transcript

Speaker 1:
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Speaker 2:
[00:31] No one goes to Hank's for his spreadsheets. They go for a darn good pizza. Lately though, the shop's been quiet. So Hank decides to bring back the one dollar slice. He asks Copilot in Microsoft Excel to look at his sales and costs and help him see if he can afford it. Copilot shows Hank where the money's going and which little extras make the dollar slice work. Now Hank says, line out the door. Hank makes the pizza, Copilot handles the spreadsheets. Learn more at m365copilot.com/work.

Speaker 3:
[01:05] We are the nightcrawlers. We deal with the weirdest and the wildest because we are the weirdest and the wildest of them all.

Speaker 2:
[01:12] That is right.

Speaker 4:
[01:12] Tonight, they are really going to be crawling.

Speaker 3:
[01:14] Now go get some.

Speaker 4:
[01:25] Welcome to The Pitt Podcast, the official companion to The Pitt on HBO Max. I'm Hunter Harris.

Speaker 5:
[01:29] And I'm Dr. Alok Patel. It's 9 p.m. The shift is finally over. Season two is over. Kind of sad. We've got a lot to talk about regarding episode 15. We're gonna be joined by Sepideh Moafi, the newest attending, and the two executive producers, John Wells and R. Scott Gemmill, to hear their thoughts about this season and what's up next for our crew at PTMC.

Speaker 3:
[01:49] The real reason was Robbie pushing Langdon to get out of his comfort zone, and realize that he is a good doctor, and he can get back on the saddle, back in the saddle. The doctor the fuck up was just something I had in my back pocket for a long time, just waiting to drop it.

Speaker 4:
[02:06] Today's shift starts now.

Speaker 5:
[02:10] What are your big takeaways, your favorite moments from this episode?

Speaker 3:
[02:14] Oh my gosh.

Speaker 4:
[02:15] I think that the delivery, the baby, that was one of the toughest cases this season, and I got actually emotional watching it.

Speaker 5:
[02:24] Listen, from the medical standpoint, I think that was the most impactful, powerful medical procedure in the entire season. I'm right there with you. It speaks to so many levels. I mean, we can get into that later.

Speaker 4:
[02:37] Well, Alok, I know we have a lot to get into. Can we start going through some of the moments medically and story character moments that really made this episode pop?

Speaker 5:
[02:46] Oh, mentally, I've already been doing that, Hunter, starting out with the climactic conversation, calling a conversation because I'm being nice right now, between Dr. Al Hashimi and Dr. Ravi about this underlying medical condition we got to discuss.

Speaker 6:
[03:02] You didn't rat out Langdon for stealing fucking drugs.

Speaker 7:
[03:05] But I kicked him out of this department until he got the appropriate help that he needs and the same goes for you. You've got until Monday to let the administration know, I will.

Speaker 4:
[03:14] I was surprised. I did not know that you could have a seizure without shaking. I did not know a seizure could be just kind of blinking out a little bit. But this was a big reveal.

Speaker 5:
[03:27] It really was. The writers, the medical consultants, did such an incredible job of building up detention to this moment and kind of drop in little context clues. What we can now probably see with more confidence is that Dr. Al-Hashimi is having a focal temporal seizure. A focal seizure means that you don't necessarily have that full body shaking that you think of when you think of a typical quote Hollywood seizure or a stereotypical seizure. Because of where it is in the brain, there can be really interesting phenomena. Somebody might have auras, like see lights or have a sensation. They may have deja vu, or they could just step away and lose focus for a second. But what I specifically looked into in the research is, this type of seizure can originate from somebody who has viral meningitis in childhood, which is exactly what we heard at the end of the last episode. That Dr. Al Hashimi had viral meningitis when she was five years old and now has this. The last part I'll add is the sequence of treatment, which she mentions is you can take more medication. She mentions Keppra or there are surgical options as well, such as they can implant different devices, literally on or next to the brain to control the seizures. If all this fails, including medications, you can go and then get potentially something called a temporal lobectomy where they very precisely remove the part of the brain that's causing seizures. Here is another fun detail that throws back to an earlier episode. Anytime somebody with seizures is going to get one of these invasive procedures, they are consulted in talking to a neuropsychiatrist. A neuropsychiatrist is who's really going to be able to help you understand your symptoms and how a potential procedure might affect your language and other neurological function. You know, Sepideh Moafi, her acting in this entire portion, not only with the explosion towards Dr. Ravi, but even in getting in the car at the end, stopping crying, just bravo. She is up there in the acting award category with Baby Jane Doe.

Speaker 4:
[05:33] No, I think you're completely right. It's something I didn't know how I felt about this. You know, Dr. Al-Hashimi trusts Dr. Ravi with this really intimate, really sensitive information about her own health, and it really feels like an extension of an olive branch almost, because this whole shift, they've been sort of butting heads, they've been trying to find common ground, trying to work with each other, and it felt very intimate for her to trust Dr. Ravi with this information, and he almost immediately kind of does a heel turn and really lays down the hammer with her and says, I don't think I need you in this ED, and I like that she brings up, okay, but Dr. Langdon, he was stealing drugs, and all he did was get sent to rehab. I don't know where I landed with this. I felt very conflicted.

Speaker 5:
[06:17] I think it's fascinating to now look back on Dr. Al-Hashimi from the start of the season and look at things from her lens with her knowing she has this condition. I know that's really interesting.

Speaker 4:
[06:29] Yeah. Well, in a more shallow way, I want to look back and see if the dead body in the car is when he arrived exactly and what he was doing during the day. Maybe to figure out if he was a day shift or night shift patient.

Speaker 5:
[06:40] We need to ask the makeup department too. Did they change his makeup if he was in the background? All of a sudden. I mean, because guys got like, he does not look alive.

