How Real Doctors Brought ‘The Pitt’ To Life

We go inside the scientifically accurate ER world created for the TV show with one of its medical consultants.

Speaker names marked ? are inferred from speaking time and the show’s known hosts — they are not voice-verified.

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• 0:47Ira Flatow?

  Science Friday is supported by Mathworks, creator of MATLAB and Simulink software for technical computing and model-based design. Mathworks, accelerating the pace of discovery in engineering and science. Learn more at mathworks.com. This is Science Friday. I'm Ira Flatow. Today on the podcast, the new medical drama, The Pit, gives an unflinching look at what it's actually like to work in an ER, and healthcare workers can't praise it enough.

• 1:21Speaker 02

  I think the overarching goal was to create the most accurate and realistic medical drama series in history, which they accomplished.

• 1:29Ira Flatow?

  I have been watching and enjoying The Pit. This is that new medical drama on Max from the creators of ER. And starring one of that old show's young key actors, all grown up, Noah Wiley. The season takes place over a single shift, and each episode in the show is one hour of that shift in real time. Medical professionals are praising the show for its accuracy, and I think the issues are so contemporary and the characters so defined that I'd describe it as The West Wing meets ER. But just how true is the show to what it's actually like to work in an emergency room?

• 2:12Ira Flatow?

  With the overcrowded waiting rooms, the lack of hospital beds, constantly presented with life and death health conditions, and trying to maintain your sanity at the same time? Here's what listener Lena in New Jersey had to say.

• 2:27Speaker 03

  As a new EMT who is prepping for nursing school, I absolutely love The Pit. It's one of the rare shows that is more medical than drama, unlike so many soaps with scalpels out there. Medical jargon, nuances of patient care, depiction of PTSD. It's all impressive stuff.

• 2:44Ira Flatow?

  The Pit's season finale is now streaming on Max. And joining me now to talk about the medical accuracy of the show is one of its medical consultants, Dr. Sylvia Owusu-Ansa, Associate Professor of Pediatrics and Emergency Medicine at the University of Pittsburgh School of Medicine in Pittsburgh, Pennsylvania. Dr. Owusu-Ansa, welcome to Science Friday.

• 3:08Speaker 02

  Thank you, Ira, for having me. This is, it's so exciting. It's a dream come true. I've always aspired to be on NPR, and here we are with the legendary Ira Flatow. So, so honored to be here.

• 3:19Ira Flatow?

  Thank you. You know, I have to say, I'm with Lena from New Jersey. The Pit is one of the rare shows that is more medical than drama, and it's pretty intense, really intense. Looking so realistic. You've worked in emergency medicine for over 20 years. Is it intense for you to watch it?

• 3:38Speaker 02

  Oh, it's utterly intense. But it's also engaging because it feels so real. For once, we are validated as healthcare providers watching The Pit. I have never been a fan of the medical drama, period. And I have to admittedly say, I didn't watch ER that much. I think I was more focused on getting into medical school. But The Pit has broken every type of ceiling when it comes to this genre of television. And kudos to everyone who's worked on this.

• 4:11Ira Flatow?

  Yeah, yeah, I agree. Let's get into this a bit because as you understood it from the writers, what was the overarching goal of the show?

• 4:22Speaker 02

  I think the overarching goal, there are several overarching goals. I think one was to do what they have done, create the most accurate and realistic medical drama series in history, which they accomplished. I think the other thing that they're using this platform for is to talk about many issues that a lot of us struggle with, where there may be a lot of conflicts, but allow media to tell the story, to tell the story of human beings and their struggles, to tell the story of end of life, to tell the story of health disparities and sickle cell disease, of abortion, a lot of these controversial issues, just allowing people to hear, to the best of their

• 5:05Speaker 02

  ability, both sides of the story, but understanding that in each story, there's a human being behind there and a human being that you yourself can relate to in some way, shape, or form. And finally, in addition to pulling the wider audience of non-healthcare providers, they've now done the phenomenal thing of pulling us health providers in as well.

• 5:25Ira Flatow?

  Yeah, that's amazing because they really go out of their way to discuss these social issues. Does the emergency room feel, in real life, like a microcosm of society to you?

• 5:40Speaker 02

  A hundred percent. So the way I describe the emergency department to most people, we are the gateway to healthcare. We don't turn anybody away. We don't care what, who you voted for, whether you have insurance or not, what age you are, if you're super sick or maybe mildly sick. We take everyone and we make sure that you get the healthcare outcomes that you deserve. And when you look at any other division or department or specialty in medicine, nobody has as open a gateway as emergency medicine.

