Reaction: The Pitt, "7:00 PM" | Season 1, Episode 13

Considering how much time we have spent within this trauma center, I was struck this week by the use of the space and how overwhelming it is to have this many gurneys and wheelchairs filling nearly every square inch. But even knowing how full the ER looks, I was still shocked when Dr. Robby is told that 85 patients have gone through the doors. It is still far from over (though it is slowing) as more people roll up in the backs of cars and pickup trucks, and The Pitt continues to be one of the best new shows of the year in its ability to depict scale without sacrificing character moments.

Competency is a big part of what makes last week’s episode such a jaw-dropping ride as we watch this large staff snap from a normal day into emergency mode. However, this second episode digs into how one person going off-book is detrimental to the entire ecosystem, with Dr. Robby’s personal involvement clouding his judgment, coupled with the PTSD-induced panic attacks that lead to the ER boss becoming incapacitated at the end of the episode.

What follows are the observations I took from this thirteenth episode.

• Robby has been teetering on the edge for most of the day, which all comes to a head after the team cannot save Jake’s girlfriend, Leah. The bullet has pierced her heart, and Robby goes above and beyond to bring her back. Going against the set game plan regarding heroic measures when a patient is in this condition underscores Robby’s temperament and makes it clear he is about to unravel. It takes Dr. Abbott to remind him that there are other people who need attention and that Leah’s injury is so severe she probably wouldn’t survive if they could use every procedure possible. It all comes back to the “Peds room,” which is now a makeshift morgue, and the juxtaposition of cheery cartoon creatures and the blood-stained sheets is sobering. It is here that Robby’s mentor died during the pandemic, and while I have been so-so about the flashbacks from that day, I think they work here. Robby’s choice to take Jake to see Leah’s body underscores Robby’s inability to think clearly and is part of the decline in decision-making over the shift. He has been staring into the abyss all day, and this pushes him over. Noah Wyle is once again making a case for an Emmy, and it is unclear how they will pull him out of this hole—or who might be the one to do it (Dana or Dr. Abbott are the obvious choices). Someone get this man to therapy once this day is done.

• The Jake question has been answered, and David has also reappeared. I think his coming back to the hospital all but confirms he isn’t the shooter, even if the cops are treating him as a person of interest. There is so much meticulous attention to detail in portraying this mass casualty event (this Vanity Fair piece mentions that writer and medical advisor Joe Sachs spoke to physicians who worked in the aftermath of Columbine in 1999, Aurora in 2012 and Las Vegas in 2017) that to have David be the perpetrator feels like a huge contrivance. I might be wrong (I hope I am not).
• There are already signs of mental trauma as the woman who was crying last week continues to be in a distressed state. Mel and Santos have run through all the medical issues that could be causing this, but it seems more likely that she is suffering from PTSD. At this point, they are focusing on physical wounds, but this is a reminder of the other long road ahead. Social worker Kiara and ward clerk Lupe have the extremely grim task of telling one woman that her husband has died. As with most of the ER staff, they have also already been on shift all day and are equally vital to keeping this machine running.

• It is hard to keep up at times with the critical cases, and the speed at which they come through the door is purposeful. While Robby’s deviating from emergency protocol is a cause for concern, there are various ingenious and unorthodox life-saving tricks up the physicians’ sleeves. Langdon uses a method he heard on a podcast, Mohan uses the IO to reduce an intracranial bleed (using info from a case report in a medical journal), and Santos does a procedure she should not be doing unsupervised. While I still bristle at some of Santos’ brashness, I have to admit I was glad to see she got both admonished and praised by Dr. Abbott.1 Mohan’s out of the box thinking earns her a “holy shit” from the younger staff like Whitaker and a WTF from the older. The IO is the star of the episode as it is also the source of a Whitaker fumble (who uses it on a conscious patient) and allows McKay to deactivate the alarm on her ankle monitor—there isn’t much time to show this, but I worry how this might impact her chance of custody.

• Equipment continues to run out (batteries, too), but Dr. Abbott has a “go bag” of his own, which includes equipment that isn’t stocked in the hospital due to budget reasons. Experience triumphs despite bureaucratic and red tape obstacles (see also the empty ward that Whitaker mentioned last week, without the nurses available to staff it).

• Even in the chaos, there are plenty of smaller character moments that stood out. Whitaker’s got great bedside manner (IO issue aside), and is the only one to ask if any patient saw the shooter—though I am unsure if he should be asking this. His inexperience is still a factor, but he is growing in confidence, particularly with the portable ultrasound. Dana’s look to Abbott that Leah was gone and she needed his help to step in with Robby showcases the unspoken communication, and Dana gently touching Leah’s head after pulling the sheet over her face was an act of tenderness occurring in the background of a shot. On a funnier note, Dr. Shen regrets the second coffee he had as he hasn’t had a chance to go to the bathroom.

Nothing about this episode is a repeat of the previous one, other than the patients coming from the same place, and the energy remains high throughout. One part that gave me chills and that I had to rewind because it happens so fast is when the patient goes for a gun in an ankle holster because I couldn’t quite get over how in unison everyone was ducking down—some, like Perla, threw their bodies over their patients. It is a terrifying reminder of what they are up against and shows how primed the staff is when Langdon yells “gun.” They don’t need the big halftime locker room speech (at one point, Dr. Ellis in triage asks if Robby is giving his version of one) while everyone is getting on with the task at hand, but I am curious what the final two episodes have in store and whether anyone will be able to take a beat once the next hour hits. What are your thoughts on how the mass-casualty story has played out so far and how it has dovetailed with Robby’s storyline?