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Dr. Jacob Lentz
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Dr. Alok Patel
When either of my kids was acting
Hunter Harris
like this, I gave them a timeout in their room.
Dr. Robbie
Oh, you're not my mother.
Dr. Alok Patel
Yeah, well, too bad. You need one?
Dr. Robbie
No, I had one. She left. I don't need another one. What I need is someone who could actually run this place while I'm gone.
Dr. Alok Patel
I'm sorry, I didn't know.
Dr. Robbie
Nobody knows. Who needs to know? Who gives a. I think you need a break.
Dr. Alok Patel
Welcome to the Pit Podcast, the official companion to the Pit right here on HBO Max. I'm Dr. Alok Patel.
Hunter Harris
And I'm Hunter Harris. It's 7 o' clock in the pit this week. We're in episode 13. Can you believe we only have two more episodes left of this season?
Dr. Alok Patel
We're going to talk about how the show was filmed, the chaos, the choreography, all the movement, everything. We're talking to the director of photography, Joanna Coelho.
Joanna Coelho
Finding the right angles that that's it. The moment it's cut, then we can't do that cut anymore on the prosthetic. So we have to find two angles that works for that work at the same time. That allows you to see well and are visually interesting.
Dr. Alok Patel
Today's shift. Lights, camera, action starts now. A squared. It is good to be back. I feel like we are turning a corner on this roller coaster and starting to get towards some climactic endings. Multiple patient cases and character arcs starting to develop. I find it hard to believe that this is still all just one ER shift. But what's your overall assessment on this episode? Like, what's, what's the vibe? How are you feeling?
Hunter Harris
This one is a stressful one. I mean, we say that every week, but this time I think we're really getting a sense of, like, the depth of Robbie's despair, honestly, the depth of his loneliness. That fight with Charter and Stana where they're kind of in the corner, really having it out was the first moment That I felt like he had said, like, that it landed for him that he actually, like, has a suicidal ideation. He'd mentioned it with Whitaker whenever he asked. I'm not gonna come back and you, like, have a bachelor pad. But this was. I felt like his, like, throat caught. And he was actually really emotional over it. And I wonder. I mean, I don't know. I kind of feel like the sabbatical is really an exit strategy for him to really cover up, like, how lonely he feels, how much he doesn't want to be with us anymore.
Dr. Robbie
I also don't know if Langdon is going to relapse. I don't know if Whitaker is going to be able to take care of my shit. I don't know if Javadi's going to give up on what she's good at or if Samira's going to flame out because of some bullshit with her mother.
Dr. Alok Patel
Is there anything else? Yeah.
Dr. Robbie
You know, I don't know about you running around full syringe of a set in your pocket. I'm worried about the people that I
Dr. Alok Patel
care about who all manage until you come back. We always do.
Joanna Coelho
Yeah.
Dr. Robbie
What if I don't come back?
Dr. Alok Patel
You almost get this sense of almost like a codependency issue that I think Dr. Ravi has with the ER when he starts going through the entire line of staff where he's like, I don't know if I can trust Dr. Al Hashemi. I don't know if Langdon's going to relapse.
Dr. Jacob Lentz
I don't know.
Dr. Alok Patel
I don't know if Javati is going to live up to her potential or go to a different career. Like, that's a new one that he's now carrying with him. Like, he really does have this interesting emotional dependency and responsibility towards every little corner of, quote, his er.
Hunter Harris
Something else that I want to talk about that is a very brief moment, but I think we need to talk about it a lot, is Dr. Robbie says that he grew up without a mother, that his mom left when he was young. Did you catch that?
Dr. Alok Patel
I did catch that when he was talking to charge nurse Dana, like, I don't need another mother.
Hunter Harris
I had one and she left. I think it's very satisfying as an audience member to catch something like that. Like a very important character detail, but sort of in passing, because that is how something like that would come up. And I like that charge. And Staina is like, well, I didn't know that. And he's like, why would you. That felt very real to me. And I wonder. I mean, I think obviously Robbie growing up without a mother or without just, you know, like this very big parent figure definitely has a lot to do with how accountable he feels to others and also how responsible he feels for the people that he's leading. And I think that was. It made me emotional. Aerogen, it has a 5 millimeter mesh that vibrates over 120,000 times per second.
Dr. Jacob Lentz
Doctor ahashimi,
Dr. Alok Patel
You okay? Dr. Alhashimi is an impressive position in general, but it's impressive how she know these details about medical supplies like Aerogen, because she could spit out facts. But she has another one of these moments, these moments where she kind of zones out and freezes for a bit. Hunter, what's your take? I have. I have a couple theories, but I'm. I want to know your take.
Hunter Harris
We know that she was on the phone with a, like, someone from Neuro she called earlier in the shift. But this one, I think is more like the most concerning because she sort of pauses and then like, kind of rushes out of the room. And we see Robbie watching her through glass and then her, like, kind of continuing on, like, down the hall. So I don't know what it could be.
Dr. Alok Patel
What a fascinating character because she. She's very human. She has this side of what's happening, but on top of that, she is just an efficient machine. But this all adds into Robbie's stress about leaving because he sees this and he's like, oh, my gosh. He talks to Mohan about it. He's like, dude, have you seen something? Like, what is going on?
Hunter Harris
So we have this moment between Whitaker and Ogilvy, or Whitaker and evil Whitaker, where Ogilvy's patient dies. The patient with the AAA that he missed. And he's in a state of, like, basically shock over having, like, set in on the surgery. He has still blood all over his. And Whitaker is. It honestly reminds me of a very McKay moment where he's like, I understand why this job is really difficult, but it's really nice being there for someone on the hardest day of their lives. And I think this is a really sweet character moment for both of them. I honestly have been waiting for Ogilvy to be humbled. I'm sorry that it came at the expense of this really nice English teacher, but this was a very sweet scene that really tugged at my heartstrings.