• 6:14Ira Flatow?

  You're at the University of Pittsburgh School of Medicine. The show takes place in Pittsburgh, hence the name The Pit. Why Pittsburgh and what were you asked to consult on?

• 6:28Speaker 02

  Yeah, I mean, I guess, you know, in talking to Noah Wiley, because I asked him the same thing, it's why not Pittsburgh? I mean, Pittsburgh has some solid healthcare history. You have Tom Starzl, who did one of the first liver transplants. You have Freedom House Ambulance Company, started off with 25 black men and later women, who are the reason why we have EMS today.

• 6:52Ira Flatow?

  And they talk about that in the show. I don't think anybody knew about that until they exposed the information on that.

• 6:58Speaker 02

  Yeah, and that's the beauty of media, right, is being able to tell the masses the true story, the true history behind what we do. And so, yeah, we'll talk about that and how I aided in that process.

• 7:10Ira Flatow?

  Yeah, how did you? Tell us.

• 7:12Speaker 02

  Yeah, so they were looking for an expert in health disparities in Pittsburgh, who works in the emergency department. And Dr. Beth Hoffman, who's at the University of Pittsburgh School of Public Health, tagged me to be that person. She works closely with a nonprofit called Hollywood Health and Society. Their job is to bring medical expertise to all TV shows, not just medical dramas. Ms. Roberta Kruger, from the Hollywood Health and Society organization, then connected me with the writing room of the Pitt. So on a Zoom call, virtually, sat in front of Dr. Joe Sacks and the entire writing team, and they asked me various questions about health disparities in Pittsburgh. I'm also a pediatric emergency medicine physician and an EMS physician. So I talked about storylines,

• 7:56Speaker 02

  my personal storylines on health disparities in sickle cell and pain management. As an EMS physician, I felt it was very important that we talk about Freedom House Ambulance, of which I'm helping to lead on the Congressional Gold Medal for those wonderful men and women. And things such as language equity. The Nepali woman talked about the different languages spoken in Pittsburgh, outside of Yin speak. And you know, some additional, the pediatric, the ingestion of the gummies. So things that I thought in pediatrics needed to be brought to the fold, not all the pediatric cases. So then partake in the measles case or the hair tourniquet, but the gummies and some additional other storylines.

• 8:36Ira Flatow?

  Mm hmm. And I, I watched some extra videos where the actors were, were actually being put through medical boot camp, too.

• 8:43Speaker 02

  Yeah. I mean, they, they have gone above and beyond. They have about three to four emergency physicians on the set, on the production set while filming. And so not only did the actors and actresses go through a medical boot camp, so where they actually learned how to place a breathing tube in or intubate and learn how to put an IV in or learn how to do various procedures as opposed to mimicking those procedures. And it's important to know that Dr. Joe Sacks is an emergency medicine physician who went to film school, hence ER. And he still works part time in the emergency department. So he was able to bring all this ingenuity to light on that set every day. He's a main medical advisor.

• 9:24Ira Flatow?

  Right. We have, we have a listener question from Ava in Denver, which I wondered myself because she, she writes, I'm blown away by the volume of patients waiting to be seen in the ER on this show. What percentage of ERs are that busy? How typical is the pit ER in that aspect?

• 9:46Speaker 02

  It is a crisis, Ira. We, we've had this healthcare crisis before COVID. I think COVID was the tipping point. I would say the majority of emergency departments, especially when you think of smaller, like suburban areas or rural areas, we have community hospitals or tertiary care centers where we are the hospitals that may only have certain types of specialty groups or surgical groups. We're overwhelmed all the time. At my hospital, UPMC Children's Hospital of Pittsburgh, we see about 200 kids a day, 80 to 100,000 children a year in the emergency department alone.

• 10:22Ira Flatow?

  No kidding. And we also get to see on the program jobs, support jobs in the pit that people don't usually get, you know, they don't usually get a role on other medical shows of the social workers, the janitorial staffs, the ER truck drivers, things like that.

• 10:39Speaker 02

  Yeah, they've done a phenomenal job with that, too. I do have some of my colleagues last night where they're like, where are the PAs? Where are the respiratory therapists? You know, there's always some additional caveat, but Dr. Sheila Roth, who's a good friend of mine and is a social worker here in Pittsburgh, advised on the social work role, I believe, for all episodes, and her husband, Dr. Ron Roth, the former Pittsburgh EMS medical director, advised on the mass casualty incident. And they also used Las Vegas data and information to advise on that as well. So they have gone above and beyond to make it look, feel, get the sense of being in a real emergency department.

