TVTVThe hospital evaluator is here, ready to hand out performance reviews for the Pittsburgh Trauma Medical CenterHBO/Ringer illustrationBy Austin GayleJan. 8, 1:20 pm UTC • 16 min
Full disclosure: I’m not a doctor. Or a nurse. I can’t remember the last time I’ve been to an emergency room, and I don’t think I can name more than two bones in my body But I’m a sucker for the lifesaving maneuvers of The Pitt. I don’t care that I don’t immediately know what REBOA or pre-peritoneal packing means. I live for the stakes and the drama. Plus, The Pitt explains pretty much everything in layman’s terms eventually. Obviously, a REBOA is a procedure where they blow up a balloon in your aorta (the most important artery in your body), and obviously, pre-peritoneal packing involves stuffing sponges in your gut to quickly stop life-threatening internal bleeding caused by really bad pelvic injuries. They basically stuff you like a Build-A-Bear. (The Pitt is gory as hell. It’s an important piece of the show’s decor. I’m going to be dropping some pretty gnarly screenshots throughout, so be forewarned.)
All images via HBO
The Emmy-winning show gets away with constant medical jargon because it’s life or death minute to minute. Creator R. Scott Gemmill locks you in the throes of a Pittsburgh emergency room in constant patient overflow, with Noah Wyle—the erstwhile Dr. John Carter on ER, now known as Dr. Michael “Robby” Robinavitch on The Pitt—at the center of it all, and you sort of just strap yourself to a gurney and go with it. (In the spirit of the show, I’m also going to be using a shitload of ridiculous medical terms. Hopefully you can keep up.)
Season 1 is 15 episodes long, each representing an hour in a real-time shift, and the series features more than 20 traumas and at least 10 crashes before a season-climaxing, three-episode, 112-patient mass casualty event after a shooting at PittFest. It’s cranked up to 11, with basically no time spent outside the hospital or in calmer operating rooms. All of the focus is on heroic, oftentimes graphic procedures performed by a Pitt crew of (mostly) rock stars. Wyle, playing Dr. Michael “Robby” Robinavitch, is the undeniable GOAT, but everyone has their own moments.
Because everything is moving a mile a minute, it’s hard to keep track of all the different high-impact plays made by the staff. So I rewatched the first season to rank who pulled off the most medical magic on The Pitt. These were the four key criteria:
- Could they handle basic intubations? Intubations are the first step in the ER learning cycle, like an ollie on a skateboard. These have to become bread and butter for you if you’re ever going to rise through the ranks.
- Did they ace a first-time procedure? A lot of residents are begging for new opportunities early on to level up their talents, starting with intubations, chest tubes, and crikes. But the more rare, the better (obviously).
- What kinds of mistakes did they make? The Pittsburgh Trauma Medical Center is a teaching hospital, so mistakes are expected—but there’s a difference between a student dropping a 10-blade scalpel in someone’s foot and a resident doing it. Maintaining a high standard of care is a major priority for Robby’s ER.
- What is their special sauce? Per the conversation Dr. Samira Mohan and Dr. Melissa King have in Episode 10, “special sauce” is the unique trick of the trade that gives great doctors an edge over others.
There’s a mostly natural progression within the tiers below, given that there’s a clear hierarchy in the experience of students, interns, residents, and attending physicians. But some characters outperform their rank on the totem pole. Here’s the full list of the staff, based on where I’d draft them if I were starting an ER from scratch. Let’s start with a much-deserved honorable mention.
Honorable Mention: The Day Shift Nurses (Princess, Perlah, Donnie, Jesse, and Mateo)
The five nurses working the day shift under the charge of nurse Dana Evans (more on her higher up the list) are Princess, Perlah, Donnie, Jesse, and Mateo. Donnie and Jesse don’t have a ton of screen time, but they’re always working, always moving—high-effort players who show up big, specifically alongside the medical students. Mateo is as reliable as they come and a Pitt heartthrob. And when Princess and Perlah aren’t churning the rumor mill, they’re leading from the front as two of the top dogs. Perlah is my personal favorite of the bunch. She takes over for Dana in a critical spot and doesn’t break stride, and when a gun is spotted in the hospital in the middle of the mass casualty event in Episode 12, Perlah is one of the first people to throw her body over a patient to protect them. You love to see that.
