Watching The Pitt at the End of an Era for HBO

On February 26 of this year, all the systems went down at The Pitt. Up to that point, the doctors and nurses and interns working in the emergency room at the fictional Pittsburgh Trauma Medical Center—colloquially, “the Pitt”—had already dealt with a cascade of isolated catastrophes, from an abandoned baby to an unexpectedly violent patient to the implementation and then malfunction of a new AI charting program. By its eighth episode on the 26th, season 2 of HBO Max’s hit hospital drama had piled on emergencies at the same pace as its paradigm-shifting first season, but the show had yet to reveal its big bad. The Fourth of July setting of the new season—which implied the possibility of some fireworks-related mass casualty event to rival last season’s festival shooting—turned out to have been a red herring. Instead, this year’s big twist was a coordinated cyberattack against the hospital. The Pitt wouldn’t be overrun with casualties of an external disaster; instead, they’d have to deal with the casualties of an internal one. So, midway through this season, on February 26, the Pitt shut down its electronic systems and went analog.

HBO Max experienced a systems failure of its own on February 26. That morning, Netflix announced that its purchase of Warner Bros. Discovery—which owns HBO—was off. David Ellison’s Paramount Skydance, which also had been vying to buy Warner Bros. Discovery, had come in with an offer of $31 per share, and Netflix dropped out of negotiations, clearing the way for conservative mogul Ellison to finalize his takeover of yet another media conglomerate. Last summer, Ellison’s company Skydance merged with Paramount in a move to consolidate several legacy media assets under a new, Trump-friendly umbrella. The changes made to Paramount post-merger have been both substantively and symbolically significant; in particular, the axing of Stephen Colbert’s resistance lib version of The Late Show and the hiring of Free Press provocateur Bari Weiss to run CBS News. Ellison has stated that entities like HBO and CNN will continue to operate independently if and when Paramount Skydance completes its acquisition, but, if you’ve been paying attention, then you know to be skeptical of such claims.

So, as The Pitt’s second season comes to a dramatic end, we are left to wonder if HBO is coming to an end of its own. For over two decades now, HBO has sold a sometimes hyperbolically praised but largely exemplary vision of creative freedom and risk-taking. There have been ebbs and flows, and the network’s recent overreliance on spin-offs and existing IP seemed to foretell the beginning of its “enshittification” era. But, all the same, the network that ruined Meadow Soprano’s college visit to Bowdoin, chopped off Ned Stark’s head, and pulled the chair out from under Tim Robinson is facing its first real looming possibility of active outside constraint. What does HBO look like if it can’t do whatever it wants?

For obvious reasons, it would be too much to say that The Pitt is about Ellison’s looming acquisition of HBO’s parent company. It is, however, a show about a virtuous and brilliant group of workers whose vision and independence allow them to thrive even as their industry crumbles around them, destabilized by new, unregulated technology, corrosive financialization, and the broader cultural devaluation of their work. This is a state of affairs that might sound familiar to people who work in television.

Season 2 of The Pitt begins with Dr. Robinavitch, or “Robby” (Noah Wyle), riding his motorcycle helmet-less across one of Pittsburgh’s many gorgeous golden suspension bridges, looking forward to either getting away from work for a while or killing himself. It’s unclear which. While each season of The Pitt takes place over the course of one long shift, during which time a never-ending stream of almost unmanageable crises unfolds, a running refrain is that this is what every day is like in the ER. The Pitt is almost always in crisis; the people who run it are able to do so because they are, just barely, hanging on.

Robby, one of the ER’s attending physicians, has been right on the knife’s edge of breakdown since we met him. In the first season, this was largely the result of post-pandemic PTSD. Robby occasionally had to duck into a corner of the ER to have a quick panic attack, and the show intermittently cut to hair-raising flashbacks of the hospital managing the fallout of Covid-19. This season, his stress is more existential. As the boss of the Pitt, he is both its primary manager and its sin eater. Every horror and every mistake, no matter whose fault, makes its way back to his mortal ledger. This season, we find him lashing out at his colleagues—residents, charge nurses, interns—mostly, it seems, because he so acutely feels the weight of all the devastation for which he is, according to the org chart at least, responsible. And he feels the start of the unraveling that he fears might take place if he were ever to leave.

