The Pitt
11:00 a.m.
Season 2
Episode 5
Editor’s Rating
Photo: Warrick Page/HBO Max
Obviously, there’s a whole bunch of phrases you never want to hear your doctors say, but “Could be MRSA … or worse” is definitely high up on the list. Unfortunately, this is exactly how last week’s episode of The Pitt ended for our overworked waitress Debbie, whose supposed cellulitis on her foot has spread up her calf by the time she returns to PTMC to talk to Dr. Langdon. I’m sure anyone who has watched, like, even one other medical drama immediately thought: Oh, this is necrotizing fasciitis — a fast-moving bacterial infection under the skin that is too dramatic not to deploy at least once in your fictional hospital. And that certainly seems like the conclusion everyone is coming to as Langdon gets Debbie into an ER trauma room. Everybody referring to it as “nec fasc” makes it seem sexier, sure, but the situation is no less dangerous as Debbie’s leg gets worse and her vitals plummet.
Robby is all over it. Yes, partly because he’s the attending in charge (even though Dr. Al reminds him that she’s his equal in this ER, which he loves) and this is a complex case, but come on, his interest in Debbie is mostly because he doesn’t want Langdon around. He is talented, he is a strong leader, and he is petty as hell. All morning, he’s been annoyed if Langdon so much as breathes near him, he dismisses any course of action Langdon suggests with Debbie even when he’s clearly right, he refuses to hear Dana when she points this out to him, and when Langdon asks Robby if he has a few minutes to talk — something they clearly need to do — Robby responds “I don’t” and huffs off. Honestly though, Robby being a little bitch when it comes to Langdon only makes him hotter; He isn’t without flaws and that needs to be seen!
Speaking of Robby being hot, he has never been more attractive than when he overhears Debbie getting reamed out by her boss on the phone, grabs it from her to ream him out, inform him that’s he’s happy to be a witness when Debbie sues his ass for wrongful termination, and then hands back the phone while assuring her that he’s got her back. A man who tells you he supports you, AND gets you out of work, AND is a doctor? That’s a dreamy combination right there. In this episode, Robby also gets pretty hot-tempered, too. As labs come back, as the infection on Debbie’s leg keeps growing, and as her blood pressure drops and she needs to be intubated, Robby is sure this is necrotizing fasciitis and she needs to get into an OR. But the Westbridge patients have been pouring in — all of their ORs are closed now, too — and surgical consults are hard to come by. When they send down a guy who just graduated med school to take a look at Debbie, Robby is livid and runs him out of the room with a “don’t take this personally, I just need a fucking grown-up down here.” I bet he takes it personally.
When Dr. Garcia finally shows up and wants more testing, including a CT scan, to confirm this is nec fasc, Robby’s head might explode. Debbie doesn’t have a lot of time here and they all know what this is. So, instead of letting Garcia do what she wants, he ignores her, and gives his patient the ol’ “stainless-steel scan,” cutting right into her leg, revealing necrotizing fasciitis’s signature dishwater exudate (the soft tissue is dying) — a confirmation of his diagnosis, even if the technique isn’t exactly following protocol. Garcia has zero time for his attitude or recklessness, and as she takes Debbie up to the OR, she remarks that his sabbatical is coming just in time. Robby’s just pissing everybody off on the way out at this point.
If Garcia cherishes the thought that this version of Robby will be off on his motorcycle for three months, she might want to steer clear of a chat with Noelle, the case manager Robby’s boinking off-shift, who gives her doctor-with-benefits four to seven weeks before he’s had enough of being out on the road alone. She tells him this to his face. She knows he has “the seven-week itch” which, I guess, is also a dig at how their relationship is going. Robby just walks away after the comment, but unfortunately for Dana, standing nearby, Noelle continues unspooling her theory about “Motorcycle Mike’s sabbatical,” which is based on the fact that she knows Robby can’t fall asleep without the TV on, and he hates being alone that much. Dana is horrified by even the implication of Robby’s sex life and asks to be excused from this narrative, please, although not before suggesting that maybe Robby is looking to rid himself of old ghosts, or for something new, and maybe Noelle should get off his back about it. It’s a real “I can hassle my family, but if anyone else does, I’ll be all over their ass” type of situation, and you have to respect it.
Why is Noelle down in the ER traumatizing Dana? She’s back to help Orlando Diaz and his family with their health-insurance debacle. Orlando, who has been rationing his diabetes medication and doesn’t want to stay in the hospital for his extremely necessary insulin drip, continues to have one of the most frustrating storylines on The Pitt. Noelle arrives with “good” news — the hospital can offer a discount plan in which they will pay for 40 percent of Orlando’s bill. It sounds nice, but as Orlando is quick to point out, he’s already staring down a bill of $100,000 or more. He and his family would still be on the hook for $60,000 — they can’t afford that. The whole thing is both insane and yet so common — Orlando either forgoes lifesaving treatment or he goes into debt for the rest of his life.
