The Pitt Podcast

Looking Back at Season One

48 min
Jan 6, 20263 months ago
Listen to Episode
Summary

This episode of The Pitt Podcast recaps Season One of HBO Max's medical drama "The Pit," discussing how the show achieved critical acclaim through medical accuracy, diverse character representation, and real-time storytelling. Hosts Hunter Harris and Dr. Luke Patel interview executive producer John Wells and showrunner Scott Gemmel about the creative decisions, narrative structure, and social issues tackled throughout the season.

Insights
  • Real-time narrative structure (one episode = one shift hour) forces precision writing and eliminates melodramatic personal arcs, creating authenticity that resonates with audiences
  • Medical accuracy achieved through embedded physician and nurse consultants with veto power over storylines, differentiating the show from traditional medical dramas
  • Healthcare worker representation matters: elevating charge nurses, social workers, and support staff as central characters reflects actual hospital hierarchy and operational reality
  • Storytelling about systemic healthcare issues (racial bias in pain management, addiction among physicians, violence against healthcare workers) drives cultural relevance beyond entertainment
  • Emergency medicine's transactional nature (treat and street) creates narrative closure challenges but authentically reflects physician experience of not following up with patients
Trends
Increased audience demand for medical accuracy and procedural authenticity in healthcare-focused entertainmentGrowing cultural conversation around healthcare worker mental health, trauma, and occupational violenceShift toward ensemble-cast storytelling that elevates support roles (nurses, social workers) over traditional protagonist-centered narrativesUse of entertainment media to humanize healthcare system failures and systemic inequities (racial bias, addiction stigma, insurance gaps)Real-time narrative structures gaining traction as a way to create immersive, high-tension viewing experiencesHealthcare professionals increasingly consulted as creative partners with editorial veto power in medical entertainmentAudience interest in seeing healthcare workers' personal struggles and emotional labor, not just clinical competenceMass casualty incident and trauma response narratives becoming more prevalent in medical dramas post-pandemic
Topics
Medical accuracy in television productionReal-time narrative storytelling structureRacial bias in healthcare and pain managementPhysician and healthcare worker addictionViolence against healthcare workersEmergency medicine operational realitiesHealthcare worker mental health and PTSDSocial determinants of health and social work in hospitalsVaccine hesitancy and medical misinformationMass casualty incident response and traumaSickle cell disease and underserved populationsHealthcare system staffing and resource constraintsPatient-provider communication and empathyMedical student and resident trainingHealthcare billing and insurance access
Companies
HBO Max
Platform distributing "The Pit" medical drama series and official companion podcast
People
John Wells
Executive producer and director of "The Pit" discussing creative vision and real-time narrative structure
Scott Gemmel
Executive producer and showrunner of "The Pit" discussing story selection and medical accuracy integration
Hunter Harris
Screenwriter and cultural critic, co-host of The Pitt Podcast analyzing the show's cultural impact
Dr. Luke Patel
Physician and journalist, co-host of The Pitt Podcast providing healthcare professional perspective on show authenticity
Mel Herbert
ER physician consultant who contributed medical accuracy to "The Pit" writing and production
Joe Sack
ER physician consultant who contributed medical accuracy to "The Pit" writing and production
Quotes
"The pit really nails the medical accuracy as much as you can for television. Obviously you have to take some liberties because you got to make TV entertaining."
Dr. Luke Patel
"Medicine is the wallpaper of what's going on. The medicine is important, but it's really about how the doctors interact with each other, how they interact with the patients, and what's going on internally with themselves."
Scott Gemmel
"There are people who actually have to do this. Let's not forget that in these conversations. It's not just about constitutional rights, it's about who actually has to carry the weight of some of these decisions."
Scott Gemmel
"The charge nurses, I know in the hospital, I would never mess with. They just know what they're doing. And I think the interns like allude to that. They're like don't piss off the nurses and things are going to be good."
Dr. Luke Patel
"You're not thinking about it that way. You get rid of all the medical melodrama in the sense of the personal lives, the characters beyond what you would actually experience during the course of a single shift."