Joanna Coelho
You know what I think?
Dr. Jacob Lentz
What?
Dr. Robbie
I think you should go home.
Dr. Alok Patel
I think you should sleep on it,
Dr. Robbie
and I think you should at least wait till the morning to decide if you want to come back.
Dr. Jacob Lentz
I Don't really want to go back in there and see anybody.
Dr. Robbie
Yeah. Okay.
Dr. Alok Patel
Pull off your gown. I'll take it in.
Dr. Robbie
Shift is over. Go home.
Hunter Harris
I think it's very satisfying to see Ogilvy after all of this. Finally he seems humbled, and he really has, like, a lot of shame about how he has acted during the day, which I think is, you know, sad but meaningful to see.
Dr. Alok Patel
All gotta get humbled. All egotistical boys. Doesn't matter if you are a businessman, doctor, or an athlete. There's gonna be that moment you're always gonna remember. Ogilvy's gonna remember this shift forever. And it's gonna be a pivotal, important one. I have this conversation with new trainees all the time on the first shift or the first patient case where all of a sudden they realize that all that textbook medical knowledge doesn't always come through the way you think it's going to alok.
Hunter Harris
There's a lot of tension in the trauma room. Whenever Orlando Diaz comes in, Dr. Mohan really kind of snaps back at Dr. Ellis and says, I'm helping the patient. Like, she completely dodges a question, like, punts it on. And then whenever the chief of neuro comes down and asks for an assist, she looks to Javati because she has known Javati's mother for years. And Giovanni is a little bit apprehensive. Like, it's the end of my shift. I'm trying to go home.
Dr. Robbie
This is kind of an amazing opportunity.
Joanna Coelho
I'm exhausted.
Dr. Robbie
The chief of neurosurgery is here. She's kind of a legend.
Hunter Harris
Maybe one of the night residents can do it.
Dr. Robbie
Is this about the mobiles case from earlier? Because if it is, you made a mistake.
Joanna Coelho
Sake.
Dr. Robbie
You need to move on. I do not want to come back here and find that you've applied for residency in Durham. Step up to the plate. Do it. Giovanni will assist.
Hunter Harris
Excellent.
Dr. Alok Patel
It was tension balanced by Dr. Robbie looking up and having reverence for this, this chief of the division of neurosurgery who's quote, working on a weekend and she's obviously, she's badass and she's super cool with it and so helpful. And Dr. Mohan, Samira rejects the procedure first. She's like, I don't want to do it. And ninja body's tired and like, honestly, like, fourth year of medical school. Those rotations are painful memories because you're kind of a non audition. You're the first one to show up. You're the last one to leave, traditionally speaking. And you want to impress everyone while Also learning while potentially getting letters of recommendation while trying to figure out what you're going to apply to that dictates the next 20, 30, 40 years of your life. You can tell I have repressed memories of this. And so I understand where Jabari is coming from. She's like, I want to go home. I'm exhausted. But, dang, I should probably stick around and do this. She earns Dr. Robbie's approval at the end with the two thumbs up. And, you know, it's there. There's a lot happening. There's also Dr. Ravi ignoring what Samira, Dr. Mohan is clearly going through as she tried so hard to protect Orlando, keep him from leaving, getting him resources. And she probably sees this as her. As a failure, even though she did everything she could.
Hunter Harris
Yeah. No, I mean, completely. You can see the guilt on her face, especially when his wife shows and she's like, we did everything we could. I tried to get him to stay. I tried to send him home with everything that, you know, he needed to take care of himself. And still, like, against medical advice, he left. There's nothing I could do. And we know. We saw. There's nothing that she could have done to keep him there.
Dr. Alok Patel
That part is so sad when she walks into and she's like, I have a chicken burger or chicken sandwich for him, and it's just lettuce. And again, they're trying to explain, hey, it might be a long time before we see how he's doing. They're pretty quick. I mean, in general, in the pit, they're pretty quick with giving out discharge dates and how long somebody's gonna be in the hospital. There's a lot of I don't know in medicine or explain to families what the next one to two days look like. And when Orlando's wife is like, hey, is it gonna be better? They're like, it's gonna be a few weeks before we know, and he's probably going to be, you know, needing some type of assistance for a year or it's like they're very prescriptive with how they tell him. And I think there is an importance in doing that and being realistic. I was just cut off by how fast they are with those specific numbers.
Hunter Harris
Does he take any other medications?
Joanna Coelho
Just the albuterol.
Hunter Harris
He used to be on Montelukas and Simacort.
Dr. Robbie
Why did you stop that?
Hunter Harris
Because he lost his Medicaid two months ago.
Dr. Alok Patel
So tight.
Dr. Robbie
Nothing's getting through.
Dr. Jacob Lentz
Mel.
Dr. Alok Patel
EpiPen on it.
Dr. Jacob Lentz
0.3 milligrams. That may open his lungs. So the nerves can work.
Dr. Alok Patel
All right, Grady shot in the thigh.
Hunter Harris
Can we talk about Grady? And what was the big thing that Dr. Langdon missed? Was it a pneumothorax? He wanted to intubate. What was going on in that scene?
