So... I Need to Talk About "The Pitt"

Yes, like everyone else, we heard great things about this show on HBO Max. 

However, I normally do not watch hospital shows for three reasons.

1) They tend to devolve into soap operas about the characters' and their families' lives outside of the hospital.

2 After over thirty years designing and testing medical devices, they remind me too much of being at work. 

3)  They get A LOT wrong.

Fortunately, Rosa decided to give it a try, and I quickly went from having scenes catch my interest as I passed, to watching the second half of season one in large chunks with her. 

In between when we were watching season two as it aired, I caught up on the episodes I'd missed during exercise time, making what I'd already viewed make far more sense.

It turns out the show had answers to all three of my usual issues with Hospital shows and then some. They were all addressed by excellent writing and research. This let the fantastic performances completely capture my attention. It is a testament to the quality of the show that:

A) I didn't notice there was no background music until someone else pointed it out in a review part way through season two.

B) I am continually surprised seeing the cast photographed dressed all fancy, as actors usually are, because of the strong association of them I have with their scrub wearing personas.

Here is how it addressed the reasons I usually don't watch this sort of thing.

1) Because of the "real time" nature of the show, (15 episodes per season, each one hour of a fifteen hour shift) there isn't an opportunity to devolve into a soap opera. Yes, personal issues arise, but they are presented as they interact with the work day. Home life does affect everyone, as it does in real life, but we don't have to waste time seeing it in detail.

2) The show reminds me of work, but in some good ways. The demonstration of what quality leadership looks like is spot on, as well as deficiencies in that area. Those deficiencies can come from both internal, stress related concerns, as well as the interpersonal fit between folks. Overall it has great examples of both leadership and mentorship, which are two different sets of skills. There's also the give and take between those with a great deal of experience (hello!) understanding what has worked best in similar situations in the past and why, and those fresh out of school with training in the latest, more advanced methods. The positive effect of the young people not having had their optimism and enthusiasm beaten out of them by life yet helping the overall morale is also nice to see illustrated accurately.

3) The creators of this show have done insane amounts of research into the accuracy of the medical procedures and protocols. Also, to borrow from other online reviews, anyone making a horror movie should be calling the practical effects crew from this show as it looks amazingly (and sometimes disgustingly) real. Setting the show in a teaching hospital provides reasons for exposition and explanations of what is going on to the medical students (in story) and the rest of us sitting on the edge of the couch (at home). They have admitted a couple of alterations are necessary for television. The staff is streamlined for story telling purposes. However, there have already been instances when a missing specialist who is normally seen in the ER, like the pulmonologist, neurologist or orthopedic surgeon, was added in the second season. They have also admitted that the CPR compressions are too shallow when done on a human, to prevent breaking any actor's ribs. Yet, they do include ribs cracking and it being pointed out as normal during those procedures in story. Another way they accomplished the realism is via the "choreography" for lack of a better term. Instead of sets for individual rooms with an "open fourth wall" as many series use, they built a fully sized and stocked ER. There are very few cuts, and instead the action flows organically as it follows the doctors and nurses around from patient to patient. The realism extends to the fact that every patient has a story, and their interaction lengths vary from those that are followed the whole season, to those that are transferred elsewhere, treated quickly, or (sadly) lost and never heard from again.  Every medical decision for every one of those patients is based on a benefit risk analysis, just like every medical decision should be made in real life, whether it is for a patient's specific treatment, or an element of design of a device.

There is one aspect that has kept me involved in this show more than any other, and it is a combination of the second and third element above.

The Pitt shows what I have seen working for a medical device company for over three decades. 

Healthcare workers are highly skilled and also supremely compassionate individuals who nearly always have patients' well being at the core of who they are. Sometimes they protect themselves through outward cynicism, dark humor, or emotional detachment, but that core feeling is always there. This includes those who have left the clinical setting and "gone corporate" working for my company. That passion never leaves them. Throughout my career I've made it a point to always listen the most carefully to the people whose main purpose is to emphasize there is a patient on the other end of our devices.

The show illustrates how that belief remains, though tested by irrational patients, financial limitations of treatment, the most questionable portions of this country's health care system, and elements of both government and society that seem designed to counter their good works. It also shows the physical and mental end effects on the health care workers of that constant testing. Sometimes that pressure combined with the continued stress of making life or death decisions can grind them down. However,  the patient focus always remains.

A special shout out on accuracy goes to Nurse Dana. She has perfectly portrayed just about every head nurse I've spoken to in clinical settings who are really running the show protecting their staff and keeping it patient focused. There have been many occasions we have been called into hospitals to have the doctors "discuss" both issues and "issues" they've had. Inevitably after that meeting, someone says. "Now lets talk to the nurses and find out what is really going on."

Final thought- I am convinced Doctor McKay had an ankle monitor in season one because she really is Bart from Dirk Gently's Holistic Detective Agency, who has turned her life around after escaping Project Blackwing. While being one of the most openly compassionate members of the team (which is saying a lot) there are times she looks more than ready to efficiently take out the more problematic visitors to the emergency room who prevent others from getting care.