John Wells
Full Transcript
to your one trauma ETA six minutes. And so it begins. Welcome to the Pitt podcast, the official companion podcast for HBO Max is the pit. I'm Hunter Harris, a screenwriter and cultural critic. And I'm Dr. Luke Patel, a physician, journalist, basically a loudmouth for public health. Each week we'll go inside the pit and talk to people who make the show possible. And then we'll step outside the hospital so we can nerd out about the real medicine, the story, the drama, the culture, the ethics, all of it. Season two of the pit drops in a few days on January 8th. And so to prepare, we're going to look back at season one, think about all the doctors, characters, medicine, patients, all of it, and think about what we can expect from season two. And to do that, get you more insight. We're going to talk to executive producer and director John Wells and executive producer and showrunner, our Scott Gemmel. Today's shift starts now. We have, I have sickle. OK, stop. Everybody stop. Stop. Open your locker. You're going to work on your fucking locker, or I will have security smash it open. Multiple cheers, dubious. There's an active shooter at PIPFEST. Hunter, the pit, like, came in hot with audience reviews, ratings. I mean, there's like Reddit threads over everything related to every episode. But I think what really caught everyone's attention was how many Emmys the pit won. I think it's 13 nominations, five wins, best actor, supporting actress, guest actor. And then what was awesome is it won the Emmy for outstanding, medic, outstanding drama. So like, the pit is like onto something. From your perspective, what do you think is making the pit this cultural phenomenon? Why are people so fascinated by the show? I think it's a lot of things. I think first of all, the show is very good. And has this like, like, frenetic, fast pace. It feels like you're, you know, in these characters, you choose it all times, which I think is really, it has a lot of the performances and also just the directing and the writing. And I think that it's been a long time since a medical drama has, at least to a lay person like myself, felt like how it feels to be in the hospital. I mean, healthcare is like a nonpartisan issue right now. And seeing that from frontline workers is honestly very moving and very like personalized. Like they're putting faces to statistics or to like news stories in a way that I think is really special. You're seeing it as almost like the show is humanizing. All these headlines or stats like that's how I'm here. What you're saying. Yeah, I also feel like maybe my doctor now I've watched enough of the pit. I mean probably I probably go under and start doing some surgery as an intern, just get your hands bloody. Just dive in. But I want to ask you the same question. Like as a healthcare worker, professional, how do you feel like the pit? Why do you feel like it has that much cultural capital, so much residents? So I feel like I get to answer this question over the course of like 15 hours because there's so much to talk about. But I think one thing that's incredible is the pit really nails the medical accuracy as much as you can for television. Obviously you have to take some liberties because you got to make TV entertaining. I've joked with my friends and I've been like, if you made a really accurate medical show, it would be a bunch of us charting for a few hours, which nobody's going to watch. But they I really have to hand it to the writers to, you know, ER doctors, Mel Herbert, Joe Sack, so I came in and add a lot of accuracy. You know, the team themselves like brought in so much real world experience. So for the medical community, medical accuracy like watching procedures. It felt reassuring because you're like, oh my gosh, like there's someone actually they're making sure that they're in a legit looking ER. That they're doing procedures that they have the right type of equipment. But then also this show didn't skip out on any of the characters, any of the actual real issues that people have in medicine. And it talks about in the first season, there's a single mother. There is issues with PTSD. There's topics about addiction and they don't shy away from any of that. I think there's this perception. Sometimes it like doctors and nurses just all of their shit together. And it's just we're people for humans. And when you have baggage, you go to the hospital and you just have to bring the baggage with you. Yeah. And like Noah's mentioned multiple times throughout interview is that humans have to compartmentalize our issues. When you show up for your family for friends for work, you got to like try to separate these issues and then be present. And you have to do in the hospital too. And they just portray that beautifully in this show. I almost wonder like to my mind, everything is medically accurate. Like if you show a bandaid, that's medically accurate to me. But they all act with such conviction that I'm going to trust it outright. But I do really like maybe one of my favorite parts of the show is that every hour is like an hour in the shift. Every episode is an hour of the shift. And it really, I don't know. It's like I like how the personal becomes professional becomes personal again. And that kind of line between like what is a private moment versus like what's us just doing our jobs together is really really touching. Oh, I love that. Yeah, because teamwork is a huge part of it. And I'm glad you actually brought that up because I think something else that this show does. It's very special is it's not just a show about the star physician and the surgeon and the residents, but they really show you how a functional ER, a hospital is a real. It's a it's a team effort. And you have a huge cast of characters. So like massive shout out to the pit for making charge nurse Dana such a central character. But she's like the boss. She runs that place. She almost like controls the tone and that's that's real. Like the charge nurses. I know in the hospital. I would never mess with they just they know what they're doing. And I think the interns like allude to that. They're like don't piss off the nurses and things are going to be good. That's real and like Dr. Robbie has that respect. That's accurate. But then also let's talk about the fact that Chiara the social worker. She is so incredibly important in the show. But in real life, like we cannot run our healthcare system without social workers. It's not happening. But the social worker Chiara who's played by crystal McNeil. Like that is such an important representation because there's certain situations in the hospital where yeah, you see a patient and you've got, you know, diagnosis, treatment, the actual medical plan. But then they're human beings who still have needs whether those are housing, transportation