“From the beginning I enjoyed the work. In 1918 nursing was a simpler thing than it is today.”
-Dorothy Day
Earlier this year, HBO found a big streaming hit with The Pitt, a medical drama starring Noah Wyle. Plenty of thinkpieces have been written about why the show was so good (here’s a good one) and plenty of weird horny fanfics have been written about various character pairings on AO3 (I’m not linking to those, you can look those up yourselves), and now it’s time for me to come out: I am also a big Pitt-head. I originally had no interest in watching the show - although I had a tremendous amount of interest in the lawsuit from Michael Crichton's estate alleging that the medical drama starring ER's Noah Wyle and created by ER producer R. Scott Gemmell and originally set in Chicago1 just like ER was might actually be a derivative work of ER2 - but my wife suggested we watch it because she grew up loving ER and also as a young lady growing up, seeing Noah Wyle made her Feel A Certain Way.
The Pitt, shown to viewers essentially in real time, uses a full season to cover one half-day shift in the emergency department at the fictional Pittsburgh Trauma Medical Center; the action of the series does not leave the hospital grounds until the final minutes of the final episode, when the doctors clock out and walk across the street to a park bench. The characters are great, the acting is great - Wyle will probably get an Emmy nomination and deserves it - the writing and direction and production design are super-tight, and it is, according to the medical community, a pretty accurate picture of what practicing emergency medicine is like in 2025. Everyone is traumatized from the COVID pandemic. There are fentanyl overdoses and patients assaulting nurses and long wait times and obsession with patient satisfaction scores and funding shortages and moms who think Anthony Fauci is lying to them about measles. What you see throughout all of this is a group of messed-up stressed-out people being heroic in a crumbling system. There is so much misery happening outside of the walls of the hospital. The hospital itself has been gutted, labor-wise, and there are not nearly enough doctors and nurses to get to everyone as quickly as they should. But they still have a job to do, and they do it together and they do it heroically. They do not have time to worry about all of the other bullshit, they have lives to save, and they save them.
I am, in a weird way, jealous of the fictional doctors. They see the misery of the world much more closely than we do, but they do not actually have time to ruminate on it. They do not have time to let it paralyze them or overwhelm them or have them curl up in a ball and cry for a day before calling their psychiatrist to refill their ativan scrip for the first time in five years3. It is just on to the next patient, the next life you have to save. The work does not stop, which is terrifying in its own way, but it also means you don't have time to think about why the work doesn't stop. You just have to go save that next life. The world is hell, and the workplace is a lot more hell-like than it used to be, but whatever, we've got no time for that, on to the next patient. This is a show where, after several episodes, my wife and I have had to say “okay maybe one old episode of 30 Rock to get over how intense that was”, but it is also a show that, weirdly, makes me feel hopeful and comforted. Everything is crumbling and there are still heroes. There will always be heroes. I can be one of them in my own way.
But, also there will always still be work to do. There's one scene where a resident (Dr. McKay, right in the screenshot above), shadowed by a med student (Javadi, left), is treating a woman who burned herself on a Sterno light while trying to make s'mores with her kids. McKay, whose character has Seen Some Shit In Her Life, suspects the woman and her kids are unhoused and is trying to slowly draw more information out of the patient so they can plug her in to the help she needs. But, of course, Javadi, who has basically no social skills at all, puts her foot in her mouth at one point, the patient gets offended and storms out before McKay can do more. Javadi is mortified when this happens, and asks McKay what she can do to make it right.
“Oh, she's probably never coming back here,” sighs McKay. And I don't remember the exact line, but she follows that by saying something to the effect of “but lucky for you, there will be hundreds of people just like her that you get to see.”
Dorothy Day was a nurse in 1918. It's an easy part of her career to overlook, I certainly didn't know about it. “Right, she was a journalist and then she was a Catholic Worker” no dude she was a nurse at one point in there, too. She writes about it in one short chapter in The Long Loneliness; during the first World War, there were a lot of nurses serving overseas, so Day was one of many women who signed up for an on-the-job probationary crash course in nursing to keep the local hospitals staffed in New York. Obviously, this wasn’t The Pitt, it’s not like Day was dealing with the aftershocks of the COVID pandemic in a pressure-cooker setting, she was dealing with the aftershocks of a different pandemic because the Spanish Influenza was spreading around the world and Day would clock out after walking past rows of body bags. As you would expect from everything else Dorothy Day did in her life, she worked hard to recognize the dignity of the people she served, but as you would also expect from everything else Dorothy Day did in her life, she chose to do work that was often extremely unpleasant. She specifically described working in emergency medicine, the fracture ward for elderly patients, as “this ward broke me, the work was so hard,” and described being attacked by patients and ground down by a crumbling and understaffed system, just like Noah Wyle’s fake doctors were on my TV earlier this year. The things that we see are things that have happened before and that will happen again. But at the same time:
“I shall always remember with what gentleness the assistant superintendent of nurses came and talked to me about the responsibilities of the nurse and the dignity of her profession and the ‘sacrament of duty’. She might not have used those words, but that was the tenor of her talk and I have never forgotten it…Nursing was like newspaper work. It was impossible to suffer long over the tragedies which took place every day. One was too close to them to have perspective. They happened too continuously. They weighed on you, gave you a still and subdued feeling, but the very fact that you were continually busy left you no time to brood.”
Pray that we may keep ourselves too busy to brood as we do important and heroic work in a crumbling system. Pray that we may engage in these sacramental acts of worship, the term that I’m using for the things that we do when we are too busy to brood about how miserable things can get. I got that term from Day:
“One thing I was sure of, and that was that these fellow workers and I were performing an act of worship. I felt that it was necessary for man to worship, that he was most truly himself when engaged in that act.”
I have no idea what the working title of the series was before the setting changed to Pittsburgh, but I assume it was something like “No-Ketchup Hospital”.
I'll be honest, as funny as this lawsuit has been, and as funny as it is to see Wyle do press for the series and be legally obligated to say “well it's not really anything like ER at all”, I'm kind of on the show's side. Wyle is allowed to be a TV doctor more than once. They let John Laroquette be a TV lawyer like 20 times.
Although Noah Wyle's character could have benefitted from this.