¶ Intro / Opening
Here I am back from the
Deborah Vance is back, and so is the official Hacks Podcast. I'm Paul W. Downs.
I'm Lucia Angela. And I'm John Stat.
And we're the creators and showrunner. Just
Celebrate Hax's fifty.
and final season. We are back in the podcast studio ready
Final ten minutes.
Including what you see on screen.
And what went on in the writer's room and behind the scenes.
Listen on HPMX.
Tier one trauma, ETA, six minutes.
And so it's not a good thing.
🎵 Music
¶ Welcome to The Pit Podcast and Season One Overview
Welcome to the Pit Podcast, the official companion podcast for HVO Max's The Pit. I'm Hunter Harris, a screenwriter and cultural critic.
And I'm Dr. Alok Patel, a physician, journalist, basically a loudmouth for public health. Each week we'll go inside the pit and talk to the 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 eighth, and so to prepare, we're gonna 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 and get you more insight, we're gonna talk to executive producer and director John Wells and executive producer and showrunner R. Scott Gemmel. Today's shift starts now.
Okay, stop. Everybody stop.
🎵 Music
You're gonna record.
Or I will have security smash it open.
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 ME. The pit one. I think it's thirteen nominations, five wins, best actor, supporting actress, guest actor.
And then what was what was awesome is it won the Emmy for outstanding medic outstanding drama. It's 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 this show?
I think it's a lot of things. I think first of all the show is very good. It has this like like frenetic, fast pace. It feels like you're you know, in these characters' shoes at all times, which I think is really a testament to the performances and also just the directing and the writing. Um, 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.
¶ The Pit's Cultural Impact and Accuracy
You're seeing it as almost like the show is humanizing all these headlines or stats. Like that's how I'm that's how I'm hearing what you're saying.
Yeah, I also feel like maybe I'm a doctor now, I've watched enough of the pit.
I mean probably. You're probably like going there and just start doing some surgery as an intern, just get your hands bloody, just dive in.
Ask you the same question. Like as a healthcare worker professional, how do you feel like the pit, um, why do you feel like it has so much cultural capital, so much resonance?
So I feel like I could answer this question over the course of like fifteen hours because there's there's so much to talk about. But I think one thing that's incredible is the pit really nailed.
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 Sachs, who like came in and added 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 these procedures. It felt reassuring because you're like, oh my gosh, like there's someone actually there 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 it talks about in the first season, there is 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 that like Doctors and nurses just all of their shit together. And it's it's just we're we're people. We're 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 interviews that
Humans have to compartmentalize our issues when you show up for your family, for friends, for work. You gotta like try to separate these issues and then be present. And you have to do that 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 band-aid, that's medically accurate to me. Um, but they all act with such conviction that I'm gonna 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
¶ Authentic Teamwork in the ER
Oh, I 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. She's like the boss. Like she runs that place. She almost like controls the tone. And that's that's real. Mm-hmm. 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 gonna 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 KR, who's played by Crystal McNeil.
Like that is such an important representation because there's certain situations in the hospital where, yeah, you 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 gotta find a way to bridge that gap. So the fact that they had a social worker front and center, like
Kudos. When w so when people in the healthcare system see that, they're like, oh my God. 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 talk to the same twelve 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 E D I should say run. And that's really important. It feels like, you know, accurate to any workplace, not just the E D.
I'm with you by the way, where I can never decide if we call it the ER or the E D. I feel like TV is like ER and then in the hospital they'll say E D or like go to the E D, which is kind of funny. But then some people hear E D and they're like, Oh yeah, like erectile dysfunction.
That's what I thought. For a long time.
I'm glad you 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 it really are 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 how to bring a vision to life in theater? Like what stood out to you in that sense?
¶ Character Depth and Societal Issues
I think it's really character. I think the fact that let's take McKay for example, that we see her with an ankle bracelet and then, you know, we like don't really talk about it because you're in the course of a day. How's that how are you gonna ask someone why why why are you wearing that? What's that from?