and other resources. And you got to find a way to bridge that gap. So the fact that they had a social worker front and center like kudos. So when people in healthcare system see that they're like, oh my gosh. They're actually elevating all of healthcare and really bringing out these frustrations. Yeah, I think from a character and like structure perspective. One of the things that I like the most about this show is that it's not a traditional drama where it's like you talked to the same 12 people every single episode. It really does, you know, have a moment of like here's a police officer here's a security guard. Here's a nurse. Here's like, and you might not ever see those people again like in the course of the day or in the course of the shift. But they still are a part of the fabric of what makes the ER or ED I should say run. And that's really important. It feels like, you know, accurate to any workplace, not just the ED. I'm with you by the way, where I can never decide if we call it the ER or the ED. I feel like TV is like ER and then in the hospital, they'll say ED or like go to the ED, which is kind of funny. But then some people hear ED and they're like, oh yeah, like a reptile dysfunction. And I'm like, that's what I thought for a long time. I'm glad you brought up characters. It makes me think about like how the show was created and it almost to the untrained eye like me feels like theater. Because I did read that it's a four-sided stage. It looks like a really hard when you walk in and the cinematographers had handled cams and it just feels like this like controlled chaos. But I wanted to ask you, what stood out to you as, you know, as a journalist, but also as a screenwriter. Someone who truly understands how to bring a vision to life in theater. Like what's it out to you in that sense? I think it's really character. I think the fact that let's take my K, for example, that we see her with an ankle bracelet and then, you know, we don't really talk about it because you're in the course of a day. How's that? How are you going to ask someone? Why are you wearing that? What's that from? And it's like, that it's kind of a slow rollout of all of these like personal details. I think feels so true, especially as people who are like, you know, working to say lives. The patient stories are also so moving. The brain dead teen from like episode three, I believe like that one really I was like, wow. And that's like the top of the season basically. Like that's the beginning of someone's day. And that really moved me. Oh my gosh. And let's also talk about how when McCay took the drill to her commander. I was like, yeah, I can't think of any of them. I love it. I love that they also they throw these moments of humanity out like the ankle monitor. We'll stick with that. But they don't sit and make this whole segment. I got an ankle monitor because of this case. Like it's almost just like she throws it aside. Yeah. Like I'm a doctor. This is a little side story that audience can like think about and make your own judgment about. But this first season also tackled as we mentioned addiction and PTSD, but also these elements of child abuse, of overdoses, of human trafficking. There's a little nod to human trafficking of, you know, situations with fertility. Like there's so many of these societal issues that happen in the ER that they just kind of threw in to show people like you're dealing with the entire person. Yeah. Were there any moments like that that stood out to you where you were like, oh my gosh, like this happens. Oh my goodness. I think that the like masking debate between two women and where one of the women was like, okay, I don't want to wear my mask, but I want my doctor to be wearing his mask. That really hit home for me. I think that as much as you're saying, like there are such serious issues being tackled. Something I like about this show in particular is that we also see kind of like lighthearted more of like, okay, how did you really get a nail in your chest? Like that kind of stuff, which I think really speaks to maybe like the levity that you can, the dark humor you can find in the middle, but a very difficult day. Humans got a laugh. Yeah. Like, you know, I'm glad the show like includes that. Because during the pandemic, people would see these videos like TikTok videos, for example, in hospitals and say, oh my gosh, why are they dancing? Why are they laughing and not actively treating patients? And I'm like, well, in the break room, you know, after a shift, any time you have downtime, like doctors, nurses, technicians, everyone, they need this a little bit of an emotional release. And people have different personalities. And so on the pit, I love the fact that they included not only some of the banter between themselves and the dark humor, but they're joking with patients to make, making these little comments here and there, which I think is like, is so incredibly necessary. Yeah. Before we get ahead of ourselves and talk about season two, I need a little recap of season one, the big stories, the big characters and a, you know, bustling cast, I would say. So let's do a little recap of the big moments from season one. I'm totally game. Before we do the recap, I'm going to make sure that we're, you and I are on the same page. We're trying to understand the hierarchy of residents. Please. I know it's confusing. So we've got Dr. Michael Revenovich attending physician. He's Dr. Robbie runs a pit. Then he is mentoring these resident doctors of varying years. So you've got Collins, Langdon, McCay, Mohan, King, Santos, and then two med students, Whitaker and Javati. Okay. Like there's actually charts you can find online, but this is basically, this is the dream team. And basically anything and everything can come through that door, such as the case with the sickle cell patient. And I think this speaks to what we were talking about is about many themes that the pit really illustrates. In this case, a little bit about racism and healthcare, stereotyping and kind of making these assumptions without getting to know a patient and their situation. And this whole interaction with Dr. Mo and the sickle cell patient really illustrates that. Yeah. Let's watch it. Let's take a look. I've been screaming for an narcotics nonstop. You found an empty purchasing. How are you doing? Why did you call it? It's been uncooperative in combat. Since we picked up. I need our go. Stop fighting. Come to fuck down on the car. Come on. Hey, man. That homework working. Please. I have sickle. Stop. Everybody stop. Stop. What's your name? It's Joyce. It's Joyce. Take it. Joyce, is this your sickest health thing? Yes. 10 milligrams of IV working. Really one time? Yes. Repeated and five minutes of needed and she needs a dilated drip. This is a vasocluis of crisis. I think