I Wasn’t a Fan of Medical Dramas - Then I Watched 'The Pitt'

Minor Spoilers for season one of The Pitt

I have never been a fan of medical dramas. There are so many out there, too numerous to name, and I’ve seen the same storylines played out on multiple shows. The doctor who fakes cancer in their patients so that they can bill people for chemo? I’ve seen that storyline on three different shows: Grey’s Anatomy, The Resident, and Chicago Med. Medical dramas occupy a neutral space, neither good nor bad, just there.

Then I watched The Pitt, and it changed everything. 

To put it in perspective, at the same time as The Pitt, Netflix had just released their first medical drama, Pulse, centered around a group of residents at a level one trauma center in Miami, Florida. If you haven't heard of it, it’s because it's been overshadowed by The Pitt. The small portion I did watch of it wasn’t bad, but nothing to separate itself from the massive pool of other medical dramas out there.

A new series, which premiered on Max in January, comes from R. Scott Gemmill, John Wells, and Noah Wyle, the latter of whom is best known for his tenure as Dr. Noah Carter in the 1990s medical drama ER, where Gemmill and Wells served as executive producers. 

(The question of ER’s influence is now under scrutiny of a copyright lawsuit with ER show creator Michael Crichton's estate, but that’s another story.)

It centers on the emergency department staff at Pittsburgh Trauma Medical Center as they navigate their way through a fifteen-hour shift, hour by hour. Each episode equates to one hour of their shift, led by seniors attending physician Dr. Michael "Robby" Robinavitch (Noah Wyle) and nurse Dana Evans (Katherine LaNasa). Four years since his mentor, Dr. Adamson, was diagnosed with COVID-19, it will be Dr. Robby’s first time working on the anniversary. Not to spoil anything, but his day goes from bad to worse for Robby, and that’s before the measles. 

When ER was on television, I wasn’t even in middle school; I only knew it through the one crossover episode they did with Friends.

Noah Wyle, I apologize; I was unfamiliar with your game, but now that you’ve caught my attention, I cannot bear to look away. His gradual breakdown throughout the day is palatable; he kills every scene he has while still being a very giving scene partner. His scene with Patrick Ball (Dr. Frank Langdon) at the end of episode ten is heartbreaking and a delicious display of their talents. His breakdown in the peds room, monologue about loss to his pseudo step son Jake Malloy (Taj Speights) was, in a nice way, the worst thing to watch. 

A personal favorite performance of mine is Fiona Dourif as Dr. Cassie McKay, a 42-year-old second-year resident with an ankle monitor. Don’t worry, once you meet Chloe, you’ll realize McKay’s actions are entirely justified. There is also Supriya Ganesh as Dr. Samira Mohan, a third-year resident with the unfortunate nickname “Slo-Mo.” Robby is tough on her, but only because he knows she has more potential than she gets credit for. No doubt we’ll see her grow as a doctor, and by the end of the series, she’ll be running The Pitt like Robby does now. 

Another unique thing about The Pitt is its filming process. Unlike most shows, which shoot in order of location requirements, most shots for The Pitt were done continuously, one episode at a time. Executive producer Wells described it as such:

“People come in and they’re in the emergency room waiting room for seven, eight episodes, with a line or not a line at all. And then we see them come back and they might have two or three lines. And then an episode later, they have a huge scene. So we had to have buy-in from everyone — including all of our primary cast — that they’re going to be background [for other actors]. “You’re going to be moving through things. We’re going to see you every which way.”

For this show, it works not only to create the environment and energy of an emergency room but also, as a deliberate choice, gives them a sense of worldbuilding, which I’ll delve into later. Most of all, it works to establish the patients as characters. In standard medical dramas, patients and their families are often one-off characters, creating drama for a single episode and then departing. However, the patients in The Pitt feel much more realistic, and their actors delivered some stellar performances. 

The only patient issue that lasts the whole season is that of Theresa Saunders (Joanna Going) and her son David (Jackson Kelly). A concerned mother trying to get help for her emotionally withdrawn son, who wrote a list of girls his age that he wanted to hurt. David appears in only the first episode and the last two, but his presence haunts Robby and McKay for the rest of the shift. These four have seen each other in the finale, which showcases the rawest emotions, especially from Theresa, which drives home this mother’s love for her child. It's almost a shame we probably won’t see Going and Kelly next season, because this plot was great.

David’s plot and character could've easily fallen into the commentary on toxic masculinity and incel culture, but its so much more than that. David needs professional help, and Theresa loves her son but is not blind to his concerning behavior. 

