SPOILER ALERT! This story contains details from the season finale of The Pitt.
Max’s clutch drama about a fictitious Pittsburgh hospital and the harried professionals who work inside the emergency room came to a breathless and (mostly) satisfying conclusion Thursday. Some issues have yet to be resolved — like whether Noah Wyle’s Dr. Robby has the mental capacity to continue his thankless job as the attending physician, if Patrick Ball’s Langdon deserves to keep his job and whether Katherine LaNasa’s Dana has worked her last day as the unofficial den mother.
And does Gerran Howell’s Whitaker really know what he’s doing by moving in with Isa Briones’ Santos?
Watch on Deadline
Here, Executive Producer John Wells and EP/Creator R. Scott Gemmill break down the first season and reveal how keeping costs in check wasn’t the main reason for limiting the action to one room (but it boy, it sure helped).
DEADLINE When you were conceiving this show, how much did economics come into play when you were putting the idea together?
R. SCOTT GEMMILL Yes and no. I said the next job I was going to do, I was never going to leave the set. The job can be hard on the crews when you’re out working nights and you’re all over the place. So the thought of doing a stage show was kind of appealing. And then ultimately, we came around to doing a medical show. It was a perfect combination of being in one spot and being able to tell great stories.
DEADLINE John, is it more affordable?
JOHN WELLS Very. But again, that’s not the primary consideration. I think the consideration was how do you actually show what medical professionals, nurses, and doctors are going through now in urban hospitals, in the emergency rooms. We’ve all stayed in contact with a lot of the people who we worked with on ER who were physicians. Noah Wyle just started to be overwhelmed with people letting him know how horrible it was and how many people had died, and this sense that we were going to forget about it somehow. It ended up being very financially advantageous to shoot this way, but it’s also the best way to tell the story. It was about determining what the story was and then realizing that it would actually be a much more financially effective way to shoot it. We live in these smaller worlds, in these smaller spaces. Part of the reaction of the show is it’s a human level show. It exists where we exist. We are going into spaces and meeting people that you meet all day long in your own life. Audiences love both. They want to go to places they’ve never been before. And they also want to be connected to what’s really in their day-to-day life. Again, the economics work out well, but that wasn’t the reason that anybody set out to do this.
DEADLINE There have been so many compliments about The Pitt being realistic. Isn’t that the kind of positive feedback you got on ER?
JOHN WELLS It’s always relative to what else is on or what else people have seen. ER felt extremely real and part of the reason was in the pilot, we shot in a real hospital. When we built the set for the rest of the episodes, we were mimicking the real hospital we had been in and did exactly the same thing we’re doing now, which is a lot of doctors who were involved in the show were on the set and in the writer’s room. So that really makes the difference. But yeah, we absolutely had that reputation on ER.
DEADLINE Viewers appreciated Noah Wyle’s depiction of an ER doctor even more after seeing his mental breakdown. This is, of course, depicted as a weakness on his part. But viewers didn’t care. Is that the reaction you were expecting?
GEMMILL He never dealt with his feelings and the repercussions of Covid. We all have things that we try to stuff down and forget about. Over time, I think as we get older, hopefully we realize that it’s not the best solution. Eventually that stuff will find its way out. In that episode, that’s when Robby found his way out and hopefully now that it’s out, he can learn to deal with it and move on.
WELLS We’re always trying to write complicated human beings. And when you write people in all of their complexity, there are moments at which point they seem like you could classify them as anti-heroes and there other moments when they may seem heroic. You’re never all of one thing, which I think what Scott’s referring to.
DEADLINE What kind of feedback have you been receiving for the show?
GEMMILL We get feedback constantly. I mean, one of the things that we really strive to do here is to involve medical professionals in the process. We talk to them across the board, everything from PTSD specialists to people dealing with the AMA to people dealing with immigration. So when we talk to we always ask what are some of the things that we don’t see? What part of your job isn’t really known to the public? What would you like people to know about your profession?
DEADLINE Is that what happened with the measles storyline? Talk about timing!
WELLS Everybody in the medical profession has been concerned for years about the anti-vaccination …. I would call it a crisis, particularly with children not being vaccinated in sequence. It was just inevitably going to happen. That story was [broken] months ago, as most are. We’re constantly going to trip over these things because we’re asking questions about what people are worried about. And they do happen. We had the same thing happen all the time on The West Wing, where we seemed to be ahead of something that was just happening and we were shooting eight, nine months in advance. But that’s because we’re doing our research with the political professionals and medical professionals who are telling us what they’re worried about and then it shows up.