that clip is so well done. It almost pushes the audience to check their own internal bias. It's like, would that be the same situation if she looked differently? If she was a man, if she was rich, if she was young, like, how would that have altered? I mean, you immediately heard someone say calm the fuck down. We're going to call the cops. Yes. No, and look at how the security or the cops brought her into the hospital. Like holding her down, yelling at her. And the fact that Dr. Mohan asked for her name and asked, like, was listening to her and listening to her cries and hearing that she was saying sickle cell is so moving. And also, who does this disproportionate fact other than black women? Right on. I mean, listen, there's there is a population who doesn't really understand or necessarily believe that racism exists and health care. But basically every single study and patient survey says otherwise. And this clip is proof of that. That's just one example of how good the pit is and how varied all of these conditions are. For sure. We have a complicated birth. We have a measles outbreak. And we also at the toward the end of the season have the, I would say most affecting moment, which is the MCI, the mass casualty incident where it's all hands on deck. And we're, you know, it's really, really tense and dire. The, the MCI, the mass casualty incident that we are now kind of seeing the, the intro of, the shooting, the minute you hear, Nostana pick up that call, I think it just stopped every viewer in their tracks. Yeah. Because we are unfortunately living in a time when mass shootings happen way too often. And the show knew that they not only had to make sure that the intensity was there, but they, the accuracy was there. And they took the time to talk to trauma surgeons, ER health professionals, especially those who worked in the hospitals after the loss, phagished mass shooting. And they went for accuracy, emotional accuracy. And I think they, they really did an amazing, incredible, heartfelt job and making sure this tragedy that happens all the time in America was portray the way it needed to be. Not only with like, these are the statistics, these are the headlines, but more like, these are the humans who are actually in the hospital receiving these patients. Yeah. Let's take a look. You're a good man, we're a bit of itch. Don't let this place take that from you. Okay. Come on. Yeah. Code triage. Multiple chest dubious. There's an active shooter at PIPFES. Check in as girlfriend in there. So there's so much going on in the scene, but I mean, we have to talk about how nurse Dana was just punched by like an unruly patient. And she's now introducing like what's going to define like the last back half of the season. You can't help but notice the black guy. Yeah. And the fact that she almost has been through this before. And her character really kind of speaks to what nurses deal with on a regular basis. You know, surveys are showing that almost nine out of 10 doctors and nurses have experienced some type of assault who work in the ER. Like it's wild. And like that happens. And you know, the creators of the pit are like, Hey, we're going to introduce major storylines, but we need to make sure that we elevate all these necessary conversations. Yeah. Yeah. In healthcare. And something else, you know, when I think about a mass casualty incident, of course think about the victims. But I'm not thinking about the trauma that it can conflict on healthcare professionals and healthcare providers. Everyone who worked in the hospital that day saw something, felt something, and that this show shines light on that. Also, I thought was very special. Also, no, Wiley delivers this amazing monologue at the beginning when he's kind of rounding everyone up. And he like flawlessly puts his arm out and like hits that slap bracelet. Yeah. It's just like, it's just all around amazing acting. Triage will decide who goes where, depending on their injury. Every department will have a designated primary who will oversee their staff. If you need someone, look for the vest. We're all going to have walkies. We can get you whatever you need. No patient goes into a room unless it's a trauma bay and they will have four patients each. We need to keep everybody out in the open so we can keep an eye on everything. Triage is going to assess and assign every patient to a specific zone with the colored slap band. Patient who comes in with a red slap band goes to the red zone, which is the trauma rooms with overflow out here. Something about Robbie, too, is that he's dealing with his own trauma and his own pain in trying to be that support for everyone else. He's still thinking about his mentor who passed away during COVID. He's having flashbacks to the COVID like time of emergency rooms being overrun. And that kind of carrying that with you into this extremely tense situation, I think is like I could not imagine. Something I want to go back to is Dana's plaque eye. We talked about it a little bit, but earlier in the day, she had a disgruntled patient who was waiting in a waiting room forever. And he sees her outside on a smoke break and hits her in the face. And I listen, I'll go to war for Nurse Dana. No, like get behind me. That's my girl. I could not believe this happened, but I guess this violence against healthcare workers is more calm than I would ever think. It's awful because people are like frustrated with the healthcare system straight up. They're frustrated with how long it takes to get into an ER. Then they get frustrated with things such as healthcare billing. Like there's so many issues out there. And then people break. And the oftentimes take it out on a healthcare professional. They take it out on a nurse. They take it out on someone. You have so many variables involved and it happens so often. It's raising yet another very important topic. What are we doing to protect these people? Yeah. What are we doing to boost up staffing and security? And I think they like this happens. It gives the audience like a moment to say like, oh, I'm going to find that guy at the cops don't find them. You must at Nurse Dana. I will find him. I'm on the streets. I'm looking. No, let's watch. Hard to work. I'll take my chances. People who work in the hospital are people too. And they've got their lives. They've got their situations. The show highlights that, you know, Mel King is taking care of her sister. Dr. Collins is dealing with a miscarriage. You've got Whitaker. We find out who doesn't have a place to live. It's kind of wild. He's like living in the hospital somewhere. It's kind of a smart move though. Rent free. House is not smart. I mean, you can't live where you were. You can't. I mean, like, sorry, that's bad. It's not smart. But Whitaker doesn't have a place to live. And that kind of highlights