Speaker 6:
[06:50] Rape kits are supposed to be picked up within 72 hours of collecting them. This one's been here for over two weeks. That's not on us. Well, it's on somebody. Some bad enough these poor women go through an assault, plus the indignity of the whole collection process. But nobody from the police department even has the human decency to come get these things. Like nobody there gives a flying.

Speaker 8:
[07:12] We got it. We'll see that these get put into evidence properly.

Speaker 6:
[07:15] Thank you.

Speaker 5:
[07:16] I love charged nurse Dana Spire. I have respect for her advocacy. I think the entire moment of her as the sexual assault nurse examiner is one of the most powerful parts of this entire season. But I needed a little bit more in this moment. I felt like it was just a quick line to address the box. But what do you think?

Speaker 4:
[07:34] I agree. I needed the detectives to really feel the anger because I would be angry too if I were a nurse Dana. If I had gone through all of this trauma and taken so much time with a woman who'd survived a sexual assault and the detectives don't even care enough to pick it up, I would be enraged.

Speaker 5:
[07:53] I respect that. I think there needs to be more people who take up this cause and raise awareness. I'm complaining that the scene was too short, but at least they address the scene because guess what? Other medical shows don't.

Speaker 4:
[08:04] No, I think it's very important.

Speaker 5:
[08:06] There are people who didn't know what a sane was until they watched that episode or heard our podcast. Yeah. Yes, that is the protocol and I'm glad people are talking about it. The beauty of The Pitt.

Speaker 4:
[08:17] I'm happy that Charger's Dana also gets her look back.

Speaker 5:
[08:20] Yeah, fair.

Speaker 7:
[08:21] I thought you left already on my way out. Hey, I'm sorry that I didn't find the time today to have that conversation. Yeah, that's all right. Seems like you didn't really want to. I didn't.

Speaker 5:
[08:37] Langdon laying it down.

Speaker 4:
[08:39] Yeah, so there's this deadbeat dad called Dr. Robbie. I loved this scene. I loved Langdon kind of turning the tables and saying you are the one who is forcing the standard of perfection onto yourself. Because this is also kind of what Dr. Robbie comes back to when he's talking to Dr. Abbott where he says it's hard holding myself to being a standard of perfection, being a role model, all of this stuff. And I like how Langdon really makes him see that this is not perfection that you're showing us. You're not being a very good role model when you're putting yourself at risk and putting your own mental health at risk in every moment. And that he saw a lot of people in rehab that were behaving just like Dr. Robbie was. That was a big moment.

Speaker 5:
[09:26] Yeah, like some vulnerability from Langdon too. And acknowledgement of the time he's putting in and how he's made up or trying to make up for what happened. And Dr. Robbie's still writing him, I don't know if this is the conversation to have in front of patients. I'm just going to be honest. They just have it out right there in the ER, like maybe go to the staff break room or go in the hallway with lockers or something.

Speaker 4:
[09:48] I mean, you can say that. However, Dr. Langdon has been trying to talk to Dr. Robbie all day. And Dr. Robbie has kept pushing him away, making go to triage, refusing to have any kind of conversation with him about that needs to be had between these two men. So this is how it has to happen. The set has to go down. If you're dealing with someone who keeps running away.

Speaker 5:
[10:09] There's that patient in the background who's getting assessed and he just has to listen to the attending and the Chief President just talked about like-

Speaker 4:
[10:15] I love gossip. I would want to listen to.

Speaker 5:
[10:18] That's fair.

Speaker 6:
[10:18] Fine.

Speaker 5:
[10:19] Let's go for an ER. What's happening?

Speaker 6:
[10:22] You have a condition called preeclampsia.

Speaker 1:
[10:24] How did that happen?

Speaker 7:
[10:25] No one really knows actually. It affects about 10% of the pregnancies, high blood pressure, headaches, protein in the urine and swollen ankles.

Speaker 1:
[10:34] Well, it's a wild pregnancy, so that means no medical care.

Speaker 7:
[10:38] Why are you here?

Speaker 4:
[10:41] A woman comes in to the ED, complaining of some complications with her pregnancy. Although she says that she's having a free birth, a wild birth with no medicine, no doctors, nothing. She has preeclampsia, which turns into eclampsia. Can you tell me what's going on here?

Speaker 5:
[11:02] It reminds me of the measles case from the first season. It kind of represents misinformation, mistrust of the medical system, complications people don't talk about in a situation like straight up, I see the downstream problems from these natural birds, these wild birds, these free birds, whatever people want to call them. It affects the baby and their situations, as mentioned in this case, where it can be life-threatening for both baby and mom. If not life-threatening, can cause lifelong complications. This woman who's pregnant, she has preeclampsia. We don't completely understand how it happens. But let me put it this way, when there's a developing fetus, there's signals sent to arteries in the placenta, and the arteries get bigger and they form a certain way to make sure that there's good blood flow to the baby. In preeclampsia, some of those signals are off, and so the arteries might be a little bit narrowed, they're not properly formed. And what can happen is some early symptoms, such as headaches, or protein in the urine, or elevated liver enzymes, so those are kind of signals of liver damage. And if that doesn't get treated, that can progress to eeclampsia. So just get rid of the pre, and eeclampsia is when symptoms get so bad, they break down the blood-brain barrier, they can cause swelling in the brain, and seizures, which is exactly what we see play out here. What is so important that is mentioned is that this woman says she has not had any prenatal care, and she's doing this on her own. So that means at some point, she must have had hypertension. This is screened for in prenatal visits. Doctors, health professionals catch preeclampsia, and they do their best to manage it symptomatically and keep everybody safe. She goes in the ER, and Dr. Robbie's line, when she's like, I don't want medical care, and he's like, then why are you here? Yeah, that is a question. That is a thought that every single doctor has. When somebody comes to the emergency department and says, I don't trust doctors, I don't trust medicine, I don't want anyone's help. I'm glad you're here because I'm going to do everything I can to keep you safe, in this case, to save your baby's life, but the breakdown in care. My last rant, and I will stop, is this whole concept of natural is safe, natural is better. It's not, now if you want to have some of the home birth experience or you prefer different situations, there are ways to do it and make it a little bit safer, such as having a medical team, having a midwife, which is why Dr. Abbott asks about that. But anyway, I will stop.

