on the case of a college kid found unresponsive in his bed, while Langdon and King find themselves confronted by a mysteriously somnambulant toddler, both boys the victims of accidental overdoses. After some medical detective work, the doctors discover that the toddler has ingested some pot gummies from his father’s pocket, inevitably triggering both his mother’s rage and an investigation from CPS. 

In her fury, the mother berates the father for leaving their child vulnerable to learning disabilities or symptoms of autism, which hits King with a lightning bolt of indignation. The case worms its way under her skin, increasingly irritating her in a way that Dearden strategically underplays (the way anyone who has had to practice hiding her upset under a veneer of detached professionalism might) until the CPS team enters the family’s room. She can no longer contain herself, rushing outside to self-soothe by singing along to “Savage” by Megan Thee Stallion—until a car rumbles up and a shooting victim spills out of it. 

While the show is trying to make a point about the overwhelming load these doctors must take on every day, there are a number of smaller patient encounters that don’t provide any depth or insight into our doctors, including a guy whose girlfriend glues the shock collar he got for her dog to his own neck (he had it comin’) and an unhoused man with scurvy (and a gaggle of rats hiding in his clothes). They don’t add much more than bursts of comic relief. 

But with so much story to cover, and so many characters to juggle, they feel like tedious distractions. Viewers would be rightfully more curious about the ankle monitor on McKay, or for, frankly, anything more about Collins, who spends the episode helping to track down the nation of origin for the poor woman who ended up on the railroad tracks and diffusing the flirtations of the cop on the case. Their flirtation that doesn’t quite come to fruition is a deftly written scene, a volleying of monosyllabic queues and throaty laughs that is given a real spark by the performers. 

Of course, Robby happens to witness this exchange, and the sly repetition of the scene, where a question is met with a look or a particular inflection of a murmur, begs the question of whether there was a past between the two. In a show that is generally about as blunt as a body electrified on a live wire (another patient of the week in an episode stuffed with them), it’s a lovely moment of subtlety and character work. And it goes on just long enough to spark intrigue without providing answers too soon. 

Then we’re off to the room of the college kid, who will not recover from his overdose, a reality that Robby reveals to his parents slowly, over a series of interactions that helps them to acclimate to the idea (as much as anyone ever can) of losing one’s child. Despite the need for beds to open up, he’s giving them the grace of dignity and the gift of time—until, of course, he absolutely can’t delay the inevitable. Empathy can make tragedy a little easier to bear, but it can’t stop it entirely. 

This is a lesson that Whitaker will also learn, when the same genial man with a gallstone, the one who told him that his parents must be proud of him, is found unresponsive. Whitaker refuses to lose this man, who seemed so warm and funny, enamored of his wife and the finer things in life, and keeps doing chest compressions, even as the other doctors tell him there’s no point. The young doctor has gained a new appreciation for his patients as people, but that doesn’t mean he can save them all. 

As Whitaker attempts a futile act of resurrection, the mother of the college boy howls her anguish into the fluorescent void of the trauma bay. All the other patients and even the doctors are cowed and awed by the power of the unbearable, as if confronting the center of the sun in a woman’s scream. Despite his own desires, and what he knows is right, Robby goes to add more suffering to the day by ventilating the older man. It’s only hour two, and we’ve already seen the entire spectrum of human emotion.  

Stray observations

• • The MVP scene for both episodes has to be when an inebriated patient and frequent flyer offers to show Robby her vagina, and, without missing a beat, he deadpans that he’s already seen it. 
• • A close second is when the rats come bursting out of the unhoused man’s coat, prompting Collins to toss up her hands and simply yell, “No!” I mean, same.