Pod Insights Short Wave Is ‘The Pitt’ accurate? Medical experts weigh in About this episode Medical drama The Pitt https://www.imdb.com/title/tt31938062/ is winning Golden Globes… and health care workers’ hearts. Medical experts say the show, which chronicles a fictional Pittsburgh hospital emergency department, is perhaps the most medically accurate show that’s ever been created. But what about The Pitt makes it so accurate… and does the second season hold up as well as the first? Stanford Global Health Media Fellow (and fourth-year medical school student) Michal Ruprecht https://www.npr.org/people/g-s1-75872/michal-ruprecht joins Short Wave to discuss.
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Transcript Speaker names marked ? are inferred from speaking time and the show’s known hosts — they are not voice-verified.
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0:18 Speaker 01 You're listening to Short Wave from NPR.
0:23 Regina Barber? Hey, Short Wave-ers. Regina Barber here with Michal Ruprecht. He's the Stanford Global Health Media Fellow embedded with us here at NPR. Hey, Michael.
0:31 Speaker 03 Hey, Gina.
0:32 Regina Barber? Michael, welcome to the show. I hear you are bringing us a story about one of my favorite things: TV.
0:38 Speaker 03 Yeah, it's a medical drama.
0:40 Regina Barber? Awesome.
0:41 Speaker 03 But can I admit something to you, Gina?
0:43 Regina Barber? Definitely.
0:44 Speaker 03 I'm not a huge fan of medical dramas because I'm a med student in real life. I'm studying to become a doctor and I feel like most medical dramas like ER or House, they aren't super accurate.
0:57 Regina Barber? House, really?
0:58 Speaker 03 Yeah.
0:59 Regina Barber? Yeah, I know.
0:59 Speaker 03 But last year, all of my medical school friends, literally all of them, were talking about this one show. And they told me that this one was different. This one, like, I had to watch it. It's called The Pit.
1:13 Regina Barber? Yeah, I just started watching that one. It's the one about a fictional emergency room in a hospital in Pittsburgh, right?
1:19 Speaker 03 Yeah. Season one came out last year and the show just won two Golden Globes, including the prize for best TV drama.
1:26 Regina Barber? Yeah, I thought it was a really cool concept that each episode is a single hour of a 15-hour shift. So it's like, one season is one day.
1:34 Speaker 03 Yeah, you know, it's pretty fast-paced. And that means there's no time for deeply romantic subplots or even the sometimes far-fetched storylines that usually dominate those other medical dramas.
1:48 Speaker 04 The Pit is by far the most medically accurate show.
1:53 Speaker 04 That I think has ever been created. And I'm not the only one to share that opinion. I hear that a lot from my colleagues.
1:59 Speaker 03 That's Dr. Alok Patel. He's a pediatrician at Stanford Medicine Children's Health. And she's obviously a fan of the show.
2:06 Regina Barber? Yeah, I mean, I'm a fan, too. I'm not in the medical field. I'm a different kind of doctor. But I found it really resonated with me, like especially the way they portray political division and mistrust in science, which we've definitely talked about in Short Wave.
2:20 Speaker 03 Yeah, totally. Not to mention even the corporatization of healthcare. On the whole, it's pretty realistic.
2:27 Speaker 01 Patients, they check in for registration here. A nurse eyeballs them, make sure they're not dying. If not, they're moved to one of two triage rooms for vitals and a quick chair exam where you can do labs and your x-rays. And then they come back to... Waiting room, till bed opens up.
2:43 Speaker 05 Is it always this busy?
2:45 Speaker 01 Uh, no. It gets a lot busier.
2:48 Regina Barber? And the new season, it just started. Michael, I heard you got to watch it early.
2:52 Speaker 03 Yeah, Gina, it was so cool. And the show's new season is streaming on HBO Max now. So we're here to discuss whether it really holds up to the last one.
3:03 Regina Barber? Today on the show, we dive headfirst into the pit, the medical drama that's breaking barriers on how hospitals are portrayed, and why healthcare workers are obsessed with it.
3:13 Speaker 03 Plus, a sneak peek at what season two has in store, from AI to misinformation and the realities of healthcare insurance.
3:22 Regina Barber? You're listening to Short Wave, the science podcast from NPR.
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4:47 Regina Barber? Okay, Michael, we're gonna dive into season two of The Pit, but before we do that, let's get a quick recap of season one.
4:54 Speaker 03 Totally. So the first season centers on the main character and veteran attending physician, Dr. Michael Robinevich, also known as Dr. Robbie. He's played by Noah Wiley.
5:05 Regina Barber? Okay, I remember him from ER, but what's an attending physician?