Dr. Alok Patel
Dr. Langdon really carried this one with him. So essentially, you have a asthma exacerbation or an asthma case that has gone terribly poorly. And if you even backtrack a little bit on what presumably is happening with Grady's. This guy's got asthma. His mother knows what to do. She says Symbicort, which is a combination inhaler, is usually what helps him. Loses their medications because they've gotten kicked off of Medicaid, which, by the way, is unfortunately, a massive problem all over this country. We see it in the ER all the time, and people can't afford their meds. And then this happens. And what you essentially have is the tiny tubes that bring air throughout your lungs are swelling. And when you start to open them up with bronchodilators or medications that can open up those tubes, they're also giving him epinephrine. They're doing whatever they can to get air in there because they're swelling. You can sometimes get air in, but it's hard to get air out. So you could get this dynamic hyperinflation. And presumably that is what happened to his lung. And so anytime that we are treating these asthmatics and we're giving them all these medications and we're trying to open up their lungs, you're also doing a lot of listening. Sometimes you don't hear any air at all. And you're like, oh, my gosh. Or you'll hear people say, like, oh, my gosh. He sounds really tight because you don't hear any air. And then you slowly open up the lungs with medications, and it sounds like whistling and wheezing. And so if you put too much air in too fast, you can cause a little bit of trauma. And that's essentially what happened. So when they listened and said, hey, I don't hear any air, Langdon was like, okay, well, he's obviously working too hard. He's not able to move air anymore. And that's when Chen is like, or we blew a hole in his lung,
Hunter Harris
and that's why the lung collapses.
Dr. Alok Patel
So essentially what happens is you have this little puncture in the lung, and then air can fill up in between the space outside your lung and the chest wall, and then that can collapse your lung. And so you gotta get rid of the air so the lung can re Inflate, like there's a whole. There's a process to it. But again, if you intubate someone and they already have a hyperinflation problem, that's an issue.
Hunter Harris
Okay, okay.
Dr. Alok Patel
So the lungs, lungs are phenomenal in the way that they can close off lungs. Part of the lung can close off on its own to protect the rest of the lung. And they're really responsive to these external forces. And so getting rid of some of that air can allow for the, the chest wall to re expand. Which is why immediately when they did that, Grady's like, oh my gosh, I feel better. I can breathe again.
Hunter Harris
Yeah.
Dr. Alok Patel
Hunter, how are your cinematography skills? I feel like you are a one stop shop for all things social media and traditional media.
Hunter Harris
I don't know. My celebrity crush is a cinematographer though.
Dr. Alok Patel
Really?
Hunter Harris
Roger Deakins? Yeah, look him up. That's very documented.
Dr. Alok Patel
That is so cultured.
Hunter Harris
I think that people who have not had the privilege of going to the pit set as we have may not understand how cool and how like truly 360 it is. And I don't know how you shoot a show like this without like so much complicated blocking and choreography. And I'm so curious about that on this show.
Dr. Alok Patel
Likewise. I think even watching the very first episode, season one, going into this, you know, this season you almost feel like you're part of the pit and you're moving with the characters and then if you take a step back, you're like, somebody has got to have a very slick camera setup. And so I've been reading about the cinematography of the pit. You know, handheld cameras, 360 degrees, having it being shot like live theater. I've read a little bit about Joanna Coel and her background in documentary filmmaking and how she brings that to the set. She called the er, quote, a living organism and she wanted to shoot it that way. I have so many questions, so I'm so excited that we get to talk to director of photography, Joanna Coelho.
Hunter Harris
Let's do it.
Dr. Jacob Lentz
Two cameras. They mark tails on b Sut or set and background action.
Dr. Alok Patel
Joanna, thank you so much for taking the time to chat with us. I hope everyone understands how important your role is on the show and bringing the. The drama and the action and all of it with your camera. It's phenomenal. Could you start out and just please tell us what exactly is a director of photography and what is your role on the show, aside from everything. But what is your role in the show?
Joanna Coelho
Absolutely. So director of photography is the person that really brings to life in images what's on the script. So working with the showrunner and director's vision and putting in visuals completely. So that involves all the camera department and all the grip and lighting department.
Hunter Harris
Can you tell us a little bit about shooting the Pit and what makes this show different from other shows that you've worked on?
Joanna Coelho
Yes. Shooting the Pit is something that I've never really approached anything like that before. It really is a mix of different formats of different kind of genres and experiences. In a way, there's the documentary approach to it that is very interesting. That gives you this feeling that you're living something real. And there's obviously the narrative approach that really gives you this cinematic experience. And in addition to that, you have a little bit, or so, I feel, of kind of mixing with documentary, a little bit of, you know, TV reality, where there's a lot of things going on at the same time and you always need to be open to grab it and emphasize more on the story by these little moments that are not always expected, you know.
Dr. Alok Patel
On that note, Joanna, it almost feels the way the show's filmed. It almost feels like someone watching the show is in the room with them and kind of running around and following them. I know that sounds like common sense, but I wanted to ask you, what do you feel is the visual home base of the show? What is the kind of net perspective you're trying to achieve?
Joanna Coelho
Yes, when the first time I read the scripts, it was so intense, and it's continuous, obviously. And there was really this feeling of immersion that was in the script. And I thought it was so important visually to give the same feeling. So the only way to do that was. Was really to get the camera in the middle of everything and following the characters really close to them so we could experience the same shift as them as an audience. So that was all these elements that were very important. So it's a very immersive style. It's all handheld. We're using different tools that give us the handheld feelings, but that help us to do specific camera moves that are not always easy to do just handheld, it's really following them and seeing things as they happen in their own perspective.
