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The Pittis the television darling of 2025 and rightly so.
It successfullyreinvented the procedural for the streaming age.
Its hyperrealistic portrayal of what a hospital emergency department actually looks like isresonating with medical professionals everywhere.
And it reminds the masses, once again, that Noah Wyleis a babe.
The Pitthas been described as being perhaps the most realistic depiction of what an emergency room looks like.
Does that ring true to you?Absolutely.
Hes eventually depicted as suffering from schizophrenia, but he also comes off as an uneasy spectacle.
Hes presented as a problem to be dealt with, not a person in distress.
Everyone is trying to forget about him.
Its so theatrical and dramatic.
Its nothing that resembles the kind of treatment we aim for in psychiatric emergencies.
I thought it was really dehumanizing.
But sometimes its more subtle.
In that case, theyll be referred to psychiatry.
Im usually in the ER, but there are some hospitals that dont have a dedicated ER psychiatrist.
We help to discharge them or decide if the person needs to be admitted to the inpatient mental-health unit.
We venture to limit coercive means of treatment.
The scene saw six different staff members pulled from their positions to restrain him.
But if you move to engage a patient verbally, youre looking at something more one-on-one.
Another thing we have a go at do is offer choices.
People in an acute psychiatric crisis often dont know the options available to them.
Simple things like, Do you want the door open or closed?
Lights off or on?
Do you want a chicken sandwich or an egg-salad sandwich?
(No one wants tuna.)
How did you feel the show rendered that interaction?That was a really good model.
They wrap it up nicely with Whitaker meeting the patient, and he initially accuses him of using meth.
The patient says, No, Im actually sober.
Its just been hard.
I dont have stable housing.
I cant afford my medication.
Its a neat resolution, but the arc now is all about Whitaker and the triumph of his learning.
Psychiatric patients dont get tidy resolutions.
He doesnt have access to stable housing; he cant afford his medication.
On the one hand, I want to expect better from the show.
So I do feel a deep empathy for where Dr. Robbys character is coming from.
SoThe Pittgoes beyond total accuracy in those moments to demonstrate what we could do.
So I do think there are harms that are perpetuated by what they depicted accurately or not.
Would a normal ER shift encounter more patients with mental-health needs than what appears in this season?
Or does it depend on the day?Thered be so many more, I have to say.
More challenges coping with the day-to-day.
Yes, we are a slower breed because of the nature of the work we do.
It takes time to gather psychiatric histories to document our psychiatric reports.
But thats not a character flaw.
I also thought it was really interesting because hes pressuring her to call psych and shes resistant.
Shes trying to see the whole picture.
In those situations, the term we use ismedical clearance.
What Dr. Mohan ultimately identifies is mercury poisoning, which is very rare in medicine.
Its never fully reconciled, though.
He kind of nods at her and maybe says Good job, but thats a pretty tremendous find.
Dr. Mohan is great, and there are moments where she really misses the mark.
Dr. Robby rightly reams her out for that.
Does that track with you?
Or does it differ from state to state?It differs from state to state.
There are lots of interesting elements in that situation.
Im not convinced that the mother is okay.
She probably needs additional support herself.
What kind of situation do I produce?
I like to practice with caution and safety in the front of mind at all times.
If I put him on a 72-hour hold, and we assess him and can help him, awesome.
If he doesnt let us help him, intervention is minimal.
There are times when intervening that way does really get people the treatment and the care they deserve.
Do you hope to see what comes of Davids situation in season two?Of course!
Im very interested in that.
I hope that these outcomes for all of these people are worth it.
So much of the show circles around mental distress.
From the get-go, there is this tone of mental distress, but it only happens in secret.
Dr. Robby cries in a room in secret.
Dr. Langdon is addicted to pills in secret.
His colleague is on the roof thinking about suicide in secret.
Often, I see patients who have waited 14 hours before theyre even seen by a physician.
But time is its own currency.
If youre spending 14 hours waiting to see the doctor, youre paying with something.
