Loading summary
Transcript208 lines
- [00:00]
Volvo Narrator
When life gets unpredictable, preparation matters. In medicine, it's all about staying alert, ready for whatever comes through the door. On the road, it's no different. That's why Volvo designs vehicles to help anticipate risk, reduce harm, and protect lives. The Volvo XC90's advanced safety systems inspire confident decisions wherever the road takes you. The Volvo XC90 for life. Proud sponsor of the Pitt podcast. Learn more@volvocars.com US
- [00:32]
Dr. Alok Patel
Monster Energy. Everybody knows White Monster, Zero Ultra, that's the OG it kicked off this whole zero sugar energy drink thing, but Ultra
- [00:41]
Crystal McNeil
is a whole lineup now.
- [00:43]
Dr. Alok Patel
You've got Strawberry Dreams, Blue Hawaiian Sunrise, and Vice Guava. And they all bring the Monster Energy punch. So if you've been living in the White can branch out.
- [00:53]
Crystal McNeil
Ultra's got a flavor for every vibe,
- [00:55]
Dr. Alok Patel
and every single one is Zero Sugar. Tap the banner to learn more.
- [01:01]
Hunter Harris
Tier one trauma ETA six minutes.
- [01:03]
Crystal McNeil
And so it begins.
- [01:10]
Hunter Harris
Welcome to the Pit Podcast, the official companion podcast for HBO Max's the Pit. I'm Hunter Harris, a screenwriter and cultural critic.
- [01:18]
Dr. Alok Patel
And I'm Dr. Alok Patel, a physician journalist. Basically a loudmouth for public health. Each week we'll go inside the Pit and. And talk to people who make the show possible. And then we'll step outside the hospital so we can nerd out about the real medicine, the story, the drama, the culture, the ethics, all of it.
- [01:35]
Hunter Harris
Season two of the Pit drops in a few days on January 8th. And so to prepare, we're going to look back at season one, think about all the doctors, characters, medicine, patients, all of it. And think about what we can expect from season two.
- [01:46]
Dr. Alok Patel
And to do that and get you more insight, we're going to talk to executive producer and director John Wells and executive producer and showrunner R. Scott Gemmell. Today's shift starts now.
- [01:56]
Hunter Harris
Please, I have sickles. Okay, stop. Everybody stop.
- [02:00]
Dr. Alok Patel
Stop.
- [02:02]
Crystal McNeil
Open your locker. You're gonna regroup in your fucking locker or I will have security smash it open.
- [02:09]
Hunter Harris
Multiple gsws. There's an active shooter at Pitfest Hunter.
- [02:13]
Dr. Alok Patel
The Pit, like, came in hot with audience reviews, ratings. I mean, there's like, Reddit threads over everything related to every episode. But I think what really caught everyone's attention was how many Emmys the Pit won. I think it's 13 nominations, five wins Best Actor, supporting Actress, Guest actor. And then what was. What was awesome is it won the Emmy for Outstanding Outstanding Drama. It's like the Pit is, like, onto something from your perspective. What do you think is making the Pit this cultural phenomenon? Why are people so fascinated by this
- [02:44]
Hunter Harris
show, I think it's a lot of things. I think, first of all, the show is very good. It has this frenetic, fast pace. It feels like you're, you know, in these characters shoes at all times, which I think is really a testament to the performances and also just the directing and the writing. And I think that it's been a long time since a medical drama has, at least to a layperson like myself, felt like how it feels to be in the hospital. I mean, healthcare is like a nonpartisan issue right now. And seeing that from frontline workers is honestly very moving and very, like, personalized. Like they're putting faces to statistics or to, like, news stories in a way that I think is really special.
- [03:20]
Dr. Alok Patel
You're seeing it as almost like the show is humanizing all these headlines or stats. Like, that's how I'm. That's how I'm hearing what you're saying. Yeah.
- [03:27]
Hunter Harris
I also feel like maybe I'm a doctor now. I've watched enough of the Pit.
- [03:30]
Dr. Alok Patel
I mean, probably never. You're probably like going there and start doing some surgery as an intern. Just get your hands bloody, just dive in.
- [03:35]
Hunter Harris
But I want to ask you the same question, like, as a healthcare worker, professional, how do you feel like the Pit, why do you feel like it has that much cultural capital, so much resonance?
- [03:43]
Dr. Alok Patel
So I feel like I could answer this question over the course of like 15 hours because there's. There's so much to talk about. But I think one thing that's incredible is the Pit really nails the medical accuracy as much as you can for television. Obviously you have to take some liberties because you gotta make TV entertaining. I've joked with my friends and I've been like, if you made a really accurate medical show, it would be a bunch of us charting for a few hours, which nobody's gonna watch. But I really have to hand it to the writers, to ER doctors, Mel Herbert, Joe Sachs, who came in and add a lot of accuracy. The team themselves brought in so much real world experience. So for the medical community, medical accuracy, like watching these procedures, it felt reassuring because you're like, oh, my gosh, like, there's someone actually there making sure that they're in a legit looking er, that they're doing procedures, that they have the right type of equipment. But then also, this show didn't skip out on any of the characters, any of the actual real issues that people have in medicine. And it talks about in the first season, there is a single mother, there's issues with ptsd. There's topics about addiction, and they don't shy away from any of that. I think there's this perception sometimes that, like, doctors and nurses just all have their shit together, and it's. It's just we're. We're people. We're humans. And when you have baggage, you go to the hospital, and you just have to bring the baggage with you.
- [04:59]
Hunter Harris
Yeah.
- [04:59]
Dr. Alok Patel
And, like, Noah's mentioned multiple times throughout interviews that humans have to compartmentalize our issues. When you show up for your family, for friends, for work, you got to, like, try to separate these issues and then be present. And you have to do that in the hospital too. And they just portray that beautifully in this show.