Hunter Harris
There's something about the pit that, you know, even though it's a single location, it takes place in one hospital, but it's in and out of trauma rooms and out of exam rooms. How do you keep the show looking interesting and not just, you know, so flatly? Single location?
Joanna Coelho
You know, that was a bit of the worry at the beginning to have so many episodes in the same Space and with the same characters. And you're right, it's. It's like, how do we keep it interesting? But the really core of the Pit is, you know, they are getting into different situations and different stories in every single episode, even though it's all continuous. And the shots are really designed around the blocking. So every single blocking in every different scene is actually different. The way they move, the way, you know, they interact with each other, the emotion, you know, point of the scene, what perspective are we following? And so with all these elements that really help us actually to have a different feel to everything. It's in the same visual language and style, but, you know, it never feels like the same camera movement or the same blocking. It's always very different just because the situation is different.
Dr. Alok Patel
So I feel like you would be the most fun and informative person to watch this show with, to explain to people, you know, how all of it really comes to life. And so we're talking about episode 13 today, and I was hoping we could watch a scene with you and you could walk us through, you know, how you captured it, give us your perspective. Can we. Can we do this?
Joanna Coelho
Absolutely. Let's do it.
Hunter Harris
Stay perpendicular. Okay, good. All right, now, four turns to get through the outer table. Yep. Then half turns till you penetrate the skull. Three, four.
Dr. Alok Patel
So cool. So sorry, Joanna. Hunter and I visited set, and, you know, ceiling, floor, four walls. Like, you really have to be in the mix. And so in this specific scene, could you tell us how exactly this was filmed? How were you able to capture everything that was happening while also preserving the clarity and the detail of the procedure?
Joanna Coelho
These scenes with prosthetic work and big surgery involved are always, you know, a little more complicated and tricky to do and to really make sure we get all the elements. This is actually a full body prosthetic. And so that's what allow us to really do these cuts, you know, while we're shooting and not having anything really hidden. In a way, I think you mostly see one camera on this shot, but there's a second one. Because there's two monitors. You could see the second one. And it's really trying to find, especially for these moments that are involving cuts, there's a special effects in there that I think on that behind the scene was not working, but it was supposed to blow a little bit on the head. And then we managed to get it work later. But finding the right angles, that that's it. The moment it's cut, then we can't do that cut anymore. On the prosthetic so we have to find two angles that works for that work at the same time. That allows you to see well and are visually interesting for this moment. That's why you can hear also the human moving a bit. The foam, it's covering a bit right there on this camera. We want to make sure it's clear on both cameras. So it's really a collaboration with the prosthetic and makeup team to make sure. How does all of this work? How many takes can we do? And here, in that case, when it's a cut, it's cut. So we can't really switch the head, you know, it's only one. And so we know that when we do that cut, that's the moment and it has to happen. There's a bit of special effects involved. So we have to get to hide the special effects people in between everyone around the table and the two camera operators and so on. You have special effects hiding under as well. So it's really, you know, making sure everyone has their space to do their job and to be in the right position and really working together that we get the best angle possible and the best special effects and, you know, the best parts of the prosthetic that's very. Actually different from another scene. If you take a scene that, you know, that is happening in the central of the. Of the er, and everyone is working with background distance scenes goes from beginning to the end without any interruption. And so that's very specific choreography with everyone and the cameras moving. And we don't stop in the middle here for prosthetic work and intense surgery, we stop in the middle because it's so precise.
Dr. Jacob Lentz
Here we go from the injection. Let's overlap. You picking it up and bringing it in. There we are. We are set. And background action.
Hunter Harris
Nope.
Dr. Jacob Lentz
A straight shot into the lateral ventricle.
Joanna Coelho
Now, this shot, again, was showing a lot about the cuts here, you know, and making sure we got it correctly. But sometimes we do shots in the surgery room. Of course, that is more coverage. So then in that case, you know, we'll be more on the facing, the faces, getting the dialogue and all that. And hopefully sometime we'll be able to connect from the dialogue to the cuts or the prosthetic work at the same time. So then it feels real and it feels like it doesn't stop. Right. So it's all, like, figuring out, really, the possibilities of the prosthetic, the placement of everyone, and making sure they have medical rehearsals to make sure they all dialed in so we can actually capture everything at the same Time, when possible.
Hunter Harris
Wow. That is.
Dr. Alok Patel
I mean, so much in one shot. Incredible.
Hunter Harris
I have two follow ups. First, how long does a scene like this typically take? And second, does, like, the. I don't know, like, scope of the procedure, impact that, like, if it's. This is like quite a small incision. But what if it's, you know, like you're opening someone up or like. Like digging into someone's chest.
Joanna Coelho
Yes. So I think this scene. I know there was multiple scenes with Orlando, and we can't always. We're showing it in order most of the time. So, you know, we don't really block shoot. So, you know, I think there were little scenes spread out through the episode. And I would say, you know, a scene like that probably takes two hours. I would say, because of the prosthetic work, you know, it has to work specifically in a specific way. If it's not as confident, complicated in a surgery room, sometimes it might be shorter if there's less pages on the script as well. And then, you know, when there's work that is fully open, a chest, for example, like a bigger cut, like you said, of course, it's a prosthetic bullet. Sometimes we actually have an actor as well. So you have the actor sitting down on the gurney, so his body would be. They would make a special gurney where the actor actually sits. And then the rest of the body is on him, right on her. So that's. The head is real. The chest, you know, is all prosthetic. And. And then, you know, when they open it up, then it's a lot of special effects as well, because then you see the hurt moving, you see the lungs breathing and all of this. So there's a lot of elements that have to work at the same time. And again, it's all about space because we want to be in there right off the shoulders, you know, really in the middle of the action. It's really hard to make sure everyone their space. And we are as close as we can with the cameras. So there's a huge work that's happening with the camera operators and the actors around the table. So sometimes they have to arm it up more so the camera can get a little closer. And then sometimes they're cross. They exchange tools nonstop above the table and all that. So they all talk to each other how, you know, the scene is planned medically with all these actions. So the camera operators can either back up to let them do something and come back in, et cetera, et cetera. So even when we just around the table, that's a choreography as well.
