My Therapist Said I Needed a Hobby - The Pitt s02e07

The joy of this season of The Pitt has been its slow, escalating boil. It's different from season one, which felt casually relentless before the high intensity aftermath of the Pittfest shooting. There, the drama came from the beleaguered staff, worn down after the first 11 hours of their 12 hour shift, having to shift into a high pressure, mass casualty incident for an indeterminate amount of time.

For season two, the 4th of July holiday has made it feel relentless in a different way. Even without Westbridge's shutdown, there's a lot of patients with a lot of needs. Still, they're moving through the incoming at a clip. The third hour felt like everything was more or less chugging along and the sixth (for all its heavy emotional weight) seemed somewhat similar. Even the most dire patients cycle through quickly, be it Debbie's necrotizing fasciitis or the various motorcycle accidents. Many of those who make it past the front desk don't stick around much past the hour. Two at most.

On the one hand, this is deceptive. It makes it feel like things are going better than they actually are. Every performance bears the weight of the endless churn. Just because they're moving efficiently does not mean that the wear isn't getting to them. On the other, it allows the show to make those recurring guest stars (ones who stick around for longer than those two episodes) stand out more. Roxie not going home presents a problem for the team and taking up a precious bed removes a room for the team to situate patients. If they're averaging one per hour, this is the first hour where Roxie is keeping the department from processing a different patient. There will be at least one more. Meanwhile, Jackson needs observation, but every episode that goes on with patients in rooms feels like an expenditure of resources that could better be utilizing elsewhere. Awful as it is for Mohan to learn Orlando skipped out, at least it gives a small place for Abbot (with a little help from her) to patch himself up.

And then there's those stories that only feel like they're getting started. Harlow Graham (the deaf patient) has been present since the premiere. She only recently got a room (and Santos as her doctor), but they're barely into diagnosing her issue at all, stymied as they've been by the ASL language barrier. The longer this goes, the worse it's probably going to be. Not just for Harlow (whose wellbeing is on the line), but also for Santos, who's struggling with all her assignments. Harlow had a headache a week ago that's turned into a stomach ache? And this hasn't abated yet? That ain't good.

The final minutes reveal that all of this is only going to escalate. Yes, the computer network going offline was in the season's promos, but it's something else to watch them drop this particular hammer at the midpoint of the season. There are still five hours left on this shift (plus whatever those extra three hours are going to be), and they're going to have to do the entire thing with just pens and paper.

If there's a link to all of this, it's that this is the point where the season proves that the trauma department is amassing too many high stakes issues, and the sense that there might be any breathing room evaporates the second the team leaves Louie's bedside in the viewing room. Every single one of the cases in this episode are mission critical and the show treats them with the intensity to match. Be it helicopter arrival, children entering, or even the silence of a private room that bears witness to the aftermath of a horrific crime. All of these are equal. All of these are bad.

And the hospital just turned out the lights.

Three attendings on the floor

While the episode ends with the voluntary crashing of the hospital's computer networks, this hour sees the return of Dr. Abbot. Lucky. Between him and Dr. Al shadowing Robby throughout this shift, that means there are now three attendings at hand who can help manage the about-to-get-more-chaotic emergency department.

Combat medic

Abbot himself is wonderful, and Shawn Hatosy has been a standout player since his first appearance on the roof in the very first episode. It's crazy how few episodes he was in, and yet the mark he left feels like he was basically omnipresent at times. His role during the Pittfest shooting was a highlight in an already gripping arc of episodes, and the beat at the end of the shift when he pulls off his prosthetic leg is a tremendous moment of revelation. Like Robby, he's just a good man who is doing what life has called him to do, and the bit he has with Dr. Mohan where he tells her he will pay for Orlando's medication feels impossible. After all the nickel and diming, just the knowledge that Abbot is going to ensure the welfare of a patient he will probably never meet speaks volumes about the man's dedication to the Hippocratic Oath.

