Why the Lessons From The Pitt About American Healthcare Are More Accurate Than Most Medical Dramas Have Ever Managed to Be

Early in the second season of The Pitt, Noah Wyle’s character Dr. Robby leans against a wall in a hallway that hasn’t been cleaned in hours, and you can practically smell the place. Over something worse, use bleach. Compared to entire seasons of previous medical dramas, that one shot is more effective. Without anyone having to say anything, it tells you where you are.

Since its January return to HBO Max, the series has developed an odd kind of reputation. Physicians adore it. On Reddit, nurses debate it for hundreds of comments at a time. Even when they disagree, they take it seriously, treating it more like a colleague’s viewpoint than a source of amusement. That’s unusual in and of itself. That was never understood by Grey’s Anatomy. House didn’t either.

The Pitt appears to recognize that American healthcare is not a backdrop, something that most medical dramas have been dancing around for thirty years. It’s the adversary. Imagine the construction worker who already owes $100,000 in medical bills and is rationing his insulin. It’s not a plot device disguised as social commentary. An emergency room physician in Cleveland, Phoenix, or Pittsburgh could have entered it yesterday morning before coffee.

One comment made by emergency physician Brady Pregerson, who reviewed the program for Pulmonology Advisor, really resonated with me. He meant it as the ultimate compliment when he compared The Pitt to ER, which he watched during his medical school years in the 1990s. ER played a role in the careers of a generation of doctors. You suspect that no one is being recruited by the Pitt. What people already feared is being confirmed.

In a piece published in The New Yorker, Dhruv Khullar made an important distinction. According to him, the most technically accurate medical shows aren’t always the best. They are the ones who depict the experience of doing the work. The tiredness. The fleeting moments of grace, almost embarrassing. The administrators who are more concerned with complaints than with making repairs. According to a 2022 ACEP survey, 85% of emergency physicians believed that workplace violence had escalated during the preceding five years. Burnout was reported by 87% of respondents. You realize the true meaning of those numbers when you see Robby recoil at a beeping monitor.

The format is another. About an hour of a single shift is covered in each episode, which may seem like a gimmick until you realize that it forces the show to act like real medicine, where nothing is resolved neatly and the next ambulance is already arriving. Catharsis powers the majority of TV hospitals. This one doesn’t. Cases are transferred. In waiting rooms, people pass away. In between scenes, a nurse you’ve grown to like quits.

British viewers, who began watching the series in late March, have reacted with a certain kind of horror that is difficult to ignore. Even though the NHS has its own problems, those who haven’t lived there are still shocked by the financial cruelty woven throughout American healthcare. Perhaps The Pitt excels at bridging that gap between the system that Americans accept and the one that outsiders clearly see. Even though it has long since become routine for the people inside the building, it refuses to make any of it appear normal.

It remains to be seen if the show makes any changes. Most likely not. Seldom does television. However, the doctors and nurses who are observing believe that something exceptional is taking place. They are being observed.