Speaker 4:
[13:40] No, well, I just wanted to kind of double click on one thing, and it's when Dr. Cruz is trying to do the ultrasound, and the woman says, oh no, ultrasounds aren't safe for the baby. And I love the way Dr. Abbott says, not true. That was perfect. That was perfectly timed.

Speaker 5:
[13:54] Every health care professional who works with babies, who works with pregnant individuals, all my OB colleagues, all my NICU, PICU, ER, all of you, many people have had an experience with a home, wild, free water type of birth gone awry. And it's traumatic for everyone.

Speaker 7:
[14:13] You go off to kind of a rough start. Well, that makes two of us.

Speaker 5:
[14:35] Hunter, your winner for Best Supporting Actor has a pivotal scene with Dr. Robbie.

Speaker 4:
[14:41] Yes, so Dr. Robbie's season ends holding Baby Jane Doe. And can I say she breaks the fourth wall, looks right at the camera. Just diva, diva. She knows her power, what can I say? No, I love this moment for Robbie. I like that we sort of, the season begins with this moment with Baby Jane Doe, and it ends with a different sort of intimacy with Robbie holding her, cradling her, says that he would like to be swaddled too. But it comes back around to his story of, you know, being abandoned by his mom. That was really moving.

Speaker 5:
[15:15] I think super vulnerable. He just kind of like lets it all out. I'm curious how many takes it took to get those expressions from Baby Jane Doe, because the minute Dr. Robbie holds her and her eyes are wide open, breaks the fourth wall, as you say, like beautiful moment, and then she like closes her eyes and she's like kind of snoozing. I'm like, all right, this is phenomenal.

Speaker 4:
[15:34] Yes, it was very precious. But I think after a day for Dr. Robbie that he has gone through every emotion, he's been, you know, angry, frustrated, felt alone, felt, you know, suicidal ideation, but that he can end on with some hope, something that he didn't have even a couple of hours ago. The way that he tells Baby Jane Doe, you have so many people to love and so many people who are going to love you, I think that he'll come back from the sabbatical. I mean, I don't know, but I'm now trusting that maybe his helmet will be on.

Speaker 5:
[16:06] Yeah, let's hope so. It felt like he was speaking to his former self, or he was speaking to himself as a child after he was abandoned. Hunter, of all the characters that have been talked about, fan theories, medical theories, speculations, interest, I think Dr. Al-Hashimi is at the top of that list.

Speaker 4:
[16:25] I agree. I mean, from the first episode, when she joined the cast, that was a lot of intrigue. So let's go inside the pit and talk to Sepideh Moafi, who plays Dr. Al-Hashimi.

Speaker 5:
[16:38] Title CO2 is 70.

Speaker 7:
[16:39] That's crazy high.

Speaker 9:
[16:40] It'll come down. Tie down the tube, control all the bleeders. Spray an epi-vapy on a stack of 4x4s.

Speaker 7:
[16:46] Okay, stats are up to the 90s. Good, CO2 is in the 50s. Good heart rate. You forgot the last step. Change your underwear.

Speaker 8:
[16:54] How many of these have you done?

Speaker 9:
[16:56] First one.

Speaker 5:
[16:57] Are you serious? Thank you for being here in person. This is a vibe.

Speaker 4:
[17:01] Thank you.

Speaker 9:
[17:01] I'm so happy to come back full circle.

Speaker 4:
[17:04] From your perspective, how has it been watching the audience's reaction to Dr. Al? I feel like it's been love-hate or love maybe critical. People are very defensive of some of these characters. How have you felt joining and watching that?

Speaker 9:
[17:19] I was prepared for that for a number of reasons. This is a well-established cast. They've created something beautiful and cemented these characters into our consciousness already. Being one of the new characters and the only new series regular, the only new main cast who comes up against America's golden boy, I knew that I'd have some tough critics. But I also knew because she's a woman and she's in a position of leadership, and she takes the reins and she knows what she wants. She knows what she's after. She's very purpose-driven. That still rubs people the wrong way. I was prepared and there was some jokes thrown around throughout the season, like get ready for it, Seppi. But I love it because it stirs conversation. I think anything in this day and age where we're stuck behind screens that can create community and conversation, and people have a wide range of opinion and takes on each of these episodes and each of these characters. And so I love the fact that it's made this more of a, as some other people have said, like this water cooler show where people are watching it and then texting their friends or calling their friends or bringing it up at work. That's really satisfying.

Speaker 5:
[18:36] It's a pivotal moment. I'm just curious about what was going through your mind as an actor, what was going through Dr. Al Hashimi's mind when she was like, this is how I'm going to reveal the diagnosis to Dr. Robbie, by having him read my chart.

Speaker 9:
[18:52] It was a slow burn throughout the season. I learned about her condition in my audition right before the final phase. I didn't know how there would be a big reveal, like how they would play it, but I knew there would be a big reveal at the end or at some point. So I worked my way back and started with the very basics of who this woman is, how she came to be, not only as a physician with her vast diverse medical background, but also as a woman who's juggling these two identities that are kind of loaded as an Iranian and an Iraqi, what that means having those mixed identities, like having these two homelands and being an American. So there was a lot to unpack, a lot to work through and sort of mine throughout the process. And I knew that as someone in this leadership position and based on how she was written that she doesn't show her card, she doesn't play her cards. She's someone who's zipped up and from the women that I've met throughout my life in leadership positions and specifically women in medicine, you know that you are within a system that is not necessarily built for you and you have to play within the game in order to get ahead. And she has some big, pretty colossal goals and ideas that she wants to implement in this very broken, as you both know, very broken, very fractured system that's just unraveling by the day. And so she knows that in order to get in there, she has to learn the rules and follow them strictly so that she can break them. And so there was, I found this, even though, for the most part, throughout the show, you don't see too much, she doesn't express too much, but her character, her personality, her inner life is expressed in the most subtle ways, the way she touches and connects with patients or with other doctors, the way she's constantly encouraging, you know, her residents, her students. I love Noah, but despite Dr. Robbie's, you know, consistent, incessant condescension, the way she handles him, the way she deals with him, she's not a last word freak. She lets him have it because she knows she sees the bigger picture and she sees what's at play here. You know, it's not her first rodeo. And she knows what she's worth, which is what makes it devastating when she's challenged or shut down, ultimately, in that interaction with Dr. Robbie, when she reveals what's going on with her and her health.

