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Dr. Whitaker
Humans are equal and reactive.
Dr. McKay
What do you got?
Dr. Whitaker
10 foot fall, altered.
Dr. Alok Patel
That's a long way down.
Dr. Whitaker
10Ft is the threshold for trauma center activation.
Dr. Alok Patel
10Ft, 10% mortality.
Dr. Whitaker
0%. Anything over 0% is a concern.
Commercial Narrator
Somebody's annoying and it's not me.
Dr. Alok Patel
Welcome, everyone, to the Pitt Podcast, the official companion to the Pit on HBO. Max. I'm Dr. Alok Patel. I'm a doctor, a journalist, and I am a fan of all things related to medical storytelling.
Hunter Harris
And I'm Hunter Harris, a screenwriter and cultural critic. This week we're going inside episode four of the Pit and talking about the 10 o' clock hour. We're also joined by two stars of the show. Fiona Duraf, who plays Dr. McKay, and Shabana Aziz, who plays Dr. Giovanni.
Fiona Derif
You'd hear Fiona doing a scene. If you weren't in the scene with her and Fiona doing background, you'd hear like, Steph Jackson.
Dr. Alok Patel
Fuck.
Dr. McKay
Again, I'm sorry. I'm sorry. Cause every time there's a huge reset, right? Cause there's like 100 people behind you, like, acting out their own medical scenes. So every time you mess up, you thank God. So sorry, everybody.
Fiona Derif
It was really fun.
Dr. Alok Patel
And then we'll go outside the pit to talk about real world healthcare issues that show up inside the show. There's a lot to discuss, especially in this episode. Today's shift starts now.
Hunter Harris
I love when you do that. But also, your shift just ended.
Dr. Alok Patel
No, it actually did. Listen, I wish I could say I was kind of putting on a character, but I literally have been up all night, A night shift rolled up, haven't shaved, haven't changed. I mean, listen, I'm in character.
Hunter Harris
Thank you for. Thank you for the commitment. I appreciate it.
Dr. Alok Patel
Another week, another episode. Hunter, I, like, took notes on this episode. My notes are loaded. A lot happened. Catch us up.
Hunter Harris
Look, you take notes on every episode.
Dr. Alok Patel
But, like, but this Time there was like. There's a lot. There's so many. So many little moments.
Hunter Harris
Okay, so there's so much going on in this episode. First, there's a code black at Westbridge down the street, and a lot of patients are coming in, diverted from the hospital, which is down. So we're expecting a lot of, I guess, increased traffic at the pit right now. And then Dr. Alhashimi has some choice words for Santos, saying that she's behind on her charting and she won't want her to repeat her R2 year. And that, to me, was like, oh, my gosh. Timely documentation is essential. Let's fix this before end of shift.
Fiona Derif
I'm on it, boss.
Hunter Harris
Good. You wouldn't want to repeat your R2 year again because of this?
Dr. Alok Patel
I mean, I'll be honest. Like, charting sucks. It's a lot of paperwork. But we're in hour four, I think, of this specific shift to. Listen, I like Dr. Alhashimi. I like the energy she's bringing. But I don't know if I'm immediately saying you're potentially gonna have to repeat your R2 year. Like, that's. That's not a thing. We're not. We're not failing residents because they didn't chart properly in the first four hours of a shift in July.
Hunter Harris
Yeah, no, that was the thing. It's like, okay, you're coming in a little bit hot right now, and you don't even know Santos that well. One of the patients in this episode is Tanya and Vince, who, like, fell in a parkour accident. They. Vince fell 10ft, and so he's being assessed in trauma one. And then Whitaker has a big win this episode when he suspects a posterior mi. Can you tell me about that?
Dr. Alok Patel
Posterior mi? Think about it like this. It's a heart attack that's affecting the back of your heart, and it's a lot less common than routine mis. And there's a scene when Whitaker is looking at the EKG and he notices some of these changes that are a little different, not typical of a heart attack. So he goes and gets the approval from Dr. Robbie to do an EKG on his back, and then he sees those ST elevations. I mean, I'm with you. That is a huge medical win for Whittaker.
Hunter Harris
I love it. Let's take a look.
Dr. Alok Patel
Hey, I could use a second set of hands here. Pulseless. VTAC. Start compressions. Charging to 200.
Dr. Whitaker
Okay, clear.
Dr. Alok Patel
Okay, resume compressions. Code semi.
Fiona Derif
It was posterior.
Dr. Alok Patel
Yeah.
Hunter Harris
Good call.
Dr. Alok Patel
You put the detect pads on? Yeah, just in case. Hold compressions. Normal sinus.
Dr. Whitaker
All right, got a strong pulse. Chicken BP. All right, we'll prep them for cath lab.
Dr. Alok Patel
Hey, Mr. Samba, you're gonna be okay. No Pearly Gates today.
Dr. Whitaker
Really good pickup, Whitaker.
Dr. McKay
Thank you.
Dr. Alok Patel
Whitaker is a character you always root for, and those are rare. Like, so if you have a posterior MI as part of a bigger heart attack, it's not that common, but a posterior mi on its own is even more rare. But the part that cracks me up. I shouldn't say cracks up because we're in a heavy situation. Is when Whitaker sees this event happening, he's like, I need an extra set of hands here. As if someone, like, had an accident on the floor. I'd be hitting the code button or something. Or screaming, call a code. We have a patient potentially dying also this week.
