By Joe Langabeer
Currently streaming on HBO Max, The Pitt is a medical drama exposing the brutal daily life of an emergency department in Pittsburgh. The programme has become an instant hit in America, as it makes important critiques on the Trump administration and Robert F Kennedy Jr, the current health secretary, for their dismantling of the healthcare system. It also comments on the problems of privatised healthcare and the burnout faced by medical staff after the COVID-19 pandemic.
[Warning – Spoilers for season one and two of The Pitt]
The show was created by the former team behind ER, another popular medical drama revered for its hard-hitting examination of the medical profession. Originally, the creators were looking to reboot that show for the modern age.
However, the creators, alongside Noah Wyle, the star of both ER and The Pitt, decided it would be more relevant to explore the burnout faced by medical staff as they continue to pick up the pieces left by the pandemic.
Each season is set over one day in the emergency department, with each episode focusing on a single hour, as if you were a fly on the wall watching a typical shift unfold. The show introduces us to Dr. Michael Robinavitch, who all the staff call “Robby”, a senior attending physician in the department.
We also see resident doctors, nurses and senior residents put through their trials and tribulations, with each case bringing new traumas they have to contend with. Robby is suffering from PTSD, having been on the frontline during the pandemic. We learn through the first season that he had to switch off his medical mentor’s life support during that time.
A shift that never lets up
Whilst we see the cruel trials and tribulations of working in an emergency department, we also get the perspective of the patients. Sometimes, the show offers light-hearted scenes of people coming into the emergency room with ridiculous injuries.
But those moments need to exist, as the show is often bleak in its portrayals of suffering and death. For those who might feel queasy seeing body parts cut open and blood spewing everywhere, you may need to pace yourself.
It can also be hard to watch continuously, as you are often met with impossible moral and medical conundrums that no person should have to face. It is the reality of medical care. Again, I would advise pacing yourself if you find these topics distressing.
Healthcare under pressure
Topics in the first season range from the fentanyl crisis, which causes a young teenager to be medically registered as brain-dead, to a woman being misdiagnosed as a drug addict when she is actually suffering from sickle cell disease. It is common for Black people to be misdiagnosed in this way, as medical research has often ignored the needs of Black people, particularly Black women.
All while the staff, both new and old, are trying to handle the myriad people rushed into the hospital, we also see the head of the hospital lecture Robby about his patient satisfaction scores. Robby argues that there are not enough nurses to help patients and improve those scores.
Rather than Robby and his staff being allowed to get on with saving lives, bureaucracy settles in, caring more about how the hospital is viewed by shareholders. The statistics that sell the hospital, such as patient satisfaction rates, remain the priority, even when they stop staff from doing their jobs properly.
This is not only an issue for the American healthcare system; that type of bureaucracy has also seeped into the corridors of the NHS. Rather than being treated as a service that helps people and saves lives, it has been treated like a customer service company, where interests such as PFI contractors and private shareholders, who hold some of the monopoly of the NHS, continue to run it as if it were a privatised service.
Underfunding turns into horror
About halfway through the show, we see the results of underfunding when a mass-casualty incident is declared after a shooting at a festival near the hospital. What starts as a bleak and depressing programme becomes a horror show, where you cannot believe how these medical staff keep going as dead bodies come through the door, alongside missing body parts and injuries so severe that the staff are constantly on the brink between saving a life and losing one.
Once the incident is over, the head of the hospital congratulates the staff and suggests that this type of day is not normal. That is the talking point of the hospital’s senior figures.
But, as season two shows, these days are very normal for medical staff, and the burnout and trauma from the pandemic and events like this show why there is a growing exodus from the profession. This is particularly true when staff are receiving less pay in relation to rising inflation, while hospitals are reluctant to give them the resources they need in order to protect their profits.
Season two is set on the 4th July, with the expectation that the emergency department will be busy, as it often is during holiday celebrations. The problems of understaffing and scarce resources remain, while the team has still not fully recovered from the festival shooting a year earlier.
The cruelty of privatised healthcare
In a heart-breaking story spanning multiple episodes, Orlando, a man who has pushed himself to the limit to provide for his family, is taken into hospital because he cannot afford the insulin he needs to control his diabetes. He is terrified that being in hospital will only add to his bills.
He tries to leave, but the medical staff devise a plan based on his insurance that might make the cost manageable. Even then, it is clear he will have to work harder to cover those bills, which is what made him unwell in the first place.
He leaves without proper medical treatment, collapses, and is brought back in. He may now have brain damage as a result. Disgustingly, because he may be permanently disabled for the rest of his life, he is now entitled to full insurance cover.
Privatised healthcare is a vicious cycle that keeps people trapped in poverty, with people like Orlando regularly becoming its victims. Robby, in a pretty blunt fashion, suggests that Orlando made a choice and that it was his mistake.
When questioned by one of the medical staff, he clarifies that he is not referring to Orlando’s diabetes or the fact that he left, but that he should have chosen a higher spot to fall from. It is the harsh reality of the American healthcare system that, with no way out, people can feel pushed towards suicide because the prospect of burdening their family with so much debt is too much to bear.
Politics in healthcare
A couple of episodes also showcase the brutality of Trump’s policies, namely the bolstering of ICE agents to find migrants or protestors and shove them into detention centres. Two ICE agents, cowardly hiding behind masks and balaclavas, bring in an ill woman they want “patched up” before taking her to a detention centre.
They are bullying and cruel, causing havoc in the emergency department and stopping staff from doing their jobs. Without the woman receiving full treatment, the ICE agents attempt to take her away. When a nurse tries to stop them, they arrest her without giving any reason. The show clearly presents its disdain for ICE agents and the way they disrupt the lives of medical staff, who have far bigger concerns in trying to save people’s lives.
This show will make you angry at the American healthcare and political system, and that is a credit to the writing team, who have clearly brought medical professionals on as consultants.
Noah Wyle, also an executive producer, has argued in interviews that the privatised model of American healthcare is not working, and that an NHS-style system would be much better for the States. I agree with him, as the reality facing American workers, as this show portrays, looks less like the American dream promised by capitalism and more like an American nightmare.
People might groan about the state of the NHS, and justifiably, as it has been cut to the bone and pushed into decline by incompetent private outsourcing companies. But when watching a show like this, I am thankful that we have it. We should not, however, rest on our laurels.
Instead of simply praising what the NHS has done, let us fight for what it should be: fully funded, properly resourced and out of private hands. Socialists in the US should argue for the same, using this show as an example of the dangers of private healthcare and the need to give staff, both in the UK and the US, the resources and staffing they need to do their jobs without being burnt out by the demands of the bosses.
[Featured image: The Pitt logo, sourced from Wikimedia Commons. It can be found here.]
