Healers, Not Judges - The Pitt s02e11

As they cross the street early in the episode, Ogilvie expresses confusion as to how people get hooked on drugs. He says he's empathetic, but he doesn't understand why people fall into addiction or even using in the first place.

"You need to try," Cassie says. And then talks about how everyone working are "healers, not judges". What a thesis.

It feels like Cassie's arc this season has ended with her plunging the last round of Roxie's pain meds into her I.V. She was very slow to accept that this terminal cancer patient's outlook was grim enough that doctor-assisted suicide was the only real option here. Between that and the permission structure of Robby's empathy about palliative care, it feels like she levels up somehow. Like she can accept that in knowingly killing her patient, she's not doing anything wrong. That care takes many forms, and it's not on her to determine what is right and wrong. It's the dispensation of that care itself that is the point of her profession.

Ogilvie, meanwhile, has let his ambition overtake his entire existence. He starts the episode anxious to get a third intubation done so he can set a first-week record. By the episode's end, he's completely frozen. A patient he was close to almost dies from his negligence.

And so when the opportunity to intubate arises in that very case, he doesn't even respond. The most we get out of him (besides utter shock) is when he cops to his mistake in front of Javadi's mom.

Meanwhile, Robby eventually blames Mohan, but in doing so reiterates the theme: her personal problems intruding into her work makes her a less excellent doctor. The most important thing is the care they provide, regardless of anything else in the world. The human body, diseases, injuries? All the judgment in the world will not fix those things.

The only way to effectively be a doctor is to provide care.

To heal.

To balance objective truth with empathetic wisdom and response.

Man in a mask

The legacy of this episode for the foreseeable future is going to be the presence of ICE Agents in the trauma center. They bring in a woman who is having shoulder pain, and the two individuals refuse to leave her side or even to let her make a phone call. It's honestly surprising that they remove her restraints.

Trying to capture the current zeitgeist always feels dangerous for television. It's easier in linear broadcast TV, where episodes come out every week less than two months after the script was just a loose idea. Seeing the world like this on a prestige drama is like watching The Wire or something. Lived in, topical. It's one thing to hear about Trump's secret police force bombing around communities in unmarked vans, snatching up bystanders while refusing to give identification or information, show their faces, or even present a warrant justifying their actions.

It's another thing entirely for a tall dude wearing a baseball hat and a mask covering his face to be in the trauma department. That we can only barely see his eyes as he acts with impunity, refusing to show who he is.

This all adds to the perversity of watching someone from a security service occupy The Pitt's home base. This is a place of safety, a home, a place where we convene every week to hang out with our television friends. And he's stalking through it being a total menace. Just standing there is enough.

I'm not here to make things explicitly political, but that's an impossibility in a world like ours. Politics are everywhere. People can pretend like they aren't. People can say they don't want to have a divisive conversation with someone because they're worried it will disrupt a given relationship. Personally, any strong relationship that can't weather a difference of opinion doesn't feel that strong to me (but what do I know?).

But the President of the United States doesn't let that happen. The dude is a chronically online narcissist who wants to see his face everywhere and wants the adulation of every person on the planet. He wants laudits and supplication. Worship. Attention. His policies are such that they affect every individual in the country every day, be it the taxes he illegally imposes on every person living here (tariffs) or unilaterally starting a war in Iran without Congressional authorization or appointing an HHS secretary who tries to ban vaccines... pick a reason. We don't get to live in a world where politics don't affect our lives. Anyone who says "I don't care about politics" is speaking from a place of tremendous privilege, where they think they can weather any storm or that the horrors being done in their name won't taint their precious, ignorant souls. Or maybe they think that caring about politics won't make a lick of difference in a society that ostensibly operates on the principle of self-government.

Americans can try to ignore the world as it exists, but when gas is six dollars a gallon (driving home tonight in L.A. I saw one station had premium up to $6.88), I doubt anyone is going to be saying that they don't care.