- [05:15]
Hunter Harris
I almost wonder, like, to my mind, everything is medically accurate. Like, if you show a band aid, that's medically accurate to me. But they all act with such conviction that I'm gonna trust it outright. But I do really. Like, maybe one of my favorite parts of the show is that every hour is like an hour in the shift. Every episode is an hour of the shift. And it really. I don't know, it's like, I like how the personal becomes professional becomes personal again. And that kind of line between what is a private moment versus what's us just doing our jobs is really, really touching.
- [05:47]
Dr. Alok Patel
Oh, I love that. Yeah. Because teamwork is a huge part of it. And I'm glad you actually brought that up, because I think something else that this show does. It's very special, is it's not just a show about the star physician and the surgeon and the residents, but they really show you how a functional er, A hospital, is a real. It's a. It's a team effort. And you have a huge cast of characters, so, like, massive shout out to the pit for making charge nurse Dana such a central character. But she's like, the boss. Like, she runs that place. She almost, like, controls the TO and that's. That's real. Like, the charge nurses I know in the hospital, I would never mess with. They just. They know what they're doing. And I think the interns, like, allude to that. They're like, don't piss off the nurses, and things are gonna be good. That's real. And, like, Dr. Robbie has that respect. That's accurate. But then also, let's talk about the fact that Kiara the social worker, she is so incredibly important in the show, but in real life, like, we cannot run our healthcare system without social workers. It's not happening. But the social worker, Kiara, who's played by Crystal McNeil, like, that is such an important representation because there's certain situations in the hospital where, yeah, you see a patient and you've got, you know, diagnosis, treatment, the actual medical plan, but then they're human beings who still have needs, whether those are housing, transportation and other resources. And you gotta find a way to bridge that gap. So the fact that they had a social worker front and center, like, kudos. So when people in healthcare system see that, they're like, oh my gosh, they're actually elevating all of healthcare and really bringing out these frustrations.
- [07:19]
Hunter Harris
Yeah, I think from a character and like, structure, perspective, one of the things that I like the most about this show is that it's not a traditional drama where it's like you talk to the same 12 people every single episode. It really does, you know, have a moment of like, here's a police officer, here's a security guard, here's a nurse, here's like. And you might not ever see those people again, like in the course of the day or in the course of the shift, but they still are a part of the fabric of what makes the ER or ed, I should say, run. And that's really important. It feels like, you know, accurate to any workplace, not just the ed.
- [07:49]
Dr. Alok Patel
Like, I'm with you, by the way, where I can never decide if we call it the ER or the ed. I feel like TV is like er, and then in the hospital they'll say ED or like go to the ed, which is kind of funny. But then some people hear ED and they're like, oh, yeah, like erectile dysfunction. And I'm like, that's what I thought
- [08:03]
Hunter Harris
for a long time.
- [08:04]
Dr. Alok Patel
I'm glad you, you brought up characters. It makes me think about, like, how the show was created and it almost, to the untrained eye, like me, feels like theater, because I did read that it's a four sided stage. It looks like a real art when you walk in and the cinematographers had handled cams, and it just feels like this, like controlled chaos. But I wanted to ask you what stood out to you as, you know, as a journalist, but also as a screenwriter, Someone who truly understands how to bring a vision to life in theater. Like, what stood out to you in that sense?
- [08:35]
Hunter Harris
I think it's really character. I think the fact that, let's take McKay, for example, that we see her with an ankle bracelet and then, you know, we, like, don't really talk about it because you're in the course of a day. How are you gonna ask someone, why are you wearing that? What's that from? And it's like, mm, that it's kind of a slow rollout of all of these, like, personal details, I think feels so true. Especially as people who are, like, you know, working to save lives. The patient stories are also so moving. The brain dead teen from, like, episode seven three, I believe. Like, that one really. I was like, wow. And that's like, the top of the season, basically. Like, that's the beginning of someone's day. And that really moved me.
- [09:12]
Dr. Alok Patel
Oh, my gosh. And let's also talk about how when McKay took the drill to her ankle monitor, I was like, yeah, get the
- [09:18]
Hunter Harris
thing out of here. Loved it.
- [09:19]
Dr. Alok Patel
I love that they also. They throw these moments of humanity out. Like the ankle monitor. We'll stick with that. But they don't sit and make this whole, like, segment be like, I got an ankle monitor because of this case. Like, it's almost just like she throws it aside.
- [09:29]
Hunter Harris
Yeah.
- [09:30]
Dr. Alok Patel
Like, I'm a doctor. This is a little side story that audience can, like, think about and make your own judgment about. But this first season also tackled, as we mentioned, addiction and ptsd, but also these elements of child abuse, of overdoses, of human trafficking. There's a little nod to human trafficking, of, you know, situations with fertility. Like, there's so many of these societal issues that happen in the ER that they just kind of threw in to show people, like, you're dealing with the entire person. Were there any moments like that that stood out to you where you were like, oh, my gosh, like, this happens.
- [10:04]
Hunter Harris
Oh, my goodness. I think the, like, masking debate between two women and where one of the women was like, okay, I don't wanna wear my mask, but I want my doctor to be wearing his mask. That really hit home for me. I think that as much as you're saying there are such serious issues being tackled, something I like about this show in particular is that we also see kind of, like, lighthearted, more of like, okay, how did you get a nail in your chest? Like, that kind of stuff, which I think really speaks to maybe like, the levity that you can. The dark humor you can find in the middle of a very difficult day.
- [10:34]
Dr. Alok Patel
Humans gotta laugh.
- [10:35]
Hunter Harris
Yeah.
- [10:37]
Dr. Alok Patel
I'm glad the show includes that. Cause during the pandemic, people would see These videos, like TikTok videos, for example, in hospitals and say, oh, my gosh, why are they dancing? Why are they laughing? And not actively treating patients. And I'm like, well, in the break room after a shift, anytime you have downtime, like, doctors Nurses, technicians, everyone, they need this a little bit of a emotional release. And people have different personalities and so on the Pit. I love the fact that they included not only some of the banter between themselves and the dark humor, but they're joking with patients, too.