Understandably, he wants to go on vacation, and our second season tracks his—alleged—last shift before he takes a three-month leave to ride his hog out to the Badlands. So the mood is a little bit apocalyptic. Several of our young docs are nearing the end of their time in the ER, deciding what to do next. Victoria Javadi (Shabana Azeez), a wunderkind medical student, wants to continue her work in emergency medicine, for which she’s shown tremendous skill, but her parents—high-powered docs in the same hospital—want her to dream bigger. Dr. Mohan (Supriya Ganesh), a sharply insightful resident with an intuitive bedside manner, is coming to terms with the idea that the ER is going to burn her out in the long run. Arrogant new med student James Ogilvie (Lucas Iverson) is pondering the possibility that he has neither the stomach nor the improvisatory genius necessary to survive in this job that, prior to his shift, he thought was hack work. A longtime patient dies, and several docs witness the last goodbyes of a young mother in hospice. Charge nurse Dana Evans (Katherine LaNasa) keeps trying to retire but can’t walk away. Her night-shift counterpart charge nurse has taken on a day job as a death doula. The grim reaper and all four horsemen are sitting patiently in the hospital waiting room.

All of this is complicated by the arrival of Robby’s leave replacement, Dr. Al-Hashimi (Sepideh Moafi), a bright and energetic physician who seems to be treating her stint as a sub in the Pitt as a project of institutional transformation. Within a few episodes, she’s established a new patient processing system, convinced several docs to try a new AI charting app, and even suggested that people should stop calling the Pitt “the Pitt.” Throughout the season, the show emphasizes that Al-Hashimi is a good doctor, giving her lots of opportunities to impress us with her virtuosic skill and her sometimes radiant empathy, but it also positions her as an outsider who only thinks she knows how this ecosystem works and what it means to its patients and its doctors alike. She can flag inefficiencies and minor rule violations and patient satisfaction scores, but that is missing the point, the show wants us to see. These are men and women of science, but what they practice is an art.

The counterpoint to Al-Hashimi is Emma Nolan (Laëtitia Hollard), a nursing graduate being mentored by Dana. Wide-eyed where Al-Hashimi is steely, Emma is a sponge for the Pitt’s bespoke vision of medical care. Emma helps Dana meticulously and tenderly clean and prepare the body of a homeless man for viewing, even though they know no family is coming to view him; she stays beside Dana for hours as they prepare a rape kit for a sexual assault survivor (a multiepisode arc that’s one of the most patiently detailed and humane narrative achievements I’ve seen on TV); she gets choked and nearly killed by a psychotic patient; she gives another homeless patient a fresh shave and haircut that brings him to tears. By the end of the shift, she’s a convert. Everybody around her is ready to give up or die. Emma, who walks out the door begrudgingly late in the season—after her shift ends—never wants to leave.

The Pitt could very easily tell a simple story of antagonism: executives versus docs, insurance versus the patient, new technology versus human care, Dr. Robby versus Dr. Al-Hashimi. And there is, admittedly, a clarifying simplicity to some of the program’s moral stances. When a pair of ICE agents show up with a detainee they’ve tossed around, the staff stand united against them, and Robby drags them to hell on their way out the door. The show’s frequent rage about the inequities of the U.S. health care system seethes brightly out of numerous subplots this season. But just because The Pitt is about a virtuous group of hardscrabble heroes doesn’t mean it lacks nuance.

The series spits out Al-Hashimi’s AI initiative with disgust, but it also asks us to consider that her arrival is not solely a harbinger of doom. Robby is a valiant knight in the service of humankind; he’s also a mess. As much as Al-Hashimi might seem to represent the very forces seeking to destroy his model of care—it doesn’t help that she arrives as a favorite of the aforementioned hospital execs—she also represents the possibility that someone might genuinely share the burden of the Pitt with him. As the season rolls on, she seems increasingly eager to form a partnership with Robby, rather than a rivalry. Robby is, understandably, paranoid about interlopers, but his rejection of the relief that Al-Hashimi offers, the specter of professional intimacy with another person, seems more about him than about her. Is the Pitt killing Robby, or is he killing himself?

The Pitt, in other words, is not smug or strident, despite its righteous polemics and its portraits of tortured genius. What animates this show is a sense of excitement around artistic innovation; like the best of HBO’s offerings over the past quarter-century, it is a project that rewards attention, debate, the investment of time and emotion. What David Ellison’s cynical acquisitions represent is a flattening of the ambitions of media, whether it’s journalism or entertainment. Bari Weiss’s CBS wants to silence dissent under the guise of heterodox thinking, to produce propaganda under the guise of programming for “normal” Americans. Conservative critics of series like The Pitt might claim they are liberal agitprop, the dull vessels of woke ideology. But for those watching week to week, it’s clear this show is not the same kind of blunt force political object. It’s about a group of people whose job is to remain human within a system that does not treat them that way, to practice care within a system where care is understood as inefficiency. The Pitt can feel the end coming—perhaps its own end—but it also can’t, and won’t, stop.