Hunter Harris
We get an update on Jackson Davis. So when he came into the er, he was, like, very erratic. He had just been tased by a scarlet school security guard. And now when his sister Jada comes, she's like, wait, this is not the brother that I know. He's so gentle and careful, and this is not behavior that I've ever seen him display before. So that's a mystery that we need to solve. And then we have a really sad story with Orlando Diaz and his family. He has been, like, having his insulin doses to afford the medication, and his daughter, once she learns that her parents don't have insurance, starts to go fund me, and he does not react to that very well.
Dr. Alok Patel
This little scene is a gut punch. Kind of illuminates these social factors that play into people's ability to manage their health, their chronic medical conditions. This one got to me, Hunter. This one got to me. Let's see this clip.
Fiona Derif
Do you have a glucose monitor?
Dr. Whitaker
Yes, but I can't afford the test strips every week. They're too expensive. Can we not talk about this in front of my family?
Microsoft 365 Copilot Narrator
Hi.
Dr. Whitaker
There are my girls. Did you call your brothers?
Dr. Alok Patel
There is still a SOCAR.
Hunter Harris
I have good news. I started a GoFundMe for dad.
Dr. Whitaker
A what?
Hunter Harris
To help raise money for dad's medical.
Fiona Derif
Care, since we don't have insurance.
Dr. Whitaker
No, take it down now.
Fiona Derif
But why?
Dr. Whitaker
I work hard. I don't need charity.
Fiona Derif
But, dad, we've already.
Dr. Whitaker
Ana. You heard me. Take it down.
Dr. Alok Patel
You know, I saw a meme once, and it said, america does have universal healthcare. It's called GoFundMe, which should not laugh at, but it sucks. How many GoFundMe pages we see or we get shared on social Media about people who are just trying to pay their medical bills on this shift that I'm still dressed for. Just like 10 hours ago, I was talking to a family who's worried about how they're going to pay medical bills. And we've seen people get bankrupted, have to ration care. We see so much of it. Oh, man, I'm glad that the writers included this little subplot, but I wish they didn't have to.
Hunter Harris
Yeah, yeah. I mean, a big Internet forward episode because we also found out that Dr. Giovanni has a little side project that she is a tiktoker with more followers than you would think. And a patient comes in with her eye glued shut from trying to apply lashes. Listen, been there. And she says, I want Dr. J. And Langdon is like, I don't know who Dr. J is. It turns out that it's Dr. Javati.
Dr. Alok Patel
Which is kind of awesome. Also. Can we stop for a second? You said you've been there before. Is it really? Have you actually glued your eyelashes shut or have you been there?
Hunter Harris
I haven't glued my eyelashes shut, but I have had some mishaps with trying to apply lashes. I love my lashes. Sue me.
Dr. Alok Patel
Your lashes look great. I mean, I'm guessing that this is based off a real case. You know, the fact that Javati is an influencer is such a good twist because I didn't see that coming.
Hunter Harris
Dr. J. Finally.
Dr. Whitaker
It is so nice to meet you, Dr. J. This is Willow, your new patient.
Fiona Derif
I'm actually a student doctor.
Hunter Harris
I watch all of your videos. The one about coping with difficult co workers was super helpful.
Dr. Whitaker
I gotta watch that.
Fiona Derif
So what is Willow's health issue?
Hunter Harris
My eye. It's super glued shut.
Fiona Derif
Halfway trim and mineral oil didn't work?
Dr. Alok Patel
No.
Fiona Derif
Then I would suggest cutting the full lash down.
Dr. Whitaker
I concur, Dr. J.
Hunter Harris
As long as you're the one doing it.
Fiona Derif
Oh, okay. Yeah, sure.
Hunter Harris
It feels a little shady when the patient is like, oh, I loved your TikTok about, like, working with difficult people. And he's like, I might have to watch that.
Dr. Alok Patel
Like, we'll see acting with your eyes. There's some subtleties there.
Hunter Harris
Can we talk a little bit more about Dr. Langdon for a second? Because after Robbie basically, like, banishes him to triage, Dr. Alhashimi says, okay, we have too many patients coming in. We need to bring Langdon back.
Dr. Alok Patel
She's his advocate, but it seems like she also kind of believes in the process. And she's like, hey, you went through therapy this. This program, and, like, you're a great doctor. We need you. But, you know, Dr. Al Hashmi advocates for him to come back. So does Nurse Dana. But I think think Dr. Robbie still has that internal struggle.
Hunter Harris
Yeah, I don't like that. Dr. Alhashmi is like, like, ready to go easy on LinkedIn, but then it's like, really riding Santos.
Dr. Alok Patel
Good call.
Hunter Harris
Thank you. Dr. McKay is kind of flirting with her patient, and they make a plan to go on a date for an art walk. That was a very sweet moment.
Dr. Alok Patel
Fun detail. I, I, he's got an England national football jersey on with those three lions. So I was like, that's cool.
Hunter Harris
Okay. I don't know my football well enough. I hope that means he has good taste. I mean, if he Dr. McKay, then he must, then this was kind of the moment of the episode for me is that we're in the trauma room. The patient, Vince, who fell from the parkour accident, is stable, but then there's like a little piece of glass that I think they missed on a ct. And Ogilvy, so eager, as always, rushes to pull it out. He's like, I've got eyes on it. I can get it out right now. And, okay, you'll have to explain to me exactly how this happens. But when the glass comes loose, then the patient starts, like, bleeding and is not stable anymore. And I love the moment Dr. Garcia coming in and saying, okay, why don't you let the adults make the decisions from now on?
