If you haven’t seen HBO Max’s The Pitt, GO AWAY NOW. Otherwise, prepare to be spoiled — and perhaps as confused as I am.
But first, some background. If you’ve already seen the show, you can skip the first section below.
What Is The Pitt About?
A blend of ER and 24, The Pitt is the creation of ER veteran (and Humanitas Prize winner) R. Scott Gemmill, who shares executive-producer duties with ER showrunner John Wells and ER star Noah Wyle. In real time, it traces one 15-hour shift (each hour being an episode) at a Level 1 Trauma Center in Pittsburgh.
Wyle plays Dr. Michael “Dr. Robby” Rabinovitch, the senior attending ER physician in this teaching hospital. The show opens on a day when new interns and medical students have arrived. It’s also the five-year anniversary of the death of Dr. Robby’s medical mentor during the COVID pandemic.
A steady stream of patients with just about everything short of bubonic plague comes through the ER over the course of 15 episodes.
The season ends with a multi-episode arc featuring a mass-casualty event at a music festival (size-wise, about on the level of the 2017 music-festival shooting in Las Vegas).
Many medical and personal storylines play out off-and-on over several episodes.
Is The Pitt Realistic?
Filmed primarily inside a sleek replica of a modern emergency department on the Warner Bros. lot in Burbank, California (just as ER was), The Pitt is lauded as perhaps the most realistic (albeit maybe a bit overstuffed with incident, for the sake of TV) and accurate medical drama ever.
The Pitt is not for the squeamish or the faint of heart (I’m neither. As long as I can’t smell it, I’m good.).
Also, I’ve spent a lot of time checking out doctors (ER docs, family medicine, internists, OB-GYNs, etc.) reviewing the medical aspects of the episodes on YouTube. For good measure, I added in Steven Ho (a ka a @steveioe), a content creator and standup comic who’s retired from a career as an ER technician.
The medical reviews are almost uniformly positive, but it’s interesting that only Ho emphasizes … well, I’ll get back to that.
What’s Good: Expressions of Faith Among the ER Staff
The show has two Filipino nurse characters (long overdue, since there are plenty in real life). One, Perlah, wears a headscarf and is Muslim; the other, Princess, doesn’t appear to be religious. I’m glad there are Filipino nurses, but this feels like a missed opportunity, since so many Filipinos are devout Catholics.
But, charge nurse Dana crosses herself, mentions prayer, wears a cross, and tells a patient that she believes in God. She has one of the worst days personally in the ER (including getting a shiner from an angry patient), but she never loses it.
Dana is kind, smart, authoritative, motherly, and a rock to Dr. Robby. Is she Catholic? It’s not stated, but the actress, who comes from a Catholic family, says so.
There’s also a Catholic couple whose son is brain-dead after an overdose. These parents must come to terms with letting their college-age child go, but also decide whether to honor his wish to be an organ donor. At one point, their priest comes in to counsel them.
As is correct in Catholic teaching, the priest says that organ donation is permissible. Dr. Robby and the hospital staff treat the parents’ faith and journey of grief with sensitivity and respect (Robby also does the same for atheist siblings losing their aged father).
While hospital administrator Gloria and Dr. Robby are frequently at odds, when the mass casualty happens, she asks Robby what he needs. He mentions prayers, and she says, “Amen to that.”
Dr. Robby’s Jewish Heart
As for Dr. Robby, he describes himself as being raised Jewish but “not sure” if he believes in God. But at a moment when he’s pushed to his breaking point and collapses in the throes of a panic attack, he resorts to reciting the Shema prayer he learned from his grandmother.
He also has a moment with Dana, as related at Kveller.com:
He does mention his Jewish identity earlier, in the show’s fourth episode. In a conversation with charge nurse Dana Evans, she accidentally attributes a quote that comes from the Book of Luke to Shakespeare. The line, he then corrects her, should be attributed to “Luke, the disciple, who probably heard it from Paul, the apostle, but what do I know? I’m Jewish, it’s not my book.”
Dr. Robby also has another nice moment, this time with Nebraska-farmboy medical-student Whitaker, who came in during his panic attack. Turns out Whitaker was an undergrad theology major:
The Usual: Hollywood Values on Display
The Pitt is obviously produced by writers with liberal sensibilities and the usual positive showbiz attitudes toward things like “reproductive healthcare” and LGBTQIA+ issues. This is not surprising. If you expect a giraffe to act like a chicken, you’ll live in perpetual disappointment.
Suffice to say that the same-sex relationships depicted on the show are far more warm and loving than most of the opposite-sex relationships. And just so you know, there is an extremely graphic birth scene involving a surrogate mother, who’s bearing the child for her dearest gay friends.
Also, the teen son of one of Dr. Robby’s former girlfriends shows up to get concert passes from Robby, so that he can take his teen girlfriend to the doomed music festival. More than once, the boy is urged to “be safe,” which includes handing him condoms.
Along the way, Princess confesses the wonderful teen sex she had under a blanket at a similar festival.
There doesn’t seem to be a lot of concern about the teen girlfriend having sex, which could result in an unplanned pregnancy (condom notwithstanding).
And that leads me to …
The Puzzling
This is where things get strange. Bear with me, this takes a while (and several episodes of the show).
A teen girl and her mother arrive at the ER, so that the girl can get a medical abortion. She is not in any immediate physical distress — and the ER waiting room is full of sick and even bleeding people — so it’s a bit hazy why she’s even being treated in the ER.
Apparently the teen and the adult woman showed up during the night shift. The attending, Dr. Abbot, told them to come back later — but they overslept. I’m not too sure what that’s all about.
