‘The Pitt’ and the Realities of an Overburdened Medical System
How the Pittsburgh-set medical drama reflects the ongoing challenges facing healthcare workers in a post-COVID world.
The medical drama The Pitt has been gaining praise for its realistic portrayal of healthcare workers and the challenges they face in a post-COVID society. Set in Pittsburgh at the fictional Pittsburgh Trauma Medical Hospital, each episode unfolds over a single hour of a 15-hour shift in the hospital’s emergency department. The show tackles heavy topics such as hate crimes, transphobia, child sexual abuse, substance abuse, sexual assault, human trafficking, gun violence, abortion, racism, and patient-on-staff violence.
Since its January premiere, The Pitt has earned a 93% rating on Rotten Tomatoes and has been renewed for a second season. Medical professionals have applauded the series for its accuracy and realistic depiction of the medical field.
Storyline and Themes
The series stars ER alum Noah Wyle as Michael “Robby” Robinavitch, a senior attending at the hospital who suffers from post-traumatic stress disorder (PTSD) after losing his colleague and mentor, Dr. Adamson, during the COVID-19 pandemic. Other key characters include Heather Collins, a senior resident in the ER who frequently disagrees with Robby; Frank Langdon, a senior resident; Cassie McKay, a second-year resident; and Dana Evans, the charge nurse for the ER.
Each episode covers one hour of a single shift, providing viewers with the doctors' perspective on a progressively busy ER amid challenges such as crowded waiting rooms and violent patients. The series' presence on streaming platforms allows for graphic medical cases, including full-body burns and a “degloved” foot—skin peeled off—that would be censored on network television. It also explores the challenges faced by the medical world post-COVID, including understaffed hospitals, underpaid doctors, the privatization of healthcare, and issues with health insurance.
Many medical professionals have praised the realism of the series, a stark contrast to other popular medical dramas like Grey’s Anatomy and Chicago Med.
“It’s the first time I’ve watched doctors on television and felt like I could see myself in them,” said Dr. Tricia Pendergrast, a physician from Michigan, to The New York Times.
In the same report, other medical staff noted that the series felt so realistic it sometimes made them feel as though they were still at work while watching it.
“There are moments when I literally feel like I’m watching a shift at work,” said Dr. Elizabeth Rempfer, a physician from Maryland.
“Sometimes I have to turn it off and put on Lost or something else completely different.”
The Post-COVID Healthcare Crisis
A previous report from The Introspective highlighted the exacerbated inequities caused by the COVID-19 pandemic, including the impact of long COVID — a chronic condition triggered by SARS-CoV-2, the virus that causes COVID-19. An estimated 35% of people infected with the virus developed long COVID.
Black, Latino, and Indigenous people experienced higher COVID-19 death rates compared to white people. According to 2023 data, 90% of adults in the United States believed the country was facing a growing mental health crisis, with substance abuse rising following the pandemic. In 2021, the U.S. recorded more than 106,000 drug overdose deaths — the highest number at the time.
Healthcare workers have also felt the strain. Research from the Centers for Disease Control and Prevention (CDC) found that 46% of healthcare workers reported feeling burned out or very burned out in 2022, up from 32% in 2018. Reports of workplace harassment also increased, with 13% of healthcare workers saying they experienced harassment in 2022, compared to just 6% in 2018.
"It's concerning because it's leading to early retirement, and unfortunately, self-harm and suicide levels among physicians," said Dr. Gail Gazelle, a physician and assistant professor at Harvard University, in a report by NBC San Diego.
"All of that not only is extremely tragic for those individuals and their loved ones, but what does it mean for the residents of the state of California and the care that they will need going forward?"
Healthcare workers who experienced harassment reported higher rates of anxiety and depression. According to the CDC, 85% of those who reported harassment also experienced increased anxiety, while 60% reported symptoms of depression.
Many doctors also faced significant stress during the pandemic, fearing they would transmit the virus to vulnerable family and community members.
"Many of them were camped out in hotels and apartments because of fear of transmitting it to loved ones," Gazelle continued.
"I think that shines a light on the enormous stress and burden that physicians face and can leave them feeling like they're some kind of superhero — that they can't be human."
In a separate survey, 62% of healthcare workers reported signs of burnout, with many experiencing exhaustion, depersonalization — defined by a loss of conviction and dedication — irritability, and negative attitudes toward patients. Workers also reported feelings of reduced personal accomplishment, which manifests as inadequacy, reduced capability, and the inability to cope with everyday tasks.