Tier 7: The Rising Students (Victoria Javadi and Dennis Whitaker)
Both of these kids are baptized by fire—Whitaker more so, and he’s also literally baptized by random liquids—during their first shifts in the Pitt.
Javadi is the youngest person on the staff, having started college at 13 years old, and she faces the added pressure of the fact that her mom, Dr. Eileen Shamsi is a hands-on teacher and a senior attending general surgeon at the hospital. Javadi faints in the first hour of her shift when Dr. Frank Langdon handles a degloved foot, but can you honestly blame her?
Vecna’s skin looks better than this.
After she falls, a resident gives Javadi the nickname “Crash,” and Robby drops her to chairs (the waiting room) to help Dr. Cassie McKay with the overflow. But it ends up being exactly what Javadi needs. She improves steadily under Dr. McKay in lower-stress situations until making a series of big-league plays, including her first intubation on a patient who’s been hit with a nail gun to the heart (she needs a camera assist, but still). Javadi also helps execute a hip reduction and redirects treatment after spotting a dead black widow in a patient’s Croc. Her signature moment, though, comes when she has the idea to create a makeshift chest tube out of an ET tube and a urine bag when supplies run out during the mass casualty event. Her mom calls it unconventional; Mateo, whom Javadi has had a clear-as-day crush on since she first laid eyes on him, calls it genius. Javadi ultimately gets the guy, too, even though she’d crashed and burned when she tried to ask Mateo out earlier in the shift. Mateo pulls her aside to call her a “rock star” over a shared juice box and invites her to have a beer with the rest of the gang when they finally clock out. Javadi isn’t old enough to drink, but they let it slide.
Whitaker makes an even bigger splash in his first shift: He hurts his finger when he’s transferring a patient from a gurney to a bed, and his ringtone, Edwin Starr’s 1971 “Funky Music Sho Nuff Turns Me On,” plays loudly during a moment of silence after an 89-year-old woman passes away. Whitaker proceeds to find a kidney stone in his first patient, Bennet Milton, only to lose him to a 1-in-100 cardiac event when he’s chilling off monitor in a wheelchair. Whitaker leads compressions for as long as they let him before declaring Milton dead. And even though it’s not really his fault, he (very fairly) takes his first patient death to heart.
The hits keep coming. Whitaker goes on to cycle through five (!) different sets of scrubs after repeated run-ins with random liquids, including Mylanta (by far the most pleasant of the group), pee, blood, and more blood. But when he’s done literally getting his feet wet, Whitaker starts to reveal his own special sauce: His heart is always in the right place. He asks to join the street team to help deliver medicine to people who are unhoused, and he helps Robby through his lowest moment, when he’s having an emotional breakdown in the middle of the mass casualty event. Whitaker also pulls off his first figure-eight suture on a squirting artery and handles yellow patients well with some clutch tourniquets He and Dr. King also spot a lost radial pulse off monitor and discover that a woman who initially said that she’d only hurt her leg is bleeding internally. We still haven’t seen Whitaker do an intubation on-screen, but I trust that he can get there. He snapped a loose rat’s neck without hesitation, and he was ready to sleep in the hospital between shifts if Dr. Santos hadn’t offered him her spare room at the end of the season. He’s a lovable grinder on the up-and-up.
Whitaker and Javadi still need reps, but they finish the season trending in the right direction. (That is, if we give Whitaker a mulligan for unnecessarily drilling a hole into the bone of an alert clown’s arm amid the mass casualty chaos.)
Tier 6: The Emergency Night Shift (Dr. Walsh, Dr. Ellis, and Dr. Shen)
None of these three are supposed to come into work until much later, but the mass casualty forces them into action. They’re thrown right into the deep end and never panic.
Shen is calm and focused from the jump, and Ellis sees the disaster very clearly: “The only way out is through.” The two of them split the bulk of the triage responsibilities, evaluating patients 10 seconds at a time to color-code them.