He is a wonder to watch. Serious but playful, his complete unflappability makes it feel like he's always in control. The way he manages to brush off Dr. Al in the midst of helping the soldier with the gunshot would to the neck is incredible. That little smirk? And the mutter about how they should get beer and share war stories? God, Abbot is the best.

An enigmatic phone call

For Dr. Al, the mystery persists. It was a bold move to end the first episode on her reaction to the baby Jane Doe. Here, it feels we get a partial answer... or at least, some hint as to what's going on with her. The phone call she makes in the bathroom feels ominous and enigmatic, but it doesn't explain everything. Here's the bulk of what we know:

• The abandoned baby triggers something in Dr. Al. What that is, we're not exactly sure.
• She has a son and utilizing technology to maximize her work efficiency is a result of wanting to spend more time with him.
• Dr. Al handles the Ilana examination with unflappable professionalism.
• This phone call comes after filling in Jackson & Jayda's parents about their son's erratic behavior. She leaves Javadi to explain and retreats to the bathroom to try to reach a doctor in the neurology department. It feels like there might be something neurological with her? Needing to speak with him ASAP doesn't seem like it's a good thing.

But there is one other thing.

Dr. Al mentions to Abbot that she worked in Kabul at a maternity hospital in 2020. Abbot recognizes what she's talking about. A quick google search of "Dashte Barchi" brings up a story about a suicide bombing in a maternity ward that killed 16 mothers and 8 children. Dr. Al was at least somewhat witness to that attack. What a harrowing experience that must have been. Wouldn't be surprised if the lone baby is what's triggering her.

I don't want to treat Dr. Al as a mystery to unravel, but there's enough of a thread here and they've sketched enough details that everything going on is currently unshakeable. Like Robby last season, I worry that her steely exterior speaks to something far more fragile inside. If this is building to some collapse for her... that ain't gonna be good.

So... he accepted the apology

Langdon has threatened an apology to Robby since the beginning of the shift. Now, he finally apologizes for his behavior last season. Props for ripping off the band-aid and getting to that point the second he gets an opportunity to talk to Robby in a place where the man can't avoid him.

Where it becomes a problem is in Robby's retort: "I’m really glad that you got the help that you need. But I don’t know if I want you working in my ER."

What follows is honestly the reason why The Pitt is my favorite show on television.

When it comes to the procedurals, it's often that these shows sacrifice character for technical details (procedure). Was a time in the mid-00s when I fell down the CSI rabbit hole. Its slickness and technical acumen was the sort of thing that sustained a solid 40 episodes of watching. I rapidly lost interest, though. For all that the writer folk on these shows talk about characters and how they're the focus, the truth is that the development on CSI always felt surface. Characters behave in a certain way because that's who they are on paper. Any solutions they come to stem from that original document, not because they're living, breathing characters with grand emotional arcs. An old friend who watched more than I did talked once about the rare character moments with reverence, as though the drops of water in the desert were some euphoric paradise rather than the show starving its audience of the most important aspect of compelling drama.

How is it then that The Pitt manages to succeed where so many network procedurals don't?

Robby's response to Langdon is not on the helipad. That slap in the face about not wanting him around was just the prelude. No. The worst comes while they treat the propeller victim. Robby defers to Langdon on everything. Having shaken the man's confidence, the attending pushes further, pivoting to quizzes about procedures and testing him about all of the steps of care in this situation. Like he's a student and not the most senior doctor on the floor who isn't one of the three attendings.

Langdon has trouble focusing, second guesses himself, and seems to prove Robby's point that he can't quite cut it. This isn't like Langdon. Just a few minutes earlier he was testing Ogilvie and Joy about the various procedures for the football teen suffering from heat stroke.

This is insanely specific writing. And it's not a spontaneous Robby move. As this team starts their procedure, Dr. Al pops in to ask if they need help. Robby quickly responds "Nope. We have a senior resident and an attending."

Which is... odd. Abbot's arrival brought with it the injured officer with the neck wound, Robby had absolutely no problem being in a room with both Abbot and Dr. Al. Abbot could be there, sure. Abbot was the medic who saved the man's life and helped take point on the life-saving procedures in the trauma room. But Dr. Al? Robby easily could have told Dr. Al to buzz off and handle literally anything else going on. But no. This was a situation that involved three attending doctors (not to mention the also-present Santos and Garcia). No one said a word about the saturation of highly-qualified doctors in the room.