Dr. Alok Patel
On that note about choreography, we've heard from multiple actors about the long shots you mentioned. And everyone kind of is moving in these long sequences. How does the Steadicam operator fit into that choreography? Making sure they're moving with the characters, they're capturing things while all having their own space.
Joanna Coelho
I think that's really the magic of the pits. It's such a specific dance that the camera operators are doing with the actors. Because it's a beautiful choreography between cameras, actors, background, you know, and any other elements that be in the scene. Our camera operator that's doing all the long shots is indeed a Steadicam operator, though we don't use Steadicam on the show. We use another tool that's called the Zgrig. And the Zgrig is what allow us to have it still feel handheld without being too smooth, like a Steadicam. So you always feel like it's handled all the time. So that tool, basically, it's a Steadicam vest with a Steadicam arm. But it's another tool you put on it called the zg that gives you the same control as Steadicam, except it looks handheld. And that tool is absolutely key and so important to the show because when you think about it, we do, like, a lot of backwards moves that go really fast when we're leading the actors, right? And then you have a gurney passing in front. And then the camera goes lower to be a bit low angle through the gurney to the actors. And when that happens, you know, you need to be able to get the camera down. And if you wear handheld, you know, you could, like, bend your knee. But if you have to go really, really lower, it would be too hard. So that tool helps us changing the height during shots, really moving the camera backwards side without feeling the steps of the operator. And I think that's the key, because handheld, you know, it's such a great look for the show. But if you were feeling the steps of the operators because of the immersion, it would take you out in a
Hunter Harris
similar vein, I guess. How often do practical constraints like medical equipment or how tight a hallway is or a turn dictate what we're seeing on screen and how you're creating these images?
Joanna Coelho
Well, you know, that's one of the things on the pits. Everything is aimed for realism. So nothing on our set really move except if it's on wheels. And the rule is that that would be the case in a real emergency room. And we wanted to keep that as a documentary film, that the camera should not be able to go places that it could not go in a real world. So in that way, our walls don't lift up, our counters don't move anything like that. So the only thing that moves that can wheel out are things on wheels. So when, you know, the set really looks like a real hospital. And so when the camera moves with background actors, you know, you have sound, the electricians with light. Sometimes everyone moves together. Space gets really tight. And so, you know, when we have specific things to capture on the move like this, it's very important that the timing works. So we try to make sure blocking wise, let's say, you know, there's a gurning pass by. We want to see that it arrives at the right time where the camera can leave the actor for a second, catch it in the background, and then come back on the actor, et cetera. So it's. And sometimes, you know, we get into spaces where the camera does have to go around the actor, but the hallway is too small. And because sometimes there's, you know, a cart on wheel park there. So we'll do like a holy would switch during the shot without anyone seeing it. So when the camera doesn't see, the things wheels out because it's on, so that's okay. And then camera takes that spot. And as the camera keeps rotating, the things come back in. So you never saw that things left for a second. So that's how we make space on set is by sometimes moving things around that can move around during the shot. So we can actually fit everyone in in this choreography.
Dr. Alok Patel
Oh, there's like integrity in the filming. There's no cheating. It's. It's super cool.
Joanna Coelho
There's always a bit of cheating, but nothing, you know, too obvious.
Dr. Alok Patel
Are there any characters who pose a unique challenge or you have to do something different when it comes to filming them?
Joanna Coelho
I think as a general thing, you know, all the actors are so good at really dancing and working with the cameras. They have such a great collaboration with the camera operators to really help each other in that way. Now in the of filming, I feel like character wise, there's a bit of a play with Dr. Robbie because he goes through so much emotions, you know, especially this season. I mean, I know last season as well, but it has a certain intensity to him. And so there's scenes where I feel we have to like, get closer with him, get more intense in the way we follow him or we lead him so you can feel a little more the overwhelming feeling he's going through. So I think like in that sense, his character, you know, the anxiety that he can experience gets transmitted a little more on camera in certain shots for him in this choreography.
Hunter Harris
Wow, this has been great. Joanna, thank you so much.
Joanna Coelho
My pleasure.
Dr. Alok Patel
I don't want to say people take it for granted, but people might watch a finished product of a movie, a show, and something as incredible as the Pit. And because it's so expertly done, they don't really realize how many takes, how much time and thought. It takes experience to actually capture these scenes, the choreography, the lighting. Like, there's so many really fascinating moving parts.
Hunter Harris
Yeah. And something I hadn't thought about. Just, like, from an actor perspective, how it is to, you know, move around the space when you really do have a camera very close to you. Joanna said that sometimes the cameras are almost like in the actor's way because they are trying to get a really tight shot. And I hadn't considered that as, like how that changes how you perform a scene or the blocking of the room itself, since the pit is a 360 set.
Dr. Alok Patel
God, there's so many. So many details. So many details.
Hunter Harris
Now that we've gotten all the details inside the Pit, I think it's time we go outside the Pit and hear from Dr. Jacob Lentz, who is a medical consultant on the show and also an ER doctor at ucla.