Walsh is an attending surgeon brought in to provide an extra set of eyes and hands for the dozens of gunshot wound victims during the mass casualty event. She barely breaks a sweat while handling almost all of the OR scheduling and “tying off the bleeders and slamming on vacuum dressings.” At one point she jokes that she’ll get bored if they don’t send her more patients. She’s exactly what you’d want from a surgeon in any situation: cool and collected. That is, until they start to run out of supplies and everyone starts performing what she calls “banana-pants” procedures—like when one of the residents uses a pigtail catheter to remove air from a victim’s heart. Walsh pushes back on these high-risk, experimental approaches, but she ultimately answers the call when needed. When Dr. Jack Abbot wants to do an emergency pre-peritoneal packing—something he has done before only in combat hospitals—Walsh assists, ultimately saving a hospital worker’s life after he’s crushed all of the bones in his pelvis.
Ellis, Shen, and Walsh are this low on the list only because they’re featured for just two hours during the mass casualty event and then during a much slower cooldown hour in the finale. They’ll rise up the ranks quickly if they have longer shifts in Season 2.
Tier 5: The Rising Residents (Dr. Santos and Dr. McKay)
Dr. McKay could honestly be higher, but she was constantly having to split focus between her patients, her family randomly showing up at the hospital, and a loud house arrest monitor around her ankle. Her “douchebag” ex-husband, to use McKay’s dad’s word, and son, Harrison, enter the mix in Episode 10 when her ex comes in needing surgery with three breaks in his ankle from a skateboarding accident. McKay has to leave Harrison in the lounge alone until her dad eventually comes to pick him up, and she has to deal with her ex-husband’s young girlfriend coming in with this vile shirt:
When McKay tells this girl that if she ever wears this bedazzled nightmare in front of her again that she’ll wish she hadn’t, it’s a message with a 100 percent approval rating.
McKay’s special sauce is that she just doesn’t give a fuck. She drilled a hole in her monitor when it wouldn’t stop going off during the mass casualty. Her procedure highlights include a lateral canthotomy—where she saves a baseball player’s eye from mounting pressure with high-precision cuts—and a host of intubations, chest tubes, and IOs. Her biggest mistake was when she jumped to the conclusion that a recently pregnant patient had a UTI without taking the basic steps to rule out endometriosis. That’s a big slipup for a second-year resident.
Dr. Santos, meanwhile, is an overconfident intern/first-year resident who made multiple mistakes moving too quickly and aggressively. She nearly killed a stable patient when she wrongfully put him on BiPAP and created a tension pneumothorax without first getting it approved by a higher-up, and she clumsily dropped a 10 blade in a doctor’s foot when trying to put in her first-ever chest tube. Her confidence is a blessing and a curse. She balances out her blunders with multiple dynamite saves, including performing a successful REBOA without approval and accurately treating hyponatremia before labs confirmed the diagnosis. Dr. Abbot tells her she should never do what she did with the REBOA again, but also calls what she did “badass.” Santos also performs three successful on-screen intubations, but that’s pretty boring compared to her other procedural plays, and also that time when she goes above a senior resident’s head to report him for stealing drugs.
Tier 4: The Bad Boy (Dr. Langdon)
Langdon is a good doctor. He performs multiple intubations and chest tubes throughout the shift, and he headlines several complex procedures that would be career highlights for most residents. He assists Robby on the retrograde intubation during a tonsillectomy hemorrhage; he diagnoses a coma patient with low blood sugar using what he calls his “Spidey senses;” he handles an older patient’s pacemaker failure by floating a temporary wire from his neck to his heart using a seven French triple lumen. But his signature move is going in blind and successfully pulling off a supraclavicular subclavian line during the mass casualty when a large patient needs a giant vein accessed. It’s a specific incision that Langdon apparently learned from the EM:RAP podcast. Dude was going off. Style points everywhere.
