Noah Wyle has a theory about why health care reform is so hard to talk about. As the star and executive producer of HBO Max’s The Pitt, he's watched the policy conversations stall out, the arguments fail to connect, and has seen how something always gets lost between the point being made and the person it needs to reach. Television, he believes, can do something that lobbying can't. "It's so much easier to talk about it when you can point to something objective and triangulate the conversation through a piece of art," he says. "That's what this show is designed to do, and that's what it seems to be doing."
That instinct shapes the show from the very beginning of each season. Creator R. Scott Gemmill starts the writers' room by going straight to their in-house team of medical advisors, asking what issues doctors feel aren't being talked about and what the public needs to understand that it currently doesn't. "We approach it by leaning into the experts," Gemmill says, "and asking them what the general public needs to know at this point."
For actor Shabana Azeez, who plays student doctor Victoria Javadi, that translation feels urgent. Doctors, she points out, are carrying an enormous burden that largely goes unacknowledged. People come to them at their worst moments, often with complete trust, says Azeez. The weight of that can take a toll on physicians' mental health and quality of life. “We are not helping them as much as we really should be,” she says. "The doctors aren't the system, unfortunately. It seems like a separate thing where the doctors are fighting the system, the patients are fighting the system. Who is the system serving?" It's the question the show returns to again and again, and it doesn't pretend to have a clean answer.
Actor Fiona Dourif (Dr. Cassie McKay) arrived on the show already knowing that feeling from the other side. When her mother fell seriously ill in Dourif's mid-20s, she became her sole advocate through nine years of decline, up against a system that wasn't built to help. "There was a lot of fighting with bureaucracy that was extremely painful," she says. "And I think when I look back at it, I wish I had fought harder."
The doctors inside that system face their own version of the same struggle. Actor Taylor Dearden, who plays Dr. Melissa “Mel” King, says one of the most important things a doctor can do is also one of the simplest: listen. When doctors stop listening before a patient is finished, they risk mistakes.
Actor Supriya Ganesh, whose character, Dr. Samira Mohan, routinely advocates for her patients with empathy and care, argues that misdiagnoses often come from unexamined biases from health care providers. "It's not necessarily an evil thing," she says. "It's good to look internally and figure out what your shortcuts are and how we can all be better."
Beyond the exam room, the systemic pressures are just as real. Actor Shawn Hatosy, who plays Dr. Jack Abbott, says the role has taught him that advocacy doesn't stop at the hospital door, while actor Sepideh Moafi (Dr. Baran Al-Hashimi) keeps the focus on what anchors all of it: "We do everything we can to honor the emotional and ethical landscape that these doctors navigate every day."
Executive producer John Wells wants viewers to carry that understanding with them the next time they're sitting there, frustrated and wondering where everyone is. “Nobody’s having coffee,” he says. “Nobody is out back, hanging out, having a cigarette. … I think from the patient point of view, we just want them to understand that the reason they’re waiting is because the system is overwhelmed, because we don’t finance it properly, and because it’s the primary care place for millions and millions of people.”
Wyle has heard back from viewers who understood that message; people who waited more patiently, felt less frightened, and found themselves actually talking to their doctors about common interests instead of getting frustrated with long wait times.
Actor Katherine LaNasa, who plays the deeply empathetic and fiercely protective charge nurse Dana Evans, brings a perspective that hits close to home. She was going through cancer treatment shortly before being cast and knows how important it can be to establish a connection with your health care provider. "Just the difference that really small gestures make," she reflects, mentioning the impact that a nurse who noticed she was crying in triage and pulled her aside to give her words of encouragement had on her. "She saw me," LaNasa says quietly. "She saw what I was going through. I believed her, and it really mattered, and it really helped.”
It's exactly those small yet impactful gestures the show works hardest to capture. Because, in the end, that's the point it's trying to make. Though the struggles of policy, paperwork, and bureaucracy are key elements to the narrative, what really matters are the people on both sides of the exam table.
The Pitt is on its second season and airs new episodes on Thursdays at 9 p.m. ET on HBO Max.