The Pitt Recap: A Rush of Blood

Wow folks, she really can do it all. Obviously, the “she” here is The Pitt and “it all” is the fact that this series is pumping out consistently incredible television that is intense, emotional, and built on this almost impossible choreographed chaos, working together to give both a (mostly) realistic look at medicine today and some truly well-crafted character development. It seems impossible that TV could be this good week in and week out, but I am here to tell you this is really happening, people. Soak it in!

While The Pitt has already had multiple standout episodes in its first season, what I found so winning about “5:00 P.M” is that it really takes the time to show us both sides of what it can do: the intensity and chaos feels more amped up than usual (if you can believe it), as Robby yet again bounces between two emergent cases, and then we also get two quiet character-building scenes that I have gone back and watched multiple times because I love them so. The Pitt is a show where sometimes tonal whiplash is the point because life is tonal whiplash; this line of work Dr. Robby et al have chosen is certainly rife with it. The Pitt, though, makes the blend of these sometimes disparate tones so smooth — they build this riveting cacophony. Whether we’re jumping from chaos to stillness or tragedy to lightheartedness or a woman profusely bleeding out of her vagina from a postpartum hemorrhage to a surgeon contentedly chomping on a free slice of pizza, it all continues to work together.

Another wild element The Pitt seems to handily pull off is that the pace is unrelenting and yet it never feels like a misstep. On most shows, we’d be spending the hour following a reveal and confrontation like the one we got at the end of “4:00 P.M.” — I’m honestly still reeling that Langdon played us all for fools! — really dissecting what went down, but we have no time for that here. Robby discovering that one of his senior residents is a drug addict and has been skimming meds off of patients is, uh, bad, but it isn’t an emergency just yet. That title is reserved for all the women who show up in this episode just to bleed all over the emergency department floor.

It’s not like The Pitt has just moved on from Robby firing Langdon; the fallout casts a pall over everything Robby does in this episode. Langdon’s frantic, repeated calls to Robby, the hospital main line, and Dana make sure we never forget what happened. And then there is, of course, the fact that Dr. Santos cannot seem to help herself. Her first instinct when Robby tells her that he let Langdon go is to smile and make a joke about “wanting to make an impression” on her first day, as if she thought she’d be celebrated for what she did. Santos was right to out Langdon and I was more than relieved when Robby finally tells her that what she did was right and it was brave, but that doesn’t mean Santos isn’t still acting like an ass. Oooh baby, when Garcia reacts to the news in the complete opposite way Santos assumed, telling the intern that she’s “trouble” and she doesn’t want to be a part of what’s happening, well, I will admit I enjoyed that too. Trinity Santos needs to learn how to read a room.

We do get a taste of all the emotional baggage the Langdon reveal leaves behind, but more pressing is the logistical problem losing Langdon creates for Robby — a problem that becomes wildly apparent as more emergent and pretty complicated cases continue to pour in. And with everything that seems to be piling up on Robby’s shoulders, it’s all clearly beginning to get to him — he has another PTSD episode, he seems to zone out during a major procedure for the first time — so our guy is working extra hard to hold it together at this point.

So what cases is Robby juggling? Well, there’s Natalie, who is a surrogate for her best friend Justin and his partner. By the time she’s brought in, she’s already crowning. And if you thought The Pitt’s realism and gore might stop short of showing us an actual birth in close ups, you thought so very wrong. The first time I watched this episode it was very early in the morning and I will tell you, I did not need to drink one single drop of coffee that day. It’s not even the close-up on the crowning that did me in, it was the point when, realizing that the baby’s shoulder was stuck on Natalie’s pelvic bone, we watched as Robby reached inside Natalie to rotate and pull that baby out. The stretching. Women are fearsome things to behold, do not mess with us, how many times must we warn you.

But Robby’s not only dealing with a difficult birth here. He’s dealing with a tense emotional situation, too: In the wake of Langdon leaving, Collins tells Robby that she had a miscarriage (she was doing IVF solo) but that she simply wants to work through it. Of course, then, the first patient she gets after that conversation is Natalie. Robby is hyper-aware of how Collins might be feeling. The moment when he whispers that he can take over for her, I whispered to myself, oh my god I would marry this man so fast. I mean, we already know he’s not scared of working a vagina. Collins doesn’t want to leave, so he’s managing both the patient, the baby, and perhaps a ticking time bomb.

He is also running back and forth between Natalie’s room and Dr. McKay’s patient, a woman with hepatitis B, which has led to cirrhosis of the liver, which has led to severe esophageal varices — or, enlarged varicose veins at her stomach and esophagus — that have ruptured. A truly insane amount of blood is pouring out of her mouth and through the suction Javadi is attempting. Robby arrives in time to assist McKay — who honestly is crushing it — with the Minnesota tube she’s inserting in her patient. The tube is a tamponade with multiple balloons that inflate to stop bleeding in multiple areas. It eventually does the trick, but holy hell is there a lot of blood.