So why kick out Dr. Al right before Robby goes so hard at Langdon? Because Robby knows that he's about to kick Langdon's ass and he doesn't want Dr. Al to get in his way. And Noah Wylie spends the rest of that sequence stalking around the room. Knowing exactly when to get into Langdon's space and when to abandon him. When to interrupt and when to let the deafening silence hang. It's an absolutely vicious move.

If there's a saving grace for Langdon, it's that Mel is in the room to help him through. Their relationship remains strong, and she is quiet yet encouraging throughout Robby's relentless questioning of Langdon's every move.

This is why The Pitt is the best show on television. Amidst deeply technical work, the writing staff builds the entire sequence around drama focused on the show's main character. Noah Wyle is the one who's on all the bus posters and season key art. And his character kicks a subordinate while he's down. More than that, it perfectly makes sense with Robby's character, how wounded he is after Langdon's atrocious behavior at the end of last season, and how vindictive he can be without ever putting anyone (especially patients) at risk. Robby won't let anything happen to the propeller victim. But he is experienced enough to know just how far he can push Langdon to humiliate him in front of staff without ever getting the blame for it. At most Mel would say he's being a bit hard on the senior resident. Otherwise, he's going to completely get away with this.

Bigger, the show has weaponized its technical/procedural elements to build out some of the best character work in a season already full of wonderful, dazzling moments.

It's incredible, incredible stuff.

Patriarchy sucks

Between the high octane life-saving procedures to treat the gunshot to the neck and some gnarly boat propeller gashes, it would be easy to look at Dana's diligent examination of Ilana as a moment for the show to lower the temperature. The room itself is large and private, with multiple curtains to separate out Ilana from Dana and/or Emma should there be need. It's exceptionally quiet, with every sound effect specific without being intrusive.

It would be easy to look at this storyline as an excuse for the show to decompress from the intensity of all the other intensities of the episode. There is no dire immediacy. No visceral life-saving procedures. But to say that it's a time to relax minimizes the harrwoing situation. Sexual assault is far too common. With a patriarchal society like ours, misogyny manifests in innumerable forms. It can be subtle yet biting remarks or flagrant actions designed to "keep women in their place". But it also means that there is a sense of entitlement that society instills in men from a very young age. Men have power at all levels. This breeds a sense of entitlement, like they can have anything they want, including women's bodies. What happened to Ilana is absolutely awful, a close male friend intoxicatedly betraying her trust. With lowered inhibitions, he indulged a vice he probably would not have otherwise. It's doubtful he will suffer consequences.

All of this is present here, and it's not Dana's job to create a narrative or piece together what happened. She is merely examining and reporting. Ilana's body (gross as this sounds) is a crime scene, and it's so easy to look at her and objectify her as a thing to study, a farm from which Dana will harvest evidence. Instead, Dana's approach removes that sense of stigma, and enforces that Ilana is in control here. It's hard to watch, but Dana's collections have a way of scrubbing away what happened.

Ilana can't get there, though. All of this is too much, too overwhelming. Dana can only bolster her psyche with encouraging words and soft tones that absolve her of whatever guilt she might be feeling. What's happening with Ilana is so much more than just what Dana can do physically, and the presence of the advocate only adds to the complexity. Imagine if the police were also present and taking statements. Or there were more people in the room, swarming over her like they do with every heavy trauma case. Hell, imagine if Dana didn't hold up the blanket to protect Ilana's privacy. This is a season where we've seen blood drawn from an erect penis, a bowel evacuation, and a coccyx re-alignment. These doctors see all sorts of wild shit, and we're barely halfway through our second shift of watching. This is worse than all of that.

But this isn't about them.

If anything, the only thing I could think while watching was the loud frenetic ED and dropping away when we returned to Ilana. The room was deceptively silent. Removed from its context, it felt like a respite. Within its context, it was the most harrowing thing in the season so far.