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Dr. Alok Patel
Doctor Jacob Lentz. I'm excited to talk to you, Honored that you decided to join us. You're an actual attending in the emergency medicine department at ucla. I have to ask you a question about coaching and teaching actors. Aside from the medical information, the textbooks, the procedural skills, what type of habits, instincts, or mental framework are you teaching them so they can truly dive into the role of Being an ER doctor.
Dr. Jacob Lentz
Oh, that's such a good question. Yeah. So when we do boot camp each season for the new actors, which started in season one, there's like, a whole separate section about how doctors. Doctors think. And I think that kind of begins that teaching of trying to, like, create a simulacrum of those. Of those. Of the mental habits and the kind of, like, mental modeling that doctors do. One of the people who like the person who's probably most engaged with that and really gets that is Noah. Because he'll ask, whenever he is in a scene, he'll say, like, what would. What am I doing here? And I'm like, oh, that's really good. Like, he's like, where am I looking? And I'm like, just. All you're looking at is the monitor, you know, like that you're just. You're just obsessing over that pulse ox or like you're obsessing over that blood pressure. Part of what we do is tell the actors who are playing the doctors in a given scene what they're looking at and the little movements of, like, the little things that doctors do, like making sure the drip is actually running, checking the IV to make sure that it flushes, or those little slightly OCD habits. I think Noah's really good about understanding that and asking those questions.
Dr. Alok Patel
I was just gonna say those details. Those details make a difference. There's memes of Dr. Robbie and how he. How he washes his hands, and people make jokes about it, but I'm like, ah, that's actually accurate. That is 100% how we wash our hands and how often we do.
Dr. Jacob Lentz
Yeah, it's so true. I don't. I don't love the gel. Like, I just don't like how it feels. So. But I wash my hands obsessively, and I wash my hands. I mean, when I'm at work, I wash my hands, like, 150 times. Like, just constantly washing hands and. Because you want to also, right? You're like, that was kind of gross. And you just want to wash your hands so much. And, yeah, I probably. I'm racking up quite a water bill at ucla. But, yeah, I just. Like, it's true. Like, I think you can't function if you are too much of a germaphobe. Like, if you think about it too much, you'll start to spiral. But your hand hygiene becomes very, very, very important to you.
Hunter Harris
I have more of a technical question. How do you approach teaching actors how to make an incision or how to hold a Scalpel or something like that. Like really technical procedures.
Dr. Jacob Lentz
I think the best way to approach something is to make it. You know, I think Albert Einstein said, like, think whatever sign should be is made as simple as possible, but no simpler. But like, I think you try to break it down to like, what's the goal? Why are you doing this? And like, what. What is the medical reason for what you're doing? And then walk them through it by steps, using my own personnel bias, like, it just how I do it, you know, and say like, as a medical student you learn like how surgeons hold pickups and how they hold scissors. And I'm like, okay, so you have to hold it this way, otherwise we're going to get a lot of trouble. But there's also some variance with other things. Everything is just sets and reps, just doing it enough times. And so, like, we do a lot of rehearsals, we do a lot of. And the actors are really good about showing up and really paying attention and committing to those. So, yeah, a lot of rehearsals and a lot of just kind of step by step and answering questions as you go. It's. There's no secret formula.
Dr. Alok Patel
It's just sets and Reps. Dr. Lentz, you know, we're talking about procedures, performance and reps. There are so many, scientifically speaking, cool procedures in this season, different types of suturing. That hilar flip in the first episode, are there any procedures that stuck with you, procedures you oversaw or taught that you're like, ah, we nailed it.
Dr. Jacob Lentz
I think the one that I was most intrigued by and really thought like, that's pretty cool, is we did a slash trach on a kid and that's kind of an. I don't know if it's new, but it's kind of the new guidance about how to approach a pediatric difficult airway. And then like this whole slash trach thing was frankly pretty new to me. So I was really intrigued by it. I did a lot of reading about it and CEPI did a great job with it. I was very happy with how it turned out and I felt like the core message of what that is, which is that it's a life saving procedure, it's going to be bloody, it's going to be messy. If you actually do it, you're going to get a lot of pushback and a lot of judgment, but that none of that matters because it's a life saving procedure and all the mess can be cleaned up later.
Dr. Alok Patel
I'm so glad you said this last trach. I remember watching videos when we were Filming the episode from ASIP, the American College Emergency Physicians for Everyone. Aside from Dr. Lentz and these ENT videos and people kind of going through that, different techniques. And I have a colleague who is an ENT surgeon. Saw the scene and all he said back was, nice. Awesome.
Dr. Jacob Lentz
Yeah, that's great. That makes me happy. You know, it's interesting. I do think that those that, like, you get a lot. You're going to get a lot of judgment. But I think actually, like, the otolaryngologists are actually probably going to be the ones who are most cool with you. Those. Because they'll tell. They know. They know the anatomy so well. So they'll just be like. The ones I talk to are always like, yeah, everything in the middle we can fix. Like, just. If you stay in the middle, it'll be okay. We could fix it and, you know, the person's alive and. But. But I think you'd still get a lot of. I think flack from other people is my guess.
Hunter Harris
It's so cool to hear both of you talk about this because this is kind of what plays out when Dr. Garcia comes in, right? And she's like, we're gonna have to clean up your mess upstairs.
Dr. Jacob Lentz
Yeah. Did you take a meat cleaver to him? And it's like, that is the core experience of. I think every ER doctor. One of our core experiences is people who weren't there and didn't see it and didn't have to make a decision. Like, the retrospectoscope is very powerful. And then they come in, they're like, what were you thinking here? Like, what was that about? And it's like, well, this was the best option in the situation. But anyway, I'm glad you. Glad you drove your sports car here and you brought up. It brought a bag of judgment.