- [11:06]
Hunter Harris
Yeah, yeah.
- [11:07]
Dr. Alok Patel
Like, making these little comments here and there, which I think is, like, is so incredibly necessary.
- [11:12]
Hunter Harris
Yeah. Before we get ahead of ourselves and talk about season two, I need a little recap of season one. The big stories, the big characters, and, you know, bustling cast, I would say. So let's do a little recap of the big moments from season one.
- [11:26]
Dr. Alok Patel
I'm totally game. Before we do the recap, I gotta make sure that you and I are on the same page when we're trying to understand the hierarchy of residents.
- [11:33]
Hunter Harris
Please.
- [11:33]
Dr. Alok Patel
I know it's confusing. So we've got Dr. Michael Rabinovich, attending physician. He's Dr. Rob. He runs the Pit. Then he is mentoring these resident doctors of varying years. So you've got Collins, Langdon, McKay, Mohan, King, Santos, and then two med students, Whitaker and Giovanni.
- [11:51]
Hunter Harris
Okay.
- [11:51]
Dr. Alok Patel
Like, there's actually charts you can find online. But this is basically. This is the dream team. And basically anything and everything can come through that door, such as the case with a sickle cell patient. And I think this speaks to. What we were talking about, is about many themes that the Pit really illustrates in this case. A little bit about racism in healthcare, stereotyping and kind of making these assumptions without getting to know a patient and their situation. And this whole interaction with Dr. Mo and the sickle cell patient really illustrates that.
- [12:18]
Hunter Harris
Yeah. Let's watch it.
- [12:19]
Dr. Alok Patel
Let's take a look.
- [12:22]
Crystal McNeil
He's been screaming for narcotics non stop. We found an empty purchasing bottle.
- [12:26]
Hunter Harris
What are you doing? Why can't you call it?
- [12:28]
Crystal McNeil
He's been uncooperative and combative since we picked him up.
- [12:32]
John Wells
Stop fighting.
- [12:33]
Crystal McNeil
Calm the fuck down on calling the cops.
- [12:35]
Hunter Harris
My meds at home aren't working.
- [12:37]
Dr. Alok Patel
Please.
- [12:38]
Hunter Harris
I have sickle.
- [12:39]
Dr. Alok Patel
Sickle.
- [12:39]
Hunter Harris
Okay, stop. Everybody stop.
- [12:41]
Dr. Alok Patel
Stop.
- [12:44]
Hunter Harris
What's your name? It's Joyce.
- [12:46]
Crystal McNeil
It's Joyce.
- [12:48]
Hunter Harris
Joyce, is this your sickle Pain pain?
- [12:50]
Dr. Alok Patel
Yes.
- [12:50]
Hunter Harris
10 milligrams of IV morphine.
- [12:52]
Crystal McNeil
You really want 10?
- [12:53]
Volvo Narrator
Yes.
- [12:53]
Hunter Harris
Repeat it in five minutes if needed.
- [12:54]
Volvo Narrator
And she needs a Dilaudid drip.
- [12:56]
Hunter Harris
This is a vaso occlusive crisis.
- [12:57]
Dr. Alok Patel
I think that clip is so well done, it almost pushes the audience to check their own internal bias. It's like, would that be the same situation if she looked differently, if she was a man, if she was rich, if she was young? Like, how would that have altered? I mean, you immediately heard someone say, calm the fuck down or we're gonna call the cops.
- [13:14]
Hunter Harris
Yes. No. And look at how the security or the cops brought her into the hospital, like, holding her down, yelling at her. And the fact that Dr. Mohan asked for her name and asked, like, was listening to her and listening to her cries and hearing that she was saying, sickle cell is so moving. And also, who does this disproportionately affect other than black women?
- [13:31]
Dr. Alok Patel
Right on. I mean, listen, there's. There is a population who doesn't really understand or necessarily believe that racism exists in healthcare, but basically, every single study and patient survey says otherwise. And this clip is proof of that.
- [13:45]
Hunter Harris
But that's just one example of how good the pit is and how varied all of these conditions are. For sure, we have a complicated birth. We have a measles outbreak. And we also, toward the end of the season, have the. I would say, most affecting moment, which is the mci, the mass casualty incident, where it's all hands on deck, and we're. You know, it's really, really tense and dire.
- [14:09]
Dr. Alok Patel
The. The mci, the mass casualty incident that we are now kind of seeing. The. The intro of the shooting. The minute you hear Nurse Dana pick up that call, I think it just stopped every viewer in their tracks.
- [14:21]
Hunter Harris
Yeah.
- [14:22]
Dr. Alok Patel
Because we are, unfortunately, living in a time when mass shootings happen way too often. And the show knew that they not only had to make sure that the intensity was there, but that the accuracy was there. And they took the time to talk to trauma surgeons, er, healthcare professionals, especially those who worked in the hospitals after the Las Vegas mass shooting. And they went for accuracy, emotional accuracy. And I think they really did an amazing, incredible, heartfelt job in making sure this tragedy that happens all the time in America was portrayed the way it needed to be, not only with, like, these are the statistics, these are the headlines, but more like these are the humans who are actually in the hospital receiving these patients.
- [15:03]
Hunter Harris
Yeah.
- [15:04]
Dr. Alok Patel
Let's take a look.
- [15:09]
Hunter Harris
You're a good man, Rabinovich. Don't let this place take that from you. Okay.
- [15:19]
Crystal McNeil
Come on.
- [15:22]
Dr. Alok Patel
Yep.
- [15:24]
Hunter Harris
Code triage. Multiple gsws. There's an active shooter at Pitfest,
- [15:34]
Crystal McNeil
Jake and his girlfriend in there.
- [15:42]
Hunter Harris
So there is so much going on in this scene, but, I mean, we have to talk about how Nurse Dana was just punched by, like, an unruly patient, and she's now introducing what's gonna define the last back half of the season.
- [15:56]
Dr. Alok Patel
You're right. You can't help but notice the Black eye.
