Local ER doctors agree: ‘The Pitt’ gets it right, from overcrowding to empathy

Local emergency department physicians are giving a thumbs-up to “The Pitt” — the new hit TV medical drama streaming on MAX through April 10.

The Thursday night series follows frontline healthcare professionals in a fictitious Pittsburgh hospital as they treat the critically ill, navigate workplace politics and wrestle their personal demons.

Noah Wyle — an actor with Jewish and Pittsburgh roots — plays The Pitt’s main character Dr. Michael “Robby” Robinavitch, a senior attending still haunted by flashbacks of the COVID pandemic, which claimed the life of his mentor. The character is Jewish.

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The show’s 15 episodes progress in real time through 15 hours in “the pit” — Robinavitch’s nickname for the hospital’s emergency department — as he and his staff barrel from one crisis to the next while coping with overcrowding, limited resources and tensions with hospital administrators.

Unlike other medical dramas, the on point portrayal by “The Pitt” of both the clinical and sociological dimensions of an emergency department resonates with the program’s devotees.

Dr. Joel Rosenbloom, of Allegheny Health Network’s Forbes Hospital, tuned in because of the buzz he was hearing from colleagues, and because he is familiar with Dr. Mel Herbert, a consultant on “The Pitt” as the founder of EM-RAP, an online educational tool that Rosenbloom sometimes utilizes.

“The show is well done,” said Rosenbloom, 71, of Squirrel Hill, who has practiced emergency medicine for 39 years. “It’s as realistic as it gets.”

Herbert’s input helped ensure that the medical procedures viewers see, like a rare lateral canthotomy to relieve potentially blinding pressure in the eye, are credibly presented, said Rosenbloom, who has performed the procedure. “They may have even used footage of an actual lateral canthotomy in that scene.”

Rosenbloom appreciates that “The Pitt” gives equal measure to the more nuanced challenges emergency physicians face, such as guiding families of dying patients in when to let go, he said.

In one episode Robinavitch gently tries to persuade the adult daughter of an elderly man on life support that heroic measures — which go against the patient’s wishes — are futile and will only prolong his suffering.

“You have to be patient with the family and let them take in the finalism,” Rosenbloom said. “It’s a tough decision for a family to have to make and Robby showed appropriate empathy.”

Other realities of emergency medicine are addressed, including violence toward healthcare providers, which Rosenbloom has experienced. The show’s charge nurse is punched in the face by a patient in one scene. “Working in the ED is somewhat dangerous,” said Rosenbloom, who once was bitten by a patient. “Hospital security has guns now.”

He finds Robinavitch credible as a seasoned emergency physician who, in real life, “would be loved by his staff.”

“He has a heart,” Rosenbloom said. “He also looks a little burnt. But can you be burnt and still walk the walk? Yeah, you can. It seems like he’s doing a really good job. He’s admirable.”

The show deserves special kudos, Rosenbloom said, for giving nurses their much deserved due, as when Robinavitch tells a crew of fledgling physicians that “the most important person you’re going to meet today is the charge nurse.”

On the whole, “The Pitt” conveys the passion emergency medical professionals have for their work, he said.

“Sometimes it hurts, but it’s the greatest job. Every so often you get to save a life or deliver a baby or do something that is life-changing, and what could be better than that?”

Adam Tobias, an emergency physician at UPMC Presbyterian, also loves “The Pitt” for its candid portrayal of his profession.

“It does a really good job of depicting what my specialty is like, and what the emergency department is like, which I’ve never been able to fully describe to the people I know,” he said. “It makes me feel really seen.”

The medicine is accurate for the most part, and the show captures the most pressing issues facing emergency medicine and health care, such as patient boarding, he said. “We may have 20 or 25 patients boarding in the ED and nowhere to see new patients, except in the hallway or in the waiting room. It’s literally a problem in every hospital in the country and the show does a nice job of talking about that.”

It highlights another urgent issue, the opioid crisis, in a heart-wrenching segment in which a teen is brain dead from a fentanyl overdose, he said.

Although the volume of cases handled in each one-hour episode is a bit exaggerated, Tobias said, the unrelenting pressure on attending physicians is realistically conveyed. “There’s constant activity. Robby gets interrupted in everything he tries to do. He’s lucky if he can take a bathroom break. The show captures the spirit of that”

He appreciates that Rabinovitch is sensitive to the “intense emotional” effects of treating people whose lives may hang in the balance. “Robby stays calm under pressure but he’s also human,” he said. “We see that side.”

A native of Squirrel Hill, Tobias delights in the show’s references to Pittsburgh, including the iconic Primanti Brothers.

Kevin Friend, a St. Clair Medical Group Emergency Medicine physician, tunes into “The Pitt” because he loves his work —“I can’t get enough of emergency medicine,” he said — and he finds the show refreshingly authentic, compared to others of its kind.

“It strikes me as so realistic,” Friend, 54, of the South Hills, said. “Multitasking is one of the themes, and that’s accurate; emergency medicine is the ultimate multi-tasking job. We’re thinking of four different patients at once while we’re treating another.”

He enjoys sleuthing the show’s constant array of cases from the comfort of his couch. In one episode, Friend diagnosed a patient, in severe pain from two tiny puncture wounds, as having been bitten by a black widow spider. “Very often cases come into the emergency department that are interesting medical mysteries,” he said. “You have to be a detective to figure them out.”

The show is adept at reflecting a range of strong personalities and how they interact, he said. “I like the bantering. We have nicknames for each other…but it’s affectionate and endearing. It’s cool that they include that.”

He gives the show credit for getting the equipment and technical jargon right, he said, and for including the “non-hardcore medical stuff — the social issues, like homelessness and patient abandonment” that staff routinely deals with.

One thing missing from the show is physician charting — a task that takes up a big part of any emergency physician’s day, he said. “That really stands out, but I get that showing a doctor sitting at a computer would make for bad TV.”

Overall, he said, “The Pitt” effectively conveys that emergency doctors have “the most interesting, exciting job in the world. From a medical standpoint, we see the whole spectrum and never know what we are going to be dealing with next.” PJC

Deborah Weisberg is a freelance writer living in Pittsburgh.