• 11:18Ira Flatow?

  Yeah, even to slipping on the blood on the floor.

• 11:21Speaker 02

  Yes, I know. I was waiting, looking at that blood puddle, waiting and waiting. I was like, oh, this is inevitable.

• 11:27Ira Flatow?

  Yeah. Well, let's talk about this. The special effects on this show is incredible. I mean, I have to ask you, in particular, we see a live birth, the baby actually emerging from the birth canal. Was it, how did they do that?

• 11:42Speaker 02

  Technology is so advanced in medicine now. The tools that we can use as far as simulation and simulated infants and bodies and, you know, they're almost like real human beings. Like, we have simulated mannequins that can cry and cough and say ouch and do all kinds of things. And so, and they've taken the time to do that and all kinds of prostheses. Hats off to like the makeup folks and the technical folks that spend hours and hours building these things, putting it together. It's phenomenal what they've done. But I mean, technology has moved in that way in healthcare where we're seeing, you know, immensely real life-like things that we can use to study from.

• 12:26Ira Flatow?

  After the break, more on the day-to-day realities of working in an emergency room.

• 12:31Speaker 02

  It is 100% detective work. My job is to rule out the life-threatening things, the things that that will may kill you right now that we can solve.

• 12:39Ira Flatow?

  Stay with us.

• 12:44Speaker 00

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• 14:07Ira Flatow?

  And we watch the toll it takes, the mental and the physical toll it takes on the people who work there. And there's something I was wondering while watching this. This seems like one of the hardest jobs in the world. I mean, how can someone do this, day after day? And the show actually addresses that. Here's a clip.

• 14:29Speaker 06

  The average emergency doctor gets pulled from Task A to Task B every three to five minutes.

• 14:34Speaker 02

  Remind me again why we picked this specialty?

• 14:35Speaker 06

  Because we all have ADHD and anything else would be boring as hell.

• 14:40Ira Flatow?

  Does that have any truth to it?

• 14:42Speaker 02

  Oh, Ira, it has so much truth to it. You know, there's so many times where I'm in a patient's room that's really sick and what we call trying to die. And I'll go to the next room and that patient is not as sick, but the parent doesn't understand that and doesn't want to hear that. And it's hard, you know, as a pediatric emergency medicine physician, I have to tell parents that their kid has died. I have to tell parents that their kid has cancer for the first time. I have to tell parents that their kid has to take insulin for the rest of their lives. Or, you know, we need to put a breathing tube down because they can't breathe. And there's little time to decompress and move on to the next one, just as is expressed in the pit. And so it does take a mental toll on us. We're doing a little bit better. One of the things I did advise on was, was the moment of silence, which is what we do

• 15:25Speaker 02

  at children's, anytime there is a passing, we take a moment to celebrate the patient's life and we take a moment for ourselves as healthcare providers to take a deep breath and, um, and move on to the next patient.

• 15:38Ira Flatow?

  And what we see a lot is that the doctors, a lot of times, just don't know what the patient has. It's like detective work, right?

• 15:46Speaker 02

  It is 100% detective work. And a lot of times, you know, I, I explain to patients, look, my job is to rule out the life threatening things, the things that, that will may kill you right now, that, that, that we can solve. If not that, then what we'll do is, you know, we'll work with our other healthcare providers, your primary care physicians, specialty groups, to make sure that you feel better. But we might not be able to do it here and now in this moment.

• 16:09Ira Flatow?

  And one, and one thing that Noah Wiley, the head of the ER at that time, is constantly complaining about to the higher ups, to the suits, so to speak, of the hospital, is that there's a shortage of this, there's a shortage of that, there, there is a nursing shortage, they don't want to spend money on stuff. Does that really go on?

• 16:28Speaker 02

  That really goes on. That we have, we get emails pretty much weekly, sometimes daily on drug shortages. The nursing shortage is not the only shortage that's been out there. Our EMS clinicians, our EMTs and paramedics, we've had a healthcare crisis there for a while, for decades, because they don't get paid in the way that they should get paid. There are less people going into primary care specialties in medicine. You know, the specialties that help take care of the normal ailments and keep you better on a regular basis. So there is a decline on all spectrums of medicine.

• 17:03Ira Flatow?

  The highlight of this season, and no spoilers here, was how the ER handled a mass shooting where they treated over 100 patients. Here's a clip from that show.

