It Was Almost An Olympic Sport - The Pitt s02e04
There’s always someone without insurance.
A few episodes ago, a patient named Orlando Diaz came into the trauma center. Langdon was quick to diagnose this as insulin deficiency and a diabetic coma. The Pitt was quick to fix the situation and he’s been recuperating in one of the rooms since.
This week, his family arrived and revealed they have no insurance. It’ll be near impossible to pay for this visit, and that puts him in a precarious position. To make things worse, he confesses to Mohan and Joy that he’s been rationing his insulin for some time to save money. The loss of insurance is somewhat his fault, you see. He lost his job, and with it went his capacity to keep his family safe. Mr. Diaz can’t provide for his family, but he demands the doctors keep what he’s been doing quiet so the family doesn’t learn how dire this situation is.
It’s a humiliating moment,and while not everyone has gone through this exact scenario, this pride at not wanting to show weakness something just about everyone has been through and/or known someone who has. Mr. Diaz is putting himself and his family in a precarious position because of his selfish decision to keep all of his troubles under wraps, but there is a level of human dignity people have to cling to for their own sense of self-worth.
Denying people who want to help, though? Pride keeps people from being the beneficiaries of charity, but at the same time, what is a GoFundMe if not the kindness and generosity of strangers, freely given? No one is judging him, but Diaz’s ego can’t handle even the image that there might be a problem. Demanding his daughter take it down is helping absolutely no one, and he’s already in the hospital for his bad decision making. While his pride might not be his undoing today, it’s only a matter of time before his not asking for help turns into something far worse.
With the relentless, day-in, day-out of this emergency department, it’s important for these doctors/characters to check their egos at the door. There’s too much to do. It’s all too fast. There’s no moments for self-congratulatory glory.
Four hours in, we’re starting to see what happens when that pride rears its ugly head.
Admittance is the first step
It’s not like Phylicia Ronson doesn’t know she’s has a eating disorder. It’s that the disorder is a byproduct of a whole mess of family culture plus college life that she hasn’t really dealt with. Mel manages to recognize the signs due to some history of her own, but what sets Ronson apart from Diaz is her relenting in accepting Mel & Santos’s offer of help. These doctors are only as helpful as the patients will allow them to be.
There is a humility in Ronson admitting she has a problem. It goes beyond that, though. She knows the root cause and how she got to this point. And that openness gives her the ability to tackle the root causes and get on the path to a healthier life.
Compare that to Dr. Robby and his light sparring with in-house psychiatrist Caleb Jefferson. Jefferson is a new character, and he showed up a few episodes back and teased some interaction with the Attending later in the day. There is a small moment in this hour where Jefferson gets to sit with Robby for a brief minute, though. And… man is he good at his job. He clocks the motorcycle death in the last episode and ties it to Robby and his struggles with therapy.
It’s funny, we’ve seen Robby when as a raw nerve barely holding it together (all of last season). Here, though, we get a Robby who’s tap dancing past a guy who knows his bullshit. He’s just trying to get to tomorrow. There is light at the end of this tunnel, he just has to outrun whatever it is he’s running from to get there.
This isn’t good, though. Robby will pop eventually, and all of the ambulance diversions in this episode have already started to feel a bit overwhelming. Last hour it felt like things were cycling through, treatment a solid flow of patients rolling in and out. But just a few minutes into the new influx of ambulance patients and it’s slowed the trauma center down to a crawl.
Despite on this, Robby is hardly the most prideful character on staff at the moment.
A single shard of glass
Ogilvie has been a walking medical encyclopedia for four episodes now, and early in this one he’s quick to request doing an ER intubation so he can add it to his training log. Soon as he gets the go-ahead he spouts off all the procedure/equipment he needs and how he plans to do it, taking complete charge of the operation. There’s nothing wrong with eagerness or even confidence, but the dude runs around like he’s got it all figured out.
He’s riding so high he tries to draft off the fist bump Robby gives to Whitaker after the latter’s quick thinking saves the life of Mr. Samba (more on that in a second). His slow pull back is hilarious, but him going for it was still pathetic. Shows how well he reads the room.
There’s a reason the removal of the glass shard has been in every promo leading up to this episode. No amount of visual preparation can protect the viewer from the horror of Ogilvie’s arrogance. With one simple, self-righteous act, he takes a somewhat stable patient and nearly kills him. It haunts the newbie, much in the same way the early death in season one haunted Whitaker. Ideally, this will be a teaching moment for him. He needs to slow down and acknowledge that he is there to learn, not spout off facts and showboat how great he was at the top of his class (or whatever).
To be honest, that Ogilvie moment is probably the single best reason why I’m so bloody obsessed with The Pitt right now. Yes, the makeup and props and production design of the show make for a high verisimilitude. It’s great to see what fucked up medical thing happens every week. And… yeah. I was excited to see them remove that shard of glass.
But none of that imagery prepared me for the utter shit show that followed, where the main money shot is just the catalyst for an intense several minutes as Robby, McKay, and Garcia attempting to save this guy from bleeding out. It was 100% character the entire time. Only Ogilvie would have pulled that shard of glass out, and it probably happened because that one intubation made him feel invincible.
