The Pitt Season-Premiere Recap: Another Day in Paradise

When we first met Dr. Michael “Robby” Rabinavitch in The Pitt’s pilot episode, he was sauntering into a shift at Pittsburgh Trauma Medical Center, accompanied by the comforting sounds of Robert Bradley’s Blackwater Surprise’s “Baby.” He was suffering from some severe PTSD, of course, but at least at the beginning of his shift, he felt completely in control. Season two of the now award-winning, critical and commercial hit medical drama once again kicks things off with Robby heading to the hospital for his shift, but aside from our fearless leader being back on our screens, the whole setup feels less than comforting this time around. In the ten months since last season’s shift from hell, Robby, it seems, has made motorcycles his ride of choice. He, who, in case you forgot, is an emergency department doctor, is not wearing a helmet. The song playing for his entrance this time? The Clarks’ “Better Off Without You,” full of lyrics about “looking out for number one” and yes, being “better off without you”. So, yeah, I’m still worried about my guy’s mental health status as his Fourth of July shift begins. Middle-aged men suddenly choosing the hog life really screams “I’m in crisis,” and that’s just science.

It’s not that Robby is markedly different in this first hour, although he does seem quicker to become agitated and annoyed, but still, I’d like some confirmation that he’s at least been in some kind of therapy following his raging PTSD clashing with that mass casualty event last season. And hey, maybe the fact that he is stepping away and taking a three-month sabbatical is a sign that he’s putting his mental health over his career. But a helmet-less road trip to Alberta could just point to some reckless decision-making. Time will tell! And before Robby can even head off on his trip, he’s going to have to survive this shift. It’s only 7:00 A.M. and already that might be a tall order.

On one hand, it’s business as usual at PTMC. The waiting room is already over-flowing with bloodied, weary, apparently horrifically smelling patients. (When Robby remarks that the waiting room looks “manageable,” I laughed.) The ED board is full. We are immediately being whisked from room to room as our doctors on the day shift get to work. Welcome back to The Pitt and also the Pitt. While the fact that it’s the Fourth (and also hot as hell out) will certainly come into play at some point, this feels pretty familiar. However, Robby quickly discovers that his pre-sabbatical shift will have two new sources of tension. (Like I said, surviving this shift isn’t going to be easy.)

The first comes in the form of Robby’s replacement, Dr. Baran Al-Hashimi. Highly recommended from the VA — so she has worked with both Samira Mohan and Mel King before — Dr. Al-Hashimi will be filling in as ED Chief in Robby’s absence. She’s arrived early for her first shift and has already started the residents and med students on some training by way of mock codes. Dr. Shen and Charge Nurse Lena offer Robby some intel as they hand off their night shift: Al-Hashimi is super into integrating AI into how a hospital runs, and she seems to be a stickler for the rules. Robby is immediately annoyed. And thus, The Pitt sets up what is sure to be a main source of conflict this season. This show has been nothing if not efficient in character development, and this episode (directed by John Wells and written by R. Scott Gemmill) uses a knife wound on a John Doe to expertly lay out the differences between Robby’s way of practicing medicine and Al-Hashimi’s.

Robby wants to let the residents and interns make decisions for themselves without being told. He wants them to think creatively, to trust their gut. He’s willing to try risky procedures — here he has a surgical fellow and possibly Santos’s official girlfriend, Dr. Yolanda Garcia, perform a hilar flip, and turn the damaged lung 180 degrees to help stop the bleeding. It’s an out-of-the-box solution and Al-Hashimi’s immediate reaction is extreme skepticism with a healthy mix of you’re gonna kill this patient. Al-Hashimi, of course, runs her ED by sticking to rules, order, and algorithms. She and Robby verbally step on each other throughout this entire trauma — she wants to hand-hold and she wants to take the safest approach even when the situation might call for a bolder move.

The Pitt gives us lots of reasons to be hesitant about trusting Al-Hashimi. Robby is our guy; we’re always rooting for him. Does this lady have any freaking idea what we all went through last year? On top of a jockeying for attending power, there’s her championing of AI — automatic red flag — and the fact that everyone’s favorite hospital administrator, Gloria, is already a big fan. (Of course she is.) And let’s not forget one of Al-Hashimi’s greatest sins — she hates the nickname the Pitt for the ED. Honestly, how dare she.

And yet, Al-Hashimi is clearly a skilled doctor who knows her stuff. Mohan is certainly excited at the prospect of working with her again. So we shouldn’t write her off immediately. In fact, by the end of the episode, The Pitt is practically shouting at us that there is more going on here than what you’re assuming from first impressions. In what is sure to be one of our long-term storylines for the season, a baby is left in the waiting room restroom. She looks to be around a month old, which is a problem since, as Dr. Al-Hashimi explains, if a child under 28 days old is left, the situation falls under Safe Haven rules, and there are no questions asked; after 28 days, it’s child abandonment and a crime. No one remembers anyone walking in with a baby and leaving without one, and for now, they’re going to run tests to make sure she’s healthy. Dr. Al-Hashimi joins Mohan and Nurse Jesse in the pediatrics room to review the results of one of the initial tests. Everything looks good so far. So why does Dr. Al suddenly freeze up? I mean, this is like the least unsettling thing to happen in that woodland creature room of abject pain and tears — with my whole heart, that room can go fuck itself — and yet still, kind of unsettling! Surely, we’ll be learning what’s really up with the new doc in town at some point on our shift.

