![\"Can](\"https:\/\/www.newsbeep.com\/au\/wp-content\/uploads\/2026\/01\/Mel-Herbert-982x1024.jpg\")
Dr Mel Herbert<\/p>\nEmergency medicine has been coding since COVID-19 due to overcrowding and understaffing. New television series \u2018The Pitt\u2019 \u2013 the trauma-informed, adult child of \u2018ER\u2019 \u2013 is screaming about the state of emergency health care in the United States.<\/p>\n
InSight+ asked emergency doctors, including The Pitt\u2019s Australian doctor and a writer, whether a TV series can make a difference.<\/p>\n
Dr Mel Herbert is a Professor of Emergency Medicine at the UCLA School of Medicine. He studied medicine in Australia, but has practiced in the US for the last 35 years. He was a writer for the TV show ER.<\/p>\n
\u201cWe in emergency medicine have been in denial about the stress of the job and the burnout. When I started residency at UCLA, ER docs were burnt out. We were told that it\u2019s because they weren\u2019t trained in emergency medicine.\u201d<\/p>\n
\u201cNow we have this great training, and you watch The Pitt and it\u2019s the real deal. But they\u2019re still burnt out. That\u2019s because it\u2019s a stressful job. Patients are dying.\u201d<\/p>\n
\u201cAnd then you have to see the next patient, see the next. You\u2019re fighting a system that doesn\u2019t really give a sh*t about you, because you don\u2019t bring in as much money as elective surgery.\u201d<\/p>\n
Dr Mel Herbert<\/p>\n
Dr Herbert said that the creators of The Pitt wanted to make something more realistic, especially in the wake of COVID-19.<\/p>\n
\u201cR. Scott Gemmell, the show\u2019s creator, was a writer on ER. During COVID-19, Noah Wiley (who played Dr John Carter on ER and plays Dr Michael Robinavitch<\/a> on The Pitt) was getting a ton of emails from the ER docs and nurses that he\u2019d gotten to know over the years of ER, saying, \u201cThings are so bad. Could you do a new show showing the terrible things that have happened because of COVID-19 and overcrowding?\u2019\u201d<\/p>\n Wyle and the show\u2019s creators got together to discuss how they could do it realistically.<\/p>\n \u201c\u2018Let\u2019s do it one shift, real time. Fifteen hours, hour-for-hour, relying on Joe Sachs \u2013 a board certified emergency medicine doc with a film degree \u2013 to make the medicine as accurate as possible.\u201d<\/p>\n The show has been praised by emergency doctors for its accuracy.<\/p>\n \u201c[The writing team has] a number of ER docs. Seven of us total. It\u2019s the most realistic representation of what happens in modern emergency medicine that there\u2019s ever been. Much more realistic than ER,\u201d he said.<\/p>\n Modern emergency and moral injury<\/p>\n Dr Herbert retired just before COVID-19, but decided he must go back.<\/p>\n \u201cI\u2019ve never seen so many people die.\u201d<\/p>\n \u201cWe see people die in the ER all the time, but I\u2019ve never seen so much death. It was a weird experience because you\u2019d be outside the hospital and think, \u2018Well, there are no dead bodies on the streets here. It can\u2019t be that bad.\u2019\u201d<\/p>\n \u201cIn the ER you\u2019re like, \u2018Oh my lord.\u2019 It\u2019s not just 80-year-olds: it\u2019s 30- and 40-year-olds dying.\u201d<\/p>\n Dr Herbert and his wife, a nurse, went to work at a vaccination clinic to help.<\/p>\n \u201cWe were living in a real world conspiracy at the same time. First, doctors and nurses were heroes. But then it turned. It was like, \u201cOh, you\u2019re lying. Ivermectin is the treatment for this.\u201d<\/p>\n \u201cAlso, so many nurses left the profession because it was horrible,\u201d he said.<\/p>\n \u201cOne of the biggest problems we have now is that the ED is overwhelmed. You can\u2019t bring a patient into a room and do a proper exam without doing this shuffle. And there\u2019s a lot of moral injury.\u201d<\/p>\n Dr Herbert says that moral injury \u2013 the guilt, shame, and social alienation of knowing you can\u2019t save everyone, but trying anyway \u2013 is a big driver of C-PTSD and PTSD in emergency medicine.<\/p>\n \u201cIt\u2019s right on the brink of collapsing the whole time.\u201d<\/p>\n Seeing behind the curtain, and the cape<\/p>\n \u201cThere was one scene, where one of the characters is being critical about masks and the doctor finally breaks and says, \u201cOK, so do you want the surgeons in the OR not to wear a mask, because they don\u2019t work?\u201d said Dr Herbert.<\/p>\n \u201cIn season one, when Dr Robinavich (Wyle) breaks down, it is one of the most powerful things that\u2019s happened for emergency medicine, and mental health.\u201d<\/p>\n \u201cHere\u2019s our hero, who\u2019s supposed to ride in on the white horse and make everything better. And in comes the horse, and the rider is on the ground, crying, because he can\u2019t take it anymore.