The problem is you can’t give Langdon too much credit for coming back to help with the mass casualty: He would’ve been there from the beginning if he hadn’t been sent home by Robby for lying about stealing those drugs. And even after Langdon comes back and the dust settles, Langdon gets confrontational about everything he’d need to do to get a second chance and makes a rude remark to Robby about Adamson’s death (more on that when we eventually get to Robby). He’s a hothead, a liar, a thief, and a drug addict. He needs help if he’s ever going to maximize his potential and reach the upper echelon of the ER. The good news is that it’s been reported that Season 2 will start with Langdon’s first day back in the hospital after 10 months in rehab I’m excited for the redemption tour.
Tier 3: Leading the Charge (Dana Evans)
Maybe this is too high for the charge nurse Dana Evans, but I don’t care. She’s the “ringleader of the circus,” keeping The Pitt alive through thick and thin. She took a freakin’ blindside right hook from an angry patient and still finished her shift through the mass casualty event, despite a facial fracture and a nasty black eye. She’s a juggernaut. She’s a warrior. I can’t imagine the show without Evans, and Dr. Robby can’t imagine the hospital without her. “I don’t know what I’m going to do without you,” he says when Evans contemplates hanging up her scrubs after the assault. The cliff-hanger of her packing up her things haunted me up until it was confirmed she was returning for Season 2. Thank God. The Pitt needs someone who can take and pack a punch like Evans
Tier 2: The Top Residents (Dr. Garcia, Dr. Mohan, Dr. King, and Dr. Collins)
These four residents punch above their weight and trust their gut the right way. They’re all unique and bring different strengths to the table, but what unites them is their ability to avoid mistakes and perform under pressure.
Dr. Samira Mohan gets the nickname “Slo-Mo” because she takes her time with patients and prioritizes learning their stories. She connects deeply with a sickle cell patient, making sure she gets proper pain management when others dismiss her as drug-seeking. When an influencer comes in with strange symptoms, Mohan also diagnoses mercury poisoning despite Robby disagreeing with her and wanting the patient handed over to psych. Mohan trusts her gut—and she’s usually right. But her standout moment comes when she uses an EZ-IO to drill a burr hole into a hippie’s skull to relieve cranial pressure while everyone gasps in shock.
Mohan also pulls off the “banana-pants” pigtail catheter procedure when no one else knows what to do. Intubations, chest tubes, and IOs come second nature to this legend. She works well with everyone and stands up for herself against Robby when he questions her judgment. She’s one of my favorite characters going into Season 2.
Dr. Melissa “Mel” King is only a second-year resident on her first shift at the PTMC, but you wouldn’t be able to tell from her performance. She pulls off her first crike outside the cadaver lab: makes a vertical incision to avoid the jugulars and carotids, makes a horizontal incision at the cricothyroid membrane, stuffs a 4.0 Shiley tube, bags it, sews it up. She also successfully intubates a 13-year-old pedes patient with measles. But bigger than her procedures is her standard of patient care. She handles a situation where an 85-year-old woman is left alone by her daughter for hours with patience and compassion, buys a bear from the gift shop for the girl who lost her sister in a drowning accident, and helps a patient with autism through an everted ankle when another doctor was struggling to do so. She’s a beaming light of optimism and care. Mel even donates her own blood while treating patients (squeezing the bag herself). She is a potential meteoric riser who still has so much room to grow.
Dr. Yolanda Garcia is a surgical resident, so we don’t see her as much as the three ER residents. But when she’s on screen, she’s a no-frills player with a high hit rate. Garcia leads the fasciotomy on the guy whose forearm got fried by a live wire. (His skin opens up like an alien egg when she makes the incision.)
Garcia also assists Collins on the thoracotomy for the nail gun patient, helping open the chest and remove the nail from the left ventricle. She even finishes putting in a chest tube after Santos blew the opportunity with the whole “dropping a 10 blade in Garcia’s foot” thing. She gets the job done every time, even with fewer at-bats.