like, you know, what people are going through to try to get training done. But the point is, is that like, you know, you've got these, these personal problems in these issues. And you're socializing up for patients. And the show does a good job of kind of sprinkling in those problems. Question for you. When Santos started to notice that these drugs were missing and that the count of these benzos was kind of off. And she was like calculating things. Did you ever suspect that it was going to lead to this, this bombshell that Langdon is dealing with addiction? No, because I think the show kind of sets up her as being a little bit of a bully. But the fact that she ended up being correct in the end, I was totally taken aback because Langdon is kind of like the little bit of the badass. Like kind of like Hawkeye, like big ego goes really fast. And you don't want to see that person be, you know, undermined in some way. So that was a really good way. I think turn the audience's expectations on their head. I'm like, how you load up Hawkeye. What can I say? You've got to get her in there. I'll give him that. Yeah, yeah. He's got. He like, and he also has this like almost like a younger brother older brother relationship with Dr. Robbie. Yes. In that moment, you're like, are you rooting for Santos to be right? Do you want to see the drama as a viewer with like Langdon and Robbie? Like I didn't even know where I was going. Yeah. But again, I feel like I'm like the the fun bullies right now because I keep bringing up these real issues in home care. But unfortunately, yes, there are many people in the healthcare industry who suffer from addiction. But we see this like moment with Langdon and Dr. Robbie word almost crosses over from, you know, I'm a physician who can help you to like, I'm your older brother. What did you do to me? Yeah. There's really emotions. Yeah. Let's watch it. Yeah. I'm already getting like tense thinking about rewatching it. Is the imprint code on these pills is going to match Louise Libriam? Go home, Frank. No, no, it's not like you think. You remember whenever I help my parents move, I was too cheap to pay for movies, I hurt my back, I told you that you tease me about it. Remember, will our own doctor Hegen prescribe me some pain meds in muscle relaxes? I was just weaning myself off, it was just for meetings, I'm telling Robbie, come on, you know me, Robbie, you know me, man, I'm sorry, I fucked up, I fucked up. I just, I was trying to, I don't know, I still feel like a kid. No, it's not like you don't understand. I don't fucking understand. You're not like you think. I'm not high. I'm not high. You've seen what I do, Robbie. Could a drug addict do what I do? Apparently. I'm not just fucking let him. You're done. Leave now or I will have a mod to score to you out. Robbie, please. You are done. What? I wonder if he improv that what at the end? Cause it's so good. But like that is why the show won an Emmy for outstanding drama. No, that's maybe my favorite like scene. In the whole season, I think it's so smart. Like the way that I almost wonder if Robbie was kind of like not sure, but he has to ask as like the, you know, most senior person on the floor. But the way that Langdon immediately his mind jumps to Santos. And just the way that he like he acts guilty. He says guilty stuff, I think. And you can just see the pain in Robbie's eyes and the way that is so sad. And then my favorite line, you know, maybe of the whole show again is when Langdon says, well, you've seen what I can do. Like can someone who's like, hi, do what I do. And Robbie says apparently, and I just let him like you feel the breakdown of like true friendship in that moment that Robbie is suddenly reevaluating a lot more than just what he's seen that day. 100%. Yeah. I like I, I, there's, there's so much. There's so much emotion in such a short amount of time. Yeah. And that scene like this roller coaster. Yeah. And it's like Robbie goes to like all the stages of grief like in 15 seconds. And Langdon plays it well too because you see the desperation, the kind of, once you're kind of flailing and being like, well, what about this? And what about that? And the end you know he's done it. Then you know he's guilty and he's like really trying to cover his ass. Yeah. And then you're like, torning. Like, no, we, I know that things are going to go down in the pit. And I was like, no, no, no, we need Dr. Langdon. But then you're like, wait, no, no, he's struggling right now. He just came at a felony. Wait, who's signed him? I on. But also, hello, the ED needs to be staffed. Like, one more question for you. Okay, this show has really maybe called me out, not called me in about being like the, the know it all patient. There's a really one of the most affecting patients in season one is the, is it the measles, the teenager measles and the mom is like, don't give him this final tap because I've heard it can lead to paralysis. And it's like, okay, Dr. WebMD, like you're talking to trained physicians, but she thinks that she knows it all. And I think in some cases, I am guilty of being the know it all patient who goes on Google and like gets very anxious about stuff. How often do you see that type of person? And how do you manage that in the moment? Anyone who knows me knows I'm doing my best to control my blood pressure right now. Yeah. Because we see it all the time, all the time in almost every type of patient population, condition to different extremes. Like this situation was a pretty extreme example. Yeah. When it's a life or death situation and someone saying like, Hey, don't give him a spinal tap. I have taken care of children who needed life saving blood transfusions. And their parents did not believe in blood transfusions. So they're like, do something else. You're like, I'm going to get a court order to do this. And you may have to get the police involved. So it does happen. And honestly, like I feel for parents initially, because people just want to do what's best for their families and their kids. But then all of a sudden, as you mentioned, the internet is this, this, like, treasure trove of garbage. Yeah. And you want all of a sudden, you aren't paying attention to the real signs you aren't trusting doctors. And like Dr. Robbie, like nails it when he gets mad and he like walks out the room. And he says, I forgot the exact quote, but he says something along the lines of, she's going to go to Dr. Google for advice, but she doesn't want to actually get medical treatment in the hospital. And so like a major frustration, people say is like, you're a know it all. Then why did you come here for treatment? Mm hmm. Love it. And I think with vaccines, just one example is people know no longer fear. The actual diseases that we are trying to prevent. Instead, they fear that whatever they're