In a matter of a few months, I have gone from someone who’s never watched a medical procedural drama to someone who would sooner eat glass than see any harm come to the staff, nurses, and doctors on Max’s The Pitt. To the extent that I think parasocial relationships have irreparably torn the very fabric of our society, I must admit that when Dr. “Robby” Robinavitch—my close personal friend and father figure whom I have known for years—experiences any kind of anguish, I too experience this anguish. His sadness is my own, it must be, because never in my life have I cried this much while watching a television show. From long narrative arcs that lay bare our fragile mortality to small interstitial beats of sadness, The Pitt freely presses some hidden button in my emotional response system. Every week I’ll glance over at my wife on the couch with tear-stained cheeks, heavy breath, heart rate “tachy,” and say: What is wrong with me?
The Pitt is a unique hybrid of a network show and a prestige drama. It is highly conceptual and expertly directed—it’s also broad and not immune to clunky character beats or dialogue. Its first season chronicles one exceptionally grueling 15-hour shift inside an emergency room at a fictional hospital in Pittsburgh, told one hour at a time, in real time. Episodes begin precisely where the previous one left off, in medias res. In this one day, you learn how every attending doctor, student doctor, surgeon, hospital tech, and registered nurse feels about their job, co-workers, and, ultimately, their personal lives. Even if you’ve never seen ER or Grey’s Anatomy, you know what The Pitt is all about—a new patient, a new problem, interpersonal drama, life-and-death stakes in a bloody arena.
What’s so ingenious, surprising, and effective about The Pitt is that there is almost no music on the show. You’ve truly never seen a show so pregnant with silence. There are no washes of synths or arcing guitars, no treacly cues from Snow Patrol or the Frey. There isn’t even opening theme music—an unprecedented choice when the theme music of HBO’s most popular show seems to be why half the audience watches it. Every episode begins with a comically undesigned title card that states simply what hour of the shift we’re at, and then the din of the hospital fades in.
“When you’re in the ER, there’s nobody in there playing strings when things go bad for you,” says creator and showrunner R. Scott Gemmill, a former producer on ER and procedurals like NCIS: Los Angeles, JAG, and The Unit. “No one’s playing percussion when somebody’s about to code.” Gemmill and his co-executive producers—TV veteran John Wells and the show’s star, Dr. Robby himself, Noah Wyle—worked out the sound design of the show before they even started writing it. They knew that to capture the verisimilitude and nonstop chaos of a real ER, they did not want to use a traditional score. They did not want to use any kind of score at all.