There are people who will watch this and feel that first way. Like there was some relief in seeing something so ordered and mannerly. As the Mama Nurse who always makes us feel better, Dana on screen gives a sense of security. But her job of trying to help Ilana through the first steps of healing is one of the most sacred, difficult tasks within the ED.

We've done a lot of work to get to this point. Imagine a storyline like this from even ten years ago and it would still be different. We've gone too long without discussing the aftermath of sexual assault, and normalizing procedures to help empower victims in the wake of serious, undeniable trauma. Shows like The Pitt can show just how difficult it is to process situations like this, and in that they provide an outlet for those who experience sexual assault to know that there are procedures that can help them through it. That these things do happen and that when it comes to this particular area, the medical community focused on trying to make this as accommodating as possible. But that is emphasizing recovery. It's treating aftermaths rather than trying to rip out the roots of this particular issue. To get there, trauma departments like The Pitt can't actually do anything. They specialize in emergency medicine, not acute ampathy There's a responsibility within society to teach men (especially young men) about the dangers of living in a patriarchy. Their position within it creates blindspots, and the cognizance it takes to not hurt the women around them.

We are making progress. But there is still so, so much more to go.

Relying on technology

As an instructive experience to how hospitals collect forensic data in the wake of a sexual assault, the way it fits into the episode's final minutes is... peculiar.

I'm sure there's going to be a lot more in the coming weeks about the Pitt's network going offline and having to switch to an entirely analog system. Yes, the trailers for the season made sure to put teases of the crashed computers in the various teasers. But this is also something they set up with Dr. Al's arrival, her emphasis on technology, and her encouragement in the use of A.I.

Joke's on her now.

But it's not just her. This episode features a big dramatic helicopter arrival, a virtual ASL interpreter, but nothing can replace the tactile quality of medical tools. Dana's examination of Ilana is a purely analog procedure, the sort of thing that Dr. Al's technology can't help with at all. She herself is present only for the initial screening of serious injuries, and the delicacy with which she handles the one thing she has to do (the initial check for injuries that require immediate attention and a few standard intake questions) belies just how limited technology is in the grander scope of healthcare. It makes things easier and more efficient in places, but the actual grind of the work is something digital technology can't replace.

As the ASL feed starts to fritz out and leave Santos with few alternatives, she resorts to writing down and communicating with pen and paper. It seems small, but it's crazy that she didn't do this an hour ago. This delay of care comes in the midst of her having an unusually stressful day, but the limited discussion between the two of them via pen and paper is a leap forward in progress far beyond what she's done before.

Now the entire emergency department has to continue their work but without the technology that's helped the medical community for decades. All as the patients start to fill the hallways and they keep falling farther and farther behind.

God I can't wait to see what happens next...

Meanwhile, around the Trauma Center...