Speaker 5:
[21:30] I'm just trying to piece together where does Sepideh Moafi stop and where does Dr. Al-Hashimi start? Because it's just like a seamless blend. But, you know, I think what is incredible is how you portray the subtext of what people with epilepsy are going through, what they're going up against, that tension, and the scene in the car. I mean, we messaged about this, like that hit me on a deeper level because I see patients who have gotten the traditional treatment, but there's the rest of their life they're trying to take agency of. What type of preparation did you go through to be like, I'm going to portray the other side of epilepsy that is not talked about, that needs to be?

Speaker 9:
[22:04] I think when you approach any role, there are certain things that you get for free. Certain information or things that you connect with just very naturally. There have been certain roles where I don't even need to do much research or immersion because I'm like, I don't know why but I connect to this deeply and I don't want to get in the way of the work. That was not the case with the medicine, the medical aspect of the show for me because I knew nothing. But there were parts of this character and what lived inside of her that did come for free. But something that I learned about epilepsy through this role was that a lot of people are dealing with this condition and a lot of doctors also deal with this condition, and you just learn how to live with it. It's not necessarily something that's debilitating. I think that we see representations of seizures through more grand mal, tonic-clonic seizures, which are full body. And these subtle seizures that Dr. Al-Hashimi has, they're little moments where you space out. I mean, and she says in episode 15, people don't notice, they think I'm being thoughtful. And so she's been able to hide this her whole life. And so having that knowledge and working back into how this influences every aspect of her life, her approach to her work, her world view, her lens on other human beings and other conditions, she lives in such close proximity to her own mortality. And that drives up this urgency of how do I show up every day? And in the beginning, some people were like, oh, it's a bit much, she's in people's faces, but that's because she has this feeling that there's no time to waste. Think about it, experiences that we had when we were three years old or five years old or 10 years old, like little things, we're still carrying in us, like the way that we were bullied or the way that we were spoken to. And having this at age five, how people, and I have a whole host of experiences that I've built out for myself, how her father related to her after this, how she shattered her mother's heart, seeing her mother in pain because of her, and how she wanted to right her wrongs. And part of the reason why she's so high achieving is because she wants to show, to prove that it was worth it, that I will not only deliver a legacy that you are proud of, Mom, but I will carry your legacy as well. So, I mean, there's so many, I'm kind of all over the place with this because there's so much that went into this, the specificity of her own backstory. But then with that specificity comes a universality of experience for not only people who are holding this condition, living with this condition, but also people who have had to hide any parts of themselves and their identities in order to feel like they needed to, they felt like they needed to hide in order to get ahead or in order to thrive in their work or in their personal lives. But the logistical part of it was I just talked to a lot of doctors. I talked to an epileptologist. I watched footage of people. I had access to children having these seizures. So I watched as many different takes of different people with this condition and seizing. And I read a lot of interviews with people who have lived with this condition their whole life. And something that moved me deeply was that it's not having control or authorship over your experience, not being fully present and then going away for however long, 15 seconds, 30 seconds, two minutes. And sometimes people finding themselves in these dangerous situations where they're in water and they wake up and they almost drown or they're cooking and they're hands on the stove or that it seems somewhat harmless. But what if you were driving? What if you're driving? So these are real life dangers. And part of the reason why she wants AI because there are human blind spots, not just in people who have seizures, but doctors like you all deserve to be human and have blind spots and have off days where you don't sleep and are tired and might miss something. And so she sees this as an opportunity to correct or to reduce human blind spots with obviously the strict supervision of the doctors and clinicians and everything.

Speaker 5:
[26:55] That was poetic.

Speaker 4:
[26:56] Wow, sorry.

Speaker 5:
[26:57] No, it was incredible.

Speaker 9:
[26:58] No, it was great.

Speaker 5:
[26:59] No, it was amazing.

Speaker 4:
[27:00] Wow, okay, I love that. I love the idea of her living in such proximity to her own mortality and how that really impacts that she moves throughout the ED, but also throughout her life.

Speaker 9:
[27:09] Yes.

Speaker 4:
[27:09] I'm curious from there, how do you think that Dr. Al-Hashimi as someone who has a real love and respect for perfection, but also understands that people are not infallible. How do you think she thinks about the Santos-Lengdon dynamic, where Dr. Robbie removed Lengdon from the ED, but still brings him back and he's kind of keeping him at a distance. But I don't know, how do you think she observes that conflict?

Speaker 9:
[27:39] I think the problem is not that he has this addiction. The problem was that they hid the fact that he was stealing drugs, and this is a felony. The fact that he hid it and kind of just slipped it into conversation and then threw it back on me, on my face. I think that's what was problematic for Dr. Al-Hashimi. I don't know. I think she has to deal with Langdon pretty soon after, and she's taken aback. She hasn't been able to process what has happened and what this inform... You know? And so she kind of... She draws some boundaries with Langdon because she doesn't know what to do. So it just creates like all of these threads come loose, and she doesn't quite know how to keep this thing in tact anymore. She's thrown off guard.