- [15:59]
Hunter Harris
Yeah.
- [16:00]
Dr. Alok Patel
And the fact that she almost has been through this before, and her character really kind of speaks to what nurses deal with on a regular basis. You know, surveys are showing that almost nine out of 10 doctors and nurses have experienced some type of assault who work in the ER like, it's wild. And that happens. And the creators of the Pit are like, hey, we're going to introduce major storylines, but we need to make sure that we elevate all these necessary conversations in healthcare.
- [16:26]
Hunter Harris
And something else. When I think about a mass casualty incident, I, of course, think about the victims, but I'm not thinking about the trauma that it can inflict on healthcare professionals and healthcare providers. Everyone who worked in the hospital that day saw something, felt something, and that this show shines a light on that also, I thought was very special.
- [16:43]
Dr. Alok Patel
Also, Noah Wylie delivers this amazing monologue at the beginning when he's kind of rounding everyone up.
- [16:48]
Hunter Harris
Yeah.
- [16:49]
Dr. Alok Patel
And he, like, flawlessly puts his arm out and, like, hits that slap bracelet.
- [16:52]
Hunter Harris
Yeah.
- [16:53]
Dr. Alok Patel
It's just, like. It's just all around amazing acting.
- [16:55]
Crystal McNeil
Triage will decide who goes where, depending on their injury.
- [16:58]
John Wells
Every department will have a designated primary who will oversee their staff. If you need someone, look for the vest. We're all going to have walkies.
- [17:06]
Crystal McNeil
We can get you whatever you need. No patient goes into a room unless it's a trauma bay. And they will have four patients each. We need to keep everybody out in the open so we can keep an eye on everything. Okay. Triage is going to assess and assign every patient to a specific zone with the colored slap band. Patient who comes in with a red slap band goes to the red zone, which is the trauma rooms with overflow out here.
- [17:30]
Hunter Harris
Something about Ravi, too, is that he's dealing with his own trauma and his own pain and trying to be that support for everyone else. He's still thinking about his mentor who passed away during COVID He's having flashbacks to the COVID Like, time of emergency rooms being overrun and that kind of carrying that with you into this extremely tense situation I think is like, I could not imagine. Something I want to go back to is Dana's black eye. We talked about it a little bit, but earlier in the day, she had a disgruntled patient who's waiting in a waiting room forever, and he sees her outside on a smoke break and hits her in the face. And I listen, I'll go to war for Nurse Dana. No, like, get behind me. That's my girl. I could not believe this happened, but I guess this violence against Healthcare workers is more common than I would ever think.
- [18:14]
Dr. Alok Patel
It's awful because people are frustrated with the healthcare system. Straight up. They're frustrated with how long it takes to get into an er. Then they get frustrated with things such as healthcare billing. There's so many issues out there. And then people break, and they oftentimes take it out on a healthcare professional, they take it out on a nurse, they take it out on someone. You have so many variables involved, and it happens so often. It's raising yet another very important topic being like, what are we doing to protect these people? Yeah, what are we doing to, you know, boost up staffing and security? And I think they, like this happens. It gives the audience, like, a moment to say, like, oh, I'm gonna. I'm gonna find that guy. The cops don't find him. You mess with nurse Dana, I will find him.
- [18:53]
Hunter Harris
I'm on the streets. I'm looking. No, let's watch
- [18:59]
Dr. Alok Patel
hard at work.
- [19:04]
Crystal McNeil
I'll take my chances.
- [19:18]
Dr. Alok Patel
People who work in the hospital are people, too, and they've got. They've got their lives, they've got their situations. The show highlights that. You know, Mel King is taking care of her sister. Dr. Collins is the dealing with a miscarriage. You got Whitaker. We find out who doesn't have a place to live. It's kind of wild. He's, like, living in the hospital somewhere, which kind of a smart move, though, rent free.
- [19:38]
Hunter Harris
How is this that smart? You can't live where you work.
- [19:41]
Dr. Alok Patel
You can't. I mean, like, sorry, that's bad. It's not smart. But Whitaker doesn't have a place to live, and that kind of highlights, like, you know, what people are going through to try to get training done. But the point is that, like, you know, you've got these personal problems in these issues, and you're still showing up for patience. And the show does a good job of kind of sprinkling in those problems. Question for you. When Santos started to notice that these drugs were missing and that the count of these benzos was kind of off and she was, like, calculating things, did you ever suspect that it was going to lead to this. This bombshell that Langdon is dealing with addiction?
- [20:17]
Hunter Harris
No, because I think the show kind of sets up her as being a little bit of a bully. But the fact that she ended up being correct in the end, I was totally taken aback because Langdon is kind of like the little bit of the badass, like, kind of like Hawkeye, like, big ego goes really f. And you don't want to see that. Person be, you know, undermined in some way. So that was a really good way, I think. Turn the audience's expectations on their head.
- [20:41]
Dr. Alok Patel
I like how you load up the hot guy.
- [20:43]
Hunter Harris
What can I say? He does have hair.
- [20:44]
Dr. Alok Patel
He's got good hair.
- [20:45]
Hunter Harris
He's got good hair.
- [20:46]
Dr. Alok Patel
I'll give him that. Yeah, yeah, he's got. And he also has this, like, almost like a younger brother, older brother relationship with Dr. Robbie. In that moment, you're like, are you rooting for Santos to be rooted right? Do you want to see the drama as a viewer with, like, Langdon and Robbie? Like, I didn't even know where I was going. But again, I feel like I'm like the fun police right now because I keep bringing up these real issues in healthcare. But unfortunately, yes, there are many people in the healthcare industry who suffer from addiction. But we see this, like, moment with Langdon and Dr. Robbie where it almost crosses over from, you know, I'm a physician who can help you to, like, I'm your older brother. What did you do to me? There's real emotions.
- [21:27]
Hunter Harris
Watch it.
- [21:28]
Dr. Alok Patel
Yeah, I'm already getting, like, tense thinking about re watching it.