With ICE in our communities, there is an immigration force in this country with a budget greater than the entire Israeli military. They arrest every person who might possibly be an immigrant as well as anyone who gets in their way. They never apologize for wrongful imprisonment. They slander the lives of those they execute in the street. They build themselves on the unrepentant judgment of fellow citizens. Of ripping this country apart. Of harm. There's a problem in modern policing where the police can often feel antagonistic towards the community they're supposedly trying to serve. ICE is that on overdrive.

Look at the way the dude in the mask (Agent Russo, if that's even is name) casually arrests Jesse and marches him out with nary a word. They don't even say where the hell he's going and Robby and the team have to scramble to figure that out. ICE is an organization filled with repugnant individuals. Unrepentant douchebags riding high on egos, power trips, and a sense of righteous invincibility.

There are undoubtedly viewers who look at ICE's presence and imprint what they assume. There are those who support the institution, who will remark think the show is taking cheap shots in the name of wokeness. There are those who will look at these agents and feel disgust and fury at the show for being too easy on them.

Luckily, Robby has a clear enough head to state what is happening. Nurses, janitors, staff.. they're all fleeing. The waiting room is clearing out, robbing people of care essential enough that they will wait hours for the opportunity to receive care. As a hospital, doctors have an obligation to help anyone who walks through their doors and they don't ask questions about it. People have a right to receive care, regardless of who they are. That's just the right practice for the job.

Robby, though, is no fan of ICE (look at his reaction when they show up), and from the perspective of the hospital itself, he recognizes that ICE's presence is disrupting his ability to meet his obligations.

His actions don't go far enough, and doctors like Javadi and Cassie want him to force the agents out of the sanctuary. But this is a very delicate situation. Robby is very aware of ICE's tactics and their behavior. If he tries to kick them out, maybe that would be it. But if they come back with reinforcements? If they shut the hospital down for impeding law enforcement? At that point all of his moral grandstanding would mean nothing. The department is already overrun and limping along. If ICE starts arresting people en masse, all of this will get worse and it won't just be one woman with a torn rotator cuff in zip ties. It'll be dozens and dozens of people not getting care. It's bad enough to lose Jesse for probably the rest of the season. Imagine who else will end up in the dragnet if Robby enflames the situation.

I'm hardly a fan of this compromise. But there is a rationality here. Get the patient in. Get her out. Make it as fast as possible so they can get back to business. His job is to provide her medical care, not launch a crusade in the name of something outside his capacity to make a difference. It sucks to say, but... it doesn't matter that ICE has lost the trust of vast swaths of the American public. It's awful to give them deference on this matter. And until there's a change in policy within the executive branch, this will continue indefinitely.

The PTMC is not the battlefield for this particular fight. Ideals are be important, but there's a bunch of conflicting ones going on here. Within the heirarchy, the most paramount is to do the most good for the most people. Robby does the right thing.

The sweet taste of freedom

Mel has a right to be upset. She's just finding out about her sister's boyfriend of six months, his family, and how that entire cohort is going to go do the fireworks without her. After everything she's been through today, the one thing that she's been looking forward to is now gone.

The deposition took a lot out of her, and even in the aftermath it's not like she feels any better about it.

So she overreacts. Mel goes too far inserting herself into the life that Becca's been building in secret. Caring for Becca is the one thing she can rely on and control, but that reveals an underlying problem. It's extremely difficult for anyone in the department to have life outside of work. Cassie hasn't dated anyone in ages. Mohan is having a panic attack because her mom is putting stress on her. Whitaker is forming a borderline inappropriate relationship with a dead patient's widow. Santos is trying to build a relationship with Garcia while the other is treating it entirely casually.

Mel focusing her life on her sister and the care she provides her gives her a sense of importance. A sense of value. It's that basic necessity of feeling loved and needed. Acknowledging that Becca is having her own life, separate from her is hard enough. As caretaker, Mel not knowing about such a big part of her life is reason for concern. But Becca is also entitled to the life she wants to live. Mel's "supportive decision making" means she ceded autonomy in the name of giving her sister a normal life. And if Becca wants to leave her older sister out of part of her life (for any reason) that's her right.