reading on the internet. So, you know, this teenager in the show is intubated and has this potential neurologic condition, this brain inflammation. And they're like, what? Measles can do that. And Dr. Robbie's like, I guess I'm old because I just kind of know what's up. Like that scene was, that scene was poignant. But listen, I respect, I respect an empowered patient. Well, okay. Thank you. And let me say it's usually about my dermatologist that I'm like, maybe a little laser here. Like who knows? Like maybe I do need it actually. Okay. Last question. I mean, maybe this actually speaks to what we're just talking about that. This show really has shown me how much of being a physician is about managing a patient's anxieties and even just like their emotions as much as it is treating like what they've come in to solve. Does that feel true to you? I think the interpersonal skills that it takes to be an effective nurse, doctor, health professional is really highlighted in this show. And you can kind of see it in a few specific cases. I think there's that autistic gentleman who has like the spray mangle. Yeah. And like Dr. King goes in there and she just connects with them. There's the homeless woman who gets empathy immediately from Dr. McKay. We talked about the sickle cell patient and Dr. Mohan connects with there. And that's something that we want everyone to kind of try to understand. Did that, that that stand out to you or did you just kind of watch those play out and say like, oh, that's just a doctorized good skills? Or did you pay attention and say like, oh, no, that's that specific character who found their superpower? I mean, I know I think it's a, it's a writing thing, right? It's like that patients are paired with a doctor who can maybe speak to them the best or even the patients that maybe challenge the doctor the most. That's I think a really good marker. I think who is a patient that did that? Maybe even like Louis and Whitaker, like Louis is such a good character and Whitaker is like a little bit nervous, a little bit jumpy and being met with a patient who is kind of seen it all before. And feels very comfortable in the ED. That was like a really good moment of like, okay, maybe the exact patient Whitaker needs to grow as a doctor is someone like Louis. That's a great point. I think these interns, what we're seeing in real time is they're learning so much, not only from their mentors, from their nurses, but they're learning in real time from patients. And I actually think it'll be cool. If the viewers and listeners of this podcast, like wrote in on what type of doctor or what type of nurse actually connected with them, because you hear those stories all the time. Yeah. You're about people who are like, Hey, I was in a lot of pain and I was like dismissed by, you know, this doctor, but then this person actually listened to me and like those stories happen all the time. We have so many good questions here today. And I think a lot of good observations too. Not to tutor on horns, but I'm a student. Wait, no, I'm not saying I'm toot. And I mean, I'm, yes, I'm proud of us. Just leave it there. Just leave it there. It's okay. To talk more about intention and craft and impact, we have the executive producer and director, John Wells, executive producer and showrunner, Arscock Gimel. I was so stoked for this conversation. It was a good one. Okay. Our first question, the plot of this show as viewers know basically happens in real time, one hour of the shift is one episode. What is it like to work with in a structure like that when it comes to like character development and pacing and even like the cases that you guys tackle? Well, it was, it was fun. It was a little unnerving because we didn't know if it was going to work. And we honestly, you know, that that really lasted a while, you know, it, but when it was good because it was new for all of us as actors, as directors, as producers and so and especially as writers. So we just forced you to lean in and sort of reexamine what you do. And I think it led to sort of new stuff for all of us. And but it comes with pros and cons. You don't have a lot of time to tell your story. But on the other hand, you don't, you can't get bogged down in melodrama and personal stuff. You have to, you know, all has to be in that 15 hours. So you have to be, I would say it's like more precision writing than anything else. You're working with an afraid, very specific frame. And that frame is what actually happens to you during a single day at work? What, how much can you actually reveal? How do you learn about your co-workers? What are you going to find out? What realistically happens? And as soon as there was a lot of like, oh, you would never go that far. So there was a lot of like, um, can pairing back what we're doing, which I think is respect for the audience, the audience is intelligence to fill on the blanks and to, and to be curious and interested about the people that they're just beating at work. Yeah. Like on a regular show, a network show, you know, who would fall in love over the course of the first season? Well, we only have 15 hours. So no one's falling in love in 15 hours, you know, I mean, you might be interested. It might be. Yeah, you're not. Did I get married divorced and having a kid? Yeah, exactly. Maybe a wild show. He gets in and I say, family arc, but that was really liberating because you're not thinking about it that way. You, you, you get rid of all the medical melodrama in the sense of the personal lives, the characters beyond what you would actually experience during the course of a single shift. And that was really liberating. Yeah. You're really in the moment. I mean, that was part, that's one of the reasons we did it in real time was to bring the audience, really give them the sense of being in the emergency department. So once they got there, they can't leave. And things aren't, you know, you see the, you see the painfully long day that everyone's sort of subjected to. And I think that was, that was liberating for acting and directing and for the writing in a challenge to try and remember where you were during the course of the day because the first hour of your shift, we shot in in July in the last hour, we shot in January. And yet you have to be of experience, what it's like to be on your feet for 15 hours. So how far along in your exhaustion are, when's the last time you actually had something to eat? When did you actually last get to sit down? How does that feel physically in your body? Do you slow down? Do we slow down because you slow down? Or how do you ramp back up? So just as an acting and directing challenge, it was, it was invigorating. And throughout this very long day that you're portraying, the show also highlights a lot of really important story arcs that are talking about