Dr. Alok Patel
Dr. Lentz, I'll ask you this question, and I'll be vulnerable for a moment. This show is so accurate in terms of the workflow and the personalities and the kind of level of perfection, if you will, that certain people, like Dr. Robbie, are trying to achieve with bedside communication, that sometimes I watch a show and I evaluate my own medical skills,
Dr. Jacob Lentz
my own interpersonal skills in the hospital.
Dr. Alok Patel
Based on the work you do for the show, have you changed anything about your workflow or how you approach patients?
Dr. Jacob Lentz
That's such a good question. Yes, probably. Like you, I've sort of used the show to critique my own performance and my own behavior at work. And I think it's probably. I think one thing that, you know, the character of Dr. Robbie does really well is figures out creative solutions to like, difficult issues. You and I both know so well. Like so much of medicine now is like, figure out non medical things, like the financial stuff, the social stuff, like how people are going to get. How people are going to get home, like how are they going to get up the stairs? I mean, you can spend hours figuring out how you're going to get someone back into their apartment. If you can't do that, then what? And so, like, I think, and I think Robbie on the show is very engaged with those, like, creative solutions to that. So I think it's made me start thinking more and more in a bigger way. Just try to be as, as creative and engaged as possible, sorting through those, like, next steps for someone.
Hunter Harris
I am curious though, in your work on the Pit, do you feel like it's changed how you, you know, relate to residents or how you're think?
Dr. Jacob Lentz
I think so. So I think I really like working with residents. And the further you go out from residency, I think the less current your experience is with residency. So I think for me, the Pit's been a good reminder that the current crop of residents and interns have issues and challenges that are maybe different than what I remember. I'm not that far out of residency, but it's been a good reminder. I'm like, no, I should really pay attention to what's going on with them because I think when I started as an attending, I was just like, yeah, I was doing that last week. I know what you guys are dealing with. I get it. But things change and some things are better and some things are worse. And so it's been a good reminder that I have to and listen and try to find out where they're at. And also it's a good reminder of how exhausting residency is. It's really hard, and I think it's hard for everybody except for a local. Just cruise through it. But the rest of us, I wish the rest of us struggled, but. And I know that work hard, play hard. Yeah, I know that. But then it's a good reminder that to really, like, give people, you know, like a little bit of space as able and because, like, the show does a really good job of communicating how. How tiring and stressful it is.
Hunter Harris
What a thoughtful answer. Thank you.
Dr. Alok Patel
Oh, 100%, I think conveys everything doctors go through that is kind of independent of the medical procedures and treatments. I think the show does a really artful job of portraying the whole spectrum of frustration we deal with on a daily basis as healthcare professionals. So I thank you, Dr. Lentz. I thank you and the entire team for bringing that reality to camera.
Dr. Jacob Lentz
I take very little credit for it, but, yeah, the show's done a great job with it.
Hunter Harris
Can you kind of tell us what a typical day is like for you on set? Just so that people who think that they could do what you do kind of get a clearer sense of how much work you're putting in?
Dr. Alok Patel
Sure.
Dr. Jacob Lentz
Yeah. Yeah, yeah, yeah. For each episode, we split up the episodes among the different consultants. So last season, I did four episodes. So I did 2, 6, 10, and 14. When you get the script for one of your episodes, you have to go through the whole script. So the script's about 70 pages. Ish. And then you have to go through each scene and write out for every single scene, like, what are the props? What's the makeup? What's the wardrobe? Who else is in the room, what's on any video screen, whether it's a monitor or a computer, what kind of. If there's any special effects. Like, all these things are very distinct, right? Like, if there's blood on clothes, that's makeup. Or that's. Sorry, that's. That's wardrobe. If there's blood on a piece of equipment, that's props. If there's blood squirting, that's. That's special effects. And then you have to describe, like, what. What the ultrasound is. So you say, like, there's blood in Morrison's pouch. And then you have to, like, you know, that's gonna. Most people don't know what that means. So then you have to describe. You have to. Then you create addendum to those notes. So the medical notes end up being usually 25, 26 pages.
Hunter Harris
And then.
Dr. Jacob Lentz
And then there's addendums, like, where you, like, further delineate what things are. And so, like, you'll put it for, like, scene. Scene 12. Like. Like. Like even discharge paperwork. You're like, have to have a discharge paperwork for this patient. Please see addendum B. And then you have. In addendum B, you write out what the discharge paperwork is for. Everything that's on a computer, you have to write out, like, if they're writing a progress note because it might be seen, you have to write out what the progress note is. And then once you get those notes done, you have to go then to meetings. There's meetings during the prep time. And then also just separately, you. You meet with props and wardrobe and. Oh, boy, makeup and the art department and. And everyone. And you Sit with them. And. And they'll say, like, is this what you want? You wrote this word. I looked it up. This is what I got. This is what I found for 14 French pigtails. That what you meant, you know, and then. And like, sometimes you'll be like, oh, yeah, that. That's fine. Or like, is this scalpel? Okay, you have to work with them to figure out how's that going to work. We're putting a needle into that person's arm, but obviously we're not putting a needle into that person's arm. Like, how are we going to cheat that? Or, like, you know, obviously you're not cutting into a child's trachea. What's the plan? Right? And there's like, that's. That's like, a many people involved in figuring that these questions are. They're not easy. So there are a lot of people have to be involved in every scene that has medical things going on. So you have to break it down, and you have to break down what each character is doing at every point in that scene. So that slash trach scene was like five pages, maybe six. From the time they come off that elevator, from the helicopter, to the time that Dr. Al Hashemi walks out triumphantly, you have to break down what every single character is doing that whole time. And you have to draw it out. And so you have to. To first write out what they're doing and kind of sketch things on the script, and then you then draw it out for the actors. And you have to say, like, this is what you're doing right here. And you have to make sure it all matches up so that if, you know a nurse is handing a blood vial to another nurse, you have to make sure that they're both at the right spots at the right time, but you also need them moving because you don't. You want movement because people just standing around like. Like, we actually do. Like, if you have Robbie, like, handing someone ultrasound gel, like, you have to make sure that person is ready to get the ultrasound gel because you don't want him just standing there holding it in the air. So you have to plan that all out. And like, something like the slash trach, like, you're going to get one. Ultimately, you know, we did multiple takes, but you're going to get one take with cutting, right? Because that's like, that's been built, that's rigged up. It's ready to bleed. It's a prosthetic neck. But, like, you're not going to get to reset that because there's a bunch of blood. So, like, you have to rehearse and prep for all that. So it's a, you know, they're long days. Like, you're really tired by the end of it.