Yet Becca's independence hurts Mel's co-dependency. It leaves her vulnerable. Becca gets to have lots of sex with a guy she sees all the time and she's also potentially winning in-laws. What does Mel get? A knowledge that there's a serious rift between them and the crushing fear that she might be alone forever.

If there's a savior here, it's Langdon. He has proven himself very adept at navigating the various neurodivergent needs of Mel & Becca. It sucks to be in this situation, but he is the opportunity for the friendship/camaraderie/mentorship that Mel is otherwise missing in her all-too-demanding job.

Apoligies, contrition, forgiveness, and grudges

But it's not all good for Langdon. Finally, eleven hours into the shift, he tries to clear the air with Santos.

It does not go well.

This was always going to be the hardest reconciliation on his road to recovery. He might be a good doctor who knows what he's doing, but Santos is something else entirely. She is his junior, but he was absolutely monstrous to her the one time they previously worked together. He screamed at her in front of staff on her first day and tried to get her fired. She returned with evidence that he was boosting meds, and was the impetus for his expulsion to rehab.

With no love lost between them, Langdon probably knows that Santos isn't going to forgive him, though he probably doesn't recognize the depth of her animosity. It feels like he's getting some of what he needs from their conversation, but it would have been nice to set a path of reconciling the abyss between them. Especially if they're going to work together.

Santos, meanwhile, basically tells him to go fuck himself.

For all that Santos is the thorniest character on the show, she's an incredible doctor with a very strong moral compass. With a deep-seated sense of moral justice, it's impossible for her to let this go. She wants him fired. She wants him gone. For him to atone she wants a level of honesty that goes beyond rectifying things with her personally. She wants him to tell the entire department that he stole meds from patients and got kicked out because of it. She wants everyone else to feel like she feels.

Hard to blame her.

Langdon (however clumsily and awkwardly) is trying to fix what he put wrong. At his best, he's a tremendous doctor. He heals. It's what he does. And the truth is that while the gesture to come clean might help him feel better, it's not nearly enough to bury this hatchet. What would it take to close this rift between an incredible doctor and someone who soon will be if she can just get her head out of her ass?

But Santos is still learning. And it's clear from this episode that her hangups on the world and how it works are actively starting to rot her life from the inside. Things with Garcia are dicey, she's having a tiff with Whitaker, Dr. Al is threatening to set her career back by an entire year... and while I don't think she should necessarily forgive Langdon (to be honest, nothing she's seen makes her think he's earned it) there is value in grace and healing and bridge-building. It might be worth it to start over.

More than anything else on the show, I would love for them to slowly become rock solid friends.

Around the Trauma Center...

