Season 2, Episode 5: ‘11:00 A.M.’
Dr. Robby’s beef with Dr. Langdon, or a case of necrotizing fasciitis: Which condition will prove harder for the medical professionals of “The Pitt” to handle?
By the conclusion of this week’s episode, that question remains an open one — but the two dilemmas are linked. Retrieved from his Dr. Robby-enforced exile in triage by Dr. Al-Hashimi, Langdon goes to work on the E.R.’s diciest case so far this season. Continuing to treat the woman with a painful ankle rash (Mara Klein) whom he and the nurse practitioner Donnie triaged, Langdon is alarmed to watch the rash’s inexorable spread despite a suite of antibiotics.
The case creates an all-hands-on-deck scenario that forces Dr. Robby to work once again with his estranged protégé, whom he has avoided all morning. Almost immediately, Robby faults Langdon for taking intermediary steps anyone else would have taken before arriving at the correct diagnosis: necrotizing fasciitis, known colloquially as flesh-eating bacteria.
Robby’s gruesome “steel test” — he slices open the inflamed site with a knife, unleashing a river of foul-smelling dishwater-colored pus — definitively establishes the nature of the illness and avoids a potentially fatal wait time for a scan. Even so, Robby worries that more than the woman’s infected leg is at stake if the infection continues to spread.
Robby is so busy being angry with Langdon that he doesn’t see the office politics playing out before his eyes. Dr. Al — Robby’s replacement while he’s on his “midlife crisis trip,” as his skeptical girlfriend, Noelle, puts it — has Langdon’s back throughout the episode. She is the one who calls for his return from triage to help handle not only the necrotizing fasciitis case but also the influx of cases from the shuttered Westbridge Hospital. (There’s still no word on what shut the place down.)
She tells him she is glad he returned to the Pitt. She sticks up for his work. When she tells Robby she expects to be treated like his fellow chief attending, not a resident, Langdon notices. I get the impression Langdon is a man looking for approval from authority figures, and he may have found his new fix.
Langdon, of course, is still paying emotionally for the mistakes he made while in the grips of his addiction. During a routine check-in with the Pitt’s favorite patient, the cheerfully alcoholic Louie, Langdon notices that he is developing the shakes and prescribes Librium — the same benzo he stole from Louie’s prescription last season to feed his own habit. The younger Dr. Whitaker takes over simply because Louie’s case was originally his, not because he mistrusts Langdon. But the Langdon is crestfallen nonetheless, leaving Whitaker to feel needlessly guilty.
Whitaker is also concerned about his standing with his roomie, Dr. Santos, but I think she is madder at the world than she is at him. Dr. Al has threatened to make her repeat a year of residency if she doesn’t catch up with her charting, so she spends most of the episode trying and failing to dictate a full sentence before getting called away for some case or another. Al-Hashimi pitches A.I. as the solution to the charting workload. By contrast, Robby sees A.I. as their employer’s route to replacing staff on the cheap. Santos is so overwhelmed, though, that Dr. Al’s pitch is starting to seem appealing.
Elsewhere in the Pitt, Joy helps Noelle come up with a novel cost-saving solution for her uninsured patient. She tells Mohan, who was skeptical of the plan, that she learned to work the system while growing up with a poor, sick, uninsured grandmother. She also learned she doesn’t want to spend time around the dying, she says, which makes me question her choice of profession.
Humbled by his nearly fatal error with a trauma patient last episode, know-it-all Ogilvie now seems headed for the same kind of terrible, horrible, no-good, very bad day Whitaker had during Season 1. First he is exposed to tuberculosis, guaranteeing months of worrisome testing, even if he is uninfected. (The whole waiting room has also been exposed.)
Then Ogilvie manually unblocks a woman’s impacted bowels. Soon ominous rumblings are audible, and before the more experienced doctors can warn him, Ogilvie gets sprayed with diarrhea.
That isn’t the only comic relief case this week. Langdon and Donnie deal with a doofus suffering from dry-ice burns after his brother tried to brand him with “the family crest”: the logo for the Pittsburgh Penguins. The way the two medical professionals race to watch video of the “Jackass”-style high jinks is probably unbecoming, but it’s definitely funny to watch. Even the way Robby handles the fasciitis patient’s jerk of a boss — “If you fire her, she will sue you, and I will testify on her behalf” he barks into her phone — mines a laugh from the darkness.
Other cases are unrelentingly grim. Roxie (Brittany Allen) is undergoing home hospice care for terminal cancer with the help of her husband, Paul (Taylor Handley), and her “death doula,” Lena (Lesley Boone), better known to the E.R. staff as their overnight charge nurse. Her condition has led to seizures and a painful leg fracture that makes even going to the bathroom an agonizing, embarrassing chore.
Elsewhere, a corrections officer’s callous treatment of a malnourished prisoner admitted after a brutal beating — he keeps the man cuffed to his hospital bed even though he’s no more of a flight risk than the bed itself — frustrates all the staff involved in the case, particularly King and Whitaker. My guess is that whatever the man did to incur the beating will challenge the doctors’ benevolence.
One final, potentially tragic case closes out the episode and reunites Langdon and Robby one more time. Langdon discovers that the beloved Louie is flatlining — no one had rushed to his bedside upon hearing the sound because he slipped off his pulse oximeter as a matter of routine — and he and Robby rush to revive their favorite patient. Both his life and their friendship hang in the balance.
This episode is both gory and gross even by the high bar “The Pitt” has already established. But viewers whose resolve and stomach are strong enough to stay tuned are rewarded with real movement in the Robby-Langdon story line, the most dramatic dangling plot thread of Season 1 and the most conspicuously unresolved conflict thus far in Season 2.
At its best, “The Pitt” seems to have its own Nurse Dana behind the command center, directing traffic and assigning personnel to the places where they can make the biggest difference. If fecal explosions and flesh-eating bacteria don’t cure what ails you, two difficult men trying their best to rebuild their bond of brotherhood just might.
The post ‘The Pitt’ Season 2, Episode 5 Recap: Reunited appeared first on New York Times.