5:10 Speaker 03 Yeah, that can get pretty confusing. So attendings are doctors who have finished years of training and they manage the students, residents and fellows on their teams. They're basically the boss, just like Dr. Robbie is the boss in The Pit. Plus his right-hand man, a woman. That's the charge nurse.
5:28 Regina Barber? This makes sense to me. You've got your attending and the charge nurse, they go hand in hand. It's the blonde lady that I remember. But you had mentioned, you know, med students, fellows, residents. What do those terms all mean? Like, who are these people?
5:42 Speaker 03 Yeah, totally, Gina. It's a lot to keep track of. So let's start with med students. That's me. I'm in my fourth year and med students typically start working in the hospital in their third year of school. Their job is to examine patients on their own and learn how to start diagnosing them.
5:58 Regina Barber? Okay.
5:59 Speaker 03 Next up on the totem pole, we've got residents. They're doctors who've just finished med school, and they're training in some kind of specialty. And that training lasts for several years. And then we have fellows. Those are doctors who already finished residency training, and they want to specialize even further. Finally, there are the nurses, the physician assistants, the social workers, and other people. They're just as vital to the ER and how it functions.
6:25 Regina Barber? Yeah, I'm still in season one right now, and I was very surprised, and I know I shouldn't be, but there's like a social worker that's there all the time.
6:33 Speaker 03 Yeah, and speaking of season one, to finish the summary, Dr. Robbie's struggling to cope with some pretty traumatic memories while also treating patients and managing all those members on his team, who themselves are also going through some personal struggles.
6:48 Regina Barber? Yeah, it sounds like so much. Plus, he has to remember all the patients he's like working with all day. It was kind of boggling my mind.
6:56 Speaker 03 Yeah, and Dr. Patel told me that that's one of the most realistic parts of the show.
7:02 Speaker 04 The reality is, if you're working a busy shift and you have things happening in your personal life, the line between personal life and professional life gets blurred, and people have moments, and the pit highlights that.
7:15 Speaker 03 Episode 11 was the climax of season one. In the last few minutes of that episode, Dana, the charge nurse, played by Catherine Lenasa, talks with Dr. Robbie outside the ER. And she has this big bruise around her eye.
7:28 Regina Barber? Oh, my gosh, what happened? Like, I haven't gotten to that part yet, but it's OK. You can spoil it for me.
7:32 Speaker 03 I mean, basically, she got assaulted by a patient just two hours ago. And she tells Dr. Robbie that she feels like she's at her rock bottom. People are angry, her temper's just shorter, and we're still just trying to help.
7:46 Speaker 06 I don't know. Maybe what I want and what the patients need isn't what's best for you anymore.
7:51 Speaker 03 Yeah.
7:54 Speaker 06 I just honestly don't know what I'm gonna do without you.
7:57 Regina Barber? That's so heartbreaking.
7:59 Speaker 03 It is Gina, and it's also the reality for a lot of people in the medical field. Up to three quarters of healthcare workers have reported experiencing violence. Whether that's verbal abuse, or physical threats, or even outright assault. It all takes a toll.
8:15 Speaker 04 The new season of The Pit still has some of that tension between patients and healthcare professionals. And sometimes it's completely projected or misdirected. People are misunderstanding, they're frustrated, they get pissed off, they can't see a doctor in time in the ER, and they may act out. That whole concept of having to suppress this aggression, and then the frustration that there's not enough protection for healthcare workers, that's a very real issue.
8:40 Regina Barber? Yeah, it's something I hadn't really thought of until I started watching this show. Michael, can I ask, what other aspects of The Pit are like similar to what healthcare workers have to deal with in real life? Like, do they go into any new issues in season two?
8:55 Speaker 03 Yeah Gina, you know, the second season gets into some new themes like insurance, AI, and it even gets into the weeds of charting.
9:03 Regina Barber? Okay, let's take a step back. Let's talk about the first episode of season two, which aired last Friday.
9:10 Speaker 03 Yeah, episode one opens with that same busy and crowded ER that we're all familiar with from season one. But this time around, it's July 4th, and we meet a new doctor in the first few minutes of the episode.
9:26 Regina Barber? Wait, I haven't started it yet. Is Dr. Robbie gone?
9:28 Speaker 03 Oh, no, no, no, no, no. He is still there, don't worry. But there's another physician joining him. Her name is Dr. Al Hashemi. She's played by Sepe Demowafi.
9:38 Speaker 07 She's some sort of clinical informatics expert. When she started talking about AI, I started thinking about robots and kind of stopped listening.
9:47 Speaker 03 Clear. That sort of captures the headbutting between her and Dr. Robbie that kind of becomes evident as we progress through this first episode. Her take on using AI in the ER, she actually encourages the residents to use it to take notes.