Speaker 4:
[28:33] No, I like that. I think it definitely makes sense that this is a moment more in her relationship with Dr. Robbie than in anything else where she feels like... I mean, if I'm putting words in your mouth, tell me that she's so perfect and so precise and seeing kind of Robbie's sloppiness with this situation, like I think kind of offends her.

Speaker 9:
[28:52] Yeah, and I don't think she's perfect, and I don't think she thinks she's perfect, but she strives for perfection, you know? She strives to make things... And she knows that we're human beings, if she didn't learn this in the healthcare system in the US, she learned it abroad, that we are stitched together as healthcare workers, we need each other. It is more than any other profession, I'd say, it is, it relies on interdependence and communication and teamwork. And so this idea that one person holds the ER is just false.

Speaker 4:
[29:30] How would you say that Dr. Al-Hashimi would assess her first day, based on that standard of wanting to show everyone the collectiveness of this effort?

Speaker 9:
[29:39] Her first day, like when she walks in, or her first day, hour 15? I think it's probably the worst. Well, for all the characters, we all have had the worst day. I mean, when we were shooting all of these scenes, it was really important for Noah and I to just like connect and make contact as actors. So that always, whenever you're doing emotional stuff, it's important to make sure you have each other. And it was really lovely to have Noah on the other side of this, who was just so open and generous emotionally as an actor, so that he could be kind of harsh and kind of mean as the actor, you know? And there was no sort of conflation of that on set. It was very separate and compartmentalized. We yelled cut and we were joking and telling stories and all that, and then we get in and go to the deep end. I haven't seen these last few episodes yet, so I don't know how they cut it or what takes they use, but I just remember doing that scene. It was so fucking intense. We did the first rehearsal and the entire crew was like clapping because it was just everything that we've held in, everything that, especially for her. As a woman, you, and I really don't mean to make everything about gender here. It's just the fucking reality. You have to present yourself in a certain way to be taken seriously. And if you were too emotional, too expressive, talk too much, whatever, then it's like, oh, she's hysterical or, oh, shut her up or, oh, this is too much. And so for her to finally be able to just rip into him a bit and be like, I am not your fucking patient. Do not treat me like your resident. Do not treat me like your fucking patient. Have some fucking respect and pull the line about Langdon in too. And that's at the root of this Langdon issue too, is that it's so much about the injustice of you will cover up a felony for this person. And you won't even accept that this trained professional, the neurologist says, I can work with double coverage, which is usually the case. I mean, correct me if I'm wrong, but usually you have double coverage. You have more than one attending in the hospital. So the fact that he's, you know, so it's not unusual. And so for her to say that, for him to be like, nope, you can't do it. I'm gonna expose you. I'm gonna tell everyone is like, what is happening? This is everything that I've fought against my entire life. And the fact that I can just be reduced to that. Like you are sick and you can't work after everything that I've done, after everything that I've shown, after everything that I've proven, all the ways that I've proven myself is-

Speaker 4:
[32:52] Just in the shift too.

Speaker 9:
[32:53] Just in the shift is devastating. But I mean, the reason why I get emotional is because of her struggle, but because of how it represents so many people's struggles. Wow.

Speaker 5:
[33:05] Oh my gosh.

Speaker 4:
[33:06] No, this has been phenomenal.

Speaker 5:
[33:07] One of the more powerful interviews we've heard.

Speaker 4:
[33:09] We cannot thank you enough.

Speaker 9:
[33:10] No, thank you.

Speaker 5:
[33:11] We so appreciate you.

Speaker 9:
[33:12] Thank you.

Speaker 4:
[33:15] I'm happy that we had Sepideh on because no one, I think, has been more controversial this season, other than Dr. Robbie, obviously, then Dr. Al-Hashimi. She got a lot of heat at the top of the season, even from us, a little bit, the charting with Santos.

Speaker 5:
[33:28] A little bit of that.

Speaker 4:
[33:30] Yeah, a sprinkle. A tough love. But I'm really happy that we got to hear from her to close out the season.

Speaker 5:
[33:34] She represents something very important with women in medicine, but she was also pivotal in raising awareness about so many topics that The Pitt has managed to do in just 15 episodes. One thing I'm really curious about is, obviously, the show was designed in a way to reflect the nature of what's happening in health care, but the show has created such a buzz, and I'm so curious to hear from the two executive producers, John Wells and R. Scott Gemmill, about their thoughts heading into the season, and now what their thoughts are now after seeing the reaction. Let's go outside the pit and talk to the two EPs.

Speaker 1:
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Speaker 10:
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Speaker 5:
[35:12] Thank you for being here.

Speaker 3:
[35:13] Well, thanks for having us.

Speaker 8:
[35:14] Thank you.

Speaker 5:
[35:15] Full circle moment. A few months ago, we were talking to both of you before this show premiered, and the season opens with Dr. Robbie driving a motorcycle without a helmet. Then the season ends in this very heartfelt moment of Dr. Robbie holding the abandoned and precious actor of the year, Baby Jane Doe. A lot of symbolism here. Why is this how you chose to end the season in this moment?

Speaker 3:
[35:41] I think it was showing Robbie's journey and his own confusion about what he's going to do. The idea was, it was a crazy idea, but to have that baby for the whole season, and not ever find out what happens to it. Because that's sometimes what happens in the ER, and the ER docs don't always have closure to the cases they have. And I think it's sort of symbolic of what Robbie's going through. He doesn't have a closure that he's seeking. His whole sabbatical is about that. And it just seemed like an appropriate way to end without knowing what's going to happen to either one of those two individuals.

Speaker 8:
[36:32] We should probably also say that it's the actors of the year, because there were 12 separate infants. Because we don't shoot it in one day, so they kept getting bigger on us. So the ones from the first episode were too big. Yes. For the middle episodes, the ones from the middle episodes were too big. For the last episodes, at each time we did it, we had four different infants, two sets of twins that we traded off. We have very limited time on the set with the babies that are that small, so.