Anyway, resident Dr. Collins (who is pregnant by IVF) checks the gestational age of the unborn baby. She then tells Dr. Robby (her former boyfriend) that her measurements differ from Abbot’s, and that the girl is too far along to legally receive a medical abortion.
Some doctor commentators point out that the law is different in different states, and that the girl could definitely get a surgical abortion … but that’s never mentioned as a possibility. In the videos I watched, none addressed the moral issues of abortion.
Falsifying Medical Records
When Collins goes to Dr Robby with this, he asks if she thinks Abbot fudged his numbers. Collins isn’t sure, but when Dr. Robby suggests she do the same, she refuses on grounds that falsifying medical records could torpedo her career.
So, Dr. Robby offers to do it himself, with the usual pro-choice comments about how the girl “deserves a life,” etc. Collins is told to delete any records showing she saw the patient, then Robby comes in, redoes the ultrasound and lies to the patient about how far along she is. He then instructs Collins to proceed with the medication.
Among the medical commentators, the only one I saw who emphasized the absolute illegality and career risks of falsifying medical records was Steven Ho — who is not an M.D. You can draw any conclusion you want from that.
Ho also notes that the girl refuses to look at the ultrasound, so as not to form an emotional bond with the unborn child. Bravo.
But There’s the Other Teen Mom
Just as the girl is about to down the first pill, in bursts another adult woman, claiming to actually be her mother. It turns out that the woman who accompanied the teen is really her aunt. The mother — who had given birth to the girl as a teen and says it was the “best thing that ever happened” to her — forbids the abortion.
The conflict rolls on for several episodes, with Collins eventually convincing (OK, emotionally blackmailing) the mom into giving in to the daughter’s wishes.
And Then, This Happens …
The girl takes the first pill, and bare seconds later, Collins feels pain in her belly. Off she goes to the bathroom, where she promptly has a miscarriage.
Uh, what?
This left me flabbergasted. It was dramatic, for sure, but I certainly didn’t expect it from this show, considering the attitude of the doctors and the overall tone of the series.
A priest friend of mine remarked that this was like a dark version of the Visitation, as if the spiritual reverberations of taking the pill affected the other unborn child. He said:
I doubt this was the intention of the writers, but this was my visceral reaction the first time I watched it and upon further meditation on it, days later, I’m convinced this was the spiritual reality of what happened.
I don’t know either what the writers were thinking, or if they meant for this to be anything more than a dramatic counterpoint.
But Hold On, We’re Not Done Yet …
But, a few episodes later (in episode 11 of 15), Robby finds Collins sitting by herself. She says that this was probably her last attempt at IVF, because of the cost and the physical toll.
She then confesses that she had an abortion years ago but never told the father.
Some have interpreted this as Collins telling Robby it was his baby (and Wyle’s facial expression does hint at that), but I didn’t see it that way at the time.
Collins wonders if the father will forgive her. Wyle assures her he would and then urges her to forgive herself — as she is obviously in emotional distress over the present and the past.
He then urges her to take the rest of the shift off and go home, turn off her TV, turn off her phone, take a bath, go to bed, etc. Therefore, Collins is not present for the mass-casualty event and never shows up again in the series.
So, What Was All This About?
Altogether, this is a surprisingly nuanced, complex (even contradictory) and multilayered look at the abortion issue.
My only theory is, because Wells, Gemmill and Wyle are talented storytellers, sometimes in chasing after good drama, one stumbles over the truth — because truth always hits harder than any plot manipulated to make a point.
I’d love to ask them exactly what they meant to say by this whole storyline, but I don’t think I’ll get the chance. And even if I did, I can say from long experience covering entertainment, I doubt I’d get a satisfying answer.
But, wait, there’s more …
Whither Dr. Collins — And the Actress Who Played Her
The actress who plays Collins, British-born Tracy Ifeachor, does not return for the show’s second season, which launches in January.
There was some online speculation that Ifeachor’s departure had to do with her reported membership in Jesus House U.K., an Evangelical megachurch in London. Ifeachor’s publicist denied there had been any discrimination.
In the real world, as a fourth-year resident, Collins would be unlikely to return for another year at the same hospital. Allowing she passed all the requisite exams, she would have her full medical license and be able to seek a job as an attending elsewhere, go into private practice, or enter a fellowship.
As for the character leaving before the end of the season, The Wrap quoted Wyle as saying:
“The whole end of the season is just removing bearing walls from Robby’s life,” Wyle said. “He leans so heavily on Collins and Langdon, and then you take them both away. He leans so heavily on Dana, and then she becomes compromised. Then his one last relationship, to Jake, is severed when he can’t save his girlfriend. It really was more of a, ‘Let’s take away all of this guy’s support system and have him out there.’”
“If she had been there, I think she would have been maybe one of those voices that could have reached him,” Wyle went on. “We didn’t want him to be reachable.”
So, what’s the truth? This may be it, or it may not be, but if it’s not, we’re unlikely to find out anytime soon.
My Final Verdict on The Pitt
As to the socio-political stances on the show, I never expected anything different from a mainstream Hollywood show — even if the whole abortion/miscarriage storyline left me stunned and confused.
However, in general, The Pitt is a very well-constructed, well-produced show, with interesting, layered characters, compelling plots, terrific performances and great emotional resonance.
Season 2 will bring back some characters and introduce new ones. I’m hoping that the storytelling gets even more bold, honest and balanced, especially in giving more than lip service to the power of faith.
That may be a lot to expect from L.A. writers and producers, but one can always hope.
Season 2 takes place on the Fourth of July, and here’s a preview:
Image: Warrick Page/Max
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