And it's like mm, that it's kind of a slow rollout of all these like personal details, I think, feels so true, especially as people who are like, you know, working to save lives. The patient stories are also so moving. Um, the brain dead teen from like episode three, I believe. Like that one really I was like, wow. And at 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 McKay took the drill to her ankle monitor, I was like
Here a moment.
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 like segment be like, 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 the the like masking debate between two women and where one of the women was like, Okay, mm, I don't wanna wear my mask but I want my doctor to be wearing his mask. that really hit home for me. Um 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 like get a nail in your chest? Like that kind of stuff. Um, which I think really speaks to maybe like the levity that you can the dark humor you can find in the middle of a di very difficult.
Humans gotta laugh. Yeah. Like you know, I I'm I'm glad the show like includes that. 'Cause 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.
Anytime 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 patience too. Yeah. Yeah. Like making these little comments here and there, which I think is like is so incredibly necessary. Yeah.
¶ Season One Recap: Sickle Cell Case
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. Um, so let's do a little recap of the big moments from season one.
I'm totally game. Before we do the recap, I gotta 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 Rabinovich. attending physician. He's Dr. Robbie runs a bid. Then he is mentoring these resident doctors of varying years. So you've got Collins, Langdon, McKay, Mohan, King, Santos.
And then two med students, Whitaker and Javadti. 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 a 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 in 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.
Let's take a look. I've been screaming for.
Narcotics non-stop.
How are you doing?
He's been unclear.
Cooperative and combative since we can.
Stop fighting! Cut the fuck down on the cops!
Please I have sick hole!
Okay, stop. Everybody stop. What's your name?
It's choice! It's choice!
Joyce, is this your cigar salt pink?
Yes!
Ten milligrams of ivy morphine.
I really want ten.
Yes, repeat it in five minutes if needed. And she needs a dilata drip. This is a vaso occlusive price.
I think that clip i i 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 or we're gonna 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 disproportionately affect 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 in healthcare. But basically every single study and patient survey says otherwise, and this clip is proof of that.
¶ Mass Casualty Incident and Staff Trauma
But 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're now kind of seeing the the intro of the shooting incident. The minute you hear Nurse Dana pick up that call, I think it just stopped every viewer in their tracks. Yeah. Because we're 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 that the accuracy was there. And they took the time to talk to trauma surgeons, ER healthcare professionals, especially those who worked in the hospitals after the Las Vegas mass shooting. And they went for accuracy, emotional accuracy. And I think they they really did an amazing, incredible, heartfelt job in making sure this tragedy that happens all the time in America was portrayed 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.
🔇 Silence
You're good to have a benefit. Don't let this place take that from you.
開始
Yep.
Code triage. Multiple GSWs. There's an active shooter at Pipfus.
Jake getting his girlfriend in there.
So there is so much going on in this 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 gonna define like the last back half of the season.
You're right. You can't help but notice the black eye. 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 ten doctors and nurses have experienced some type of assault who work in the ER. Like it's wild.
And, you know, the the creators of the pit are like, Hey, we're gonna introduce major storylines, but we need to make sure that we elevate all these necessary conversations. Yeah.
Yeah.
Healthcare.
And something else, you know, when I think about a mass casualty incident, I of course think about the victims. Um, but I'm not thinking about the trauma that it conflict on healthcare professionals and healthcare providers. Everyone who worked in the hospital that day saw something, felt something, and that this show shines a light on that also I thought was very special.
Also, um, Noah Wiley delivers this amazing monologue at the beginning when he's kind of rounding everyone up. Yeah. 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 vet. We're all gonna 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. Okay? Triage is gonna assess and assign every patient to a specific zone with 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 and 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 black 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 Nurs Dana. No, like get behind me. That's my girl. Um, I could not believe this happened, but I guess this violence against healthcare workers is more common than I would ever think.
It's awful because people are like frustrated with the healthcare system. Straight up. They're 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 they 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, being like, look, what are we doing to protect these people? Yeah. What are we doing to, you know, boost up staffing and security? And I think they like This happens, it gives the audience like a moment to say, like, I'm gonna I'm gonna find that guy. The cops don't find him. You mess with Nurs Dana, I will find him.