If I had to say in one sentence why The Pitt differs from many other medical dramas, I would say this: The Pitt is a medical drama, but it’s not a soap opera, and it stresses the medical to enhance the drama.

Yes, we love when the doctors' personal lives leak through into their work; it's the standard of drama, but sometimes getting a character's backstory in this setting feels equal to an "info dump" that takes us right out of the action. In The Pitt, learning about our medical staff is as easy and fluid as learning things about our own coworkers. No long, whimsical backstories, we know what's important at the time, and let the power of suggestion and interpretation of doctors' personal lives do the rest.

Even potential romance (or lack thereof), as minuscule as it is, manages to not feel like melodramatic, high-emotion angst; it is just the natural progression of chemistry into the potential for something more.

Of course, I am referring to the prior relationship implied between Dr. Robby and Dr. Heather Collins. In any other medical drama, that backstory would've taken up a quarter of the season and ended with an on-call room hookup. Such a thing is not feasible in The Pitt, and that's quite refreshing to see. IF it happens, it happens, but their earnest talk in the ambulance is more than enough for the audience.

It’s a truth universally accepted that procedurals of any kind—doctor shows, firefighter shows, cop shows, lawyer shows—are fast and loose with their realism. They can always be counted on to be “not entirely accurate”; of course, we accept it for the sake of drama. Grey’s Anatomy had Meredith witness a bomb in a patient, nearly drowning, a crazed gunman, and a plane crash. Whatever Grey’s does, others follow, the epitome of soap opera tropes. 

The Pitt does not fall into this trap - or instead, fall into this pitt (get it?)- it does not make the tragedies of their patients' lives about the doctors. There has yet to be a cheesy monologue when, after losing a patient, a doctor will go “I hold people's lives in my hands! I’m playing god”. The writers manage not to let the doctors, nurses, and overall medical staff's personal feelings detract from the casualty as a whole; it doesn’t pause to let them cry, life keeps going, and The Pitt wants us to know that contemporary medical workers' greatest strength and most significant issue. 

The outpouring of love from year medical workers for The Pitt is surreal, not just for its medical accuracy, but for depicting the real issues they face, especially in a post-COVID-19 world. Emergency practitioners face high rates of addiction, divorce, suicide, and physical assaults, and The Pitt is making people realize that other medical dramas are not acknowledging this issue in a very human way.

World building is primarily defined as creating a fictionalized world that is comprehensible and consistent, often with a sci-fi or fantasy. But what if I told you that The Pitt also has fantastic world-building? Seriously.

A big issue with medical dramas is that they don’t comprehend that they’re all about surgeons, and nothing else. Yes, surgeons have a risky job, but OR surgery scenes all feel the same; the doctors talk about the patient's circumstances, not so subtly equate it to their real-life issue, sometimes the patient dies, and sometimes they don’t—same old same old. And nothing else. Yes, surgeons have a risky job, but OR surgery scenes all feel the same. The doctors talk about the patient's circumstances, not so subtly equating it to their real-life issue. Sometimes, the patient dies, and sometimes, they don’t—same old, 

The ER is ground zero, where the most critical patients come, often on the brink of life or death. The amount of action an ER will see is extreme. Not to mention, a hospital is so much more than its surgeons; physicians, nurses, medical assistants, social workers, the cleaning crew, even the emergency room security team, and EMTs receive well-utilized attention at The Pitt. Not only does it show love and appreciation to other healthcare community members, but from a printing perspective, it also helps make PTMC a real, thriving place. Running the ER takes a village, and the characters in all these departments weave in and out of each other's lives in a way that flows so easily.  

Likewise, the production choice to have all the cast on hand for the entire shooting means we catch glimpses of other staff and participants even when they are not the crux of the issue. Especially true in the last five episodes of this season, the audience gets to witness firsthand how the ER functions as a collective unit, pursuing individual goals. 

‘It’s intense. It’s fast-paced. It’s like theater. We are a group of players. If you can be a team player who is ready to lock in with a family, then this is the place for you.’ I was like, ‘Oh, wow, this is the first I’m really getting to know of this man. And already I love it.’”

~ Isa Briones (Dr. Trinity Santos)

I've always thought that I never cared about the realism of medical dramas, I am a big fan of 911 and The Rookie, and those two have never been known for their accuracy. I am also an avid book reader, and if I had gotten up in arms at every inaccuracy I saw, I would've keeled over at the first season of Shadow and Bone.

Still, in the case of The Pitt, it's so refreshing to see a show that goes against the tropes commonly associated with medical dramas that oversaturate the market. It makes me wonder if this is how people felt watching ER back in the day. After twenty years of medical soap operas like Grey's Anatomy, it's nice to see a show with an electric and palpable energy.