Dr. Alok Patel
Yeah, she came in and she was rightfully angry and anxious about the situation. You know, I am not a trauma surgeon or a vascular surgeon, but, like, simply put, if there is something puncturing into your body, there's a possibility that it is also tamponading or putting pressure on areas around it and almost kind of controlling the bleeding. And then when you remove it, all of a sudden you've removed that pressure. So blood can happen. This is why people have probably heard or seen that age old advice that if you get stabbed with something and it's still in your body, do not remove it. Have it removed in a hospital.
Hunter Harris
Another big scene, this episode that I was really intrigued by is Dr. Jefferson having a moment with Dr. Robbie to talk about the motorcycle trip that he's taking. And I really liked Dr. Robbie saying that, like, you know, he hasn't found the right therapist. He's still trying to feel it all out. And that moment going, I've got therapy. It's like me on my bike. It was so cool.
Dr. Alok Patel
That was a good interaction because you can tell that they have some type of past. And Dr. Robbie immediately says, like, hey, I'm not on your couch right now. You know, and he's like, I don't need to be talked out of going on my sabbatical. And like, Jefferson's kind of like pushing back a little bit. Like, that's a good. That's a good moment.
Hunter Harris
And also, we know he wasn't wearing a helmet at the top of the season. Okay, let's kind of dig in a little bit more to this episode because there's a lot to discuss. I mean, starting with what do you think the Code Black is? Like, what would you put money on on the board?
Dr. Alok Patel
I love that they start out immediately by just making bets. Like, half the ER is like, oh my gosh, it's an emergency. You know, we can't, like, we can't catch a break. And then meanwhile, the guard's like, let's make some money reign. And then everyone's character kind of comes out. Dr. Al Hashmi gets in on it. I love seeing whitaker throw down 40 bucks. I mean, like, I got the direct deposit cash money anyway. I. I struggle with this and I worry just because I know how this show rolls that it's going to be something kind of dramatic. Maybe it's a bomb threat. Am I going too dark here?
Hunter Harris
Yeah. Oh, geez. I mean, what did they. Robbie was like, it could be an exploded toilet. Who knows?
Dr. Alok Patel
It could be. It could be. But I just. I don't know. I just feel in my mind, I'm like, an exploded toilet would lead to flooding, which could cause a Code Black. But I feel like I think there's going to be a social element to it.
Hunter Harris
Okay. But this is the kind of thing that will. That you think can. It'll be a runner this season. That we'll be. We'll keep seeing a lot of patients from the Code Black?
Dr. Alok Patel
I think so. And I think that we're going to. The Code Black is either going to be related to something really dramatic or it's going to be a longer discussion about healthcare. So if you just generically say Code Black, it's basically a non medical emergency. Could be flooding. It could be a natural disaster. It could also be a staff shortage. It could be, you know, a situation where you don't. A hospital doesn't have the resources, the nurses or whatever, to be able to properly staff or open their hospital. So it could be something of that nature also. It just depends. Like, the term Code Black is going to differ from institution to institution. So I don't know. We could be going into social commentary, or it could just be some dramatic tv.
Hunter Harris
I don't know. I mean, I. I think it's definitely some added intrigue this season. And, I mean, already the ER is being overrun, so we'll see what happens.
Dr. Alok Patel
You know, Hunter, I. I love how much you are analyzing the Langdon, Dr. Robbie kind of back and forth. And so in this specific episode, we see Dr. Robbie again say, Langdon is back in triage. He's not coming up here. So I'm curious, what do you make of all this? But also, how do you think Dr. Al Hashemi kind of making her own decision about Langdon is then going to affect the triangle of relationship between Al Hashemi and Robbie? Dr. Robbie and Langdon. Langdon and Al Hashmi. Like, give me some thoughts.
Hunter Harris
Yeah, well, I think it's a really good escalation in this, you know, Robbie Langdon drama for Robbie to keep trying to push Langdon away. Langdon is, like, not really sure what, you know, how to put his best foot forward and come back into Dr. Ravi's life. And then Dr. Alhashabi is like, okay, we can't have, like, a doctor this senior still in triage. Like, he needs to come back. We need the help. So I like that these two men are going to be kind of pushed together, but at the same time, it's just another relationship where Dr. Robbie doesn't really know where it stands or how even he feels, I think. And that's maybe the most complicated part of this, is that we're seeing Dr. Robbie, like, not seeing him make up his mind, but seeing him, like, try not to make up his mind, try to keep pushing this away, kind of procrastinating his em. His emotional confrontation here, I guess. And I like that. It's also coupled in the same episode with this moment that we get about Dr. Collins, who has. We hear Dr. Whitaker say, moved to Portland and had a baby. And the fact that. That in that scene, we have the camera on Dr. Robbie's face and seeing that kind of, like, a little bit of emotion, a little bit of sadness, a little bit of like. Like it's a somber beat, I think, to see him in the same scene trying, you know, not knowing what. How he feels about Dr. Laynan being back, also maybe not knowing how he feels about Dr. Collins being gone. And again, it's like, yeah, Robbie is kind of running from his emotions. And as Dr. Jefferson says, that's not a place to be. That's not. Especially in someone of his position.