I guess the 5 o’clock hour is a real party time for tamponade devices because guess who else needs one? Natalie. Oh, you thought her story was over with a painful and difficult birth? Have you not been paying attention to this show? First, Justin’s baby isn’t breathing. Collins and King have to work quickly for, well, not a long time, but long enough to be worrisome. The baby starts breathing. But when Collins heads back over to Natalie as she expels the placenta, blood just comes gushing out behind it. She’s having a postpartum hemorrhage and it is the stuff of nightmares. Things seem dicey for a while and I did go back and forth debating whether The Pitt, on top of everything else, would dare make us watch this woman die from childbirth. Thankfully, my worst fears were not confirmed for once! Collins works like hell to get a uterine tamponade inserted to stop the bleeding. Natalie’s awake and talking in no time. Medicine is awesome.

While the two most difficult cases of the day (so far) are buttoned up, that emotional time bomb Robby was worried about with Collins does come to pass. She leaves Natalie’s room in tears and Robby comes to find her taking a breather outside in an ambulance. This scene, friends. I am obsessed with this scene. The Pitt hasn’t spent time focusing on soapy interpersonal drama and characters have revealed parts of themselves slowly, and it all pays off in scenes like this one.

We don’t know a ton of details about Robby or Collins or their relationship, but the writing (by Elyssa Gershman) and Noah Wyle and Tracy Ifeachor’s performances fill in enough blanks to make this so moving. Collins talks about how this was her last round of IVF because of the cost, yes, but also because of the emotional toll it’s taking, and she is heartbroken. Robby tells her he’s never known her to give up on anything and gives her this little knee tap that did, in fact, make me yelp. When he tells her to go home early and makes sure she knows he’s there for her, you can see Collins gather up courage. She tells him that she was pregnant a few years ago but had an abortion because she wasn’t ready to be a mom and also because she was unsure of the relationship she was in. She never told him because she was scared of how he might react, that he’d never forgive her. It doesn’t take long for it to dawn on Robby that Collins is talking about him. It’s a lot to process at once, but he never stops focusing on what Collins needs. Of course the guy would forgive her and he would want Collins to forgive herself. It’s gentle and lovely.

Collins isn’t the only person Robby cares about who is having a tough go of it. At the end of the episode, he finds Dana outside taking a smoke break. (Ahmad is standing guard near her! Ahmad is the best!) She’s been trying to hold it together until the end of the shift, but she’s cracking, Robby can see it. She, too, is heartbroken. She was born at this hospital, she volunteered here in high school, so much of her life has been spent here, trying to help people and the community around her. This latest blow is simply too much. Robby assures her that she does make a difference and that “one asshole doesn’t get to change that,” but it’s bigger than just one asshole. The world is different and she thinks she’s done. In another wildly emotionally intelligent move, Robby doesn’t fight her on it. He doesn’t know how this place will run without her, but he understands if this is what she really needs. “You’re a good man, Dr. Robinavitch. Don’t let this place take that from you,” she tells him. Again, it’s such a great character moment for both of them and even though we don’t have all the shades of their relationship filled in, it hits on all levels.

Dana may be eyeing retirement, but she won’t be leaving this shift any time soon. While she and Robby are having this moment, they both get paged: There’s an active shooter at PittFest and multiple gunshot victims are on their way. You wanted to know why this shift extends past 12 hours? I think we’ve got our answer. To make things just a little more personal, Robby reminds Dana that Jake and his girlfriend are there. (Not so long ago they FaceTimed him to thank him for the tickets, in a dead giveaway that something terrible was going to happen.) I have a feeling that, while we may have thought we knew what a chaotic Emergency Department looked like on this show, we haven’t seen anything yet.

Discharge Papers

• I’ve seen a lot of theories over the past few weeks that something would go down at PittFest and that David Saunders would be the reason why, and the developments with Theresa and David’s story in this episode certainly don’t refute that. Theresa finds Robby and shows him a terrifying Instagram post her son just made about how “they” mocked him and that “it didn’t have to be this way.” Theresa’s decision to put her son on a psychiatric hold might be too late.

• I could watch Robby talk for hours about how society has failed young men by not teaching them to deal with their emotions in healthy ways and have instead pushed them toward toxic podcasts and finding community in all the wrong places. Get this man a mic!

• Mohan steps in it again when she takes the treatment of a drug-seeking patient into her own hands, not consulting Robby before giving the guy buprenorphine to, in a way, force him to admit he’s a drug addict. She’s right that the guy was lying, but Robby is sick of her going behind his back to treat patients. One day it could bite her in the ass. (And get the hospital in trouble.) Just when she was getting on his good side!

• I knew McKay’s ex-husband’s new girlfriend Chloe would be bad, but I never expected this bad! The 24-year-old shows up in a bedazzled “Bonus Mom” T-shirt and tries to keep Harrison away from his mom — and Chad is just letting her (of course). Chloe may have a restraining order against McKay, but that doesn’t stop the resident from drawing the line at coming between her and her son. She also threatens her life if she ever wears that stupid T-shirt again and I don’t blame her. I would’ve launched Chloe into the sun by now.

• King is so energized after taking part in Natalie’s case all she wants to do is share the story with her mentor, Langdon. When Santos tells her he’s gone, King looks so disappointed that he didn’t say good-bye. King should only experience happiness, this is very distressing.