very important issues, you know, drug abuse and trauma, many social situations, sickle cell disease and more. How do you all decide what stories that we want to highlight and where they're going to fall in the season? Well, we start. There's sort of two aspects to it. There's the stories you want to tell. And then there's the character. So we usually start with the characters. Where do we want them to be at the end of this shift? What's going on in their lives? And then we have the list of medicine and stories that we want to tell. And then we try and find which one is best for what character and what's going to, you know, is there the medicine is always sort of the wallpaper of what's going on and what's even in the traumas. There's usually, and there should be anyways, something going on between the characters that really make, and that's really the story that's being told. The medicine is important, but it's also, it's really about how the doctors interact with each other, how they interact with the patients, and then what's going on internally with themselves. And there's tremendous amount of research that actually goes into determining what to talk about rather than doing it kind of top down in the sense of what of the things that you want to see. A lot of it comes from talking to their two physicians who are in the room full time who are writers on the show. There are four who rotate on set who are all actually in the emergency rooms when they're not with us. We had eight nurses to 10 nurses who are also on shifts and they come in when they're not on shift to work for us. So they're telling us what they're concerned about. And then that's oftentimes what we already are aware of. But it's what are you worried about? What are you thinking about it working? So those things like, you know, the amount of pressure that's coming back in the emergency rooms is primary care as less available is eight to 10 million people lose their health insurance. What does that going to mean for the people who actually now see people who could have had ailments that were diagnosed and treated more effectively in primary care suddenly coming through the door, you know, in very bad shape. So it's, it's a process of trying to figure that out and also keeping track of that this is a teaching hospital. And during the course of a day, how much does a medical student learn? Not a lot. They have experiences during the day. How much does the, does a second year resident learn? What are they learning? What do they already know? What don't they know? And part of the challenge for us as we were doing the show is over the months that we were making the show, all of the actors got better. More than the medical students and the, and the physicians would have gotten better. So you're saying like, this is only the fifth hour of your shift. You have, you've had months to get better at these procedures, but you're not better at the procedure. So how do you unlearn what you've actually been learning just in the dexterity and physically on the set? So all of those challenges have been really exciting. And I think kept it the writing and the narrative and everything very invigorated. Well, speaking to the physicians and nurses you talk to, you don't need me to tell you this, but this is already heralded as the most medically accurate show ever made. And I'm curious how when it comes to the story arcs and what's happening in the procedures, how do the medical advisors help you kind of navigate what could be a plausible error versus what was conscious negligence, especially when it comes to how they're treating patients, controlled substances, and so forth. Well, the doctors that we work with have basically a veto power over the stories, which is one of the things that's really different for the writers. We oftentimes would say, Hey, we want to do this kind of story. And they would go like, uh, in the past, they would go like, well, you could kind of do that. I'm in the kitchen. Yeah. Yeah. We do. We're expensive. And the reality now is I go, no, that wouldn't happen. And so they, they constantly are keeping it honest. And it's a, it's a real conversation because we're doing a 15 hour shift. We have the opportunity for it to take as long as it would actually take in the emergency room during that shift to deal with these patients. So from the acting point of view, we're oftentimes hiring, hiring actors, wonderful actors saying, we're going to give you a, a, a role to audition for it. This scene is going to be the seventh episode that you're on. Before that, you're basically going to be a background extra. We're going to meet you once. You're going to be there forever. Then you're going to have this great scene. Uh, that's a lot to ask of actors. You're going to be for three months to do one scene. Um, but it's trying to, to stay true to the medical accuracy. And on the set, we have a full time ER physician who's there every single day for every single shot. And they will tell you, I can tell you as a director, you say, I got this and they go, yeah, wouldn't happen that way. They wouldn't be there. They wouldn't be doing this. And so then you have to completely reconsieve what you're doing because it's very important that we're actually, the audience knows when we're making the artifice. And we're getting as real as we can. And HBO Max has been extraordinarily extraordinary to allowing us to really show what we were never able to show before on, uh, on television medical shows. Scott, I want to ask you about the sickle cell storyline and how do you balance what mistakes are realistically possible for a doctor to make like treating pain, both still building tension and keeping the story feeling, you know, um, moving them a momentum? I think you just have to be honest, you know, I mean, I think that's the authenticity is part of the integrity that we bring. So that was a story we wanted to tell, you know, that's, uh, there are some medical places within the US that are better at dealing with sickle cell because they see more African-American patients, you know, DC is one of them. Pittsburgh wasn't one of them, you know, and that's the least what we were sort of, that was one of the stories we were getting across. And, you know, there's, you know, that was also taught dealt with sort of racial profiling a little bit in terms of because she was an African-American woman. She was, they were immediately thought she was drug seeking because she was, but she had a legitimate reason. She was in real pain. That's the other thing we know that women, uh, in the emergency department sometimes are, their pain is not considered as, as the same as it is when it's a man sometimes. So a story like that has so many different layers to it, you know, that it's worth telling. And, you know, we talked to the experts. That's