Per the gifted doctors and pedagogues on HBO’s “The Pitt,” good emergency medicine requires following established protocols to the letter until you’re forced to think outside the box. At that point, creativity and pragmatism become key. So does speed.
Taken together, that’s a decent recipe for good TV, too. In its Emmy-winning first season, “The Pitt” — which followed attending physician Michael “Dr. Robby” Robinavitch (Noah Wyle) through a shift at Pittsburgh Trauma Medical Center — was notable for how much it respected proven network formulas. For an HBO Max production (especially considering how weird some can get), it felt a little old school. A tad conventional. We know what to expect from medical dramas, after all, and “The Pitt” was strikingly uninterested in formal experiments for a “prestige” production; it gladly and competently fulfilled expectations. It also innovated and overachieved where it made sense to do so, however, with incredibly graphic, technically impressive special effects that heightened the realism of some procedures, and a “24”-style gimmick wherein each of the 15 episodes correspond to one hour (in real time) of Dr. Robby’s grueling, nightmarish shift.
The result wasn’t revolutionary, but boy, was it riveting.
That was partly thanks to an extremely talented cast, most of whom — besides Wyle, who cut his teeth as a TV doctor on “ER” — were relative unknowns. No stunt casting here, no flashy cameos. And while the show wasn’t an anthropological treatise on the state of American medicine, it ably captured many medical hierarchies and subcultures, from the dynamics between day shift and night shift crews, to the inside jokes shared by Filipino nurses, to the abrasive scorn with which a gifted surgical resident might treat the ER crew. Mainly, though, “The Pitt” handled a shocking number of storylines with dexterity and heart. The series deservedly emerged as an Emmy darling this past year. And the second season proves that the show (helmed by Wyle, creator R. Scott Gemmill, John Wells and Joe Sachs) understands its strengths — and its limits.
The second season opens with Dr. Robby merrily riding a motorcycle to work sans helmet, even recklessly passing an ambulance. While he’s clearly not in quite as dark a place as he was at the end of the last season, his choices don’t exactly scream healthy or healed, either. But he’s taking measures: This, the Fourth of July, is his last shift before a three-month sabbatical he plans to spend road-tripping on his motorcycle.
This being “The Pitt,” that shift gets off to a rough start. Baran Al-Hashimi (Sepideh Moafi), the attending physician hired to fill in for Dr. Robby in his absence, has shown up early — hoping to shadow him and pitch him her ideas for how to improve the department. (AI charting! Patient passports!) “The Pitt” milks Moafi’s spiky energy opposite Wyle for maximal comedic impact. Those who found the volume and variety of emotional traumas the show slathered on Dr. Robby during the first season a bit excessive will appreciate that the new season opens with the good doctor struggling more with annoyance than grief.
Worse still (for Dr. Robby’s mood) is the return of his disgraced ex-protégé, Frank Langdon (Patrick Ball) — the brilliant, charming senior resident whose addiction to benzos was one of the first season’s more startling revelations. Back from a 10-month stint in rehab, he’s chastened, rusty and eager to atone. Dr. Robby expends a fair amount of energy almost acrobatically avoiding him. If the first season emphasized his isolation and loneliness, the cinematography of this one highlights the protagonist’s itchy, claustrophobic state of mind. Many a frame has him squeezed into tight and awkward corners, or navigating around and away from people he sees as obstacles. He’s always looking for a place to stand. Or seizing a moment at his desk. Or peering into exam rooms only to find (to his relief) that he’s not needed.
That’s a significant shift in a show that otherwise hasn’t changed much. With the exception of senior resident Heather Collins (Tracy Ifeachor) and dreamboat ER nurse Mateo (Jalen Thomas Brooks), pretty much everyone’s back, including — thankfully — charge nurse Dana Evans (Katherine LaNasa), whose slow unraveling throughout the first season was the show’s quietest, most heartbreaking arc. Nurses Princess (Kristin Villanueva) and Perlah (Amielynn Abellera) are still efficiently dispensing care and dodging unwanted tasks, while nurse Donnie (Brandon Mendez Homer), who recently became a father, relishes his new responsibilities at home and at work.
The green doctors-in-training from last season have come a long way. “Huckleberry” Dennis Whitaker (Gerran Howell), who spent the first season gamely chasing rats and getting humiliated, is now training medical students himself with a quiet, firm self-assurance that feels earned. Equally fun is watching wunderkind Victoria Javadi (Shabana Azeez) realize she might have some actual competition from the new crop of medical students vying for spots, particularly a gunner named Ogilvy (Lucas Iverson). Samira Mohan’s (Supriya Ganesh) annoyance with her mother has her reconsidering settling in New Jersey once she finishes her residency. Without an ankle monitor to worry about, Cassie McKay (Fiona Dourif) just wants to get laid. A couple of work romances are casually referenced, but the conflict that interests me most is a tacit one brewing between abrasive hotshot Trinity Santos (Isa Briones), who still can’t fake interest in cases she finds boring, and Mel King (Taylor Dearden), whose unmatched professionalism has not prevented her from being named in a malpractice suit.
Additions to the gang include Emma, a sweet new nurse (Laëtitia Hollard) whom Evans takes under her brusque, accommodating wing. Case manager Noelle Hastings (Meta Golding) offers valuable if exposition-heavy insights on how Medicare and insurance affect patient care, and psychiatrist Caleb Jefferson (Christopher Thornton) turns up periodically to assess patients with unusual presentations (and roast Victoria). Of the newcomers, Ogilvy is the loudest. But his colleague, a tart, undemonstrative medical student named Joy (Irene Choi), is the most intriguing.
All told, there’s less adrenaline than last season (nine episodes in, at any rate), and that’s not a bad thing. While the mass-casualty event was dramatic, “The Pitt” really excels at showcasing the day-to-day challenges that plague routine health care work — the extent to which that grinds some folks down, and how others cope. This season draws attention to pedestrian issues including the burdens of documentation and charting, unreliable “virtual” interpreters who leave patients marooned and unable to communicate when they malfunction, and the brutal logistics of rape kits (including how frequently they’re not even picked up).
A crisis is brewing, of course. Some factors external to the hospital will bend the staff’s everyday struggles into the kind of cathartic story we associate with prestige TV. But it’s a testament to “The Pitt’s” workaday competence that this show feels like a well-oiled machine — watchable and rewarding — even without one.
The Pitt, Season 2 (15 episodes) is streaming on HBO Max.
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