VITAL TOPICS: SOCIAL WORK & FILM
by SaraKay Smullens, MSW, LCSW, DCSW, CGP, CFLE, BCD
However full your schedule, find time for The Pitt, nominated for 13 Emmys in major categories. You will be rewarded by a riveting 15-episode Max series, each episode documenting an hour in the 7 a.m. to 10 p.m. shift of Michael Robinavitch, MD, a.k.a. Dr. Robbie, played by Noah Wyle. In real life, Wyle’s mother was an OR nurse who took home a brain retractor to use as a butter knife, as well as gauze and tubing for her kids to play with. Wyle continued to cut his medical teeth on ER, the highly acclaimed Chicago-based medical drama, winner of 23 Emmys, which ran from 1994 to 2009, in which he played medical student John Carter.
Robbie is the leading force behind the effectiveness of emergency med physicians, residents, nurses, ambulance drivers, hospital administrators, and one highly adept social worker. This team sees, faces, and treats everything you can imagine, including but not limited to patients presenting with heart attacks, addiction, measles, problem pregnancies, a fentanyl overdose, and mass shootings. All of this is amidst lack of funding for an acclaimed, financially strapped teaching hospital, lacking staff and space, facing patient dissatisfaction as well as targeted violence against them.
“The Pitt” is shorthand for Pittsburgh Medical Trauma Hospital. It is also how employees reference the ER. But, to me, this title also holds far deeper meaning. The Pitt is symbolic of societal pitfalls, such as the breakdown of our crucial public health system, and the subsequent melding of both public and professional burnout, which—if not addressed—causes both withdrawal and dangerous acting out, each adaptation destructive to our vulnerable democracy. It begs the question: How can our country be the only existing democracy without universal health care? This leads to further examination: Can seeing, experiencing overload and suffering in a stunning series promote societal changes necessary to protect our collective future?
And see we do—raw portrayals of real lives, those who end up in a crowded ER, often without medical insurance or any semblance of a support system, and a society that treats our most vulnerable callously. These are realities that social workers know well. This focus includes the misery of non-critical patients, whom we see waiting endless hours for help, their growing anger reaching a boiling point.
The Pitt pulls viewers in through introduction to the lives, fears, and hopes of a fully devoted professional community faced with heartless realities. An immediate backdrop of Episode 1 addresses how ill-prepared hospitals were for the assault and aftermath of COVID. This day is the fourth anniversary of the COVID death of Robbie’s beloved mentor, who had been under his care, leaving Robbie in perpetual mourning, blaming himself.
We are introduced to residents beginning their medical concentration—there is so much to learn—in an overwhelmingly overcrowded Pittsburgh teaching hospital, where space in the ER waiting area and the inner treatment areas is severely limited. Time with each patient is rushed to the breaking point, a reality exasperated by pressure to achieve patient satisfaction (to keep and hopefully increase funding). Understaffing throughout the hospital, especially of the nursing staff, keeps patients from leaving The Pitt, moving upstairs to rooms with necessary beds and real doors.
As viewers catch their breath amidst these challenges, we are pulled into the lives and personal stories of the principals, professional staff and residents. Without revealing plot development, to whet your appetite, there is of course Robbie, who is surrounded by a fascinating, compelling team: the devoted, highly competent, somewhat mysterious charge nurse, Dana Evans, anchor of the ER, whom I read will be pivotal in Season 2 (Katherine LaNasa); Cassie McKay (Fiona Dourif), a single mom second-year resident older than the other residents, wearing an ankle monitor, while at the same time seeing a patient who fears her son is a mass murderer; Dennis Whitaker (Gerran Howell), a fourth-year medical student, lacking confidence, in constant need to change his scrubs; Melissa “Mel” King, a neurodivergent second-year resident with a history of working with military veterans (Taylor Dearden); Victoria Javadi (Shabana Azeez), a highly talented third-year med student whose parents are respected staff doctors; Trinity Santos (Isa Briones), a cocky, persistent first-year resident determined to take matters in her own hands; and Frank Langdon (Patrick Ball), a senior resident, and Robby’s right hand, until…
Once again, as in the last series reviewed, Dying for Sex, a capable, knowledgeable, and respected social worker is part of the team. Kiara Alfaro (Krystel V. McNeil) is called upon with regularity to process hard choices with clients and staff, and for her knowledgeable grasp of existing resources and wise direction. Unfortunately, however, in Episode 7, when a distraught mom shares she suspects her husband of sexual abuse of their adolescent daughter, misleading, dangerous writing takes over, which ignores the protocols established in the mandatory reporting process. Kiara advises that to report sexual abuse of a child, proof is needed. Not true! As we know, in most states, health care workers, as well as those in other fields, are required to report even suspected cases of child abuse and neglect, which will then be carefully examined. In this case, the adolescent daughter may well not have been able to return home.
This poor misleading advice is followed by strong dramatic writing, offering erroneous, dangerous direction viewers may believe it wise to follow, which would put mother and daughter in the gravest possible danger. Relatedly, you may remember my deep concern at the resolve of the film It Ends With Us, in which the manner of rejection of a batterer with a newborn present, if followed in real life, could have led to death of mother and child.
You should also know that the estate of Michael Crichton, ER’s creator, has filed a lawsuit, labeling The Pitt an “unauthorized reboot.” Pitt producer, Warner Brothers Television, has called these claims “baseless.” Yes, alongside Noah Wyle, other notable ER alumni include its creator, R. Scott Gemmill, who served as executive producer on later seasons of ER, and executive producer John Wells, who directed the pilot, was ER’s showrunner.
However, we are now in Pittsburgh, not Chicago, and the times offering backdrop to ER are far different from what is faced today, resulting in a more profound script confronting present dire challenges, with segment concentration on each hour of one shift intensifying potent, encompassing dangers.
Although both series reveal the frantic pace an ER demands of its staff, The Pitt distinguishes itself as far more than a reboot. The series serves as urgent reflection of today’s vast challenges, as well as a wake-up call. The hospital is a metaphor beseeching our societal necessity to bring hope and change in order that our precious, ever vulnerable democracy be protected. Be saved.
Questions for Thought and Reflection:l
- Do you see this series as one that can be meaningfully used with clients? If so, who? How would you proceed?
- Do you see this series as one that can be used in bachelor’s and master’s degree classes? Or in settings where social work placements take place? If so, how would you proceed?
- Have you ever worked in a setting where dangerous advice was offered by a colleague, supervisor, or setting leader? If so, how have you dealt with this? If there were barriers to calling attention to these dangers, what necessary changes in communication and protocol were necessary?
SaraKay Smullens' (MSW, LCSW, BCD) best selling book Burnout and Self-Care in Social Work, Edition 2 (NASW Press, 2021) grew from her researched award winning article in The New Social Worker, “What I Wish I Had Known.” SaraKay has worked with women enduring domestic violence for more than 30 years, which led to her identification of invisible cycles of emotional abuse, always part of sexual and physical violence, but deserving their own codification. In 1995, with the support of the Philadelphia District Attorney’s office, she initiated the Sabbath of Domestic Peace Coalition, a diverse, multicultural bonding of religious leaders, the domestic violence community, social workers, physicians, attorneys, volunteers, and law enforcement officials who identified clergy as "a missing link" in addressing the complexities of the virulent epidemic of domestic violence, which prayer alone could not solve. The Coalition held trainings for clergy and parishioners throughout Philadelphia and surrounding areas. Its yearly non-denominational prayer service was attended by hundreds. After several years, the SDP Coalition was able to disband as individual faith communities and houses of worship incorporated their mission.