Dr. Alok Patel
Speaking of complexity, let's go to something that's actually very fun that I'm super stoked about. And that's McKay and the fact that she is just like Cupid's arrow right now. So you have, like, previously she was dancing with this guy who seems like he's got an issue with his tailbone. And he's hitting on her earlier. But Casanova over here in the England national soccer jersey. Sorry, football from my European friends jersey. He kind of like, talks to her about how he's sad he doesn't get to have her as a doctor anymore. She drops this line where she's like, you know, you're not going to see me anymore as a patient. Are you as giddy about all this as I am? And what do you make of this in terms of kind of, like, the ongoing blurring between Dr. McKay's personal and work life? Like, where are you at in this?
Dr. McKay
I was gonna go check out a few of the art galleries in Lawrenceville tonight.
Dr. Whitaker
Have you been to that one on 40th and Butler?
Dr. McKay
No, I was gonna go by maybe around nine.
Dr. Whitaker
Okay.
Dr. Alok Patel
Cool.
Fiona Derif
Cool.
Dr. Alok Patel
Is he gonna change clothes or is he gonna wear that soccer jersey?
Hunter Harris
Hmm, maybe he'll wear the soccer. No, he'll definitely change clothes. I'm happy that McKay was so. For how, you know, harried she was in season one with this ankle bracelet on her ankle monitor on her now. She's, like, a lot more relaxed without that piece of jewelry and also, you know, a few love connections. Same with Dr. Javati, who's really this season as an influencer, but also as a doctor, of course. And we actually got to talk to the actors who play these characters, Fiona Derif and Shabana Aziz. And this was maybe the most fun interview we've had this season so far.
Dr. Alok Patel
They're so funny. I actually didn't know that Shabana was also an Australian, like, super impressive portrayal of Giovanni.
Hunter Harris
Yes. Her American accent is so good. Let's take a look. First question. I am obsessed with Giovanni being an influencer. When a patient says that Dr. J is, quote, the best doctor in Pittsburgh and that she has more followers than you would think, can you kind of tell us about that development about how, like, her Giovanni's, like, youthfulness shows up in her work?
Fiona Derif
I'm so grateful to be representing, like, Gen Z in this show. I think that, like, young people on social media, like, so maligned. And we think of it when we're talking about these, like, biases that people have about it and, like, how I think you might think it's, like, anti intellectual. Or like, you know, she's smart, but she does this influencer thing. But actually, I think it's all part of the same package of like a smart young woman who's using the tools that at her disposal to make the world a better place. With the tools she has. You know, like, she knows about medicine and she has social media and she can. She has such a unique perspective after experiencing something like the mass casualty with.
Dr. McKay
Everybody.
Fiona Derif
On what it's like to be a frontline worker. And I'm looking forward to playing with people's expectations about that storyline.
Hunter Harris
Can you also tell me about this kind of almost rivalry she has now with the new character Ogilvy? That he is just as smart as she is, but they kind of. It gets tense between them.
Fiona Derif
Yeah, I think he's going down. I think that's the writings on the wall for him. No, I'm really excited by his character. I think it's really exciting to show a different side of Giovanni. I think last season we see her sort of be like Santos punching bag a little bit and not know quite what to do about it. But she's grown in that time and she's thickened her skin and become a little stronger and then separate to that, I think Ogilvie has come in and he triggers this part of her brain that nobody else ever has and she becomes this snappy, competitive person that she's like, what is going on? She doesn't think of herself like this, but he's inspired this version of her that is mean. And he's going down.
Dr. Alok Patel
He's going down.
Hunter Harris
What is it like playing those scenes that are so quick, so fun.
Fiona Derif
Yeah. So much medical jargon. So quick. Like, because we're answering these, you know, all these scenes are. Somebody goes, and what's this thing? And we go. We just like.
Dr. McKay
Like a bunch of medical jargon, trying.
Fiona Derif
To, like, compete with each other. It's, like, really intense. We do a lot of. Lucas and I did a lot of line running beforehand and, like, a lot of checking accent for me, because I didn't like. There are some words where I go. I'm saying that in an American accent. And then like in Seal, I used to say insulin, but it's insulin. Insulin. Insulin.
Dr. McKay
Oh, like.
Fiona Derif
Oh, God. I've been saying all sorts of things. Like just adding to. You said neurosurgery. I thought it was like neurosurgery, but it's neurosurgery. Neurosurgery.
Dr. Alok Patel
Fiona. I'm pretty sure we all, like, were cheering when Dr. McKay, like, put the drill to the ankle monitor. I gotta tell you, I feel like McKay is a drama show within a drama show.
Dr. McKay
Season one, you see, McKaye's personal life is a drama show.
Dr. Alok Patel
It's a drama show. I mean, season one, you have this single mother who's handling all this drama at home, but also compassionate doctor.
Fiona Derif
And.
Dr. Alok Patel
And then in this episode, you have this patient flirting with McKay. So I just wanted to ask you, like, with McKay, why do you think the line between work and personal life is a little bit blurrier and a little bit more apparent than the other characters?
Dr. McKay
I mean, I think it's her age, right? Like, at this point, you know, she's 43, and she has been devoting years and years of her life to taking care of other people. You know, she's at home taking care of her son when she's not working, and then when she's in the ER or ed, she is taking care of other people. And it can be years and years of that, you know, and it's come to a breaking point, I think, after probably the mass casualty a little bit, where it feels like self care is sort of needed, and it's time to kind of look inside and make sure that she is also taking care of herself a little bit. And that was a really vulnerable moment. I don't know how many times you guys have asked somebody out in person.
Fiona Derif
Well, I mean, that's. Giovanni's done that.
