Episode 13 of The Pitt brings us right into the heart of the action, immersing us in the intense atmosphere of the emergency department. We are right there with Team Red in a crowded trauma bay as Dr. Robby and Dana work on assessing a police officer who has been shot in the face. The tension escalates as McKay and Langdon notice the presence of heavily-armed SWAT team members outside the ED, prompting speculation about the shooter’s whereabouts. The show keeps us on the edge of our seats, mirroring the experience of working in such a high-pressure environment.
In another scene, Javadi and Whitaker are on the rooftop helipad, receiving fresh blood for a patient being airlifted in. The urgency of the situation mirrors the chaos of a mass casualty event, providing the med students with a new and challenging experience to navigate. The exchange between Javadi and Whitaker about the significance of different clock positions adds to the sense of disorientation and pressure in the moment.
Amidst the chaos, the senior staff, including Robby, Dana, and Abbott, continue to care for patients while also keeping an eye on their junior colleagues. Dana expresses relief at the arrival of night shift nurse Bridget Young, assigning her to watch over the new staff members. The camaraderie and support among the team are evident as Bridget offers reassurance to Dana and emphasizes the importance of looking out for one another during challenging times.
Do you know the difference between IO, intraosseous access, and IV, intravenous access? While treating a literal clown, one of the kids requires a refresher. âWhitaker!â Mel says, with Bridget alongside. âTeam huddle!â The whirring IO drill device he used is only for unconscious, unresponsive patients â after all, itâs boring into the bone to reach the bloodstream. The teaching moments continue even as more victims arrive in triage. Which Dr. Abbott, as former military, is uniquely prepared for. Heâs packing a tactical airway kit â works in the dark, even under fire â and quickly and efficiently stabilizes the wounded police officerâs trachea. Dr. Mohan, observing, wonders why the Pitt doesnât stock such lifesaving equipment. âNot in the budgetâ is Robbyâs answer. It puts into relief his squabbles over funding with Gloria, from just a few hours before, as the bleeding and the saving and the dying continue. In the nearby pediatric room, which has been transformed into a temporary morgue, Kiara Alfaro photographs the defining characteristics of patients with unknown identities, those who the Pitt could not save.
That IO has more than one use. While Langdonâs got a patient who suddenly regains consciousness, only to reach for a SIG Sauer P365 in his ankle holster â the entire floor ducks â McKayâs ankle monitor begins to blare. She finds an IO, pulls the trigger, and drills directly into the device, silencing its screaming tone and robotic voice in a shower of sparks. Showâs over, folks. Even inside everything thatâs happening â the clown Whitaker treated looks anxiously â Dr. McKay is one of The Pittâs coolest customers.
85 victims from the mass shooting treated, and more are on the way. Outside, in triage, as Robby takes a moment to compliment the steady work of doctors Shen and Ellis, he reacts with alarm to the sound of Jakeâs voice. Robbyâs stepson-ish is unhurt, but Jakeâs girlfriend Leah (Sloan Mannino) is the 86th victim. And the attending surgeon goes to work. Intubation. Chest compressions. The nurse canât feel Leahâs carotid. Dana registers no response from the patientâs femoral.
Robby has already invested more time and resources into Leahâs condition than the Pittâs MASH unit protocols established. Even as other staffers call out for an attending, he stays working on Jakeâs girlfriend. (Nearby, Mohan drills directly into the skull of the aging hippie victim â ârelieving the cranial pressure so he doesnât dieâ â shocking but impressing the young team of Javadi, Whitaker, and Santos.) Leahâs pulse pops for a nanosecond, then disappears. Robby believes, he has to believe, that she can be stabilized. Sheâs right on the edge of what they can achieve as lifesavers. But Dr. Walsh and Dr. Abbott do not concur. Blood, says Abbott while he works on his own patient, âis for the ones we can save.â
Shawn Hatosy, man. Abbott pulls up beside his colleague. âBullet tore through her heart. Anyone else with a wound like this is pronounced dead in the field. You canât keep up with the blood loss. If she was our only patient, weâd do a thoracotomy, maybe ECMO, but even then I doubt weâd get her back.â Abbott pauses, looks at Robby. Theyâre two professionals; they should both know the score. But he and the entire staff see the emotion surging under Robbyâs surgical veneer. âWeâre gonna lose 10 other patients if you put all your efforts into saving this girl.â
As he finally calls it, Robby feels his COVID flashbacks coming back on. He steps in to quickly treat a few other victims on the way to find Jake and tell him. He pulls him into a quiet room, explains everything that medically transpired. But Robby doesnât have an answer to Jakeâs pleading. âWhy couldnât you save her? I mean â this is what you do!â
Would she have been saved on any other day? Yes, no, maybe â Robby, his PTSD now raging, really canât answer. Heâs tearing up. Starting to sob. âThe fact that we saved as many people as we have is a fucking miracle.â But he couldnât save Leah. And just like all the other patients who died today (this season), all of those who didnât make it â not just the victims of the shooting â we canât help but remember them with Robby as the Pittâs attending surgeon finally submits to wave after wave of crushing despair.
Johnny Loftus (@johnnyloftus.bsky.social) is a Chicago-based writer. A veteran of the alternative weekly trenches, his work has also appeared in Entertainment Weekly, Pitchfork, The All Music Guide, and The Village Voice.
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