The low probability of a posterior STEMI
The most powerful moment, though, comes when Whitaker’s quick thinking saves the life of Mr. Samba. The death of Bennet Milton was the defining moment for Whitaker’s beginning, and while they quickly absolved him of any culpability, it didn’t make Whitaker feel better. There was nothing he could have done and none of those doctors would have seen the issue, but given that it’s the first patient he loses, it’s not something Whitaker will forget.
It’s Whitaker’s tenacity that catches Mr. Samba’s heart attack in time. The posterior STEMI was something basically no one would have caught, but it’s a very specific edge case that he remembered to check for. It’s basically blind luck the man survives. Had anyone else been at that ambulance door (Santos or Javadi being the other options), it would have gone south and the man would have had a different (terminal) result. Had Whitaker followed Santos after she fucked off, their patient would be dead.
More than anyone else, Whitaker is the one up-and-comer who’s most proving himself capable of growing in a way that will help further his expertise. Santos has problems charting and is quick to judgment. Javadi is probably the smartest person in the department, but she’s still getting her sea legs. So much about the medicine in the ER is taking all of those years of medical school knowledge and applying them to learn about the human body and applying that understanding to unique situations in real, high pressure environments. Whitaker messed up once. He learned. And today he saved a life, earning respect and esteem.
Then again, there will be a point in the near future where Whitaker is going to fuck up. It happens to everyone. I shudder to think at what that’ll be.
Stray Observations
Dr. Al trying to outbid Dr. Robby is so funny. And she’s definitely flirting with him too? Dang.
Seriously, though, Dr. Al works quickly to assert her voice within her new position as the Attending. That includes ingratiating herself into the culture here. It’s a good thing to do, even if she’s already making changes Robby won’t like and he’s not out the door yet.
Props to Langdon for still holding down triage as he is. It would be so easy for him to phone it in, but everything we’ve seen of him so far this season reflects an eagerness to get his life back on track. Also? His big argument for why Robby shouldn’t can him was because he was good at his job and great at helping patients. He’s dedicated himself to his work and it’s great to see.
The story about Whitaker and the farmer’s widow is really peculiar. I doubt anything’s going to happen like “she shows up”, but it does feel like the messy situation as Javadi calls it. He’s always cared a bit too much about his patients, and that butts up against his capacity to treat his job with the critical distance it can need.
One of the biggest “complaints” about the Pitt’s accuracy is that the show doesn’t spend nearly as much time charting as real doctors would. It’s great that the show has addressed this in Dr. Al reading Santos for falling behind. Leave it to this show to take a criticism and level it at the show’s most hubristic character in an episode like this. One stone. So many birds.
Did the three ambulances rolling into the bay stress anyone else out? It’s not like I got flashbacks to last season’s mass casualty event, but jeez. Pressure already building.
On the flipside, does anyone else perk up whenever Garcia marches into the trauma room to start being a field surgeon?
Curious what the storyline is with Jada and her brother Jackson. She’s very clear-eyed about him, and her description of how he is completely clashes with his erratic behavior last episode. There is something going on here, though the security guard is suspiciously absent while it develops…
It’s less than Ogilvie pulling out the shard of glass, but between Joy sticking herself while she was cleaning up the parkour kid’s legs and the gasp when Emma drops the vial blood… gosh. Bad hour for the newbies.
Cassie hitting it off with this cute boy is adorable and good for her taking the initiative in asking him out. That said, her saying she’s going to the art gallery “around 9:00” is… worrisome. By all counts that’s the finale hour, and it’ll be interesting to see if/how that manifests when we get there.
Great to get some closure on Dr. Collins, even though it means learning that she moved to Portland and is adopting a baby. We definitely miss her, but good for her, man. Robby, though? Hearing about it and backing out of the room… Something is going on here and I’m curious what it is. Is it the sense that Collins managed to reconcile the shitty hand life dealt her while Robby is still stuck in this purgatory?
Javadi running a social account under the alias Dr. J. This rules. Who wouldn’t want to get medical help from Dr. J?
I know Santos is in a bad place by episode’s end, but “Fuckleberry” is very good.
Did anyone else gasp when Dr. Al pulled Langdon aside and told him she was pulling him off triage? (My partner did.) This is going to be a massive fight in the immediate future, and it’s not like Robby can kick Langdon back to front of house after the request from his rival attending. Not without it being clear that this is somewhat retribution.
That last moment with the infection spreading well outside that woman’s sharpie line? Hoooooooly shit that’s bad. That’s so so bad.
Future Watch:
Five hours until Mel’s deposition.
Three more hours of the trauma center monitoring Louie (this feels like a ticking time bomb). More opportunities for doctors to go in and speak to him about whatever’s on their minds.
Gross-out Moment of the Week: Gotta be the shard of glass and all the blood that immediately gushes out. Totally gnarly. Though draining Louie’s tooth and the infection well outside the sharpie line both chilled me to the bone.
Until next week, when Robby & Langdon have to work together and who KNOWs what else…