- [21:31]
Crystal McNeil
Is the imprint code on these pills gonna match Louise Librium? Go home, Frank.
- [21:44]
Dr. Alok Patel
No.
- [21:44]
Crystal McNeil
No, it's not like you think. You remember whenever I helped my parents move? I was too cheap to pay for movers. I hurt my back.
- [21:50]
Dr. Alok Patel
I told you that.
- [21:51]
Crystal McNeil
You teased me about it, remember? Well, our own Dr. Hagan prescribed me some pain meds and muscle relaxers. I was just weaning myself off.
- [21:58]
Dr. Alok Patel
It was just for maintenance.
- [21:59]
Crystal McNeil
I'm telling Robbie. Come on. You know me, Robbie. You know me, man. I'm sorry. I up.
- [22:04]
Dr. Alok Patel
I just.
- [22:05]
Crystal McNeil
I. I was trying to. I still.
- [22:07]
Volvo Narrator
Pills.
- [22:07]
Dr. Alok Patel
No, you don't understand.
- [22:08]
Crystal McNeil
I don't fucking understand. Not like you think. I'm not high. I'm not high. You've seen what I do, Robbie. Could a drug addict do what I do? Apparently, I just let him. You're done. Leave now or I will have Ahmad escort you out. Robbie, please. You are done.
- [22:53]
Dr. Alok Patel
I wonder if he improv'd that.
- [22:55]
Crystal McNeil
What?
- [22:55]
Dr. Alok Patel
At the end. Cause it's so good. But, like, that is why the show won an Emmy for outstanding Drama.
- [23:01]
Hunter Harris
No, that's maybe my favorite scene in the whole season. I think it's so smart. Like, the way that I almost wonder if Robbie was kind of, like, not sure, but he has to ask as the most senior person on the floor. But the way that Langdon immediately, his mind jumps to Santos and just the way he, like, he acts guilty he says, guilty stuff, I think. And you can just see the pain in Robbie's eyes in a way that is so sad. And then my favorite line, you know, maybe of the whole show again, is when Langdon says, well, you've seen what I can do. Like, can someone who's like, hi do what I do? And Robbie says, apparently. And I just let him. Like, you feel the breakdown of, like, true friendship in that moment that Robbie is suddenly reevaluating a lot more than just what he's seen that day.
- [23:47]
Dr. Alok Patel
100%.
- [23:47]
Crystal McNeil
Yeah.
- [23:50]
Dr. Alok Patel
There's so much emotion in such a short amount of time in that scene. Like this rollercoaster.
- [23:55]
Hunter Harris
Yeah.
- [23:56]
Dr. Alok Patel
And it's like Robbie goes through, like, all the stages of grief, like, in 15 seconds.
- [24:00]
Hunter Harris
And Langdon plays it well, too, because you see the desperation, the kind of. Once he starts kind of flailing and being like, well, what about this and what about that? And then, you know he's done it. Then you know he's guilty and he's, like, really trying to cover his ass.
- [24:10]
John Wells
Yeah.
- [24:10]
Dr. Alok Patel
And then you're, like, torn, and you're like, no, I know that things are gonna go down in the pit. And I was like, no, no, no, we need Dr. Langdon. But then you're like, wait, no, no, no. He's struggling right now, and he just committed a felony. Wait, whose side am I on?
- [24:22]
Hunter Harris
But also, hello. The ED needs to be staffed. One more question for you. Okay. This show has really maybe called me out, not called me in about being, like, the know it all patient. There's a really. One of the most affecting patients. Is it the measles? The teenager with measles and the mom is like, don't give him the spinal tap. Because I've heard it could lead to paralysis. And it's like, okay, Dr. WebMD, like, you're talking to trained physicians. But she thinks that she knows it all. And I think in some cases, I am guilty of being the know it all patient who goes on Google and, like, gets very anxious about stuff. How often do you see that type of person and how do you manage that in the moment?
- [25:06]
Dr. Alok Patel
Anyone who knows me knows I'm doing my best to control my blood pressure right now.
- [25:10]
Hunter Harris
Yeah.
- [25:11]
Dr. Alok Patel
Because we see it all the time. All the time in almost every type of patient population condition to different extremes. Like, this situation was a pretty extreme example when it's a life or death situation and someone's saying, like, hey, don't give him a spinal tap. I have taken care of children who needed life saving blood transfusions and their Parents did not believe in blood transfusions, so they're like, do something else. You're like, I'm gonna get a court order to do this.
- [25:38]
Hunter Harris
Yeah.
- [25:38]
Dr. Alok Patel
And may have to get the police involved. So it does happen. And honestly, like, I feel for parents initially because people just want to do what's best for their families and their kids. But then all of a sudden, as you mentioned, the Internet is this. This, like, treasure trove of garbage. And you have, all of a sudden, you aren't paying attention to the real science. You aren't trusting doctors. And, like, Dr. Rabi, like, nails it when he gets mad and he, like, walks out the room and he says, I forgot the exact quote, but he says something along the lines of, she's going to go to Dr. Google for advice, but she doesn't want to actually get medical treatment in the hospital. And so, like, a major frustration people say is like, you're a know it all, then why did you come here for treatment?
- [26:17]
Hunter Harris
Love that.
- [26:17]
Dr. Alok Patel
And I. And I think with vaccines, just one example is people no longer fear the actual diseases that we are trying to prevent. Instead, they fear that whatever they're reading on the Internet. So, you know, this teenager in the show is intubated and has this potential neurologic condition, this brain inflammation, and they're like, what? Measles can do that? And Dr. Robbie's like, I guess I'm old because I just kind of know what's up. Like, that scene was. That scene was poignant. But listen, I respect. I respect an empowered patient.
- [26:47]
Hunter Harris
Well, okay, thank you. And let me say, it's usually about my dermatologist and I'm like, maybe a little laser here. Like, who knows? Like, maybe I do need it, actually. Okay, last question. I mean, maybe this actually speaks to what we were just talking about, that this show really has shown me how much of being a physician is about managing a patient's anxieties and even just like, their emotions as much as it is treating, like, what they've come in to solve. Does that feel true to you?
