Noah Wyle, left, Mackenzie Astin and Rebecca Tilney, right, in a scene from The Pitt.Warrick Page/The Associated Press
When Amie Archibald-Varley first tuned into The Pitt a few weeks back, she was skeptical.
As a registered nurse and health equity specialist in Toronto, she has mostly felt irritated by airbrushed, oversexed portrayals of her workplace on television.
“I thought it was going to be more of these not-a-hair-out-of-place actors, and we’re supposed to believe they have just worked a full shift,” Archibald-Verley says. But by the end of the pilot, she was a convert – and not just because The Pitt has plenty of bad hair.
She had watched the first episode with her husband, who suggested a break: “He was like, ‘I can’t believe you can watch that doing what you do – it gives me so much anxiety,’” she recalls.
Her own take was totally different. Rather than feeling anxious, she felt seen: “I was like, “Wow, this show actually gets it.’”
Amid an extremely crowded class of new hospital-set entertainment options, HBO Max’s Noah Wyle-fronted entry is best in show.
It’s praised by critics (97 per cent on Rotten Tomatoes), Stephen King (an unabashed stan who described the show as, “Realistic and heart-wrenching. Come for life-or-death medical situations, stay for the human drama, which is real rather than corny”) and by actual health care professionals such as Archibarld-Verley, who appreciate the unvarnished representations of their daily reality.
Like the medical landscape it portrays, The Pitt is a product of the pandemic. Wyle, who was still getting fan mail from ER devotees 30 years after that show premiered, started to notice a distinct vibe shift: fewer mash notes to Dr. John Carter, more stories from nurses and doctors about the challenges they were facing.
“Something is going on in health care, and I think we need to talk about it,” is how the actor put it to his friend and ER showrunner John Wells. One year (and one lawsuit launched by the estate of ER creator Michael Crighton), and The Pitt is staging those essential conversations.
Sure, there is a nostalgia element that comes from seeing Wyle back in a familiar setting (squint and our current chaos falls away to a time when the controversial cut everyone was talking about was George Clooney’s Caesar-inspired do). But the emergency room at Pittsburg Trauma Medical Centre is oozing 2025 (along with various other bodily fluids that are forever sending Whitaker to the clean scrubs dispenser).
There are storylines that deal with COVID explicitly (Wyle’s Dr. Michael “Robby” Robinovitch is managing post-pandemic PTSD and the loss of his beloved mentor to the virus), but it’s also the run-off issues: staffing shortages, burnout, an argument about mask-wearing that briefly turns the waiting room into a boxing ring.
Wait times don’t necessarily sound like must-see TV, but here they lead us to The Pitt’s true bad guy: an underfunded system.
“Going there” is how Archibald-Varley puts it: Whether it’s a storyline about a sickle cell anemia highlighting medical racism and frequently dismissed Black pain, or the conflict between Dr. Robby and the hospital’s chief administrator who is constantly demanding higher patient satisfaction scores while refusing to hire more nurses, the show is true to life.
“Watching that I was like, ‘Oh my god, someone is actually listening,’” Archibald-Varley says. “We may have a different system in Canada, but it is that same thing of wanting to stick a band-aid on problems rather than address the root causes.”
After watching a few episodes, Mattias Berg, an ER doctor at St. Paul’s Hospital in Vancouver, was struck by the ways that The Pitt echoed his experience. A little research revealed that one of the consultants on the series is the founder of EM:RAP (a popular platform for emergency care education that Berg uses to update his skills).
Watching can feel like a game of ER bingo: “The guy who came in with the nail gun to his heart – I had that patient!” Berg says. Overall, he says he’s probably encountered about 95 per cent of the show’s dramatized scenarios. “That’s over 10 years as an ER doc, though,” he clarifies, “not all in one shift.”
The show’s high-concept structure – each episode is a real-time hour, and the season plays out chronologically over a single shift in the same ER – does require a certain amount of suspension of disbelief. But it functions in service of greater emotional truths.
There are no table-setting voice overs and tear-jerking conclusions to bookend each episode (and we never head back to a character’s apartment or over to Joe’s for a tequila shot). Instead, it’s just one gruelling case (and hour) after the next.
Dr. Robby doesn’t even get that pee break until the fourth episode. Instead, he’s been counselling two adult children about end of life decisions for their near-dead father. It’s a frustrating and tragic and psychological tightrope walk.
Our hero isn’t flexing his scalpel skills so much as exhausting emotional energy, and amongst the many things The Pitt gets right, this stands out.
“Compassion fatigue is very real for medical workers, and it can be hard to talk about when you are surrounded by other people’s grief,” says Berg, who just recently got told to burn in hell by his patient. “Doctors are human, and it can be tough.”
Which may be why prefers Wyle’s scruffy, wounded, hoodie-wearing top doc to other McDreamier portrayals.
“You’d think it would be gratifying to see your profession portrayed like rock stars, but it’s actually so much more rewarding to watch a show that recognized the struggle,” he says.