Stream It Or Skip It?

When we heard about Noah Wyle and John Wells teaming up again to make the Pitt, a show where Whyle plays an ER doc in a city hospital, we thought that the show might be ER but in a different city. We weren’t the only one to get that impression; the widow of ER author Michael Crichton sued Warner Brothers, calling it derivative of the series based on his novel. As we watched the first episode of The Pitt, though, we realized that the shows are different in a lot of key areas, not the least of which is the fact that healthcare in 2025 is a different world than it was in 1994.

THE PITT: STREAM IT OR SKIP IT?

Opening Shot: Scenes of Pittsburgh. Then we see a man in scrubs and a hoodie walk to work at the Pittsburgh Trauma Medical Hospital.

The Gist: Dr. Michael “Robby” Rabinavitch (Noah Wyle) is the chief attending physician of Pittsburgh Trauma’s emergency department, and he’s starting his 7 AM – 10 PM shift. He looks at the board of patients waiting for care and waiting for rooms elsewhere in the hospital, and gets a briefing from Dana Evans (Katherine LaNassa), the charge nurse.

She wonders if he’ll be OK coming in today; what we find out when Dana sees one of the senior residents, Dr. Collins (Tracy Ifeachor) puking from morning sickness — she’s trying to keep her pregnancy quiet until the 12 week mark — is that this is the first time Dr. Robby has worked on the anniversary of the death of the former chairman of the department, Dr. Adamson, in 2020. It was during the first harrowing weeks of the COVID pandemic, and he still blames himself for Adamson’s death.

Dr. Robby goes to find the attending from the last shift, Dr. Jack Abbott (Shawn Hatosy); he’s on the roof getting air after a particularly rough shift, at least somewhat contemplating jumping off.

A new group of interns, residents and med students are starting, and Dr. Cassie McKay (Fiona Douriff), a 2nd year resident, takes them through the waiting area that’s packed to the gills; when the intimidated newbies ask her if it’s always this bad, she replies that it sometimes is a lot worse.

Dr. Robby introduces the newbies to Dana, Dr. Collins and the other senior attending, Dr. Frank Langdon (Patrick Ball). Dr. Melissa “Mel” King (Taylor Dearden) came from the VA and is way too happy to be at “The Pitt,” as Dr. Robby calls the ER. Dr. Trinity Santos (Isa Briones) is an intern, and likes to give people nicknames; for instance, she calls 3rd year med student Victoria Javadi (Shabana Azeez) “Crash” after she faints while looking at a patient with a greusome compound leg fracture. It turns out that Victoria, who’s only 20, is the daughter of two attendings who work at the hospital. Dennis Whitaker (Gerran Howell) is a 4th year med student who catches his finger on a flatboard when he helps move a patient off a gurney.

What Shows Will It Remind You Of? Well, the obvious comparison is ER, given that Wyle is playing an ER doc in a city hospital, and the series is produced and directed by John Wells. But, as we’ll explain below, the vibe of the two shows are a bit different.

Our Take: It would be easy to dismiss The Pitt as “John Carter 30 years into his medical career,” but there are a couple of things that set the series, created by R. Scott Gemmill, apart from ER.

For one thing, each of the first season’s fifteen episodes takes place during an hour of Dr. Robby’s shift. Although it looks like a lot happens during the first hour — the lady with the compound fracture who doesn’t speak a launguage anyone knows, a triathlete who goes into v-fib, a 4-year-old who accidentally gets into his dad’s cannabis gummies, etc. — that volume of cases seems reasonable in a jammed big-city ER.

For another thing, Wells and company aren’t trying to recreate the feel of their classic series; they revolutionized how medical dramas were staged and shot, with trauma response scenes using handheld cameras that circled the actors and pulse-pounding music as the doctors and nurses worked on a patient. Here, it’s more of a calm, collected feel, even as a patient comes in and the team surrounds the person to diagnose and give treatment. The concentration isn’t as much on the action as it is on the competency of the people working on these patients with little advanced info or medical history.

It does feel like Gemmill, Wells and their writers are going to position The Pitt as a commentary on our broken healthcare system. As Dr. Robby responds to Gloria (Charlene Hyatt), a hospital administrator who is telling him he needs to get his patient satisfation ratings up, he points out that lack of staffing in the hospital has led to too many “boarders,” who are in the ER waiting for beds upstairs. That causes a backlog in triage, because they only have so much room to bring in patients and treat them. That messiness definitely feels like it’ll be an issue throughout the 15-hour shift we’re witinessing, and we’ll probably get stories and/or speeches that invoke how messed up our insurance system is, among other topics.

The character types we see are where the strongest comparisons to ER are, from the burnt-out attendings to the over-eager interns and arrogant residents, to the nurses who keep everything running. There are also doctors coming in and out whose functions we don’t necessarily know, and a reporting structure that exists but seems nebulous when things go sideways.

We’re also intrigued by Dr. Robby’s trauma over what happened during the worst of COVID, which Wyle plays well. As he chases the son of a patient who made herself sick just to get the teen some mental health assistance, who decided to bolt rather than get help, Robby gets a ringing in his ears that he has to work through, which is when we get a flashback to those heady days when the doctors wore hazmat suits to treat infected patients.

All of the performances are good, but Wyle is the calm in the middle of this storm; he’s not ruling by intimidation, but through the example he sets. When he upbraids a resident or intern, he does so in even tones in an effort to help them learn. Robby and Collins seem to have a bit of a rivalry, which is interesting given that Robby is Collins’ boss, but that may also speak to the fact that Robby is the kind of leader who wants everyone he supervises to be the best they can be, even if they challenge him in the process.

That is certainly a different dynamic than what we’ve seen in other medical shows, and it’s the biggest reason we want to keep watching.

Sex and Skin: Because this is on streaming, we can actually see a female patient’s bra being cut open or a man sitting on a bedpan as he tries to poop after an enema.

Parting Shot: Robby flashes back to the paniced feeling he had during the beginnings of the COVID pandemic.

Sleeper Star: We haven’t mentioned Supriya Ganes as Dr. Samira Mohan, whom Robby chides for taking too long with her patients. Also, Kristin Villanueva and Amielynn Dumuk Abellera play nurses who, in the spirit of ER, will get their lines but will mostly be part of the fabric of the emergency department, so we want to give them their due here.

Most Pilot-y Line: One of the first things Robby sees when he checks in at 7 AM is a naked patient running away from the nurses because he doesn’t like needles. That was a weird way to set the tone for the day.

Our Call: STREAM IT. The Pitt is a medical drama that doesn’t try to make its doctors and nurses into superheroes and doesn’t try to sugarcoat the problems that medical personnel have in the world of 2020s American healthcare. Yes, you could look at it as ER 2025, but you’d be missing a lot if you do.

Joel Keller (@joelkeller) writes about food, entertainment, parenting and tech, but he doesn’t kid himself: he’s a TV junkie. His writing has appeared in the New York Times, Slate, Salon, RollingStone.com, VanityFair.com, Fast Company and elsewhere.