- [27:10]
Dr. Alok Patel
I think the interpersonal skills that it takes to be an effective nurse, doctor, healthcare professional is really highlighted in this show. And you can kind of see it in a few specific cases. I think there's that autistic gentleman who has, like, the sprained ankle and like, Dr. King goes in there and she just connects with him. There's the homeless woman who gets empathy immediately from Dr. McKay. We talked about the sickle cell patient, and Dr. Mohan connects with her. And that's something that we want everyone to kind of try to understand. Did that stand out to you? Or did you just kind of watch those play out and say, like, oh, that's just a doctor has good skills. Or did you pay attention and say, like, oh, no, that's that specific character who found their superpower?
- [27:53]
Hunter Harris
I mean, I know. I think it's a writing thing, right? It's like that patients are paired with a doctor who can maybe speak to them the best, or even the patients that maybe challenge the doctor the most. That's, I think, a really good marker, I think, who is a patient that did that. Maybe even like, Louis and Whitaker, Like, Louis is such a good character, and Whitaker is like, a little bit nervous, a little bit jumpy. And being met with a patient who has kind of seen it all before and feels very comfortable in the ed. That was like, a really good moment of like, okay, maybe the exact patient Whitaker needs to grow as a doctor is someone like Louis.
- [28:28]
Dr. Alok Patel
That's a great point. I think these interns, what we're seeing in real time is they're learning so much, not only from their mentors, from their nurses, but they're learning in real time from patients. And I actually think it'll be cool if the viewers and listeners of this podcast, like, wrote in on what type of doctor or what type of nurse actually connected with them. Because you hear those stories all the time.
- [28:47]
Hunter Harris
Yeah.
- [28:48]
Dr. Alok Patel
Hear about people who are like, hey, I was in a lot of pain and I was, like, dismissed by this doctor. But then this person actually listened to me. And those stories happen all the time.
- [28:57]
Hunter Harris
We have so many good questions here today, and I think a lot of good observations, too. Not to toot our own horns, but I'm tootin.
- [29:02]
Dr. Alok Patel
Wait, I'm not saying I'm tooting. I mean, I'm. Yes, I'm proud of us.
- [29:06]
Hunter Harris
Just save it. Just leave it there. Just leave it there.
- [29:07]
Dr. Alok Patel
It's okay.
- [29:08]
Hunter Harris
To talk more about intention and craft and impact, we have the executive producer and director, John Wells, the executive producer and showrunner, R. Scott Gemmell.
- [29:17]
Dr. Alok Patel
I was so stoked for this conversation.
- [29:19]
Hunter Harris
It was a good one.
- [29:21]
Volvo Narrator
When life gets unpredictable, preparation matters in medicine. It's all about staying alert, ready for whatever comes through the door. On the road, it's no different. That's why Volvo designs vehicles to help anticipate risk, reduce harm, and protect lives. The Volvo XC90's advanced safety systems inspire confident decisions wherever the road takes you. The Volvo X C90 for life, proud sponsor of the Pit podcast. Learn more@Volvocars.com US Spring is here, and
- [29:53]
Hunter Harris
there's a whole new way to chai at Starbucks that's made perfect for you. Choose your sweetness, Dial it up or keep things light. Add a touch of pistachio, a hint of strawberry or vanilla, or make it a spring classic with lavender. Because this season, there's endless ways to chai at Starbucks. Okay, our first question. The plot of this show, as viewers know, basically happens in real time. One hour of the shift is one episode. What is it like to work within a structure like that when it comes to, like, character development and pacing and even, like, the cases that you guys tackle?
- [30:28]
John Wells
Well, it was. It was fun. It was a little unnerving because we didn't know if it was going to work. And we honestly, I, you know, that lasted a while, you know, but it was good because it was new for all of us, as actors, as directors, as producers and so. And especially as writers. So we just. It forced you to lean in and sort of re examine what you do. And I think it led to sort of new stuff for all of us. But it comes with pros and cons. You don't have a lot of time to tell your story. But on the other hand, you don't. You can't get bogged down in melodrama and personal stuff. You have to, you know, all has to be in that 15 hours. So you have to be, I would say it's like more precision writing than anything else.
- [31:17]
Crystal McNeil
You're working within a frame, a very specific frame. And that frame is what actually happens to you during a single day at work. How much can you actually reveal? How do you learn about your co workers? What are you going to find out? What realistically happens? And as soon as there was a lot of, like, oh, you would never go that far. So there was a lot of paring back what we're doing, which I think is respect for the audience, the audience's intelligence to fill in the blanks and to be curious and interested about the people that they're just meeting at work.
- [31:50]
John Wells
Yeah. Like on a regular show, a network show, you know, who would fall in love over the course of the first season? Well, we only have 15 hours, so no one's fallen in love in 15 hours.
- [32:03]
Crystal McNeil
You know, I mean, you might be interested.
- [32:05]
John Wells
You might be.
- [32:05]
Dr. Alok Patel
Yeah.
- [32:05]
Crystal McNeil
But you're not. Like, you're not getting married, divorced and having a kid.
- [32:09]
John Wells
Yeah, exactly.
- [32:10]
Dr. Alok Patel
It'd be a wild show, family arc.
- [32:13]
Crystal McNeil
But that was really liberating because you're not thinking about it that way. You get rid of all the medical melodrama in the sense of the personal lives, the characters, beyond what you would actually experience during the course of a single shift. And that was really liberating.