10:03 Regina Barber? I just got a new family doctor and she used AI. She recorded our exam and she was like, there's gonna be a transcript, so I know what we talked about.
10:11 Speaker 03 Yeah, totally. This is something that's on our radar and people are excited about it, but there are some real concerns, like patient privacy and accuracy, and they talk about that in the show.
10:23 Regina Barber? Yeah.
10:23 Speaker 03 Another interesting aspect of the season is how it gets into disability and access.
10:28 Regina Barber? What do you mean?
10:29 Speaker 03 Well, there's this scene in the first episode where we see a patient sitting in the waiting room, and this waiting room is super busy, but as the camera pans over to her, it all goes silent.
10:47 Speaker 03 And we quickly realize that this patient is deaf, which really impacts her experience in the hospital, how the doctors interact with her, the type of care that she gets, and that's unfortunately true in the real world as well.
11:01 Regina Barber? What do you mean the type of care she gets? Like, can you give me an example?
11:06 Speaker 03 Well, when a patient, like in this case, needs an interpreter who can sign ASL, the doctor-patient relationship can thin out. And later in the season, we see this patient's first interaction with the doctor. Instead of making eye contact with the patient, the doctor faces the ASL interpreter during the interaction, and while it's subtle, you know, it can leave patients feeling pretty sidelined or even invisible.
11:32 Regina Barber? Yeah, that makes total sense. How else does disability make its way into this season?
11:39 Speaker 03 You know, later in the season, we also meet a doctor who uses a wheelchair to get around, which is just a reminder that medical experts are not a monolith, right? And there are both disabled and non-disabled people working in the ER.
11:53 Regina Barber? Yeah, that's a really powerful message. You'd mentioned earlier that insurance was a theme in season two as well, right?
12:02 Speaker 03 Yeah, and we don't quite get into it in the first episode, but viewers will definitely notice in later episodes that insurance takes a big role. You know, it's almost like a character itself, which seems pretty apt for this moment when many Americans are facing a really sharp rise in costs. And in real life, this unfortunately happens pretty regularly. While patients shouldn't have to worry about insurance, they do. Like, sometimes my patients only get what their insurance will reimburse. And, you know, that treatment they do get, it's not always the best, or even the standard of care.
12:42 Regina Barber? Yeah, and along these slightly depressing lines, there's growing misinformation that doctors are battling in the real world, right?
12:51 Speaker 03 Yeah, you'll find it in the pit too, unfortunately. And I don't want to spoil anything here, but it does involve someone getting their information from social media.
13:02 Regina Barber? My doctors have actually mentioned this.
13:04 Speaker 03 Yeah, I mean, it's a pretty accurate representation of how misinformation can spread. I still remember this moment from my pediatrics rotation when I was counseling a parent on immunizations.
13:16 Regina Barber? Okay.
13:17 Speaker 03 And I could tell the parent really, really loved their kiddo, but they ultimately declined to vaccinate their child because they were worried about a debunked myth. And while I think it's incredibly important, patients do their own research and are empowered in their care. The sources they turn to are equally as important.
13:37 Regina Barber? Yeah. Did Dr. Patel or other experts you talked to say what was less accurate to real life in this show? Like, was there anything the show got wrong?
13:48 Speaker 03 Not everything is totally accurate. For instance, med students can't order meds. You need that MD after your name to do that.
13:57 Regina Barber? That makes sense.
13:58 Speaker 03 And another thing that is unlikely is for One Shift to have so many complex cases. These cases definitely happen, but usually not all in one day. And one common complaint among all medical dramas is how inaccurate CPR is.
14:16 Regina Barber? Really? How so?
14:17 Speaker 03 Well, CPR is pretty violent, actually. Rib fractures occur in a majority of patients who undergo CPR, and other trauma can happen, too.
14:26 Regina Barber? Well, it is a show. They can't be too violent with their actors. Michael, thank you so much for talking to me about all this. I'm excited to watch the second season.
14:36 Speaker 03 Thanks so much for having me. This was such a blast.
14:41 Regina Barber? If you liked this episode, follow us on the NPR app or whatever podcasting app you're listening from. Also, you might want to check out our episode on the history of tuberculosis with John Green, or our episode on the closest thing we have to a cure for allergies. We'll link to them in our episode notes. This episode was produced by Hannah Chen. It was fact-checked by Tyler Jones, and it was edited by our showrunner, Rebecca Ramirez. And Maggie Luthar was the audio engineer. Beth Donovan is our vice president of podcasting strategy, and I'm Regina Barber. Thank you for listening to Short Wave from NPR.
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