Dr. McKay
Yeah, Giovanni's done it. That's right. Yeah, yeah, yeah. I can think of. I think maybe I've done it once, but, yeah, there's a lot of, like, heart palpitations and vulnerability that goes into that. It's just like, if not now, when did it work?
Dr. Alok Patel
When you did it that one time?
Dr. McKay
You know what it did?
Fiona Derif
Yeah.
Dr. Alok Patel
See, and I think with McKay, I'm.
Dr. McKay
Telling you, it's a long time ago, but it did.
Dr. Alok Patel
But it's like you mentioned, there's a lot of medical terminology that Javani knows. And then with McKay, there's also a lot of medical terminology, but then there's a different aspect of bedside manner and really getting to know the patients, those interpersonal skills. I'm curious, what was it like for both of you to have to step into that role, learn that character, learn the terminology, learn how to do all that, and then memorize it and recite it. What was that process like?
Dr. McKay
I figured out that if I were to repeat the medical jargon 40 times, 4, 0 times before I get to set, I can reliably say it and then there's a lot of research in exactly what it means. So I'll remember ceftriaxone, and, you know, I'll remember exactly what it is for probably, like, three days after, and then it's gone. But, yeah, there's just a lot of prep work for me to remember the lines and then be able to say them. Portraying skill. Right? Cause I'm not. My character is in the second year of residency. I really. There's a lot of these procedures I've done before, and so that was extra intimidating to. To deliver it and be technically doing a lot of it. Cause we really try to portray realism and really feel like I know what I'm talking about. Yeah, it got me a little spark.
Fiona Derif
In comparison because you had to look like you knew what you were doing. I could be like, what's that? And that was really useful.
Dr. McKay
Yeah, there was a lot of pacing for me in season one before I pace a lot. I was like, I'm gonna be able to get all this out.
Fiona Derif
There's a lot of. Like, you'd hear Fiona doing a scene if you weren't in the scene with her and Fiona doing background. You'd hear like, steph direction. Fuck.
Dr. McKay
Again, I'm sorry. I'm sorry. Cause every time there's a huge reset, right? Cause there's, like 100 people behind you, like, acting out their own medical scenes. So every time you mess up, you're like, God. So sorry, everybody.
Fiona Derif
It was really fun. Yeah, she's very charming about it. It was really fun. I also think there's something about, like, the. The world is so immersive. Like, everybody's doing so much stuff that you do. It helps you get into it, like, in terms of, like, the jargon and then the equipment. I think, for me, it's harder when you're cheating equipment, too. Like, you know, when you're doing, like. Cause you're doing the job, you're saying the words, and then you're doing the procedure. But then you're also doing the procedure for tv, which is sometimes the same procedure, because you're suturing, say, on a silicon pad that's been stuck to a person's arm. And then you don't have to fake anything because you've got the fake pad. But if, say, you're doing your lines and you're stopping at the right word to take a fake intubation tube out and put the. You know. Or take the real intubation tube out and put the real one in, you're stopping and starting A lot too, in your lines. And so there's. It's like another dance. You're doing on top of the top of the surgery dance. You're doing the acting dance, you're doing the words dance. It's like a really, like a layered kind of approach, for sure. And I think this season I've done a lot more medicine. Like last season, obviously it's my first day I faint. Day one, episode one. So I'm sort of on the back foot a little bit and don't get so much trust until the mass casualty event where they just have to trust me to do like 100 test tubes. But this season it's more hands on for Giovanni because she's not new anymore and the trust has been rebuilt. And so it was a lot more like, oh, I gotta practice this straight.
Dr. McKay
Up surgery 40 times. You know what a really hard thing to do was when I was doing CPR to save somebody and it was an actual body, it wasn't a mannequin. You can't actually press, but you need your body to move to look like you're pressing to look like you're pressing. And that took so long to figure out how to do. And I'm still kind of bad at it, I think.
Dr. Alok Patel
Yeah.
Fiona Derif
I haven't seen you.
Dr. McKay
Sorry, I didn't mean that like that.
Fiona Derif
I meant that like. Yeah, I hear you.
Hunter Harris
I meant that like, I'm sorry.
Dr. McKay
CPR is probably the most challenging CPR in a real body, it's easy to.
Fiona Derif
Look ridiculous, but you don't if that's a real person there. Like for me, even as an actor, I go, the stakes for their safety is more important than the stakes for my performance.
Dr. McKay
Always. Obviously some of the background during the mass casualty deserved awards for the amount of time they had things in their mouth, like fake intubation tubes in their mouth for just hours and hours and hours on end.
Fiona Derif
Fake chest tubes taped to them all the time. They'd get up and go to lunch with these tubes hanging off them.
Dr. McKay
It takes a village, man. The pit takes a village. Yeah, it's. Yeah.
Dr. Alok Patel
I think all those details is why this is the most medically accurate show on television ever. And exciting. We're so stoked for the rest of it. Thank you both.
Hunter Harris
Thank you.
Dr. Alok Patel
Hunter. The part that cracks me up is this discussion about how they learned the medical terminology and how to recital these procedures. And then like Shyvana dropping f bombs. Imitating Fiona. Hilarious.
Hunter Harris
Yes. I think my favorite part of this interview was you asking Fiona if she's ever asked someone out like F River if she ever shoots her shot. And I feel like I was like, what's gonna happen? And she said, yes, that was cool.
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Hunter Harris
Now we're going outside the pit and this week we have a special privilege. Our guest is our own Dr. Alok Patel.