Speaker 5:
[37:00] That's great trivia. So when the Emmy is given out, there's going to be 12 babies on stage. I love it.

Speaker 8:
[37:05] They'll all be smoking cigars now. Right now. Knocking back beards. They're all like two years old. I love it.

Speaker 4:
[37:12] A new sag ensemble, you can say. In this finale, you really lean into the ambiguity. We don't know if Robbie is going to go on the sabbatical. We don't know the status of Dr. Al-Hashimi's health. Can you tell us how you think about leaning into this ambiguity over providing neat and tidy conclusions for every single character in every single case?

Speaker 3:
[37:33] Yeah, I think that's just the reality of life, and we try and be as truthful as we can in what we put out there. I think you don't always get the answers you're looking for, the closure you want. I think for some of our characters, that's part of their struggle is we don't wrap everything up in a nice bow at the end of the shift. I think that's just part of being truthful in the storytelling.

Speaker 8:
[38:00] I also think it's part of the reality of what you can do during the course of storytelling for one day with these characters. So people don't come to full resolutions about the issues in their lives over a 12 or 15 hour day. And so being truthful to the narrative.

Speaker 3:
[38:16] Yeah, that's true.

Speaker 8:
[38:17] Yeah.

Speaker 4:
[38:18] I have a question about, thematically, leadership has come up a lot this season with Dr. Robbie literally handing over the keys to the ED to Dr. Al-Hashimi. But also how to be a leader and how much pressure that puts on Robbie and as he comes to learn this season. Can you sort of tell us what truths or what you wanted the audience to think about or maybe how to challenge them in thinking about leadership and mentorship?

Speaker 3:
[38:43] Boy, that's a tough one. You know, I think, I don't think of it in terms of that specifically. It was really about Robbie's journey, but I'm sure that's part of it, you know, in terms of his, you know, part of his angst was leaving the ER in someone else's hands, you know, and some of that's legitimate and some of it's ego, you know, that he's, it's, he considers it his ER and even Al Hashimi sort of takes him to task on that at one point, because he keeps saying, my ER, my this, my that. But I think he takes so much ownership in the hospital and specifically his emergency department that, you know, he's, he's reluctant to, to leave. And part of that, I think, is his own insecurity. I think Robbie has gotten to a point where his, his whole life is wrapped around the emergency department. And outside of that, I think he has a sort of a, a crisis of consciousness in terms of what, who he really is, you know. He sees himself as a doctor. And I think a lot of his personal life has suffered because of it. And part of season three will be about seeing him trying to re-engage with that aspect of his, his life.

Speaker 8:
[40:04] Yeah, I think we also live in an era when whatever your political persuasions were suspicious of leadership. And, and I think that part of what the show is doing well is simply showing simple integrity and leadership and competency and leadership over science. And we have real questions about competency and science and everything that happened to everyone throughout COVID. And so the show being able to kind of just say here are competent people who are have training and who are experts at what they do. And they're trying to, they're, they're not infallible, but they're trying to show that they care is important sort of thing to put out into the world.

Speaker 5:
[40:46] Were there any episodes or moments where you both were curious to see how the audience would react? What the reception would be? What the debate would be?

Speaker 3:
[40:54] I think we feel that way. Almost every story we tell to some extent. It's certainly how the ICE episode was going to be received. That was, you know, there were some questions about how well that was going to go over. But I think, I think we did a very fair and accurate portrayal. And I think the reception was, in most cases, fairly benign. I think people thought we did a good job, but it wasn't as controversial as we had maybe thought it could have been.

Speaker 8:
[41:26] Part of that's because we shot it before what happened in Minneapolis. So in, you know, contrast to what happened, you know, a few weeks after we actually shot it, it seemed fairly mild. But the issues are real. You know, there have to be places in which sacred spaces, which can't be intruded upon by by immigration custom enforcement, no matter how appropriate it is, whether you believe that they should be enforcing or not enforcing, we have to have spaces for all of our health, for all for public health, where people can go and be seen and not be afraid, or else we endanger everyone. And I think there are a number of issues like that, that the show has tackled thoughtfully and tried to show a lot of different points of view. But ultimately, what's happening in the country, the difficulties that are going to now, we're going to start to see more and more with the loss of rural hospitals, with people, because the work requirements, people no longer being able to get Medicaid. That's all going to fall on the shoulders of the public health system and particularly the urban public health system. So you're going to continue to see a lot of discussion of that because it's a real thing. It's not something we're making up. It's not a political statement. It's the truth about what some of these choices that we've been making as a country. What the truth is about the impact that it's going to have on the people we expect to actually take care of us.

Speaker 5:
[42:52] There's a bittersweet insight to the show. There are people who didn't know what a sane was and didn't know how sexual assault survivors are treated in ER. So the show's done a lot to amplify this conversation and it's been amazing, I can say, to see all the articles that have come out about these topics. The show's almost predictive of what the national conversation is going to be, and that is a nod to the writers and the people who are putting in the time.

Speaker 8:
[43:18] The research, the extraordinary amount of research you do.

Speaker 3:
[43:20] Yeah. I think it's really about when we talk to all the experts and ask them, what keeps them up at night, what messages would they like to be out there? When they tell us what's bothering them, what they worry about, all we do is extrapolate it to the next stage, and that's how it sometimes seems like we're a little omniscient with the vaccine, the measles outbreak and things like that. But those were inevitable if you talk to the experts, it was just a matter of time.

Speaker 4:
[43:53] I do have to ask about secretly one of my favorite moments, Doctor the fuck up from Robbie to Langdon. Can you tell us about that little moment?

Speaker 7:
[44:04] It is progressing, Doctor Langdon. What is your plan? This is right here, right now. This guy is going to be a living head if we do nothing. I could paralyze him. Doctor the fuck up.