While this is no means a perfect fix, it’s our med student Joy who comes up with a better plan. If Orlando gets admitted to the med-surg floor, his overall cost would be much lower. Mohan dismisses the idea since med-surg would never take him with an insulin drip, but Noelle figures it wouldn’t hurt to ask. Later, she returns with some actual good news: Med-surg will take him; They can put him on the SQuID protocol instead of the drip, and instead of $100,000 or $60,000, the Diaz family is looking at a bill closer to $20,000. It’s insane that this is considered a good outcome here, but alas, America, am I right? Orlando still isn’t pleased, but his wife and daughter push him to say yes.
In a telling gesture, Mohan doesn’t hesitate to apologize to Joy for dismissing her idea; Not every doctor in that ER would apologize to a med student. Joy is unbothered, but does explain that she knew med-surg was an option because her own family had to find creative ways to work the healthcare system when her grandmother fell ill. She learned a lot from it — including the fact that she doesn’t want a job that entails watching people die. No wonder she’s been treating her stint in the ER like her least favorite chore.
While Orlando’s story is anger-inducing, if you’re like me, you may be looking around at The Pitt’s episode count and wondering when the tear-inducing storylines might kick in. Make me weep, show! It seems episode five gives us a few contenders: Enter Roxie. She’s a 42-year-old married mom of two boys who is in hospice after seven years of lung cancer that eventually spread to her bones. When she has a seizure at home and injures her leg during the episode, her husband, Paul, panicked and called 911. Roxie and Paul and their sons are going to break us, aren’t they? She is clearly in an enormous amount of pain every time we see her in this episode — Javadi and McKay are both shocked to hear how much pain medication she’s on at home. Even after they get a boot on her injured leg, she’s suffering. She doesn’t want to use a bed pan in front of her husband, but simply dangling her legs off the edge of the bed makes getting into a wheelchair or walking to the bathroom impossible. When the doctors run down all the new equipment they’ll need at home — a wheelchair, shower chair, a hospital bed, and her new self-administered morphine drip — you can see in her face that to her, this means she is only becoming more of a burden to her husband. Sure, they have their death doula — surprise, it’s night-shift charge nurse Lena! — who has been “a lifesaver,” a joke Roxie points out but her husband doesn’t want to entertain, but so much of Roxie’s care has fallen to Paul, who also takes care of the kids and everything else that comes up in their lives. Lena subtly pulls Paul from the room when she notices how reluctant Roxie is to use the bedpan, but it seems like the bedpan might become low on the list of problems Roxie has real fast. Prepare yourselves, that’s all I’m saying.
Although, the episode ends with a development that might lead to some emotional outbursts sooner than expected: Langdon goes to check on Louie, only to find him unconscious with no pulse. Langdon and Robby start CPR. Is The Pitt really going to kill Louie?! Don’t they know we’re all already trying our best just to survive out here? Now this?! Very rude, if true.
• Dr. Al-Hashimi, Mel, and Whitaker take on Gus, a prisoner involved in a nasty fight, who has multiple rib fractures, a pulmonary contusion, a huge gash on his arm, and is suffering from severe malnutrition. Dr. Al seems poised to take up his cause.
• We’ve been grossed out a lot by this show, but watching Whitaker and Ogilvie literally scoop shit out of a woman’s impacted bowels? Seeing Ogilvie take a blasting of ass juice once things get loosened up in there? I am drawing a line, The Pitt.
• Ogilvie was already having a shitty day before the literal shit: He also got exposed to TB while taking care of a very grumpy unhoused woman. And he thought becoming Santos’s lackey while she attempts to catch up on her charting would be the worst thing to happen to him this hour.
• As Santos continues to spiral after Dr. Al basically threatened to make her repeat her second year of residency, the new attending attempts to push her generative AI app. Santos took Mel’s advice to start dictating her notes, but she’s still so behind that she’ll try anything. Dr. Al swears she isn’t trying to erase her own profession, but like many other people, she tells our anti-AI stalwart Robby, would like to spend less time charting and more time with her son.
• Langdon seems poised to get out of triage duty and back into the ER, but he and Donnie really did make a great team while it lasted. They couldn’t be more eager to see the video of their patient who let his brother brand him with the family crest via dry ice, but are also on the same page about how stupid the whole thing is — both the dry ice and the fact that the “family crest” is just the Pittsburgh Penguins logo.
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