how we knew that there were underserved populations and how sometimes those individuals are treated as if they're coming in with a whole different condition just because they're not used to, that hospital is not used to seeing it. I'm curious how you think about like closure on a show like this where sometimes we don't really get to see like what happens to a patient after they leave the emergency room and how you feel about the audience's expectation maybe about that in a show like this. That's the reality of being an emergency doctor. You know, you, some people go into emergency medicine for that very reason that they don't have to have regular patients. They don't have to follow up, you know, they basically call what we say with a treatum and street them. That's just, you know, our, and our show tends to follow the, the doctors and the nurses more than the patients, which a lot of shows maybe more patient forward and it's about the patient comes and we see the doctors save them. Whereas our show is more about the paid, the doctors treating these patients and then they're gone, you know, and sometimes we will follow up. But usually that's if a doctor or one of the characters wants to follow up. But the reality is they never, half the time, never see these patients again. And so, you know, once, 90% of the time, yeah, yeah, yeah, probably more than that. You're right. And so that's just trying to be as authentic to the emergency department as we can. And we've spent a lot of time in emergency departments and with emergency physicians. And I remember one time being in one and there had been a very dramatic sort of gun shot and saving trauma team came down. They kept them alive. And at the end of that shift, which was probably 10 hours later, somebody came down and said, Hey, that guy made it and the physician was like, what guy? Seemed 30 patients since that guy said, was that today? Oh, yeah, that guy. That was today. That's the experience in the emergency room for trauma physicians and emergency room physicians in major urban centers. So they're like the on the assembly line. Fixed somebody and let them go. It's like controlled chaos. Yes. You know, and I think back, how could I not think back about the episode after the pit fest shooting, which I think that hit healthcare, the healthcare audience in a different way. TV ratings are through the roof. Everyone talked about that episode. In the beginning of it, you have triage tags. You have chaos in the ER. People taking on different roles. You also have these small flashes of humanity and dark humor as creators, as writers. What mattered the most to get right? All of it. Yeah, I think all of it, you know, just the, you know, it's tricky when you do some a story like that because you're not, it's not, it's not fictionalized, you know, it is, but it's all based on things that have happened and tragic, tragic things. So I think you have to handle it with real honesty. I always go back to honesty, but I think you have to be careful and very empathetic about to those who did suffer that. So we just tried to do it really as close to the truth as possible. And we talked to so many people and watched, you know, a lot on the Las Vegas shooting and talk to survivors and talk to doctors who were involved and just tried to tell that story the way it would play out. And really give, you know, we see these, we've almost become numb to them. It's almost like a weather report in terms of the today's mass shooting, you know, and, and then there's, you know, everyone says, oh, our thoughts and prayers are there, but you never see what really happens and the aftermath and the aftermath isn't just the bodies. It's also the ones who survived that. And then there's also the impact it has on the doctors and nurses who had to live through that. You know, once the trauma is over, it doesn't end when, you know, when you patch them up, that trauma stays with the doctors for a long time. And that's ultimately what the first season, Robbie's story was about, was that sort of trauma that he had never really dealt with finally reaching ahead. And that led to, you know, what happens now in terms of how he deals with it. And you, you have to maintain an integrity about how you're going to do the storytelling because you're talking about experiences of people have had. And you are honoring it, the, you're honoring in some way the people who actually respond to that. So it's sure it's a gun control story, but it's primarily, let's not forget that every time one of the things happens, there are a whole group of dozens and dozens, sometimes hundreds of people. Who actually have to clean up, who have the aftermath, who have to deal with the aftermath, who have to talk to the families, who have to do all this. Let's not forget that in these conversations, it's not just about, you know, constitutional rights, it's about who actually has to carry the weight of some of these decisions that we've made in our country about how what we're going to allow and not allow to happen. I don't want to debate the constitutional amendment. I just want to say there are people who actually have to do this. Thank you guys so much. Thank you. Thank you. Hunter, that conversation was awesome. It was. We needed like several more hours. And we have several more questions too. John, our Scott, if you're watching listening, let's get drinks and talk more. Hunter, what's it out to you from that conversation? The idea of medicine as the wallpaper, that was a really good visual. And like the doctors, the patients, the character stories as the set dressing. That was really special. I don't think any other medical drama thinks about medicine in that way, which shows why this shows different. What about you? The passion that they they both have, the integrity they both brought to the script. The fact that they went and talked to some of the people in the healthcare industry to make sure that it was not only entertaining, but it just raised awareness in the right way made it relatable all of it. That's it for today's episode of the pit podcast. We'll be back here every Thursday right after each new episode drops. You can watch us on HBO Max or wherever you get your podcasts. The pit podcast is a production of HBO Max and collaboration with PRX. The executive producer of PRX is Jocelyn Gonzalez. Our managing producer is Courtney Florentine. Our editor is Lucy Perkins and our video producer and editor is Anthony Q. The assistant editor Damon Derell Henson. The show is engineered by Tommy Pizarrian. Our production managers are Ebon Achoa and Tony Carlson. The executive producer of HBO podcast is Michael Gluckstad. The senior producer is Allison Cohen Sarocaj and the associate producer is Aaron Kelly. I'm a low Patel. And I'm Hunter Harris. We'll see you next week in the pit.