Speaker 3:
[44:15] Yeah, that was supposed to be in the first season and never got around to it. I just wanted to say that to somebody because I thought it sounded cool. And we really wanted, you know, part of Langdon coming back after rehab was having some ring rust on him and not sure if he's ready to be back and really seeing him sort of lose his confidence and flounder a little bit and then having Robbie really push him almost to the point of being inappropriate, you know, I think at the time you're wondering if Robbie's being an asshole to him, you know, and he sort of is, but he's also, I think he thinks and he knows that Langdon pulled this off and if he doesn't push him to get past this fear, he's never going to, you know, he's going to be months or he may never get back there. So the real reason was Robbie pushing Langdon to get out of his comfort zone and, you know, realize that he is a good doctor and he can be back, get back on the saddle, back in the saddle. The doctor the fuck up was just something I had in my back pocket for a long time, just waiting to drop it.

Speaker 4:
[45:23] What a line to have in your back pocket. I love it.

Speaker 8:
[45:26] Exactly. One of my favorite things was in the pre-Eclampsia that turned in the Eclampsia story. You had those greatest sides from Abbott about how many women actually die as well.

Speaker 3:
[45:40] Oh yeah, life expectancy.

Speaker 8:
[45:46] And the position in this episode isn't that women shouldn't use birth doulas or midwives or anything. It's that you have to have prenatal care, and you have to be aware of the dangers. And there's a lot online. You're talking about this in the same way people talk about raw milk. I've just given you some of my opinions in one sentence. But there are real dangers. And there's a reason why if you go to cemeteries, a hunt that have tombstones 100 years ago, about a third of them are infant that don't even have a name on it. So loved all of that that you wrote.

Speaker 5:
[46:27] We were so impressed by throughout this season. I mean, so many different character arcs and stories, but the medical procedures and learning from the prop department, the designers about how these procedures were actually done. I know you can't pick favorites, but do either of you have a favorite medical procedure or procedure that when you finally saw it on camera, blew you away this season?

Speaker 3:
[46:50] Well, I think the emergency hysterotomy was pretty impressive that we did in 15, and that took a lot of time. It's so easy for me to write it. It's so hard for him to direct it. So I feel a little badly because that took a long time, but it was, I mean, how many people? I mean, it takes-

Speaker 8:
[47:12] Dozens.

Speaker 3:
[47:13] Dozens of people to pull that off. The craftsmanship, and we have great doctors, Dr. Joe and Dr. Mel, they were helping us and our doctors who are on the set, who make it look so realistic. But there were problems with where we put the goop on the silicone baby, and then when we put them in the amniotic sack, then all the amniotic fluid would wash all the gunk off. Then they had to figure out a way to put gunk on the baby, and keep it on the baby within the sack, and it's all these things you never think of.

Speaker 8:
[47:46] We had four uteruses, and so we could only cut them so many times. Sometimes we weren't cutting, we couldn't actually get through the uterus. So we actually had to punch a hole in it, then pretend it wasn't there and try and keep it in, and then cut it. Yeah, it looked great.

Speaker 3:
[48:01] Yeah, it was a magic of television.

Speaker 8:
[48:03] But it took about three days to do.

Speaker 4:
[48:06] Oh, incredible. This is my last question. I want to know, what can you tell us about season three, if anything, or where are you in the prep stages?

Speaker 3:
[48:16] We're just sort of in the beginning. All the writers would just let him go for the day. It's going to be about Robbie returning, what has transpired in the time he was away, what's his journey moving forward, and we have a lot of things planned for everybody. But we're still in the sort of initial stages of figuring things out, but it's going to be a good year. We got some really fun stuff planned. The process right now is, this part of the season, is where we do talk to all the experts, in every kind of aspect of medicine that we're interested in portraying, and new stories, and life goes on in the Pittsburgh Medical Center.

Speaker 5:
[49:02] This medical professional feels seen, and I've never been more motivated to doctor the fuck up, so thank you both.

Speaker 4:
[49:10] Thank you, guys.

Speaker 3:
[49:11] I appreciate that. Thank you.

Speaker 5:
[49:13] Incredible. Thank you, and congratulations. I hope there's a little bit of a moment to raise a martini and chill for a bit before everything gets out of hand.

Speaker 3:
[49:19] I like that idea.

Speaker 5:
[49:23] Amazing hearing from John Wells and R. Scott Gemmill, but we have some end of season reflections to Hunter Harris, culture critic extraordinaire.

Speaker 4:
[49:32] Okay.

Speaker 5:
[49:33] I'm curious if we just have a couple of moments here to talk about some little highlights from the season. The first question, are there moments or details from this season that now when you look back on them, feel more important than when you first saw them?

Speaker 4:
[49:47] I think the big one was Robbie asking what occurred, a house set for him. Because in the moment, I was, listen, thinking about what he said, like that throwaway line about Abbott doing naked yoga. That was funny. But I feel like if you're a very attuned watcher, that was maybe the first instinct, the first suggestion that maybe Robbie isn't planning to come back from this motorcycle trip.

Speaker 5:
[50:12] That was a good one. My three quick ones. I think the generative AI was so much more than a tech conversation and tapped into this humanity and medicine and human's role. An obvious answer I feel like is Dr. Robbie with no helmet. I didn't realize that was going to be such a pivotal foreshadowing, heading to episode 15. But then also, baby Jane Doe. Not only does she get the scene with Dr. Al Hashimi's first seizure, she gets Santos in there singing the lullaby. She gets, pediatrics makes an appearance finally in the show, a very short-lived appearance. And then, you know, she's got this pivotal moment with, with Dr. Robbie when he opens up to her. This is why she gets the Oscar for Best Supporting Actor.

Speaker 4:
[51:07] Well, no Oscars for TV, but totally.

Speaker 9:
[51:10] I like what you're thinking.

Speaker 4:
[51:11] I mean, but no, I like that she's kind of in the through line through which we kind of can track people's emotional well-being growth this season.