GEMMILL I think the biggest difference between now is we were never dealing with the level of disinformation that is being disseminated to the public. People trusted their doctors. There may have been some who had the odd misinformation about old wives tales, but it wasn’t like it is now where people are coming in with the whole Dr. Google thing or they’re on these far extreme websites. It’s just rampant. And that’s a big challenge for doctors to try and convince people that what they’re trying to do is help them.
DEADLINE I want to get in the weeds a little bit with some of the plot decisions this season. First off, are there any medical techniques or thingies you created specifically for this show?
WELLS This is kind of a ride along with an emergency physician and his team, so we wanted to show the audience exactly what they see. That involves a lot of what you don’t even really notice now, which is a lot of medical nudity in the sense that there’s nothing lascivious about it. There are the specifics of what the events are and all of the various medical procedures that we’re able to show on streaming, which we were never able to do in the past.
GEMMILL One of the things that we did create, which I think Joe Sachs came up with, was the slap bands for identifying victims in the mass casualties episode. We slapped bands on the patients as they came in, whether they’re red, orange, green, or black and white for those who are dead. In terms of the other stuff, we’re constantly trying to figure out how to do the baby birth and how to do the amniocentesis, but we have a great special effects and makeup team that can basically do anything we dream up.
DEADLINE I’m glad you brought up the baby birth. You went the extra mile on that birth in episode 11. We saw, ahem, a lot.
WELLS It makes for better storytelling. You feel like you’re really there. Every man I know went ‘oh my God’ and every woman I know went, ‘see?’ It’s a real thing. Let’s show what it really is. None of the women were putting their hands up in front of their faces during that scene.
DEADLINE I was kind of expecting a big come-to-Jesus moment in the final episode between Langdon and Santos, but we didn’t get that. Is that a battle to come? Will that ever happen?
GEMMILL Yeah, there’s still some water to be explored between those two. That’s something to look forward to.
DEADLINE When Katherine LaNasa’s Dana got hit, was that based on a story that you heard?
GEMMILL Twenty-seven percent of hospital workers have been subjected to violence or abuse. That’s just a reality. One of the nurses I talked to had her cheek broken and lost a tooth. Everyone has their story. It’s very prolific.
WELLS We live in an angry time. We haven’t recovered from Covid. And also as a country, there’s just a lot of aggression and anger and stress, and it’s been meted out to the medical professionals.
DEADLINE In episode 12, Dr. Abbott is giving blood while working on a patient. Is that something that happened in real life?
GEMMILL I don’t know if that’s ever happened in real life in a hospital. I’m sure it’s happened in a combat situation, but it was a situation where they had no choice, and we put them in that situation, and that seemed to be the only solution. It’s a big gamble, but do you save a life and risk infection or do you lose a life? Maybe we pushed the envelope, but given the circumstances, I would’ve done that and I would’ve asked for forgiveness later.
DEADLINE You didn’t get cutesy this season with any outrageous surgeries until we saw the poor girl with a fork in her nose in the finale. Was that your little Easter egg for those who’ve come to expect this from medical dramas, those nutty cases?
GEMMILL That’s a real story. The original victim was just a toddler. But that would’ve been too hard to do in terms of doing prosthetics on a toddler. But yeah, we have docs on set, and they all have their special stories, and a lot of them have photos to go with it. So we’ve all seen the fork in the nose photo.
WELLS But you want to be careful about it. You don’t want to do too many of those little gags because it does start to feel like the heart getting away during the transplant and scooting across the floor. That doesn’t happen. In that episode, with having them go through so much over the last few hours of the show, I certainly felt like we could afford to have somebody smile.
DEADLINE How’s it felt like creating this hit? Have you stood in front of the mirror and said, ‘Hey, I still got it. I’m still a hitmaker!’
GEMMILL That’s exactly what I did! I would say when you make a show, you just hope it doesn’t suck and you don’t get crucified. The reception has been beyond belief for me, and it’s been just so enjoyable. I can’t even begin to express how happy I am.
WELLS You make shows that you just hope will connect with people. What’s been great is that this show connected so quickly. As an example, we made Shameless and it really didn’t become a hit until its fifth season because it just takes a long time with so many shows in the market. The thing that’s been really gratifying is that a lot of people found The Pitt really quickly, and that to me is a miracle in the world we live in now.