There is another point of tension Dr. Robby needs to contend with. Today might be his last shift for a while, but it also happens to be someone’s first shift back: Dr. Frank Langdon. Langdon has been gone for the past ten months in rehab and counseling for his benzos addiction. “The prodigal son returns,” Lena calls out as he re-enters the ED for the first time since that day Santos outed him to Robby and Robby went ballistic on his ass. Most people are more or less happy to see Langdon. Dr. Mel King, the biggest Langdon-head on the planet, is ecstatic. Her awkward almost-hug upon seeing him back? I missed this woman so much. Langdon has a lot of faults, but his mentorship to Dr. King will always endear me to him.

Santos, understandably, isn’t thrilled by his return, but she mostly avoids him for now. She’s pretty busy anyway, now that she has entered the hell that is second-year residency, which mostly means she’s trapped in a sea of charting. (Only made worse by Al-Hashimi constantly asking about it.) She’s also tied up on a case that looks like it’s going to get very complicated. Nine-year-old Kylie comes in with a chin laceration after falling down the stairs, but not long after, Santos and Nurse Perlah find other bruising and suspicious past injuries. When there’s more blood than urine in her urine sample, Santos is sure they’re looking at a case of child abuse. Robby and Al-Hashimi give her the go-ahead to call in social services, which means this whole thing is about to get messy.

It is, as always, just one item on Robby’s list of messy things to manage. Put it right under “try not to rip Langdon’s head off in front of the entire ED even though I, like, really, really want to.” Not surprisingly, Robby’s reaction to bumping into Langdon is mostly anger. He had one more day to get through without getting involved with this clown again, but here he is, a ticking time bomb of an emotional confrontation. Robby can barely stand to look at him, but Langdon has clearly come to work ready to face his consequences and make amends. He almost immediately brings up wanting to have a conversation with Robby, but is shut down. Robby relegates Langdon to triage for now — there’s less of a chance the two will run into each other that way.

That’s okay! I’m sure these two will have it out eventually. I hope it’s cathartic and just a little bit horny. But just because Robby won’t talk to Langdon doesn’t mean the returning doc doesn’t get to begin making amends. He happens to run into a patient we know and love from last year — Louie. He’s the unhoused, alcoholic, frequent flyer whom Landgon stole some meds from, and he’s back now with a deeply infected tooth and a rigid belly full of fluid. Langdon comes clean about stealing his medicine. He explains his addiction. He apologizes and tells Louie he’d understand if he wanted a different doctor. Louie accepts the apology, but he likes Langdon, and I’m sure the fact that Louie is also an addict plays into his easy forgiveness, too. I doubt all of Langdon’s apologies will go so well. Still, this means Langdon can move on and treat Louie. He orders Whitaker, excuse me, Dr. Whitaker, and his two new med student ducklings — Ogilvy, an insufferable know-it-all and Joy, who doesn’t seem at all engaged — to drain the fluid from Louie’s belly. It’s his third draining in six months. Louie is in a bad way, folks.

Speaking of new faces in the ED, a recent nursing school grad named Emma arrives to shadow Dana that day. Yes, you read that right: Charge Nurse Dana, who when last we saw her was debating whether or not she’d ever return to PTMC. After a shift in which she was assaulted by a patient and then had to work through the PittFest mass shooting, no one would blame her if she walked off into the sunset never to return. Dana did, in fact, take some time off, but as she describes it, she’s like an old trail horse — she always finds her way back home. Nurse Emma doesn’t know how lucky she is to have Dana Evans as her mentor. She better not waste this!

Of course, Emma’s first hour isn’t exactly fun. She’s using rectal thermometers, washing down an unhoused guy named Digby, and learns the nurses’ safe word (it’s “hula hoop”). But even in the not-so-glamorous aspects of the nursing gig, Emma already gets a meaningful lesson from Dana — that even simple things like “a little soap, water, and human decency” can make a huge difference in a patient’s life. I mean, don’t worry, Dana hasn’t gotten all schmaltzy on us — she does this while snapping her gum and in a possibly even thicker accent than last season while also whipping all her nurses, medical assistants, and most importantly, the doctors into shape. I missed this woman so much and am glad to see her back in action after everything and yet I remain worried about what another seemingly long-ass shift might do to her. Happy Fourth of July, I guess?

Discharge Papers

• Increasingly horny Dr. Cassie McKay (someone help her get laid, stat!) spends most of this hour with Mr. Williams, who tripped over a laundry basket in the dark and ended up with a bloody nose and broken wrist. He is clearly agitated at times and at first gives off strong Doug Driscoll vibes, but by the end of the hour, McKay can tell something else is going on. He is extremely confused — her initial worry about a head injury feels like the right track to follow here.

• Mel King is not herself today. She’s distracted — she doesn’t even notice a bicycle accident victim flirting with her. Although that would probably be true on any given day. But her distraction is not random: She’s been named in a malpractice suit and her deposition is later that day. She is unwell over it.

• Mohan (now a fourth-year resident), too, is distracted: She decided to take a position at a hospital near her mother in New Jersey only to learn that her mother sold her house, is getting married to a man she’s only known for a few months, and the two are going on a year-long cruise.

• And what of young Victoria Javadi? She’s still a med student and still unsure of what type of medicine she wants to pursue — which means her mother, Dr. Shamsi, is still all over her ass about choosing a surgical residency. She doesn’t even ease up knowing that Javadi’s 21st birthday is in just a few days, how rude.

• Big news for Donnie Donavan: Not only is he a doting new dad, but he’s also an NP. And running triage like a boss. What a season two upgrade.

• The place Robby’s riding to for his sabbatical is called Head-Smashed-In Buffalo Jump in Alberta, Canada. Do with that information what you will!

• The Pitt is stressful enough as it is, so I’m thrilled we get to watch season two knowing that the series has already been renewed for a third outing.

• New season, new glasses for Dr. Robby. Now, that’s what I call fan service, baby.