Dr. Alok Patel
Privilege and curse.
Hunter Harris
No, not at all. I have so many questions for you. As someone who, like, has a fake job watching TV all day, it's like really a privilege to talk to someone who's a real job, which is saving lives.
Dr. Alok Patel
I'm so honored by that. But also, that is a real job. Hunter Harris, your legion of fans agree with me.
Hunter Harris
Oh my gosh, you're too kind. Okay, in this episode we get a real sense of PTSD and trauma from people in the medical community, medical staff, support staff. And there's a moment where Dr. Jefferson talks to Dr. Robbie about, like, how are you taking care of yourself in this chaotic and high stress environment? And so I want to ask you some sort of the same question, like, how do you manage the stresses and the complications of this work? And how do you see others in the medical community doing that?
Dr. Alok Patel
Great question, loaded question. And an important one because you almost get the sense that Dr. Ravi dismisses it. Maybe he doesn't at all. And he kind of puts his heart and soul into his work at the expense of his own.
Hunter Harris
I mean, that's what we saw in season one when he, like, has that breakdown and it's like, well, if you, if you kind of push your own mental health to the side, then you can't really be a caregiver, which is what his job is.
Dr. Alok Patel
And let me just come out, come out with it and tell you that a lot of healthcare workers push their mental health issues to the side, whether that is anxiety, depression, substance use, it's ptsd, whatever it may be. There's many reasons why. If you look at statistics and Studies. Healthcare workers are less likely than the general public to seek treatment for a mental health condition, which is alarming. And, you know, part of it might be related to awareness of symptoms. It's hard to tell if what you're feeling is burnout or if it's just exhaustion or if it's actual depression. It's undertones that happen in healthcare as well, where someone might say, oh, my gosh, if I say that I have anxiety, my boss may be like, oh, you're not resilient or you're not tough. And then all of a sudden, you feel pressure, and you see it happening in the pit. You feel pressure because you work in a busy clinic or hospital. Maybe there isn't backup. You know, I've been at the hospital in shifts, for example, where somebody was going through something personal, but all of a sudden was like, I can't leave because we're overbooked, or, you know, we have a full icu, there's no extra doctor, and we've had to band together. You need to go home. And so people kind of feel that pressure also. And then the system knows that we're willing to do that, so they almost take advantage of the altruism. But long story short, doctors are terrible at separating and actually going and seeking help. Now, for me personally, I had to go through a breaking point. I mean, we're gonna. You and I are getting, like, a therapy session right now on the podcast. But I actually had my own form of an emotional moment in residency, and it was triggered by a breakup.
Commercial Narrator
Really?
Dr. Alok Patel
It was just, Listen, everyone's been through a breakup.
Hunter Harris
Yeah.
Dr. Alok Patel
But somehow this one breakup, like, knocked me over like a house of cards. And I was like, why is this hurt? Why is this, like, destroying me so much? And it was. One of my mentors were like, something else is happening. Like, you should go talk to a therapist. And it took that for me to go talk to a therapist and be like, oh, I need to, like, you know, develop some tools, unpack a few things, but also get awareness of what those symptoms are. So now, fast forward, that was 12 years ago. Fast forward for me now and some of my colleagues I talk to, it's awareness of what you're feeling. Is it something you should seek help with? Is it something you might just need to go and sleep? Do you need a day off? But it's also forcing us to detach. And when I say detach, it could be reality television. It could be scuba diving. It could be dancing. For me, it's martial arts. But something that is taking your brain away from work. And, like, for me, that's been everything. Perhaps that is what Dr. Robbie is seeking with the sabbatical.
Hunter Harris
I think so. I mean, he. He, like, wants to get out on the road. He wants to, like, get. But I don't know if that's going to work. I mean, we'll see, I guess. But I want to know as, like, a doctor, as a leader, how do you maybe identify or check in with people who you work with who might not be taking that time for themselves? Like, what's the gentle way to address that?
Dr. Alok Patel
It's exactly. You kind of hinted there. It's just checking in. Even if it's like, how's your day? Do you wanna grab lunch together? Is everything cool? And doing it in kind of a bar conversation as opposed to a interrogation or a lecture. For example, it gets that scene again with Dr. Robbie when he's like, I'm not on your couch right now, but just checking in with friends. Like, hey, is everything cool?
Hunter Harris
Yeah.
Dr. Alok Patel
Like, do you need a minute? I've seen. I've seen my colleagues talk to residents, for example, and say, hey, difficult patient scenario. Or, you know, this was a lot. Like, why don't you just take 10 minutes, go get a coffee? 10 minutes does not seem like a huge burden. And it does seem like someone's more able to be like, you know what? Yeah, let me go. Step away.
Hunter Harris
Like, take a moment to, like, focus. Re. Center.
Dr. Alok Patel
Take a moment. Anything. Just take a moment. These. These scenes in season one that were so incredibly powerful were the flashbacks of COVID And I cannot even tell you how many colleagues I have who have messaged me and said, like, it was. Not only did it hit close to home, but it almost hit too much. I have one friend in particular who loves a show and couldn't watch those scenes, and it caused him to break down because he was, like, in the. He was in the front line in New York in March 2020, and he's like, it was, like, too much. And then you start thinking about these moments people have where maybe someone didn't check in with them and say, hey, are you okay? Especially when it comes to something like ptsd, which a lot of people in healthcare have faced.
Hunter Harris
Yeah. I mean, not to generalize, but how much do you think we're still. Or maybe as like, a medical community reckoning with, like, March 2020, like, the height of the coronavirus?