- [32:29]
John Wells
Yeah, you're really in the moment. I mean, that was part. That's one of the reasons we did it in real time, was to bring the audience, really give them the sense of being in the emergency department. So once they got there, they can't leave and things aren't, you know, you see the painfully long day that everyone's sort of subjected to. And I think that was liberating for acting and directing and for the writing
- [32:53]
Crystal McNeil
and a challenge to try and remember where you were during the course of the day. Because the first hour of your shift we shot in July, in the last hour we shot in January. And yet you have to be experienced what it's like to be on your feet for 15 hours. So how far along in your exhaustion are. When's the last time you actually had something to eat? When did you actually last get to sit down? How does that feel physically in your body? Do you slow down? Do we slow down? Because you've slowed down. How do you ramp back up? So just as an acting and directing challenge, it was invigorating.
- [33:32]
Dr. Alok Patel
And throughout this very long day that you're portraying, the show also highlights a lot of really important story arcs that are talking about very important issues. Drug abuse and trauma and many social situations, sickle cell disease and more. How do you all decide what stories that we want to highlight and where they're going to fall in the season?
- [33:53]
John Wells
Well, we start. There's sort of two aspects to it. There's the stories you want to tell, and then there's the character. So we usually start with the characters. Where do we want them to be at the end of this shift? What's going on in their lives? And then we have the list of medicine and stories that we want to tell, and then we try and find which one is best for what character and what's going to, you know, is there. The medicine is always sort of the wallpaper of what's going on and what's even in the traumas. There's usually, and there should be anyways, something going on between the characters that really make. And that's really the story that's being told. The medicine is important, but it's also. It's really about how the doctors interact with each other, how they interact with the patients, and then what's going on internally with themselves.
- [34:46]
Crystal McNeil
And there's Tremendous amount of research that actually goes into determining what they want to talk about, rather than doing it kind of top down in the sense of what are the things that you want to see? A lot of it comes from talking to their two physicians who are in the room full time, who are writers on the show. There are four who rotate on set who are all actually in the emergency rooms when they're not with us. We had eight nurses to 10 nurses who are also on shifts, and they come in when they're not on shift to work for us. So they're telling us what they're concerned about. And then that's oftentimes what we already are aware of. But it's what are you worried about? What are you thinking about at work? And so those things like the amount of pressure that's coming back in the emergency rooms as primary care is less available, as 8 to 10 million people lose their health insurance, what is that going to mean for the people who actually now see people who could have had ailments that were diagnosed and treated more effectively in primary care suddenly coming through the door in very bad shape? So it's a process of trying to figure that out and also keeping track of that. This is a teaching hospital, and during the course of a day, how much does a medical student learn? Not a lot. They have experiences during the day. How much does a second year resident learn? What are they learning? What do they already know? What don't they know? And part of the challenge for us as we were doing the show is over the months that we were making the show, all of the actors got better more than the medical students and the physicians would have gotten better. So you're saying, like, this is only the fifth hour of your shift. You've had months to get better at these procedures, but you're not better at the procedures. So how do you unlearn what you've actually been learning just in the dexterity and physically on the set? So all of those challenges have been really exciting and I think kept the writing and the narrative and everything very invigorated.
- [36:41]
Dr. Alok Patel
Well, speaking of the physicians and nurses you talk to, you don't need me to tell you this, but this is already heralded as the most medically accurate show ever made. And I'm curious how, when it comes to the story arcs and what's happening in the procedures, how do the medical advisors help you kind of navigate what could be a plausible error versus what was conscious negligence, Especially when it comes to how they're treating patients, controlled substances and so forth.
- [37:06]
Crystal McNeil
Well, the doctors that we work with basically have veto power over the stories, which is one of the things that's really different for the writers. We oftentimes would say, hey, we want to do this kind of story. And they would go like in the past, they would go like, well, you could kind of do that.
- [37:21]
John Wells
We cajoled an interesting.
- [37:22]
Crystal McNeil
Yeah, we force them into it. The reality now is I go, no, that wouldn't happen. And so they constantly are keeping it honest and it's a real conversation. Because we're doing a 15 hour shift, we have the opportunity for it to take as long as it would actually take in the emergency room during that shift to deal with these patients. So from the acting point of view, we're oftentimes hiring actors, wonderful actors, saying, we're going to give you a role to audition for. This scene is going to be the seventh episode that you're on. Before that, you're basically going to be a background extra. We're going to meet you once you're going to be there forever, then you're going to have this great scene. That's a lot to ask of actors. You're going to be here for three months to do one scene. But it's trying to stay true to the medical accuracy. And on the set we have a full time ER physician who's there every single day for every single shot. And they will tell you, I can tell you as a director, you say, I got this. And they go, yeah, wouldn't happen that way. They wouldn't be there. They wouldn't be doing this. And so then you have to completely reconceive what you're doing, because it's very important that we're actually. The audience knows when we're making the artifice and we're getting as real as we can. And HBO Max has been extraordinary at allowing us to really show
- [38:44]
Dr. Alok Patel
what we
- [38:44]
Crystal McNeil
were never able to show before on television medical shows.
- [38:48]
Hunter Harris
Scott, I want to ask about the sickle cell storyline and how do you balance what mistakes are realistically possible for a doctor to make, like treating pain while still building tension and keeping the story feeling, you know, moving the momentum.
- [38:59]
John Wells
I think you just have to be honest, you know, I mean, I think that's the authenticity is part of the integrity that we bring. So that was a story we wanted to tell. You know, that's. There are some medical places within the US that are better at dealing with sickle cell because they see more African American. You know, D.C. is one of them. Pittsburgh wasn't one of them, you know, and that's at least what we were sort of. That was one of the stories we were getting across. And, you know, there's. That was also dealt with sort of racial profiling a little bit in terms of. Because she was an African American woman. She was. They immediately thought she was drug seeking, because she was. But she had a legitimate reason. She was in real pain. That's the other thing. We know that women in the emergency department, sometimes their pain is not considered as the same as it is when it's a man sometimes. So a story like that has so many different layers to it that it's worth telling. And we talked to the experts. That's how we knew that there were underserved populations. And how sometimes those individuals are treated as if they're coming in with a whole different condition just because they're not used. That hospital's not used to seeing it.