• Man Emma's really getting into it during her first shift. Can't imagine what else she's going to have to deal with. And none of this is going to put her off nursing? God yes.
• On the subject of "technology going analog", the waiting room patients turning Dr. Al's "patient passports" into makeshift fans is quite a nice change.
• There wasn't room for her above, but it feels like there's something more going on with Roxie and Paul that we're not getting. Her reticence to go home feels like it's coming from more than guilt, and Paul's bringing their children into the hospital to see their mom feels manipulative. This is starting to give really bad vibes. Not in like... an abuse way. But it feels like there's something bigger going on here that we haven't gotten to the bottom of yet. She says "it's not that I don't want to go home". So what is it, then?
• Jayda putting on the eyemask and trying to sleep in one of the rooms feels like a direct homage to the early days of ER. This week's podcast talked a lot about the patients and doctors treating empty hospital beds and unused rooms like this. Still... just thought about ER as soon as it came up.
• Princess taking over for Dana speaks to both the importance of Dana's role as a SANE and how critical a service it is. They literally sacrifice the department's standard operating procedure in the name of it. Princess does a fairly good job handling things considering how bad it's starting to get. Curious if that's going to continue in the upcoming hours. These examinations can take quite a bit of time, I think.
• Also? Princess slamming a sugar-free Red Bull. Hell yeah.
• Weird time to bring up Mel and her sister. I doubt they're going to put her sister in any peril at this time, but maybe it's a reminder of the stakes Mel is feeling with her upcoming deposition. Strange.
• And on the subject of the deposition, my partner blurted out at this point in the episode "her deposition's on a fucking federal holiday??" Good point.
• Whitaker tossing the protein bar to Ogilvie and Joy feels like him paying forward something similar from season one.
• Langdon calming down the heat stroked football player by saying "Sorry, our student doctors are discussing a rare condition you don’t have" was incredible bedside manner. That's a dude who's been around too many student doctors and knows how to handle their yapping.
• Poor Orlando. Having a hundred grand in medical debt on top of whatever the hospital was going to charge him. No wonder the guy wants to get to work. But in a world where the work is probably going to end up killing him and it's not helping to make his debts go down faster as is, it feels like a sad state of priorities. And also? We need to fix our healthcare system. Situations like this are everywhere, and it's a stain on America that it thinks anything like this acceptable for the richest country in the history of the planet.
• The little smirk when Joy outthinks Ogilvie. Great to see Ogilvie getting things wrong.
• Robby calling Mel one of the very best residents he's ever trained. God yes. And goodness does all this boosting Mel up is starting to make me nervous about this deposition...
• Dr. Al lifting up Santos on her work in the trauma room proves that she's not entirely heartless. The comment about her having to repeat her second year of residency is still going to linger, but at least she's not just completely beating up on Santos.
• Also the moment where Robby casually asks Santos is Langdon's talked to her yet... It is inevitable, but that's going to be a hell of a confrontation when it happens.
• This is yet another time the story of Whitaker and the farmer's widow has come up. Wonder what Robby thinks of this entire situation.
• Javadi sitting down with Jayda to talk about Jackson and the revelation of their uncle's suicide is a fabulous moment of patient bonding. It feels so, so different from the Javadi a few hours ago who was spouting off facts and figures and trying to one-up Ogilvie. The latter might give Javadi a run for her money, but what good are all the facts if a doctor can't also boost a patient's spirits? This job is about way more than just the physical wellbeing of those on the beds. It's also about the peace of mind and sanity for those sitting beside them.
• Abbot shirtless? Snack.
• Robby's blink-and-you'll-miss-it double take when he sees Mohan helping to patch up a shirtless Abbot made my partner and I laugh so hard we scared our new dog off the couch and into the bathroom for like... at least an hour. Poor boy. But god dammit that moment was just spectacular.
• Santos singing "Ili Ili Tulog Anay" is staggeringly beautiful. Sure, it's partially to stop Baby Jane Doe from scream-crying so Santos can get some work done, but after an entire shift where hee bedside manner has been... lacking, to see her with empathy and care really is tremendous. Now if only she could stop repeatedly bouncing from Harlow's room... That's not going to lead to quality patient satisfaction scores.
• Linking this idea of Santos and Javadi having good bedside manner is the moment where the two briefly cross paths in the bathroom. I love that the show takes the time to show that the relentless nature of the job means basic needs fall by the wayside. But the big reveal here of Santos's cutting scars is so devastating. Sure, this feels like it could be the sort of bullshit "does this count?" character work that CSI would do, leaving empty cyphers into which the viewer can pour their reads on the characters. But that's not how The Pitt operates. I hope that Santos is okay and whatever haunted her before isn't still doing it now.
• Dr. Al giving the greenlight for the network shutdown and going around Robby to do it is remarkably shitty. I know time is of the essence, but... man that's gonna be yet another wedge between them.

Next Time...

Oh my god I cannot wait to see the upcoming batshit of this already-too-much day getting a little bit worse with the lack of computers and electronic records. Do you think Dr. Al is going to get pissed at Santos for falling behind on pen-and-paper charting? And how is anyone supposed to read charts if everyone has doctor scribble handwriting?

I guess we'll find out...