Longer wait times have been reported since the pandemic, with overcrowded emergency departments leaving patients in hallways and waiting rooms for extended periods, further impacting patient care.
"People were coughing and vomiting," said Marissa Long, a patient who was admitted following possible organ rejection. Long said she spent three days and four nights in an ER hallway due to long wait times.
"I already have a low immune system. I was scared to get sick," she said.
Research from Penn State University found that patients are 5.4% more likely to die on days when the ER is crowded. On days the department is not crowded, an average of 2.6% of patients die.
"Though it is understood that a lack of available inpatient beds can lead to emergency department crowding, this is the first time that research has examined whether this crowding was associated with problems throughout the hospital," said Charleen Hsuan, an associate professor of health policy and administration, in the report.
"When policymakers and hospital administrators think about this problem, they need to consider the impacts on all patients and not just those in the emergency department. Policymakers may need to take a systems perspective on improving the quality of care in hospitals."
Further research from Yale University described ER overcrowding as reaching “crisis levels,” putting patient safety and care access at risk. Boarding times — the amount of time patients were kept in the ER after being admitted — increased following the pandemic. The median boarding time rose to more than six hours, twice as long as the standard four hours.
"Hospitals must have some flexible capacity so there are places for patients with emergencies requiring hospitalization to go," said Alexander Janke, a former fellow at Yale University who is now at the University of Michigan.
"That capacity doesn’t exist in a lot of places."
Longer wait times have also led to more patients leaving ERs without being seen or treated by a doctor. From January 2017 to December 2021, the average rate of patients leaving without being seen rose to 2.1%, up from 1.1%. Rates climbed as high as 10% at hospitals that were underperforming.
Pittsburgh as a Backdrop
The Pitt's setting in Pittsburgh offers insight into the city’s healthcare challenges. Research conducted by students at Carnegie Mellon University found that Pittsburgh ranks in the top 1% for cancer risks from toxic air pollution, due in part to the city’s industrial history. The city also has one of the highest rates of asthma, cardiovascular disease, and chronic obstructive pulmonary disease (COPD)—a condition caused by lung damage and inflammation that blocks airflow.
The impacts of redlining — policies that restricted Black people from buying homes in certain areas — continue to affect Black Yinzers, a slang term for Pittsburgh residents. Many Black residents live closer to industrial sites such as steel mills and river edges where waste is disposed of, contributing to severe health risks. Many of these neighborhoods are also located in food deserts, further impacting residents’ well-being.
The University of Pittsburgh Medical Center (UPMC), the city’s primary healthcare system, acknowledged these disparities in a 2022 press release following a community health needs assessment (CHNA) that highlighted residents' experiences.
“Information from the CHNAs allows us to prioritize programs and services because through this process, we can better understand the needs of our communities and develop a roadmap to direct resources where services are most needed and where our impact would be most beneficial,” said Mark Sevco, then-president of UPMC hospitals.
“Ultimately, our goal is simply to improve the community’s health.”
However, UPMC has faced criticism from medical staff. Reports indicate that 93% of Pittsburgh hospital workers surveyed have considered leaving their jobs at least once a month, and 90% said their units lack sufficient staff to manage the workload.
“In my seven years of nursing, staffing has never been this bad,” said Jackie Strange, a registered nurse (RN), in the report. “The emergency room has become one of the largest inpatient departments in the entire hospital. Patients are spending days on end in ER beds because there are not enough beds due to staff shortages in every single department.”
In the same report, many staff criticized UPMC for generating billions of dollars in revenue while employees struggle financially.
“Despite having a bachelor’s degree, advanced training in my specialty, and years of experience, my family’s financial security balances on a knife’s edge,” said Walter Gates, a magnetic resonance imaging (MRI) technician.
“Knowing how much money UPMC makes on the backs of its workers and patients — and the taxpayers — and the struggle and stress of trying to stay afloat makes me angry.”
The Pitt has resonated with viewers for its realistic portrayal of healthcare workers and the challenges they face in a strained medical system. As the series continues to draw praise for its authenticity, it serves as a reminder of the lasting impact the COVID-19 pandemic has had on both medical professionals and the communities they serve.
Thank you for sharing! This stat is shocking: "Reports indicate that 93% of Pittsburgh hospital workers surveyed have considered leaving their jobs at least once a month".