I'm looking. No, let's watch.
🔇 Silence
Hard at work. I'll take my channel.
¶ Personal Struggles and Physician Addiction
People who work in the hospital are people too. And they've got 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 got Whittaker, we find out, who doesn't have a place to live. Yeah. It's kinda wild. He's like living in the hospital somewhere. Which kind of a smart move though, rent free.
How's this out smart?
I mean, it was just like
Where you were?
You you can't. I mean like sorry, that's bad. It's not smart. But but Whittaker 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 you've got these these personal problems in these issues, and you're still showing up to your patience, and the show does a good job of kind of sprickling in those problems. Question for you. When Santo 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 gonna 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 a little bit of the badass. hot guy, 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 like how you led with the hot guy.
What can I say?
He's got good hair. He's got good hair. 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 wanna 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 police right now because I keep bringing up these real issues in healthcare, 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 where it 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 real emotions. Yeah.
Let's watch it.
Yeah. I'm already getting like tense thinking about rewatching it.
Is the imprint code on these pills gonna match Louis Librium?
🔇 Silence
Go home, Frank.
No, no, it's not like you think. You remember whenever I helped my parents move, I was too cheap to pay for movers. I hurt my back. I told you that, you teased me about it. Remember? Well, our own Dr. Hagan prescribed me some pain meds and muscle. I was just weaning myself off. It was just for maintenance. I'm done, Robbie.
Come on. You know me.
Robbie, you know me, man. I'm sorry, I fucked up. I just I I was trying to either
What steel pills?
No, like you don't understand. Not like you think. I'm not hot. You've seen what I do, Robbie. Could a drug addict do what I do?
Apparently.
Might just fucking let him.
You're done.
Leave now or I will have Ahmad escort you out.
Robbie.
You are done.
What?
🔇 Silence
I wonder if if he improved that what at the end, because 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 it 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 the 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 in a way that is so sad. And then my favorite line, you know, maybe of the whole show again is when Uh 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.
Robbie is suddenly reevaluating a lot more than just what he's seen that day.
A hundred percent. Yeah. It there's there's so much there's so much emotion in such a short amount of time. Yeah. In that scene, like this roller coaster. Yeah. And it's like Robbie goes through like all the stages of grief like in in 15 seconds.
And Langdon plays it well too, because you see the desperation, the kind of once you start kind of flailing and being like, Well, what about this and what about that? And then you know he's done it. Then you know he's guilty and he's like really trying to cover his.
Yeah, and then you're like
Torn. She's 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, no. He's struggling right now and he just committed a felony. Wait, whose side am I on?
But also hello, the ED needs to be staffed. Like
¶ Patient Misinformation and Doctor-Patient Dynamics
Um, 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 um patients in season one is the, is it the measles? the teenager with measles and the mom is like, Don't give him the spinal tap because I've heard it could lead to paralysis.
And it's like, okay, Dr. WebbMD, 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.
Yeah.
Yeah. Um, because we see it all the time. Mm-hmm. 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's saying, like, hey, don't give them 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 I'm gonna get a court order to do this. Yeah. And may have to get the police involved. So it does happen. And honestly, like I feel for parents initially, because people just wanna 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 up all of a sudden you aren't paying attention. to the real science 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 gonna go to Dr. Google for advice, but she doesn't want to actually get medical treatment in the hospital.
And it's like a major frustration people say is like, you're a know-it-all, then why did you come here for treatment?
Mm.
And I think with vaccines, just one example is people no longer fear the actual diseases that we're trying to prevent. Instead, they fear that whatever they're reading on the internet. So, you know, this teenager in this 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, and I'm like, hmm, maybe a little laser here. Like who knows? Like maybe I do need it actually. Um, okay, last question. I mean, maybe this actually speaks to what we were 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 doctor healthcare professional is 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 sprained ankle. Yeah. And like Dr. King goes in there and she just connects with him. There's the homeless woman who gets empathy immediately from Dr. McKay.