• 17:14Speaker 07

  We saw 112 mass casualty patients come through here in the last four hours. And 106 of them are going to live.

• 17:22Ira Flatow?

  Have you ever been through a mass shooting like that, that you had to take care of patients?

• 17:27Speaker 02

  I have not personally been through a mass shooting, but we practice. We do what's called disaster preparedness and we run tables and we practice that, which is a scary, scary thing. But it is very real. I mean, I saw Mr. John Wells last night, and one thing he said about that is, you know, nowhere in there did they mention the word gun control. But the whole idea is that, you know, just by telling the story, you recognize how certain behaviors or certain acts can be devastating on all parts.

• 17:58Ira Flatow?

  Right. So tell me what the response has been like from the healthcare community in general.

• 18:04Speaker 02

  Finally, finally, we can say thank you. Thank you for validating us. I felt, we feel like there was this transient period where people during COVID recognized that we were superheroes. And it's nothing to take away from the banging pots and pans in the windows every night, but that easily faded away. But the work that we do has never. I mean, we've been working like this before COVID, markedly increased during COVID, and we're still doing the deed after COVID. And so finally, finally, finally, thanks to these phenomenal executive producers and writers at the pit, I think we as healthcare providers feel validated in what we do. And to your point, Ira, earlier of like, wow, I didn't realize this job was so hard. We have patients come in that don't recognize that.

• 18:48Speaker 02

  And I think now we're starting to have patients because of the pit that we're like, they recognize that. We have family members, spouses, aunts, uncles, parents that are like. Wow, like my best friends, I call them the Bear Girls, shout out to them. You know, they watched it with me and they were asking me, they're like, but you don't really see that many patients. And I've known them for 20 years, Ira. And I was like, yes, I do. But they're not all trying to die. I said, but yes, they are. You know, and they're like, wow, and we've known each other for 20 years and I love them to death. And it has made a difference. It has made an impact.

• 19:23Ira Flatow?

  Well, that's a good segue into this final clip I want to play from the season finale. And I'll set it up. They've just finished a brutal shift. Noah Wiley's character, Dr. Robbie, the head of the ER, speaks to the ER staff.

• 19:38Speaker 07

  We saw our better angels come to the aid of our patients. Each of you rose to the occasion. And I

• 19:49Speaker 07

  I can't tell you how proud I am of all of you. This place will break your heart. But it is also full of miracles, and that is a testament to all of you coming together and doing what we do best.

• 20:02Ira Flatow?

  Real sentiment there?

• 20:04Speaker 02

  I couldn't have said it any better. I couldn't have said it any better.

• 20:08Ira Flatow?

  Yeah. Yeah. The pit, I understand, just got renewed for its second season, and one of the show's creators said it would take place during a busy July 4th weekend. Can you imagine what that would be like?

• 20:23Speaker 02

  Yes. And so for people that don't know, the beginning of July is when we get a new set of trainees, fresh eyes and ears in medicine. And so, and it's also during the summer, we get the most traumas. So you can imagine the combination of new trainees, lots of traumas, you know, whether it be gunshot wounds, broken bones, motor vehicle accidents, drownings, you name it. It can be a tough month for all involved, the trainees and the trainers.

• 20:57Ira Flatow?

  I can't wait. And I want to thank you for what you do and for taking time to be with us today.

• 21:03Speaker 02

  Yes, thank you, Ira, for giving me the opportunity to speak and thank you for what you all do in the media space to get the word out to millions.

• 21:11Ira Flatow?

  You're welcome. Dr. Sylvia Owusu-Ansa, Associate Professor of Pediatrics and Emergency Medicine at the University of Pittsburgh School of Medicine in, of course, Pittsburgh, PA.

• 21:27Flora Lichtman?

  Hey, Flora here. One of my favorite parts about working on Science Friday is getting to interact with you. Y'all remind me every day that no matter what pops up as I doom scroll, the world is actually filled with curious, smart, hilarious people. And at Science Friday, we depend on you in lots of different ways. You make the show better with your questions and your comments and your insights. And we've always depended on your support to keep the lights on. As you probably know, because you listen to this podcast, it is a tenuous time for science and for independently-produced public media. So listener support is now more crucial than ever. And it doesn't even need to be

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• 22:34Ira Flatow?

  That's about all the time we have for now. A lot of people helped make this show happen.

• 22:39Speaker 09

  Diana Plasker. Jordan Smudgic. Emma Gomez. Valissa Mears.

• 22:44Ira Flatow?

  I'm Ira Flatow. Thanks for listening.