Medical dramas are like the old aphorism about pizza and sex: Even when they’re bad, they’re still pretty good. Since the glory days of ER faded in the late ’90s, there have been plenty of TV series of varying quality set in hospitals. But the best ones have always taken a flashier storytelling approach: the elaborate mystery-solving of House, the soapy romance antics of Grey’s Anatomy, the early-20th-century grotesqueries of The Knick. Those efforts, however, have been few and far between, leaving wanting viewers to subsist on thin gruel such as Chicago Med, Code Black, and The Resident—all pale imitations of ER at best. I had been longing for something more meat-and-potatoes—and then along came The Pitt, Max’s hit new show starring ER’s Noah Wyle. The first season is still airing, yet it’s already without question the finest example of the genre in more than a generation.
I’ll admit, somewhat cheekily, that my interest in The Pitt was first piqued by an ongoing lawsuit. The author Michael Crichton’s estate sued Warner Bros. over The Pitt’s very existence, arguing that it was an unauthorized, thinly disguised reboot of ER. Crichton (who died in 2008) created the NBC smash in 1994, which was based on his 1974 screenplay about his own experiences as a medical student; his actual participation in it throughout its 15 years on the air, though, was minimal. The other thing that caught my eye was Wyle’s involvement, along with that of ER creative luminaries such as R. Scott Gemmill and John Wells. Their presence certainly suggested a program that was trying to harken back to the genre’s better days: straightforward stories of doctors and nurses moving through case after case with steadfast professionalism.
It turns out that The Pitt’s rendition of this formula has a twist, perhaps enough to distinguish it from ER in a copyright sense. The 15-episode first season encompasses a single shift in the emergency room of the fictional Pittsburgh Trauma Medical Hospital, hour by hour. Where an installment of ER might take place over a day or two, The Pitt’s structure allows it to be super granular. The original regular ensemble of ER was just four doctors, a medical student, and a nurse, for example, whereas The Pitt has a credited ensemble of seven doctors, two students, and a nurse. The tighter focus allows the story to explore, with even more realism than its predecessors, how trauma cases progress. Meanwhile, the slower pace helps viewers settle into the comforting routine of watching people be good at their job.
That repetition is the secret sauce to any great procedural series: Audiences love watching people be good at their job. That doesn’t mean these stories can’t include interpersonal conflicts and flawed characters. But the gestalt of almost any long-running drama about professionals such as detectives, lawyers, and doctors is the mega-satisfaction that comes with observing core competence. Crimes will be solved, cases closed, and maladies healed; yes, sometimes things will go wrong, but only rarely—so that the program can emphasize how often things go right instead. The Pitt follows an ultra-concentrated version of this formula by zeroing in on an emergency room, because the job of a trauma doctor is just to stabilize patients and then move them along. Plenty of emotion is mixed in with all the medical jargon, but the task before each member of the staff is always the same: keep beds clear and patients moving.
Wyle has plenty of experience projecting competency after playing the emergency physician John Carter for most of ER’s run. Carter arrives as a fumbling, awkward, lovable med student—the audience surrogate in the chaotic and intense environment of a fictional Chicago emergency ward. But he stuck around long enough to become the wise veteran, setting the tone for the other residents and functioning as a sort of moral bedrock. I grew up watching Carter’s journey and continue to think that Wyle is one of TV’s most underrated actors; though he got five Emmy nominations for ER, other cast members such as George Clooney and Julianna Margulies emerged as bigger stars. I worried, however, that The Pitt might feel like little more than an easy nostalgia play for him.
I shouldn’t have: His performance as Dr. Michael Robinavitch, known to everyone as “Robby,” has a pretty healthy distance from Dr. Carter—he’s earthier, grumpier, and appropriately world-weary in his leadership. Robby, the senior attending physician in the hospital’s ER, is reckoning with PTSD from working the nightmarish early days of the coronavirus pandemic, a current-day wrinkle that The Pitt handles with a lot of care and sensitivity. Apart from that contemporary struggle, Robby faces timeless dilemmas, in which he often assumes the role of a reliable mentor. Not all of those dilemmas are high-risk, either: One of the most memorable problems he’s dealt with thus far has been his need to use the restroom, only to be held up repeatedly.
Wyle’s steadiness is pivotal to The Pitt’s success, but just as crucial is the carefully formed ensemble around him; the real pleasure of any good hospital show is watching doctors philosophically ping off one another. Over the slow build of the season, character details emerge without need for much didactic exposition. A quick favorite is Dr. Mel King (played by Taylor Dearden), whose experience taking care of her neurodivergent sister has made her a particularly empathetic doctor. But pricklier characters, such as Isa Briones’s Trinity Santos (an impatient intern with ambitions beyond her station) and Victoria Javadi (Shabana Azeez), a “nepo baby” medical student struggling to distinguish herself, are vital figures in many of The Pitt’s background plots. Tackling tough medical crises comes first, but the writers have skillfully set a dozen subplots bubbling on the stovetop and tended to them throughout the season.
The mix between the personal and the professional is key to making a hospital drama work. So why has The Pitt been so much more rapturously received than its contemporaries? Chicago Med, for example, has delivered solid ratings for years on NBC, but The Pitt has become the stuff of online discourse and fandom in a manner that feels unusual for a straightforward procedural today. The easiest answer to its popularity is the genre blending—that the real-time concept, in the vein of the espionage thriller 24, helps the series stand out from the competition. This format comes with constraints; each episode can cover only a specific portion of a single day. But the show uses its efficient storytelling to create a quiet sort of magic—something that is very, very hard for even the best TV programs to get right. Just a few moments with anyone gives the viewer enough to remember them by; we pick up quickly that, say, Dr. Cassie McKay (Fiona Dourif) is adept at sussing out patient backstories, and that Dr. Samira Mohan (Supriya Ganesh) is compassionate to a fault. The audience becomes invested from minute one, making it possible to build impressive emotional arcs despite the restrictions of The Pitt’s central gimmick.
My biggest anxiety about the show’s future is what will happen when its small-scale realism must be trumped by end-of-season stakes. Every major hospital show has confronted this tonal clash throughout its run; stalwarts such as ER and Grey’s Anatomy have depended on ever larger and more absurd set pieces (tank invasions, ferry disasters, helicopter crashes) to ratchet up the action. These situations always come off as incongruous at best and like transparent efforts to drum up ratings at worst. The major incident that The Pitt has been leading up to—a shooting at a music festival—was telegraphed well in advance, by comparison, and it strikes me as finding the right balance between a big moment and the smaller moments within it. The shooting is the kind of scenario that would overwhelm an already taxed emergency room, but it’s also the kind of real-world crisis that’s depressingly common of late. If the next season of The Pitt (which Max has already ordered) sticks to this grounded level of catastrophe for ballast, I’ll be satisfied—because what I’ll really be coming back for is the little things.