We talked about the sickle cell patient and Dr. Mohan connects with her. And that's something that we want everyone to kind of try to understand. Did that s did 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? Um
Maybe even like Louie and Whitaker. Lou like Louie is such a good character and Whitaker's like a little bit nervous, a little bit jumpy and being met with a patient who has kind of seen it all before and um feels very comfortable in the E D. That was like a really good moment of like, okay, maybe the exact patient Whitaker needs to grow as a doctor is someone like Louie.
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. Mm-hmm. And I actually think it would 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. Cause 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, f 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 toot our own horns.
Well I'm not saying I'm Toten. I mean I'm probably
Just save it. Just leave it there. Just leave it there. It's okay. Um, to talk more about intention and craft and impact, we have the executive producer and director, John Wells, the executive producer and showrunner, Arscott Gemmel.
I was so stoked for this conversation.
The truth is, no one does it alone. And why would you want to?
🎵 Music
Brought to you by Adidas.
Some say the bubbles in an aerotruffle piece can take 34 seconds to melt in your mouth. Sometimes the very amount you're stuck at the same red light. Rich, creamy, chocolatey arrow truffle. Feel the arrow bubbles melt. It's mind bubbling.
¶ Producers' Insights: Real-Time Structure
Okay, our first question. Um 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 um unnerving'cause we didn't know if it was gonna work and we honestly I you know that that prevented lasted a while, you know. Um it it but it was good because uh it was new for all of us as actors, as directors, as producers, So and especially as writers. So we just it forced you to lean in and sort of re examine what you do. And I think it led to sort of uh
new stuff for all of us. And it but it 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 fifteen hours. So you have to be I would say it's like more precision writing than anything else.
You're you're working within a frame, a 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 coworkers? How what are you gonna 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, kind of parrying back what we're doing, which I think is respect for the audience, the audience's intelligence to fill in the blanks and to and to be um curious and interested about the people that they're just meeting at work.
Yeah. Like on a r a regular s show, uh a network show, you know, who would fall in love over the course of the first
Season well.
We only have fifteen hours, so no one's falling in love in fifteen hours, you know.
Yeah. Yeah.
Yeah.
You're not getting married, divorced, and having a kid.
Yeah, exactly.
It'd be a wild show. Family art.
But that was really um 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 of the characters beyond what you would actually experience during the course of a single shift. Um and that was really liberating.
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 em 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 and directing and for the writing.
And 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 uh July and the last hour we shot in January. And yet you have to be experienced what it's like to be on your feet for fifteen 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're slowed down? So just as an acting and directing challenge it was uh it was invigorated.
¶ Producers' Insights: Story Development and Accuracy
And throughout this very long day that you're portraying, the show also highlights a lot of really important story arc. that are talking about very important issues, you know, drug abuse and trauma and many social situations, sickle cell disease and more. How do you all decide what stories that we want to highlight and where they're gonna fall in the season?
There's there's sort of two aspects to it. There's the stories you wanna 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 life? And then we have the list of medicine and stories that we wanna 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 anyway. something going on between the characters that really make and that's really the story that's being told. The 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 what's going on internally with them themselves.
And there's tremendous amount of research that actually goes into determining what they want to talk about. Rather than doing it kind of top down in the sense of what are 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 ten 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 at work? And so those things like.
Um you know, the amount of pressure that's coming back in the emergency rooms as primary care is less available as eight to ten million people lose their health insurance. What is that gonna mean for the people who actually now see people who could have had ailments that were
um diagnosed and treated more effectively in primary care suddenly coming through the door, you know, in very bad shape. So it's um it's a process of trying to figure that out and and also keeping track of that this is a teaching. And during the course of a day, how much does a f 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 procedures. So how do you unlearn what you've actually been learning just uh in the dexterity and physically on the set?
So all of those challenges have been really exciting and I think kept the the writing and the narrative and everything very invigorated.
¶ Producers' Insights: Ethical Dilemmas and Authenticity
Well, speaking of the physicians and the 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 procedure. 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 the doctors that we work with ha basically have veto power over the stories, which is one of the things that's really different for uh 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
Yeah.