Dr. Alok Patel
Oh, sadly, we. We are, yeah, directly looking at what Covid did in terms of stressors. You've got the Level of burnout went. Went high from 2018 to 2023. Burnout skyrocketed across healthcare. But also, we've lost funding, we've lost resources. Hospitals are still overflowing. Then you have the entire component of public mistrust and the attacks against doctors and nurses, which pisses me off. People can't tell my blood pressure is high right now. You know, there's people in the world, people in the general public who are like, we don't trust doctors. Doctors are evil. Where are you going to go in an emergency? You're still coming to see us, though.
Dr. McKay
Yeah.
Dr. Alok Patel
You know, and it's like, doctors are dealing with this every day. So I. I do think that there's these remnants of COVID that are hitting people, you know, and I've had patients, I've had colleagues actually go through these symptoms when a child is getting intubated, or if somebody comes in with a certain scenario, or if there's a trauma, for example. And it takes a community to step back and like, are you okay? With more awareness has come more normalization of people going through stuff. People struggling, not just in medicine, but just across the world. When we see celebrated figures, celebrities, artists, going through therapy and being public about it, I think it lets everyone know, like, oh, my gosh, even with fame and money and success, people go through shit. Therefore, it is okay if I do as well, and it makes me a stronger person. If I can celebrate getting a trainer in the gym, I should be able to celebrate getting a therapist in the same way. And so in hospitals, we have physician wellness organizations. There are groups dedicated towards addressing burnout. And there's, like, there's teams there specifically looking at that to make sure that people have the tools, they have access. And it's not just pizza parties and yoga picnics, but it's actual, like, interventional tools to help you. And then people are more open about it, you know, Like, I have way more colleagues now who talk about seeing their therapist, who will say things like, hey, I took a lunch break and I had a video call with my therapist. And we're like, that's awesome. And we almost celebrate it now. And I see the difference it makes with their patients, with their colleagues. And so with me, what has been more empowering is when I open up about this to colleagues, patients, residents, anyone, the bond instantly, they are like, oh, my gosh, wait, that's so cool. And I'm like. Because I don't want people to think that any of us are somehow, like, rock hard. And we don't experience things. I want the next generation, if they go through struggles, to know they can be open about it and seek help. I would much rather a resident do that than to hide it and to whittle themselves down because they're trying to be tough and hard and not seem like, you know, they're imperfect. Because we all are.
Hunter Harris
Yeah. How do you deal with, you know, patients or cases that feel really personally difficult for you and, like, how much can you, like, take that stuff home with you? And how do you not take it home with you?
Dr. Alok Patel
We take it all home. It's awful. And, you know, everyone. Everyone is hit by different scenarios. We see this in the pit, and it could involve the personal scenario. It could involve something that pisses you off from a social injustice standpoint, but it hits you differently, and you often bring them home. I like when there's breakdowns in social safety nets and somebody's coming to the hospital and they didn't have enough to eat, or they were in an abusive scenario, or they're homeless and they're going back to that scenario after the hospital, and there's nothing I can do. I'm, like, enraged. And then I think about those cases all the time. If I, you know, have a child who's been bullied or assaulted or something that also, like, really pisses me off, sexual assault, I'm going to sit there and, like, dwell on that and hope that this person is safe, you know? And you. You go home and you want to be open about it. But at the same time, I don't want to, like, you know, drop all this on my friends or at the dinner table. So then it becomes normalized, and then it just becomes, like, a job, like everyone else's job, when I'm, like, dealing with really heavy scenarios, if you know what I mean. That's why it's so important that we have these outlets to go to the break room, to go to colleagues and talk about it. We see during Pitfest, we saw these small moments of dark humor.
Hunter Harris
Yeah.
Dr. Alok Patel
And these moments of the cast kind of making comments to each other, like, that's cathartic to kind of bond. People use the term trauma bond, but to, like, have those moments when you go out, like, don't ever go to a doctor happy hour unless you want to hear some stories. But that is what we do.
Hunter Harris
But I'm sure it's very sort of affirming or gratifying to talk about this stuff with someone who understands it and not with, like, someone who works in media or art. Or something like maybe doesn't understand, like, the specifics of, like, a high stress environment.
Dr. Alok Patel
Oh, for sure. It would be a much more boring episode of the Pit. But we have moments where we will have all faculty meetings to talk about specific cases. And, like, 30 of us, we'll get in a meeting and we'll talk about a really difficult case.
Hunter Harris
And that's, like, kind of unpacking it and doing, like, a debrief emotionally as well as, like, medically.
Dr. Alok Patel
Exactly. Okay, exactly that. From both. Sometimes people will share stories or talk about, like, what they would have or could have done differently. And then there's teachable moments as well. And it could be, you know, a patient who is doing better now. It could be people who have passed away. Like, someone may have died. And we sit and reflect on it. And it's crazy, because if I think about the cases that hit me the hardest, they hit me. These are the ones that stick with me. It's the teens who were living their awesome, usual teen lives. They were taken away from us way too early. And it puts you back in a place of being a teenager. It puts you back in a place where you were not yet jaded by the world.
Hunter Harris
Some of us were cynical teenagers, so let me just say.
Dr. Alok Patel
But they were just trying to be teens. And, you know, and you. The way I see that with teenagers is they might have this horrific illness, but they can still find happiness in anything, which some of us adults have a hard time doing. But one of the most impactful things I ever did, I've ever done in my entire medical career was with a terminally ill teenager. We watched Devil Rose, Prada. Okay, I love that we're not gonna cry right now. She passed away, though.
