Photo: Warrick Page/Max
Time check: It’s 11:00 a.m., and not surprisingly, the Pittsburgh Trauma Medical Hospital is running in chaos. I mean, it’s controlled chaos — In Dana We Trust and all that — but there remains a lot to keep track of as the day progresses. And yet, much like the way these patients are weaving in and out of the E.D., and everything feels under control within the world of the show, all of these storylines we’re following feel well controlled, too. The writing on this show is just really, really tight. Consider the writer of each episode — this week it’s Simran Baidwan — our own personal storytelling charge nurse directing the flow of traffic in each episode.
Speaking of, while The Pitt mostly aims to give us a realistic look at life inside a busy, underfunded hospital rather than build thematic ties between patients or storylines like perhaps some other medical dramas aim to, I did appreciate the choice this week to juxtapose two wildly different intubations for us. It is the same treatment but done in starkly different ways.
In one room, there’s Travis. The teen is having a post-tonsillectomy hemorrhage which, I will be totally honest, is not something I ever thought about possibly happening before this moment. Now it is something I will never not think about when I hear someone is getting a tonsillectomy because, babes, one minute Whitaker is helping Travis suction a minor amount of blood coming out of his mouth, and the next …well, that kid blows wide open. Why, yes, Whitaker does need a new set of scrubs! There is so much blood. There is so much blood, in fact, that Langdon can’t see what’s what in his throat and is unable to perform a standard intubation to give Travis an airway. While Dr. Garcia immediately wants to perform a crike — how very surgeon of her — Langdon and Robby, Team Emergency Med, are fighting to keep this non-surgical; Robby has a thought: They should do a retrograde intubation. Basically, Robby will come up from the bottom of Travis’s throat with a guard wire, helping Langdon orient himself from above to perform the intubation. If it sounds a little wild, well, it’s definitely not the standard way of doing things.
Throughout this emergency, we cut back and forth to Joyce’s intubation. Joyce is Dr. Mohan’s sickle cell patient. The transfusion that was supposed to help oxygenate her blood isn’t working, and she’s becoming dangerously hypoxic — she’s at risk for stroke, heart attack, and death if they don’t intubate. While it’s not coughing up a gross amount of blood and needing to “Macgyver” an intubation, this treatment plan brings its own issues. Mainly, it seems it would be terrifying to be put to sleep knowing you’re going to wake up with a tube down your throat. Joyce and her wife, Ondine, are understandably scared but appreciate Dr. Mohan’s guidance through the entire thing. You know who doesn’t exactly appreciate Samira’s relationship with Joyce? Robby. Once again, he’s all over his third-year resident for being a patient’s friend rather than their doctor. Joyce is running out of time, and Samira needs to push a little harder to get her to agree to the intubation.
Well, wouldn’t you know, in the end, it’s precisely because of the time she took to put Joyce and Ondine at ease that they agree to the procedure and, you know, that they make it through the whole ordeal without spiraling. It’s Dr. Collins who oversees the intubation once Robby is pulled to help with the tonsillectomy hemorrhage, and she actually commends Samira for how much she cares about her patients. It’s what makes her a good doctor. The Pitt has offered up several different mentor/mentee configurations to compare, and watching Samira and Heather interact in this episode has been a good addition to the mix.
Their relationship certainly seems to be less contentious than that of McKay and Javadi, who share a tense moment when Sherry, the unhoused mom who burnt her hand on a sterno, returns. Dr. McKay can see how much Sherry is struggling. McKay opens up about her rough past to comfort her and make sure she remembers that not everyone has it all figured out. She’s an addict who lost custody of her son for a while. She’s been sober nine years now and is hoping to get joint custody once her ankle monitor is removed next week — she doesn’t get into details with Sherry but calls it “a misunderstanding.” Like Samira, Cass is trying to connect with her patient to build trust. Sherry finally breaks down, admitting to how bad things have been and Cass reminds her that she deserves to give herself a little grace. But just as all that goodwill is built up, Javadi swoops in and immediately starts talking to Sherry about meeting with a social worker. Javadi is only trying to help, but a fragile Sherry sees it as a violation — she can’t believe she ever trusted Dr. McKay, and she takes off. McKay has some words for Javadi. Those words include some about learning about “impact over intent” and some about listening to patients instead of judging them. Javadi gets her back up and swears she isn’t judgemental, but McKay scoffs: She’s seen the way Javadi has been looking at her all day. McKay isn’t one to just walk off in anger, though, and she reiterates to the medical student that she isn’t trying to reprimand her; she is just trying to help her become a better doctor. Javadi could do much worse than having McKay as a mentor and she should remember that!
