Season 2, Episode 8: ‘2:00 P.M.’
Smart and diligent though they are, the staffers of the Pittsburgh Trauma Medical Center emergency room are not walking computers. Fortunately, one of them is a human camera.
This week’s episode plunges the Pitt crew into analog chaos. The E.R.’s computer systems have been turned off to prevent a ransomware attack like the one shutting down several nearby hospitals. Suddenly, the Pitt is a profusion of clipboards, folders and forms filled out in triplicate. Staff members who haven’t worked nondigitally in decades, if ever, must suddenly adjust to elaborate filing protocols and antiquated technology. Emma, the new nurse, is frightened by the unfamiliar sound of a fax machine.
While most of the Pitt’s medical equipment is unaffected, the Pitt’s central nervous system — the big board listing all the cases and their status — is out like a light. That’s when Joy steps in. The sardonic doctor reveals she has a photographic memory, and she spends a decent chunk of the episode reciting every patient name, doctor name and medical condition on the board, in order. A relieved Dr. Al-Hashimi, who made the call to close down the system without checking with Dr. Robby first, can only marvel at Joy’s ability. Show me the generative A.I. that can do that, Dr. Al!
The episode’s most prominent new case tests both the Pitt’s capabilities and its staff’s compassion. Howard (Craig Ricci Shaynak) is a friendly and extremely overweight patient experiencing abdominal pain and an inexplicable fever. Despite his accommodating nature, his size presents the team with a variety of challenges.
Howard’s veins are hard to access for blood draws and IVs. The hospital’s CT scanner can sustain only a weight of 450 pounds, and Howard is unsure which side of the line he’s on. He’ll have to lie flat on his back to be weighed, but he can’t do so without experiencing shortness of breath, so he’ll need intubation. This will prevent him from speaking, so he’ll have to relay his thoughts using a computer interface reminiscent of a Speak & Spell.
If Howard weighs too much, he’ll need to be transferred to another hospital with equipment that can accommodate him, but that will require a doctor leaving the Pitt to oversee the transfer. It’s a thrill watching Dr. Robby, Dr. Al, Dr. Abbot and the rest of the team reverse engineer their way through these obstacles to get him the help he needs.
But there’s an ugly undercurrent to all this provided by everyone’s (OK, my) least favorite student doctor, Ogilvie. His feelings about Howard are made clear with his first sotto voce wisecrack. His questions regarding the man’s condition are really just a series of veiled critiques. Is he on Ozempic or Wegovy? Has he tried water aerobics? Will they have to get him weighed at the zoo? Ogilvie says all of this either directly to Howard or within earshot.
Small wonder the poor guy keeps apologizing to the staff, as if being obese were a moral failing and his mystery illness were divine punishment. He presents the story of how his weight gain began — he was in a bad car accident, which caused severe burns and led to multiple leg operations — as though it were somehow exculpatory of a crime.
Howard’s troubles remind me of those experienced by Harlow (Jessica “Limer” Flores), the deaf patient whose treatment keeps slipping through the cracks. Finally hooked up with a real A.S.L. translator, Harlow gets the care she needs for her neck pain from Dr. Santos lickety split. But think of how much more quickly this would have gone had the hospital been adequately staffed for such contingencies, or had Santos been less eager to ditch Harlow every time communication broke down.
Based on these two cases, it is clear that medical treatment and outcomes can differ depending on the personal circumstances of the patients involved. Try telling that to the United States government, though. Mohan tells Al-Hashimi that “the White House cut the funding” of a study she was working on regarding racial disparities in health care. It’s the show’s most explicit critique yet of the Make America Healthy Again administration.
When the episode begins, Dana is still confined to the rape exam room, per protocol, while an overwhelmed Nurse Princess handles charge duty. Once Dana retakes the helm, her first order of business is a phone call to the police, in which she threatens to stop expediting the care of injured officers unless a detective comes immediately to pick up an overdue rape kit. This part of the job means a lot to Dana, and she understandably feels it should mean a lot to everyone.
Dr. Robby, meanwhile, makes a pivotal call in the treatment of Roxie, the terminal cancer patient who does not want to return home with her family just to die: He authorizes a dose of painkiller that could be lethal. “The doctrine of double effect,” he explains, holds that physicians can treat pain first and foremost, even if doing so has side effects — up to and including death. One wonders if this is what Roxie, who is clearly at her wits’ end with her adoring family’s pain on her behalf, has been after all along.
The parents of the disturbed college student, Jackson, learn that their next steps depend on whether his diagnosis is schizophrenia or bipolar disorder. Digby, the unhoused patient who had the maggot infested cast, rings the nursing station’s old-school service bell to indicate that his late friend Louie has gotten his angel wings. The abandoned baby is doing so well that she may be sent straight to foster care.
New cases enliven the proceedings. There’s a real “What would you do?” moment when a woman with sudden blindness in one eye (Staci Lynn Fletcher) must decide whether to choose a course of treatment that stands a decent chance of restoring some of her vision, a better chance of doing nothing and a 1 percent chance of killing her. (So far, so good by the time the episode ends.)
The rival brainiacs Ogilvie and Javadi team up to solve the mystery of a grotesque rash that at first appears to be a case worthy of “House, M.D.” The real answer is a bit more down to earth: margarita burn, an unusual but common allergic reaction to a combination of lime juice and sunlight — so named because it often occurs when people mix margaritas outdoors.
Two party girls on a pub crawl present the episode’s funniest case. Jackie (Briana Burnside) — C.K. to her friends — comes in blackout drunk with her best friend, Jaquie (Esther Omegba), also known as Q. A selfie gone wrong caused C.K. nearly to bite her tongue in half when Q. bonked her in the jaw. The repair surgery is hook-based body horror worthy of “Hellraiser.”
The case brings Langdon and Santos into contact for the first time since his return to the Pitt, but he is no closer to re-establishing a relationship with the woman who outed him as a thief and an addict than he was before they stitched up that tongue together. Langdon fares better with McKay, who reveals that she, too, is in recovery, sober for over nine years.
Dr. King is similarly encouraged by Dr. Ellis (Ayesha Harris), fresh off her own deposition in Mel’s case. The senior doctor tells Mel the case is frivolous, the result of a preexisting case of measles pneumonia. This, too, feels like a pointed political barb.
“We all need a community,” an elderly patient named George (Kevin Brief) says to Dr. Mohan at one point, repeating her own words of wisdom. They apply to so many aspects of this week’s episode, whether it’s a resurgent disease in the age of MAHA or an “all hands on deck” response to misanthropic hackers.
It is notable how Ogilvie’s callousness makes him seem like a man apart from the other characters we’ve come to know and love in this show. There is a lesson to be learned there: For better or worse, we’re all in this together.
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