Medical drama “The Pitt,” now concluding its second season, has exploded in popularity with both viewers and critics. The frenetic Pittsburgh-based serial is the latest in a long line of TV doctor dramas dating to ABC’s “City Hospital” in 1951.
But unlike many of its predecessors, “The Pitt” keeps its pulse squarely in the emergency room. Each episode charts one hour of a work shift at a teaching hospital as doctors and nurses triage a cavalcade of calamities.
UVA Today assembled a “Pitt”-like cast from UVA Health University Medical Center’s emergency department to diagnose the shows they like, and which ones make them reach for the remote, stat!
What is your favorite medical TV show and why?
(Photo by Lathan Goumas, University Communications)
Dr. William Brady, attending physician: My all-time favorite medical TV show is “St. Elsewhere,” a 1980s drama focusing on the daily challenges and lifestyle of interns, residents and attending physicians in a fictional Boston hospital.
Another big favorite is the 1970s TV show “Emergency,” which focused on the LA County paramedic system and a fictional hospital with nurse/doctor challenges in the ER. This show really helped develop the idea of the paramedic and advanced-level prehospital care, as well as the concept of dedicated emergency department physicians and nurses.
“The Pitt” is interesting to watch. It is still a bit new, so I will hold off on my final determination until I have finished Season 2. But I feel exhausted after watching an episode because of the show’s realism.
(Photo by Lathan Goumas, University Communications)
Tracy Ohlinger, ER charge nurse: “Scrubs.” I loved this show. I enjoyed J.D.’s (series protagonist Dr. John Dorian) narration throughout the show, along with his constant daydreaming. I related to his character.
J.D. was able to function through difficult situations because he found humor in them. There were even times that, although it was a comedy, it was extremely heartfelt with deep emotions. He always seemed to reflect at the end of the show with truly poignant thoughts. I think it showed the most accurate portrayal of the coping mechanisms we use to survive.
(Photo by Lathan Goumas, University Communications)
Dr. Zunaira Arbab, resident: My favorite medical TV show is “Grey’s Anatomy.” It’s what first sparked my interest in medicine. When I was younger, watching it made the hospital feel like this place where anything could happen: crazy cases, big decisions, dramatic saves. It made being a doctor look exciting and meaningful, and that really stuck with me.
Now that I actually work in medicine, I realize it’s not realistic at all. Residents definitely are not doing half the things they do on that show. But that’s also why it’s fun to watch. It’s dramatic, unpredictable, and every episode feels like something wild could happen.
What show is the most realistic to you?
Brady: There isn’t a show that consistently gets everything portrayed correctly all of the time. “St. Elsewhere” was great regarding the stress and emotional burden that being a health care provider entails. “Emergency” was pretty realistic regarding medical care, particularly that delivered by the paramedics.
So far, after only watching Season 1 of “The Pitt,” I will say that the medicine, resource challenges, patient needs, system demands, etc., are pretty accurate. I think that is why I feel exhausted after watching just one episode. I think I identify too much with what the doctors are experiencing.
Ohlinger: There have been many over the years, but the ones I have found to be most accurate are “Scrubs” and even “M*A*S*H.” Although they are comedies, they seem to capture the true behavior of medical professionals in high-stress, high-acuity departments. It takes a special personality type to consistently work with life-and-death decisions in congruence with some of the most ridiculous complaints and situations.
The job can be emotionally difficult and burnout is high, so you have to be able to find humor and joy whenever able, even while facing sad and depressing events.
Arbab: The most realistic medical show to me is “The Pitt.” I can’t watch it after a busy shift or during a hectic week. It feels too much like being back at work. My brain immediately switches on, and I find myself mentally working through the cases with the doctors on screen, thinking about what labs I’d order, what the next step should be or what diagnosis I’d be worried about.
The show really gets the medicine right. The way they approach problems is very stepwise and mirrors how we think through cases in the ER. A patient comes in, you gather information, build a differential, rule things in or out, and move forward methodically. That part feels very authentic.
Of course, there are still a few things that are a little over the top, like medical students doing procedures completely unsupervised or interns making big cowboy decisions on their own. That’s not exactly how things work in real life.
What do you see on medical dramas that makes you cringe?
Brady: Probably the one issue that makes me cringe is the short time to closure on all of these cases for every patient.
Real medical care, particularly in a busy emergency department, takes time to complete appropriately and correctly. Testing, treatments, consultations, admission and discharge decisions – all of these things take time. Of course, TV shows must compress their pace into a 30- or 60-minute show. The reality of time in a real emergency department may not be that entertaining, at least in a prime-time TV sense.
Arbab, Brady and Ohlinger pose in the ambulance bay. Like a fictional medical drama, this photo shoot was frequently interrupted with ER workers trying to find Ohlinger, and by ambulance drivers who needed the ambulance. (Photo by Matt Riley, University Communications)
Ohlinger: The over-dramatic seriousness. Truly ridiculous. Obviously, there are many serious discussions among physicians, nurses, dying patients and their families; however, more often than not, the emergency team is just trying to provide high-quality care in a chaotic environment. Staff does not walk around in a perpetual state of dramatic importance and weightiness to every patient complaint or situation.
High census, no beds and angry patients is a norm, and navigating each day through these regular trials requires a good sense of humor, teamwork and the ability to find the good in others. At the end of the day, you want to be able to say you provided the best care possible to each patient.
Arbab: One thing that always makes me cringe on medical dramas is when one doctor is portrayed as the “king” of the hospital, making every decision alone and barely acknowledging the rest of the team. In real life, medicine is incredibly collaborative. All the nurses, respiratory therapists, pharmacists and consultants play a huge role in patient care. When shows ignore that and make it look like one heroic doctor is doing everything, it just feels very off.
Another thing is the dramatic “hero save” that ignores every protocol. Someone suddenly invents a completely new intervention on the spot, and it works perfectly. In reality, medicine is much more systematic than that. We rely heavily on evidence-based guidelines and stepwise approaches because they’re designed to keep patients safe.
Does the UVA Health University Medical Center ER have a nickname, similar to “The Pitt?”
Ohlinger: I don’t think we have one, but open to suggestions!
