If there was an alternate title to The Pitt, it would probably be "Doctor Robby's Terrible, Horrible, No-Good, Very Bad Day." Despite the fact that the Max medical drama has aired 13 episodes, it's taken place over the course of only a little over half a day. And when Noah Wyle's beleaguered senior attending walked for his shift, on the anniversary of his mentor Dr. Adamson's death, it was clear he was in for a long day.
Robby had to shake off that weight, though, to deal with particularly arduous circumstances for the Pittsburgh Trauma Medical Hospital. A mass shooting at the nearby "PittFest" has caused a sudden all-hands-on-deck situation, with waves of victims coming in ranging from nicks to tramplings to critical life-or-death scenarios. It's been a shocking and emotionally harrowing two-episode storyline from writer Joe Sachs and series creator R. Scott Gemmill. And it was their way to not only extend a usual 12-hour shift to fit a 15-episode order, but to also use the opportunity to highlight the medical
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"You read about mass shootings in the paper once or twice a week, very sadly," Sachs tells Parade. "And I think the public becomes numb to that. But to actually see the tragedy of what happens and what goes on in the emergency department, and the trauma and the grief for family members. And also the psychological and moral trauma for the healthcare providers that have to step up and take care. So that's something that you don't really see or read about very often."
And Gemmill and Sachs brought that trauma in for Robby in a major way with one of the many casualties of the PittFest shooting. Halfway through Episode 13, Robby's stepson Jake (Taj Heights) is brought to the ER. He was attending the festival at the time of the incident. In his arms he's cradling his girlfriend Leah, who is in critical condition after getting shot.
Over the course of the rest of the episode, Robby goes to hell and back to try to save the young woman's life. He expends every resource (and blood bag) to keep her alive. But alas, it's all for naught, and Leah tragically loses her life. When Robby brings Jake into Pediatrics – serving as a makeshift morgue for all the shooting victim – to identify Leah's body, Jake tears into him, blaming him for her death.
That, evidently, is the straw that broke Robby's back (though he had tweaked it considerably in an earlier episode). Facing blame from a person he loves in the same room that he said goodbye to one of the most important people in his life years ago sends him over the edge.
"I don't know how many people I've helped today," he says, beginning to tear up, "but I can tell you every person who has died. And I'm gonna remember Leah long after I've forgotten about her. Oh f–k. Oh f–k. I'm sorry. I'm sorry."
In a frenzy, he forces Jake out of the room. He sinks to the ground, simultaneously hyperventilating and sobbing. In a room, surrounded by the dead, the pressure of not only the day, but years of trauma, have caught up to him. And, in a time where the ER is in uncharted waters, its lighthouse going down means there are rough seas ahead.
Parade spoke with Gemmill and Sachs about crafting Robby's breakdown, Leah's death, and what to expect from the final two episodes of The Pitt Season 1.
Related: Everything to Know About The Pitt Season 1
Talk to me about how you came to the decision to involve Jake and his girlfriend Leah in the PittFest shooting, and why you ultimately chose to kill Leah.R. Scott Gemmill: We went back and forth on that a few times. Are we going to kill Jake? Were we going to kill his girlfriend? And we realized we never saw his girlfriend. [Laughs.]Joe Sachs: His girlfriend actually is present on a FaceTime. And she is so bubbly and full of life and wonderful and lovely that I think you fall in love with her just based on 15 seconds on the smartphone. Gemmill: And you're happy for Jake, because when they're teasing him earlier and stuff. There was two things we had to do. One was, we wanted to capture the loss, the heartbreak, the tragedy. Think of these people who go to work or go to a festival or go to a synagogue and don't come home. And then the loved ones are the ones who ultimately suffer the most, because they're the ones who have to deal with the grief. So that was part of it. The other part was we knew that we wanted this to be the day that Robby was going to have a meltdown. Basically, this was the day that his PTSD was no longer under his control. And he's been swallowing it and pushing it down. And then we needed something to really push him over the edge. Because what case hasn't been that bad enough to do it in the last four or five years? So we know he must have dealt with a lot of horrible things, but this was just too much. It's so accumulative. So we knew that, at some point, we had to push him to that edge. And what would do that more so than him not being able to save the loved one of someone he cares very, very much about. And because of that individual's sort of youth, being angry with Robby and accusing him of not being able to save someone. Which, of course, Robby did his best. But that's the kind of thing we needed to push him over the edge.So, to that point, I imagine this meltdown was in the skeleton of the series from the beginning. Talk to me about incorporating plot points, like the storyline with David and the introduction of Jake–as well as flashbacks to Dr. Adamson's death–to build up to this moment.Gemmill: I think if you look at episodes, even there's a little bit where he moves a patient and then complains about his back. All that was already was in there to be part of the aggregate that gets him there. So there's all these little things. I mean, some are much more; that one's very subtle. But they're things that are much more overt, such as the flashbacks, obviously. But if you watch as the day progresses, he gets more and more agitated. How he treats people, he starts to snap a little bit every now and then. So it's all in there. Bbut it's just so that if you go back and look at it in retrospectively, you'll see all the warning signs are there. But hopefully there just seemed like someone struggling through a very difficult, challenging day.Sachs: I mean, it starts in Episode 1 with his frustration and his ability to reach David and to convince him to stay on a busy, crazy day. When he has his first flashback with ear-ringing panic attacks, that kind of goes over from [Episodes 1 to 2]. And then with the death of Mr. Spencer in [Episode 4] in the peds room, that obviously does it. And then we wanted to do an ECMO case that was a save. But seeing the ECMO machine go by was a trigger, because his mentor was on ECMO at the end.This mass casualty event has been absolutely seismic for The Pitt and its characters. What can you tease as to how the plane lands in the remaining two episodes?Gemmill: I think our team rises to the occasion in ways that are both heroic and, in times unconventional. And I think Robby, at the end of the day, is very proud of his people. But he is forced to really accept and confront his own trauma and his PTSD and that he needs help. He's been very good at telling everyone else what to do and making sure everyone else gets help. But he's at a place now where he has to acknowledge that he needs as much treatment as the people he is helping. Sachs: And he also is going to have to deal with Langdon. And what's the next step with Langdon?Scott, when you and I spoke previously, it was days before The Pitt was renewed for Season 2. And these past couple of episodes are a firm reminder of why we're so lucky to get more of this show. So I just wanted to commend you both for crafting this emotionally-fraught storyline that spoke to not only the characters, but the audience as well.Gemmill: Thank you. We're really trying, and we have such great people around us, experts. And we've been working on Season 2 for about three weeks now. This part is really interesting. Probably a year and a half ago, we were just talking to all these medical professionals. So we've talked to cybersecurity specialists, immigration specialists.Sachs: In 10 minutes, we're going to be talking to one of the country's experts on treatment of PTSD in emergency workers, specifically.Gemmill: And we talked about substance abuse and recovery in the medical field. I mean, that's the fun part. Last night, we spent time with 12 residents from UCLA, just talking to them, hearing their stories, picking their brains. What's new in medicine, what would they like to see shown. So the fun part of this is really talking to the experts and trying to find out what they know that the audience and the public doesn't know that they should know. So hopefully we serve a little bit of a purpose while we're entertaining as well.
Related: 'The Pitt' Creators Reveal the New Medical Procedures They Invented for Their Mass Shooting Storyline (Exclusive)
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