- [40:22]
Hunter Harris
I'm curious how you think about, like, closure on a show like this, where sometimes we don't really get to see, like, what happens to a patient after they leave the emergency room and how you feel about the audience's expectation, maybe about that in a show like this.
- [40:35]
John Wells
That's the reality of being an emergency doctor. You know, you. Some people go into emergency medicine for that very reason that they don't have to have regular patients. They don't have to follow up. You know, they basically call what we say, they treat them and street them. That's just, you know, and our show tends to follow the doctors and the nurses more than the patients, which a lot of shows may be more patient forward, and it's about the patient comes and we see the doctors save them. Whereas our show is more so about the doctors treating these patients, and then they're gone, you know, and sometimes we will follow up, but usually that's if a doctor or one of the characters wants to follow up. But the reality is they never, half the time, never see these patients again. And so, you know, once.
- [41:20]
Crystal McNeil
90% of the time.
- [41:21]
John Wells
Yeah, yeah, yeah, yeah. Probably more than that. You're right. And so that's just trying to be as authentic to the emergency department as we can.
- [41:30]
Crystal McNeil
And we've spent a lot of time in emergency departments and with emergency physicians. And I remember one time being in one, and there had been a very dramatic sort of gunshot and saving trauma team came down. They kept them alive. And at the end of that shift, which was probably 10 hours later, somebody came down and said, hey, that guy made it. And the physician was like, what guy seen 30 patients since that guy said, was that today? Oh, yeah, that guy. That was today. That's the experience in the emergency room for trauma physicians and emergency room physicians in major urban centers.
- [42:05]
John Wells
They're likely on the assembly line and let them go.
- [42:09]
Dr. Alok Patel
It's like controlled chaos.
- [42:11]
Crystal McNeil
Yes.
- [42:11]
Dr. Alok Patel
You know, and I think back. How could I not think back about the episode after the Pitfest shooting, which I think that hit healthcare, the healthcare audience in a different way. TV ratings are through the roof. Everyone talked about that episode in the beginning of it. You have triage tags, you have chaos in the er, people taking on different roles. You also have these small flashes of humanity and dark humor. As creators, as writers, what mattered the most to get right? Everything.
- [42:39]
Crystal McNeil
All of it. Yeah, everything.
- [42:41]
John Wells
I think all of it. You know, just the. You know, it's tricky when you do a story like that, because you're not. It's not. It's not fictionalized, you know, it is, but it's all based on things that have happened and tragic, tragic things. So I think you have to handle it with real honesty. I always go back to honesty, but I think you have to be careful and very empathetic about to those who did suffer that. So we just tried to do it really as close to the truth as possible. And we talked to so many people and watched a lot on the Las Vegas shooting and talked to survivors and talked to doctors who were involved and just tried to tell that story the way it would play out and really give. You know, we see these. We've almost become numb to them. It's almost like a weather report in terms of the. Today's mass shooting, you know, and then there's. You know, everyone says, oh, our thoughts and prayers are there, but you never see what really happens in the aftermath. And the aftermath isn't just the bodies. It's also the ones who survived that. And then there's also the impact it has on the doctors and nurses who had to live through that. You know, once the trauma's over, it doesn't end when, you know, when you patch them up. That trauma stays with the doctors for a long time. And that's ultimately what the first season Robbie's story was about, was that sort of trauma that he had never really dealt with, finally reaching ahead. And that led to, you know, what happens now in terms of how he deals with it.
- [44:27]
Crystal McNeil
And you have to maintain an integrity about how you're going to do storytelling because you're talking about experiences that people have had and you're honoring in some way the people who actually respond to that. So, sure, it's a gun control story, but it's primarily, let's not forget that every time one of the things happens, there are a whole group of dozens and dozens, sometimes hundreds of people who actually have to clean up, who have the aftermath, who have to deal with the aftermath, who have to talk to the families, who have to do all of this. Let's not forget that in these conversations, it's not just about constitutional rights. It's about who actually has to carry the weight of some of these decisions that we've made in our country about what we're going to allow and not allow to happen. I don't want to debate the constitutional amendment. I just want to say there are people who actually have to do this.
- [45:21]
Hunter Harris
Thank you guys so much. Thank you.
- [45:22]
Crystal McNeil
Thank you.
- [45:23]
Dr. Alok Patel
Hunter, that conversation was awesome. I feel like we needed, like several
- [45:26]
Hunter Harris
more hours and we have several more questions, too.
- [45:29]
Dr. Alok Patel
John R. Scott, if you're watching listening, let's get drinks and talk more. Hunter, what stood out to you from that conversation?
- [45:35]
Hunter Harris
The idea of medicine as the wallpaper. That was a really good visual. And like the doctors, the patients, the character stories, as the set dressing, that was really special. I don't think any other medical drama thinks about medicine in that way, which shows why this show is different. What about you?
- [45:52]
Dr. Alok Patel
The passion that they, they both have, the integrity they both brought to the script, the fact that they went and talked to so many people in the healthcare industry to make sure that it was not only entertaining, but it just raised awareness in the right way, made it relatable, all of it. That's it for today's episode of the Pitt Podcast. We'll be back here every Thursday right after each new episode drops.
- [46:12]
Hunter Harris
You can watch us on HBO Max or wherever you get your podcasts. The Pitt 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. And our video producer and editor is Anthony Q. Artis with assistant editor Damon Durrell Hinson. The show is engineered by Tommy Bazarian. Our production managers are Ebon Ochoa and Tony Carlson.
- [46:38]
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. I'm Alok Patel.
- [46:48]
Hunter Harris
And I'm Hunter Harris. We'll see you next week in the pit.
- [47:01]
Volvo Narrator
When life gets unpredictable, Preparation matters in medicine. It's all about staying alert, ready for whatever comes through the door. On the road, it's no different. That's why Volvo designs vehicles to help anticipate risk, reduce harm and protect lives. The Volvo XC90's advanced safety systems inspire confident decisions wherever the road takes you. The Volvo XC90 for life. Proud sponsor of the Pitt podcast. Learn more@volvocars.com us.