Speaker 5:
[51:20] I got another one for you.

Speaker 4:
[51:21] Okay.

Speaker 5:
[51:22] From your perspective as a TV writer, culture critic, are there, is there anything that you took away from this season? Anything that's going to influence how you approach or judge other shows?

Speaker 4:
[51:35] I like that The Pitt is not a show that, um, there aren't really like alliances or allegiances. Like they really keep you guessing about every person. And I like the idea that, you know, Dr. Santos can be like one way one episode, and then can kind of redeem herself that Mel can be, you know, really freaking out over Becca having sex. But then again, you see like the inner loneliness that she's maybe covering up. Um, it's like a very, I think that's how real people are. People are good and bad at the same time and make mistakes and are, um, fallible and I think The Pitt does a really good job of showing that kind of nuance. Okay, question for you, Uno Reverse.

Speaker 5:
[52:14] Uno Reverse.

Speaker 4:
[52:15] Is there something that you've seen on The Pitt or in thinking about this season that might change how you practice medicine, how you approach patients, or even in your healthcare advocacy work?

Speaker 5:
[52:29] Oh, good question. I don't even want to say might change. I will say has changed. Healthcare advocacy work, in my practice as a physician, everyone in The Pitt is so real with their patients, and they speak to them like they're their friends. They open up to them. They share normal stories like that. Just reminded me, just be a human. We're not talking down to people, we're all racing the same race. Favorite procedure?

Speaker 4:
[52:52] Oh, has to be the slash trach or the, oh my gosh, what is the thing with Langdon and the neck?

Speaker 5:
[53:00] Oh, the cervical spine reduction.

Speaker 4:
[53:03] Yes, yes, blind, closed. What is the phrase for it? Yes, that was incredible.

Speaker 5:
[53:08] I feel like mine is cliche because it's the season opener with the open thoracotomy and the hyler flip. But you see it and you're like, this is amazing. This is a great setup. But then as we did the podcast, I started to appreciate that scene more. Not only does every character have some type of small role in that scene, you get a little bit of character development. There's so much detail to that scene. That was like television and medical perfection.

Speaker 4:
[53:35] Okay. Last question. What do you want to happen next season? Who do you want to see? What do you want to see?

Speaker 5:
[53:42] I'm excited to see. From season one to season two, everyone basically went up one year in training. I'm excited to see what fellowship people choose, what residency, what's going to happen with Javadi, where's Ogilvy going, where's Joy going? Are they still going to be sticking around? Is Dr. Robbie coming back? There's these questions. I'm also excited to see how The Pitt continues to elevate conversations in healthcare. I'd like to see more conversations about women in medicine, but I don't know what shenanigans they're going to bring up this time. I wasn't expecting a waterslide accident or a cyber attack.

Speaker 4:
[54:12] Yeah, no one was. I think that I want to see, I really like the sort of non-medical characters on The Pitt, like the security guards, like the, I mean, they are in medicine, but the ambulance drivers. All of those characters, I think, they really build out the world of the show, environmental services in a way that I think is, really shows how, as Sepideh was saying, it's like a community effort. Medicine is something that we're all doing together. It's not just one person's ED.

Speaker 5:
[54:40] I think that's so, I think what you just said is actually, there's no right or wrong answers, but I think that's the right answer. Like that's actually what the answer should be, is the show's done such a great job of highlighting characters. And I totally, totally commend you and agree with you there, because I would love to see more of the pharmacists, the respiratory therapists. Peds, you had like two minutes in the show, like show up, go see Baby Jane Doe.

Speaker 4:
[55:03] Okay, well, I also want to see, I want to see more of Javadi coming into her own and thinking about mental health, especially because I mean, there needs to be multiple interventions in that ED. And I think she's the woman who can change it.

Speaker 5:
[55:20] She's the one who starts the program. Hunter, when I first told people about the podcast, everyone just kind of said, oh, it's going to be like a medical podcast where you explain things, but it has been a sincere joy with you. Thank you for keeping me in check. Tell me when I'm boring. Tell me when I actually sounded like a real doctor, but also for adding so many layers about the culture, the complexity and the characters to this show.

Speaker 4:
[55:40] Oh, thank you. Alok, I've had the most wonderful time getting to know you. You are my favorite doctor. Beyond Dr. Murphy, my pediatrician who I still adore and my dermatologist, but don't tell her because I need to see her next week.

Speaker 5:
[55:51] I'll take third place in that list all day long. Thank you for being effortlessly cool, also.

Speaker 4:
[55:56] Well, thank you for really being patient because I don't know anything about medicine, and I am so thrilled that you are such a patient and kind teacher.

Speaker 5:
[56:03] Fist bump. That's it for today's episode of The Pitt Podcast. That's it for the entire season. I can't believe it's already over, but this has been a passion project. It's been amazing. We've loved hearing from all of you, not only about The Pitt, the podcast, but about health care in general. This community is awesome. We hope we'll get the chance to do it again next season.

Speaker 4:
[56:24] You can watch us on HBO Max or listen wherever you get your podcasts. The Pitt Podcast is a production of HBO Max in collaboration with PRX. The executive producer of PRX is Jocelyn Gonzalez. Our managing producer is Courtney Florentine. Our editor is Lucy Perkins. Our production managers are Ebuda Choa and Tony Carlson. Our video producer and editor is Anthony Q. Artis with assistant editor Damon Darrell Henson. This show is engineered by Tommy Bazarian. Special thanks to Joe Carlino.

Speaker 5:
[56:55] The executive producer of HBO Podcast is Michael Gluckstadt. The senior producer is Allison Cohen Sorokach, and the associate producer is Aaron Kelly. Technical director is In-Sung Kwong. Special thanks to Podstream Studios, Kristin Martini, HBO Max Concept and Design Studio, Emily Servo DiDio, and Ian Fox. I'm Alok Patel, and I'm Hunter Harris.