“Everything I have done in my life is an effort to improve the system. Just because you know it’s broken, doesn’t mean you stop trying.” – Dr. Baran Al-Hashimi
It is this very quote that sets the tone for The Pitt, an HBO Max original drama series created by R. Scott Gemmill that portrays the realities of American health care. Each season consists of a single 15-hour emergency room shift, each episode representing one hour of said shift. The show is currently halfway through its second season, and building on its Emmy award-winning debut, it sets an impossibly high standard for medical dramas. This time, the shift is during the Fourth of July, one of the busiest days of the year for health care workers. The Pitt‘s unabashedly visceral and uncomfortable storytelling sets a new tone for how television dramas should confront reality in an increasingly violent and chaotic world.
The season opens with protagonist Dr. Michael “Robby” Robinavitch (Noah Wyle) riding his motorcycle without a helmet on his way to his last shift before a three-month sabbatical. The first episode then immediately immerses us back in the dynamic hierarchy of physicians, medical students, nurses, security guards and paramedics that comprise Pittsburgh Trauma Medical Center’s emergency room, or the titular Pitt, as Dr. Robby calls it. As the plot progresses, the staff is forced to manage a sudden onslaught of cases triggered by the closure of a nearby hospital (the reasons for which I’ll leave you to discover) on top of their typical chaos on July 4.
In continuity with season 1, the level of medical accuracy remains startlingly high. As a certified EMT, I’ve grown weary of the unrealistic pattern of one-in-a-million medical mysteries found in many other medical dramas. The Pitt is different. It strays away from the glamour of medicine, instead depicting unpleasant procedures, gross anatomy and the buzz of heart monitors that replace a traditional score.
The season also extends beyond medicine to treat America’s most pressing “diseases” — ableism, child abuse, gun violence, homelessness and mental health stigmatization, just to name a few. Take, for instance, a deaf patient who becomes increasingly, but silently, more frustrated over a lack of reliable interpreters, preventing her from getting the care she needs.
Most importantly, the series frequently includes scenes of the mundane administrative duties that health care workers need to perform, including charting and sorting out health insurance discrepancies. For this reason, rather than try to predict plot twists and outcomes, I urge viewers to instead remain present in the story’s unfolding and empathize with the journeys and struggles that the characters undergo.
This level of nuance extends to the series’ characterization. The show is particularly masterful in preventing the viewer from forming conclusive impressions of any single person. Despite a limited number of scenes and a relatively large cast, The Pitt is able to imply that there are missing pieces of the puzzle for each character – an unexplained scar, an odd look, a short piece of dialogue. The show also depicts the complex entanglements between characters that drive the story forward, such as how residents Dr. Melissa “Mel” King (Taylor Dearden) and Dr. Frank Langdon (Patrick Ball) push and support each other intellectually and emotionally.
Dr. Baran Al-Hashimi (Sepideh Moafi), a new attending physician poised to replace Dr. Robby during his sabbatical, serves as a quintessential example of the series’ compelling characterization. Dr. Al-Hashimi is an advocate for medical innovation and implements “patient passports” and medical simulation dummies to do so. It is Dr. Al-Hashimi who delivers the quote regarding fixing a broken system, a conviction that eventually spurs charge nurse Dana Evans (Katherine LaNasa) to advocate for an incarcerated patient.
Yet, the series adds nuance to this determination by also depicting Dr. Al-Hashimi’s vulnerability. She subtly code-switches, adopting a more stilted accent when speaking to white colleagues, representing a present-day struggle among women of color in leadership positions. She also previously worked in the maternity ward at the Dashte Barchi Hospital in Kabul in 2020. The most haunting aspect of Dr. Al-Hashimi, however, is the sudden and unexplained episodes of freezing followed by a call to a neurologist, suggesting that there is something about her yet to be fully revealed. The series ensures that every character, like Dr. Al-Hashimi, is seen as a human being who does not operate in a vacuum and therefore cannot be easily written off.
One of the most controversial aspects of Dr. Al-Hashimi is her advocacy for using generative AI in medical charting, a practice that is becoming increasingly common in health care settings and something I have witnessed multiple times in-person. While the show highlights generative AI’s ability to overcome physician burnout by reducing manual charting, it also depicts the technology’s capacity for error without proofreading. Given how relevant the issue of generative AI usage is in real life, I hope the season will provide more time to address it at a more nuanced level, posing deeper questions about when and how it should be used in medical settings. Regardless, bringing up the issue and refusing to take a definitive moral stance remains a bold and necessary choice to allow viewers to critically engage with the show.
It is incredibly rare and rewarding to see dramatic storytelling that is so poignant and realistic. In depicting health care workers amidst the Fourth of July chaos, the second season only deepens the gritty foundation it established in its debut. The show refuses to let characters reach a satisfying end, instead choosing friction that urges viewers to think independently about issues embedded in their stories. To anyone who hasn’t viewed The Pitt, prehealth or not, I urge you to tune in and witness the heart of a system that, however broken, still manages to beat.