Hunter Harris
Okay, we need to send this to everyone who emails you telling you that they should have your job because there's a lot more that goes into it than you would think.
Dr. Alok Patel
Yeah, this is the level of detail that makes the show great.
Dr. Jacob Lentz
I'm super grateful to be part of it and stuff. But yeah, it's not answering questions on email or while you're on the beach
Dr. Alok Patel
in like, your 45 minutes of free time.
Dr. Jacob Lentz
Yeah, exactly, exactly, exactly.
Dr. Alok Patel
Dr. Lentz, appreciate you. You're a true artist. We appreciate everything you do for the world, for patients and for the show. Thank you for chatting with us.
Dr. Jacob Lentz
All right, Hunter Alok. Thank you both very much. It's been a pleasure.
Joanna Coelho
Thanks.
Dr. Alok Patel
Thank you, Hunter. I'm sure you could tell that Dr. Lentz and I wanted to go on tangents and rant and this probably could have turned into a five hour interview. You know, aside from asking him about the mentality the actors needed to adopt and the amount of work it takes that other medical colleagues don't really realize when people say, like, hey, Dr. Lenz, I want your job to kind of how this has affected his approach towards patients and residents, all of it, like, really spoke to me. But I'm curious, as a non medical professional, what, like, stood out to you? What insight did you get from this interview?
Hunter Harris
How highly specific it is to both teach someone and train them how to perform all of these complicated medical tasks, but also like the extensive note taking and how extensively he annotates every single script. That was pretty cool to hear about and something that I hadn't really considered before and like 20 pages of notes on top of a 70 page script. I cannot imagine how organized he has to be to think about, like actual real hospital stuff and then additionally, like, all the pet consultation work. That's it for today's episode of the Pit Podcast. We'll be here every Thursday right after the new episode drops.
Dr. Alok Patel
And I know there's only a few episodes left, but we're all basically honorary Pit residents at this point. So I want to hear your thoughts, your comments, all of it. Maybe we'll bring them up in a future episode. Watch us right here on HBO Max or listen wherever you get your podcasts.
Hunter Harris
The Pit Podcast is a production of HBO Max in collaboration with prx. The executive producer of PRX is Jocelyn Gonzalez, 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 Darrell 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 Allison Cohen, sirocac and the Associate Producer is Erin Kelly. Technical Director is Insung Kwong. I'm Alok Patel.
Hunter Harris
And I'm Hunter Harris. We'll see you next week in the Pit.
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This episode of The Pitt Podcast dives deep into the making of episode 13 of HBO Max’s hit medical drama, The Pitt. The hosts dissect the episode’s pivotal moments, character arcs, and technical achievements—specifically focusing on the show’s characteristic immersive cinematography and bone-deep realism in medical storytelling. Guests Joanna Coelho (Director of Photography) and Dr. Jacob Lentz (Medical Consultant) provide fascinating behind-the-scenes insights into how The Pitt achieves its authentic feel, both visually and medically. Expect emotional character analysis, technical talk about filming in a 360-degree ER set, and real-world reflections on medicine and acting.
Focus on Dr. Robbie’s Struggles (02:20–04:05):
Dr. Alhashimi’s Vulnerability (05:18–06:19):
Ogilvy’s Humbled Development (06:19–07:55):
Systemic Barriers: Grady’s Asthma Case (11:34–14:12):
Medical Nuance: Procedures and Outcomes (13:45–14:12):
Immersive Visual Language (18:00–18:50):
Keeping a Single Location Visually Dynamic (19:05–19:56):
Choreographing Prosthetic Surgery Scenes (21:07–24:18):
Tools & Techniques (26:54–28:26):
No “Cheating” in Set Design (28:37–30:23):
Emotional Cinematography (30:36–31:26):
Train Like a Doctor, Act Like a Doctor (33:59–36:12):
Procedural Realism (36:22–37:51):
Pushing Boundaries: The Slash Trach (37:51–39:44):
Reflecting on Medical Workflows & Empathy (40:32–44:28):
Consultant Job Breakdown (44:41–49:20):
On Dr. Robbie’s Codependency:
On Teaching Actors Medical Mindset:
On Hand Hygiene in the ER:
On The Set’s Integrity:
On Medical Drama Realism:
Watch “The Pitt” and listen to future podcast episodes on HBO Max or your preferred podcast platform.
Share questions and comments—your insights may feature in upcoming episodes!