Dr. Heather Collins is a senior resident who the ER depends on as a consistently accurate, measured presence, but she, like Robby and others, battles difficult personal loss while trying to balance an abnormally ridiculous workload. Collins has a miscarriage during her shift—and then has to handle an extremely difficult delivery just hours later. Collins is the initial lead on the delivery when the baby gets stuck on the pelvic bone, and the mother starts hemorrhaging after pushing out the placenta. She performs a uterine massage and inserts a Bakri balloon to stop the bleeding, successfully avoiding a hysterectomy or worse. Earlier in the shift, Collins leads Garcia through the thoracotomy on the nail gun patient and assists on a pericardiocentesis with a 60cc syringe to save a triathlete from cardiac tamponade. She eventually has a heart-to-heart with Robby and agrees to go home to grieve at the end of Episode 11. Robby tells her to turn off her phone, so they can’t get a hold of Collins, and she never ends up coming back to help with the mass casualty. Can’t blame her for that, but it’s a sad end regardless. We won’t get a chance to see Collins again, as she’s not returning for Season 2. She was a top-of-the-line doctor.
Tier 1B: The Badass (Dr. Abbot)
We don’t get a lot of Dr. Abott, the night shift’s attending physician who joins the party for the mass casualty, but the amount that we do is enough to vault him up this list. He has a swagger, an aura about him that breathes confidence into the entire staff. That, and he’s a battle-tested combat medic who takes the cake for the most successful unique procedures. From the moment he walks in, Abbot sets the tone—his first mass casualty patient gets an IO, intubation, and chest tube in rapid succession before anyone else has even gotten started. He’s like a cross between MacGyver and Inspector Gadget. Abbot busts a controlled crike kit out of his bag when they’re running out of supplies. He successfully pulls off a Rummel tourniquet with umbilical tape and a neck intubation with a Foley catheter while simultaneously donating his own blood. He spots an intracardiac air embolism that no one else can see, and he gets props from vascular surgery for his work on a carotid bypass. His signature move, though, is the preperitoneal packing. He turns a trauma bay into a makeshift OR to save the hospital worker with the crushed pelvis. He’d only ever done it in combat hospitals before, and Robby had only done it in the cadaver lab. Abbot was also handing out intubations, chest tubes, and IOs like candy in between his fancier procedures, but that’s light work for our boy.
Tier 1A: The GOAT (Dr. Robby)
The basics come easy to Robby. Intubations, chest tubes, IOs, running codes—he makes it all look routine. But what sets Dr. Michael “Robby” Robinavitch apart is that the impossible comes just as easy. He diagnoses hyperkalemia in a triathlete and saves him with calcium gluconate before labs confirm it. He spots a swallowed tooth that would’ve killed a patient in a week.
Even better than his rapid diagnoses are his ridiculous intubations. No one finds an airway better than Robby. He performs a retrograde intubation on a patient with a post-tonsillectomy hemorrhage, threading a guidewire through the patient’s mouth to establish an airway when Dr. Garcia is begging to crike. He intubates a patient using a Foley catheter shoved in their throat. He also breaks the golden rule with intubations: don’t push the tube until you can see the cords. Sometimes there’s no time for that—sometimes you have no choice but to go completely blind. And Robby does.
Robby is involved in every major save at The Pitt, either leading it himself or teaching someone else how to pull it off. The entire staff performs at the level they do because Robby has been training them, trusting them, and pushing them to be better. And in addition to all of his technical talent, Robby is always helping the staff and families of patients manage their grief, even at the cost of managing his own. Reminder: The shift that comprises Season 1 of The Pitt occurs on the anniversary of the death of Robby’s mentor, Dr. Adamson.
He loses just six out of 112 patients from a mass shooting that his ex-girlfriend’s son barely survived. It all comes crashing down on him for a moment in the makeshift morgue in pedes, but he doesn’t stay down. He gets back up and finishes the shift—because that’s what everyone needs him to do. This dude is a warrior. He’s the best doctor in the building, the best teacher on staff, and the best leader The Pitt could ask for. Every resident, every student, every save has Robby’s fingerprints on it. The Pitt only goes as far as Robby goes.
Austin Gayle
Austin Gayle writes about the NFL, surviving horror movies, raw-dogging flights, and other weird stuff. He’s The Ringer’s audience engagement manager (big numbers guy) and a 10-year Oakland Raiders season-ticket holder who still thinks about Derek Carr’s leg every Christmas.
