Just Another Day in Paradise

As a person that grew up in the 1990s I, of course, watched a few episodes of ER For a while there the medical show (which debuted in 1994 and aired until 2009) was a cultural phenomenon. It was one of those water cooler shows (not that I worked at a job that had a water cooler when I was a teen), something people would talk about week after week as the various dramatic storylines played out. I didn’t watch ER religiously as I was far more into video games at the time, but I did think some of the characters were interesting and I didn’t hate seeing the show if it was on when I was browsing TV or was over at someone’s house.

Naturally, when the show ended, the various people responsible for it went off to work on other projects, but the show stuck around in their minds, not quite ever going away. Star Noah Wyle and series producers R. Scott Gemmill and John Wells kept in touch over the years, and when an idea struck to follow up with Wyle’s character Dr. John Carter from ER, finding him in charge of the Emergency Room of a different hospital, dealing with contemporary challenges in the medical industry, due to the corporate takeover of the medical industry as well as what happened in the wake of COVID-19, the three felt like it was a good enough idea to pursue as a spin-off revival of the series.

There was only one problem: ER was based on a spec script by author Michael Crichton, and negotiations with his widow over using the license for a continuation did not go well. In the end the idea of doing the show as an ER spin-off was abandoned, but the three creatives still liked the idea of getting the band back together for a new medical show. Change the names a bit, move some things around, and what was going to be an ER continuation was morphed into The Pitt, a new medical drama with some familiar faces in front of and behind the cameras.

The Pitt follows Dr. Michael "Robby" Robinavitch (Noah Wyle), senior attending physician in charge of the emergency room at Pittsburgh Trauma Medical Hospital, during a single shift at the hospital. He arrives at 7:00 AM and already things seem off for him, primarily because this day is the five year anniversary of the death of his best friend and mentor, Dr. Malloy, who worked at the hospital and died during COVID-19. This is the first year Robby has worked on that date and, obviously, it’s had some effect on him.

Still, there is a job to do and Robby has to oversee the emergency room through it all. That means dealing with people injured after getting hit by a train, children that have died from drowning, disease, or overdose, trauma victims and people with bad tickers. And there’s even a disturbed teen who might just be looking to hurt some girls and cause a major incident… but that’s only a possibility. It all comes to a head right when everyone is supposed to go home from their shift, after a mass shooting occurs at the local music festival. Then it’s suddenly all hands on deck as the emergency room is converted into a field medical center to handle all the people coming through that could be saved, might be beyond hope, and to gather those that are already dead. It’s a stressful day in the Pitt for all involved.

Sitting down to watch The Pitt, it does feel in some ways like picking up with ER after a long time away. Developed by three people that worked on the show, with other writers and crew members from that series coming back to work on this newer series, you can feel how smooth it is for all of them to pick it all up and carry on with the production all over again. The name might be different, sure, but these are practiced hands at the helm that know what they’re doing, and the series gets up and running with minimal growing pains. There might be a few lines there for the audience to understand what’s going on, a couple of quick asides that feel like they’re meant for us and not the characters saying them, but that’s quickly over and done with in the first episode and we’re off to the races from there.

With that said, The Pitt has one narrative quirk that sets it apart from ER: this show is (more or less) air in “real time”, with the entire 15 episode season of the show taking place over 15 hours of a single shift at the hospital. ER was a week to week check in with its characters, and a single 45 minute episode would cover a day in that show’s emergency room. Plotlines breezed along, medical conditions were dealt with one way or another, and the show moved at a fast clip. The pacing is different in The Pitt because not all problems can be solved in a single hour, and that makes for a show that has different narrative dimensions to it.

Take the case of a teen boy that is found unconscious and not breathing in his family home. He’s rushed to the hospital but is already brain dead by the time the doctors get him. They do what they can, but when the parents come in, Dr. Robbie has to explain to them what happened to their child: he took a drug laced with fentanyl and it killed him. They ask for tests that can show he still has a chance, and Robbie runs those off, and more off, letting them work through their grief while the tests process, only to prove their boy is gone. Meanwhile, another girl is rushed to the hospital, also suffering the effects of a fentanyl-laced drug. Soon the pieces are put together and the doctors figure out that these teens, and a few others, took black-market Xanax to help them sleep after an all night study session, and the Xanax killed them. The parents finally accept their son is dead, and then donate his organs, and there’s a whole ceremony for the boy as he’s moved out of the emergency room.

This is a storyline that takes place over multiple episodes of The Pitt, with the teen boy coming in during one episode, the girl showing up in another, the parents arriving, and then over the course of several more episodes they process their grief and accept their son is dead. It feels natural, the whole process for them, and the show gives this plotline time to breath while other stuff happens in the department. This is the kind of plotline that would have been condensed into a single episode on ER, told through four or five scenes before the characters were ushered off, never to be seen again. But here, on The Pitt, the plotline gets the kind of time it needs to become something more, and that time really brings the whole storyline to life.

Or take the mass shooting plot line. On a standard broadcast show, like ER, this would be reserved for a Sweeps Week special event, or as a cliffhanger for a season finale. It’d be one episode that condenses all the effects of the event into a single episode, and it likely would happen at the hospital and not somewhere else with the patients then getting ferried in. But on The Pitt we get four episodes for this story, letting it build up to the moment the patients start arriving, allowing us to go through the whole triage process, and then, four hours later, start to see patients get released as the event ends and the hospital can slowly shift back over to normal operations. It feels more realistic, more like something a real hospital would do, and while sure this is still a drama with character dynamics and big moments and everything you expect, it plays differently in this “real time” format.

Credit for getting the audience invested in the show does also have to go to the writing and the acting. The series gets you invested in its core, sprawling cast of characters, from Wyle’s Dr. Robbie, to the two senior residents, Tracy Ifeachor's Dr. Heather Collins and Patrick Ball's Dr. Frank Langdon, the new student doctors, Isa Briones's Trinity Santos, Gerran Howell's Dennis Whitaker, Shabana Azeez's Victoria Javadi, and many more characters on the show (too many to list in a single article). They all have their personal motivations for being there, background storylines playing out while they’re working, and everything else you’d expect from a diverse cast of characters all crammed into a single hospital floor. The show does a solid job of making all these characters feel different, fleshing them out and giving them character moments specific to these people. It works very hard to ensure you care about the people on screen and what to see what happens to them next.

Really, it’s like a much improved version of ER. It has the storytelling and character dynamics that got so many people interested in that series, on top of a “real time” format that allows the episodes and storylines time to breathe. It’s a solid version of a medical drama for the current streaming world, with episodes that can easily be binged back-to-back-to-back due to that constant, hour-to-hour format. It works so well in so many ways, it’s easy to see why it was an instant hit.

The series will be back for a second season next January and I can already say I’ll be there to watch it once the series is fully available on HBO MaxThe oldest and longer-running cable subscription service, HBO provides entertainment in the force of licensed movies along with a huge slate of original programming, giving it the luster of the premiere cable service. Now known primarily for its streaming service, HBO Max (formerly Max, HBO Max, HBO Go, HBO Now, et al).. It’s a solid medical drama, and while those aren’t usually my things, week-to-week, in this format and told this way it makes for a hard to put down streaming binge. It’s well worth the watch sometime between now and January 2026, just in time to see what the next day with these characters entails.