Yes. The reality now is I go no, that wouldn't happen. And so um They they constantly are keeping it on us. And it's a it's a real conversation. Because we're doing a f 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 hir hiring actors, wonderful actors saying, we're gonna give you a sp a a role to audition for. This scene is gonna 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 here for three months to do one scene.
Um, but it's trying to k 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 reconceive 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 at allowing us to really show. Uh, what we were never able to show before on uh on television medical.
Scott, I want to ask about the sickle cell storyline and how do you balance what mistakes are realistically possible for a doctor to make like treating pain while still building tension and keeping the story feeling, you know, um moving, the momentum.
I think you just have to be honest, you know. I mean I I think that's the authenticity is part of the integrity that we bring. So that was a story we 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, D C is one of them. Penns Pittsburgh wasn't one of them, you know, and that's at least what we were sort of
You know, that was also vo ta 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 w 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 con not considered as as m as the same as it is when it's a man sometimes. So
A story like that has so many different l le layers to it, you know, that um 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 are treated as if they're coming in with a whole different condition just because um they're not used we're the that that hospital's not used to seeing it.
¶ Producers' Insights: Aftermath of Trauma and Closure
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. Um, you know, you uh 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 treat'em and street'em. That's just, you know, our and our show tends to follow the jer the doctors and the nurses more than the patients, which a lot of shows may be more patient forward, and it's about the patient comes and we see the doctor save them. Whereas our show is more so about the pay the doctors treating these patients and then they're gone, you know, and and sometimes we will follow up, but usually that's if a doctor or one of the characters wants to follow.
But the reality is they never half the time never see these patients again. And so w you know, once again.
ninety percent of the
Yeah, yeah, yeah. Yeah. Mm probably more than that. You're right. You're right. Uh uh and so that's just trying to be as authentic to the emergency department as as we can.
And we've spent a lot of time in emergency departments and and with emergency physicians. And I remember one time being in one and there had been a very dramatic sort of gunshot. 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? Seen thirty patients. Since that guy. Zhen was that today?
Oh yeah, that guy. That was today? Uh that's the experience in the emergency room for trauma physicians and and emergency room physicians in major urban centers. So
Yeah, they're like being on the assembly line fixing somebody and let'em go.
So it's like controlled chaos. Yes. You know, and I I I think back, how could I not think back about the episode after the Pitfest shooting? which I think that that hit healthcare, the healthcare audience in a different way. TV ratings were 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?
Yeah everything. The you know it's tricky when you do a sh some a story like that because You're not it's not it's not fictionalized, you know, it 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 uh 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 as
close to the truth as possible. And and we talked to so many people and watched, you know, a lot of on the Las Vegas shooting and talked to survivors and talked to doctors who were involved and just tried to tell that story um the way it would play out and and really give you know, we we see these we're uh 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 um and then there's uh, you know, everyone says, Oh, our thoughts and prayers are there, but you never see what really happens in 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, uh once The trauma's over. It doesn't end when you know, when you patch them up.
for a long time and that's ultimately what the the first season s Robbie's story was about was that sort of trauma that he had never really um dealt with finally reaching ahead and and that led to
And you you have to maintain an integrity about how you're gonna do storytelling'cause you're talking about experiences of people Um and you're 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 Uh 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.
¶ Hosts' Reflections and Episode Conclusion
Hunter, that conversation was awesome. I feel like we needed like several more hours.
And we have several more questions too.
John R. Scott, if you're watching, listening, let's get drinks and talk more. Hunter, what stood 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. Um, that was really special. I don't think any other medical drama thinks about medicine in that way, which shows why this show is 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 so many 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 podcast. The PID Podcast is a production of HBO Max in 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 Artis with assistant editor Damon Durell Hinson. The show is engineered by Tommy Bazarin, our production managers are Ebbo Nechoa and Tony Carlson.
The executive producer of HVO Podcast is Michael Gluckstad, the senior producer is Alison Cohen Sorokach, and the associate producer is Aaron Kelly. I'm Alok Patel.
And I'm Hunter Harris. We'll see you next week in the pit.
🎵 Music