Hunter Harris
Oh, I'm sorry.
Dr. Alok Patel
But, like, oh, man, am I welling up right now. We didn't talk about our disease. We didn't talk about treatment plans. Nothing. We, like. We literally sat down. It was, like, towards the end of my shift, and one of my colleagues was like, you only have 30 minutes left. Go chill. We just watched Double Rush. Prada.
Hunter Harris
Wow. Oh, my gosh, you're such a good doctor.
Dr. Alok Patel
I mean, I was at that time. I was being a homie. And it's funny because we were talking about how, like, Anne Hathaway's character wasn't being properly supported to pursue her dream. We talked about the fashion. We, like, went all into it.
Hunter Harris
Yes. Her bad friends, her bad boyfriend. I have two questions for you to close. First, what can we, as potential patients, do to help? I guess lessen the load of medical professionals or how can we do our jobs better as patients to help the medical community, A and B, how can the medical community itself combat burnout, combat all of these, maybe trauma responses within the community itself?
Dr. Alok Patel
I think what the general public can do is stay empowered, stay curious, realize that so much of your health is in your own hands with respect to movement, sleep, managing stress, what you're eating, what you're not consuming, and not drinking. Like, there is a very large amount of preventative health that doesn't cost a ton of money. You don't need to be in an expensive longevity clinic to do all this. I would respectfully ask the general public to stop blaming everything that they find wrong in healthcare on doctors and nurses. It is not our fault. Medical costs in this country are not our fault. The long wait lines you see in ERs, again, like, nurses, take the brunt of that. Like, we. We see it play out. Patients have to realize that we are all working together in this completely imperfect healthcare system. We got the same frustrations you do. I've had families yell at me, straight up yelling that an MRI machine wasn't. Wasn't free for their child. And I'm like, I wish it was. I was like, I think this sucks as much as you do.
Hunter Harris
Yeah.
Dr. Alok Patel
For doctors, again, I think it comes down to listening. And, you know, it's a skill that can never quite be perfected because there's always something for us to learn, but it's learning how to just stop talking, understand where a patient is coming from as a total individual with unique features and then asking for help. And asking for help could be in the form of a colleague. It could be asking a patient if they have an advocate they want to call. It could be calling for spiritual services, the hospital, whatever it may be to realize that, like, hey, we are all multifaceted humans doing this together.
Hunter Harris
I like that. Thank you for the work that you do and thank you for talking to us about it being so open. This was a lot of fun.
Dr. Alok Patel
Oh, this is a deep dive. I appreciate you.
Hunter Harris
That's it for today's episode of the Pit podcast. You can find us every Thursday right here after an episode drops.
Dr. Alok Patel
And do us a favor, Pit fans, leave us a question, a comment, a critique, whatever, and maybe we'll include it in a future episode. And a very important personal note from all of us at the podcast. If you or a loved one are struggling with a mental health condition, please talk to a friend, a colleague, healthcare professional, or use the 988 suicide in crisis. Lifeline Help is there. We are all in this together.
Hunter Harris
The Pitt Podcast is a production of HBO Max in collaboration with prx. The executive producer of PRX is Jocelyn Gonzale. Our managing producer is Courtney Florentine. Our editor is Lucy Perkins. Our production managers are Ebon Ochoa and Tony Carlson. Our video producer and editor is Anthony Q. Artis with Assistant editor Damon Durrell Hinson. This show is engineered by Tommy Bazarian. Special thanks to Joe Carlito.
Dr. Alok Patel
The Executive producer of HBO Podcasts is Michael Gluckstadt, the Senior Producer is Alison Cohen Sirocac and the Associate producer is Aaron Kelly. Technical Director is Insang Hwang. I'm Alok Patel.
Hunter Harris
And I'm Hunter Harris. We'll see you next week in the pit.
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The Volvo XC90 is equipped with seven seat versatility for surprise team practice, carpools, dynamic storage for Wang, quick stops at the antique market turn into a whole new living room set with Google built in for when you choose the road, more exciting and innovative technology and advanced safety features for all your precious Cargo. The Volvo XC90 designed for life. Visit volvocars.com us to learn more. Google is a trademark of Google LLC. The Volvo XC90 is equipped with seven seat versatility for surprise team practice, carpools, dynamic storage for when quick stops at the antique market turn into a whole new living room set with Google built in for when you choose the road, more exciting and innovative technology and advanced safety features for all your precious Cargo. The Volvo XC90 designed for life. Visit volvocars.com us to learn more. Google is a trademark of Google LLC.
Release Date: January 30, 2026
Hosts: Dr. Alok Patel & Hunter Harris
Special Guests: Fiona Dourif (Dr. McKay) & Shabana Azeez (Dr. Javati/Giovanni)
On this episode of The Pitt Podcast, Dr. Alok Patel and Hunter Harris break down episode four of The Pitt Season 2, diving both “inside the Pit” (the on-screen ER) and “outside the Pit” (real-world medical issues raised by the show). The hosts are joined by series stars Fiona Dourif and Shabana Azeez to discuss the latest storylines, character arcs, medical realism, social themes, and the challenges of portraying doctors in high-pressure settings.
For more deep dives, behind-the-scenes stories, and medical analysis, tune in to The Pitt Podcast every Thursday after new episodes of The Pitt on HBO Max.