Maybe one day those two will have a relationship like Robby and Langdon, who we already know are friends, but in this episode we get to see more of the mentor/mentee dynamic. When the guys are successful with that retrograde intubation, they are ecstatic. Have we seen Robby be this proud of one of his doctors yet? Like Heather and Samira, Robby is effusive in commending Langdon for the way he held it together throughout a crisis like that. He even tells him that he’s already recommending him for an Emergency Medicine Fellowship. Admittedly, their dorky little fist bump is kind of cute.
Also cute? The eyes Robby and Collins are making at each other. We get confirmation that yes, as suspected, Robby and Heather used to date. When Dana, who catches the flirty eye thing and who, like us, has some questions, asks Collins about it, she firmly tells her that no, she will never be revisiting that situation. “Settle down, Jane Austen,” she tells Dana, who is not wrong to point out the whole “never say never” of it all. You know Robby is going to find out about Collins’s pregnancy before this shift is through, and I, for one, cannot wait to watch his reaction, whatever it may be.
So why are these old flames making eyes in the first place? Well, we should talk about our 17-year-old medical abortion patient, Kristi. Last week, Collins took on her case after Kristi had met with Dr. Abbott the day before. If you recall, Collins had to redo the ultrasound before administering the mifepristone and found something amiss. This week we learn why she looked a bit confused: It looks like Kristi is 11 weeks and a few days into her pregnancy and yet Abbott’s measurements of the fetus had it at just over 10 weeks. This is a big deal because legally, they can’t prescribe a medical abortion past 11 weeks. Kristi has missed the deadline by mere days. When Heather presents this to Robby, they both realize that Abbott fudged the numbers in order to help Kristi terminate her pregnancy. They both want to follow suit and help their patient, but Heather’s scared of the ramifications if she gets caught falsifying hospital records. She could get kicked out of the residency program, but Robby, who has tenure, has much more leeway here.
He does not hesitate one bit to take this off of Collins’s plate. This, of course, means he has to go give Kristi another ultrasound, delaying treatment, but he tells her and her mom that there was a computer glitch and they lost Dr. Collins’s note and, good news, Kristi is just one day shy of 11 weeks pregnant so they can move forward with the medical abortion. The look of relief on Kristi’s face is palpable. And this is why Dana catches Robby and Collins making nice. He came through in a big way for both Collins and Kristi.
Well, almost for Kristi. Just as Collins is handing over the meds and explaining the process to the teen and her mother, another woman comes running in screaming for Kristi. Turns out this is Kristi’s mother, the other woman is Kristi’s aunt, and Kristi’s mother refuses to allow her daughter to have an abortion. Something tells me this story has only just gotten started.
• Robby has a 17-year-old son named Jake! And Jake has a girlfriend who he’s taking to the big music festival he was supposed to go to with his dad. What do we know? Robby and Jake seem to have a really nice relationship. Robby and Jake’s mom are definitely not together anymore, but based on the fact that she had Jake ask Robby how he’s doing because of Adamson’s anniversary, it seems like it’s at least amicable?
• Everyone at the hospital really wants Jake to have safe sex, which is great. The recurring gag in which multiple people hand Jake a condom? Also great.
• Oh, okay, Princess! She tells Jake about going to Lollapalooza when she was younger and having the best sex of her life under a blanket with a guy who looked like Dave Navarro. Princess rules.
• I’m crossing my fingers that this whole thing with Mel’s elderly patient, Ginger, is not what it looks like. What it looks like is that Ginger, who has schizophrenia, was just abandoned by her daughter and full-time caretaker, Rita. Rita is clearly exhausted and overwhelmed, and when her mother falls and breaks her arm, she’s worried it will just be too much. Mel, who we learn was the full-time caretaker for her sister, who is now in a nearby facility, tries to remind Rita to take a break — Caretaker Fatigue is a real and dangerous thing. When Rita doesn’t return from parking her car, Mel worries she might have misconstrued her advice and run off when she had the chance.
• My concern about Doug Driscoll grows with each passing hour. He looks like someone who will turn violent with very little hesitation. Kudos to frequent flier Earl, though, who shuts down Doug’s waiting room complaints by explaining that yeah, the doctors need to check your vitals every four hours, ya big dummy.
• Another growing concern is the tension between Trinity Santos and Frank Langdon. This time, while working on the patient found seizing in the waiting room during the previous episode, they disagree on a treatment plan. She wants to move on to new meds when the typical amount of lorazepam doesn’t stop the seizures, Langdon says give him a little more. She also has issues opening the vial of the anti-seizure meds and thinks it could hint at a larger issue. Langdon’s extra lorazepam order works and he once again lays into Trinity about trusting her senior residents. Something is bothering her about that vial, though, and she won’t drop it. I don’t think this is going to end well. But for who? Trinity? Langdon? A patient???