\u201d<\/p>\n \u201cThat has opened up emergency medicine here in the U.S. to talk about it openly.\u201d<\/p>\n \u201cThe Pitt showed that, particularly in the US, sometimes [emergency medicine] is war. You\u2019re in a MASH unit in a mass casualty event, and you are suffering all the PTSD that soldiers and surgeons in war feel.\u201d<\/p>\n \u201cMale ER docs kill themselves at a rate of three times that of the rest of the population. So it\u2019s a profession that is in serious trouble for lots of reasons, and it\u2019s only getting worse.<\/p>\n \u201cNow we\u2019re talking about it.\u201d<\/p>\n Australian emergency<\/p>\n Doctor Belinda Hibble<\/a> is the Director of Emergency Services at Barwon Health<\/a>, a large regional mixed emergency department in the southwest of Victoria. Dr Hibble also chairs the Council for Advocacy, Practice and Partnerships at the Australasian College for Emergency Medicine (ACEM).<\/p>\n \u201cI binge watched the first season [of The Pitt], and was hanging out for the second season,\u201d said Dr Hibble.<\/p>\n \u201cOn a good day in emergency medicine, it is such a beautiful place to work. When it hums,\u201d she said.<\/p>\n \u201cShows like ER \u2013 and I remember Chicago Hope and All Saints \u2013 often imply a really linear care, and that everything\u2019s urgent, and has a resolution.<\/p>\n \u201cWhen people present for emergency care, they see themselves in a system. They don\u2019t necessarily have a broader perspective of all of the jigsaw pieces; what we experience.\u201d<\/p>\n \u201cWe might have to wait and see and not get that resolution today. And I think some of these TV shows contribute to that [expectation].\u201d<\/p>\n \u201cReal emergency medicine involves managing uncertainty at every level, balancing risk and accepting imperfect outcomes.\u201d<\/p>\n \u201cMost of the work that we do as emergency physicians is quite cognitive, invisible. It\u2019s thinking through how I can improve the care for this person in the limited amount of time and resources.\u201d<\/p>\n \u201cThe Pitt resonates with clinicians more because you see realistic emotional fatigue and cognitive load being portrayed.\u201d<\/p>\n \u201cYou see the blunting of emotions, and people getting tired, rather than being the heroes of the situation.\u201d<\/p>\n \u201cWhat the Pitt demonstrates quite well is that interrupted thinking.\u201d<\/p>\n Interesting advantages of the U.S. system<\/p>\n Dr Hibble says that while the Australian system is better, there are some advantages to American EDs.<\/p>\n \u201cHow emergency physicians are supported is quite different in the US compared with Australia.\u201d<\/p>\n \u201cIn many US contexts, the emergency physicians function as decision makers, and then all of the systems support actioning those decisions. It allows emergency physicians to operate at the top of their scope of practice.\u201d<\/p>\n \u201cBut in many Australian EDs, and particularly when it\u2019s overcrowded, the senior clinicians need to make the decisions and then they need to enact those decisions as well.\u201d<\/p>\n \u201cI don\u2019t want us to move to that. But it\u2019s interesting that there are still areas where we can still learn from how some of these other systems create efficiencies.<\/p>\n \u201cOne of the other important issues to acknowledge for emergency departments is that EDs are now managing complexity at scale. And then when the system becomes overcrowded.\u201d<\/p>\n \u201cAnd that leads to the moral injury of the healthcare workers who are constantly worried about the person in the waiting room that they don\u2019t know about yet, who has a really serious condition and is quietly sitting there, waiting to be seen.\u201d<\/p>\n \u201cThat is one of the major factors contributing to burnout and C-PTSD.\u201d<\/p>\n Dr Herbert said he is proud of the effect of The Pitt.<\/p>\n \u201cDoctors are getting help. Nurses are getting help. So it has had an incredible effect,\u201d said Dr Herbert.<\/p>\n Dr Herbert said that now that the Trump administration is making even more cuts to Medicare and Medicaid in the US, emergency overloading may get worse.<\/p>\n \u201cThere\u2019s going to be even more people.\u201d<\/p>\n Becca Whitehead is a freelance journalist and health writer. She lives in Naarm and is a \u00a0regular contributor to the MJA\u2019s InSight+.<\/p>\n The statements or opinions expressed in this article reflect the views of the authors and do not necessarily represent the official policy of the AMA, the\u00a0MJA\u00a0or\u00a0InSight+\u00a0unless so stated.\u00a0<\/p>\n Subscribe to the free\u00a0InSight+\u00a0weekly newsletter\u00a0here<\/a>. It is available to all readers, not just registered medical practitioners.\u00a0<\/p>\n![\"Can](\"https:\/\/www.newsbeep.com\/au\/wp-content\/uploads\/2026\/01\/The-Pitt-Cast-season-one-1024x683.png\")
The cast of The Pitt<\/p>\n