• The dude holding the baseball not letting go of it and forcing Whitaker and Santos to work around his demands. Bro where do you think this ball is going?
• While it's brutal opening the episode with Roxie's final dose, at least it ended quickly, off screen, and in total silence. Tremendous dignity in death. She couldn't really ask for better.
• I also think that this is the first major death since Louie? While this season has had some intense stuff, it's nowhere near the blood bath of season one. Thank god they're giving us a shift "off".
• The pressure cooker of this season is such that there's so many things that people are leaving under wraps. Robby not telling Dana his true feelings about Dr. Al makes it feel like there's a perspective on her that he's keeping from us.
• That said, his snarking about her patient passports eleven hours into the shift is long overdue.
• Great to hear that Howard Knox made it through surgery. Ugh. That would have been awful to hear going bad. Still waiting on a payoff for Baby Jane Doe, though.
• With four episodes left and the shift supposedly ending next episode (though there's still three hours to go fater it), it raises questions about what those extra hours are going to look like. Dr. Al asks if Robby is going to stick around for handoffs, but with Duke potentially admitted with a lymphoma diagnosis, we at least know why he'll be sticking around for a while. No word on anyone else though.
• There wasn't a ton of room above for discussion about the non-responsive heatstroke child. Clearly that put everyone (including that mother) through a lot, but Dr. Al surreptitiously asking for a pediatric body bag? Fucking hell.
• Donny not reacting to the baseball guy's scream while they realign his elbow. Total boss.
• Cassie trying to recruit Ogilvie to the street team would probably do him a world of good. It feels like his view is of medicine is as a challenge for him to conquer. That it will all be complicated procedures and knowing details and sussing out solutions. But this is a job where compassion and empathy are just as important. What will it take for him to learn that? Humility is not enough.
• There is a point around two-thirds of the way through this episode where the show just starts ripping across storylines. Aggressive cutting. Minimal length scenes. It all adds to the pressure and weight of things happening so fast as this relentless shift drags on. I can't imagine watching this season on a binge like I did with season one. It would probably just feel so relentless.
• Dana giving Mel the "are you fucking kidding me" glare when Mel doesn't hang up the emergency phone might be my favorite Dana moment this season after "admin's blood pastries."
• The show has spent more and more time focusing on Dr. Al in the background. The way she crosses the frame while Joy is talking to the mother about heatstroke and getting a little judgy. The way she's around while Robby and Joy are talking about the heatstroke mom. And then the last minute when Santos and Langdon are going at it. They are constantly, constantly circling back to Dr. Al and (perhaps more interestingly) when she's anywhere near a parenting/children scenario.
  • And then to have her save the heatstroke mom from walking into traffic. Yeesh.
• Javadi's mom barging in and assuming her daughter was responsible for missing the aorta check? That sucks. But the moment where Robby tasks Javadi with helping her mother with the impromptu surgery made me insanely emotional. He believes in her. More than that, Javadi's mom being so hard on Javadi means she misses her daughter's inherent skills and isn't allowing her best work. Javadi can do this, and the two working together to save their patient's life was so beautiful and healing after last week's debacle.
• This follows the ICE discussion above, but giving star and executive producer Noah Wyle the authorial voice for a monologue about how the ICE agent is disrupting the trauma department reveals where the show's loyalties lie. It's not a judgment call about ICE for the moral abomination it is, but rather a criticism of how much pain that moral abomination exudes indirectly simply by the vice of existing. It's easy to look at Robby and think he's excusing ICE as an organization and trying to enable them. To the contrary. And the show completely shuts down so he can give a little Emmy-submission speech stating exactly how the show (and the medical community) feels about ICE's presence in hospitals.
• While on the topic of ICE: of course Dr. J would have her phone out capturing video the second shit starts going down with ICE. Hell yeah, Gen-Z.
• Circling back to the idea that the show is having a lot of cyclists coming in to warn Robby off his excursion tonight: the heatstroke kid was playing on a tricycle the last time his mother saw him. These situations are getting more and more implicit, but still all the more disturbing in new and horrible ways.
• Mel should get a custom "I watched Elf 164 times and all I got was my sister having sex. Lots of sex." t-shirt.
• But ugh the moment when she says "[Becca's] got everything, and now she's got a boyfriend, and they're gonna fall in love and they're gonna get married, and I'm gonna be completely alone." The only thing more devastating is her admitting that saying it doesn't make her feel better. Because it confirms her feelings as real and valid.
• Poor Duke. Robby breaking the news to him about his health and delaying his long-awaited sabbatical to make sure his friend is okay. Their exchange ("you still gonna be here?"/"I would not feel good about riding if I rushed this") feels like a payoff to eleven hours of Robby brushing off every concerned person. It's not that he doesn't care about people like Abbot or Dana or Caleb, but those aren't people for whom he feels a duty of care. As a doctor, he cares for his friend Duke who needs him right now. It's why he can't ever quit this job.
• Obviously the final beat where the golfer patient assaults Emma. Ugh. After everything today, seeing that final headlock is just awful. Fuck the people who assault people, but especially those who assault healthcare workers.
• Gross-out Moment of the Week: While it was pretty cool to see them cut open a patient and massage his heart by hand, in no world is this anything other than Kiki's tranq'ed out leg. Necrosis of the skin and all of that just rotting flesh on top? All because people are taking animal tranquilizers? Don't do drugs, kids.

Next time...

It looks like Dr. Al expresses concerns about what she's seeing with the staff. Maybe this will be also because she overheard Santos and Langdon's interaction? And also a lot of stuff with the golfer guy assaulting Emma. Fabulous. Now... to go watch it...