Like many US hospitals, Pittsburgh Trauma Medical Center (PTMC) is a place where time melts away. Rain or shine, 1am or 1pm, everything is bathed in the same retina-frying fluorescent light. Wait times often exceed several hours; in the lobby is a barrage of all-caps warnings (\u201caggressive behavior will NOT be tolerated\u201d), while several TVs play clips of a Deadliest Catch-style show in two-minute loops. Purgatory, it seems, looks a lot like an American hospital \u2026 as recreated on a soundstage in Burbank, California.<\/p>\n
On the day I visit PTMC, the 52-bed ER on the Warner Bros lot, the hold-up is some babies. The infant actors are here to film a second season scene for The Pitt<\/a>, the HBO Max medical drama that singlehandedly resuscitated the genre back from its Grey\u2019s Anatomy flatline, swept almost every television award in the US and is now, finally, heading for the UK. (No bad blood, though: on set, I glimpse a flyer for a Pitt softball game against the crew of Seattle Grace<\/a>.) Developed by the team behind 90s hospital hit ER, The Pitt follows a melange of hospital workers \u2013 the doctors, nurses, social workers, security and administrative staff of a cash-strapped emergency room in Pittsburgh \u2013 as they deal with everything from gunshot wounds to burnout, fentanyl overdoses to dreaded note-taking, with all the emotional trauma in between.<\/p>\n The show, which premiered in the US in January 2025, became a rare word-of-mouth hit on the strength of its dramatic hyperrealism: hour by hour, viewers endured the unvarnished chaos of a US hospital. A fast-paced, first-principles TV drama \u2013 what if, radical concept, you kept costs down by following the old broadcast model of single set and relatively unknown cast? \u2013 The Pitt pulled double hero duty: an economically viable show in a contracting Hollywood that believably celebrated healthcare workers. At once gritty and relentless, dissecting American social woes with many a bloody scalpel, the show \u201cbreaks through the cynicism of the sophisticated viewer\u201d, says series lead Noah Wyle, as we meet under those glaring PTMC lights. With his travel mug of black coffee and a stethoscope round his neck, wearily explaining the pride of hiring a 400-plus crew in post-fires, post-strikes Los Angeles, the former ER<\/a> star has the grizzled bearing of a tested paterfamilias; the line between the three-decade TV veteran and Dr Michael \u201cRobby\u201d Robinavitch, the Pitt\u2019s beloved seen-it-all attending physician, appears vanishingly thin.<\/p>\n Clinical drama \u2026 Shabana Azeez, Noah Wyle and Supriya Ganesh star in season one of The Pitt. Photograph: Landmark Media\/Alamy<\/p>\n Once the babies are safely escorted out, I get to inspect the set: every drawer is fully stocked, every walkway realistically cluttered with beds, every drug bottle individually labelled (though filled with saline rather than morphine). \u201cEverything we say, everything we touch, is done as authentically as possible,\u201d Patrick Ball, a formerly unknown theatre actor now recognisable as the alarmingly handsome chief resident Frank Langdon, tells me of the set\u2019s prodigious label-maker and real scrubs-cleaning machine. \u201cThat is a philosophy and a priority.\u201d<\/p>\n Hollywood sets are generally surreal, but The Pitt has turned the blurring of reality and fiction into addictive healthcare agitprop. The set, modelled on the real Allegheny General in Pittsburgh, is an optical illusion of endless hallways with no dead ends; by lunch, I assume there is no way out. The show\u2019s concept, one that rooted millions of US viewers to their couches, is that each season takes place across a single ER shift, every episode an hour in real time. My visit coincides with a particularly brutal one for Dana Evans, the sweet-and-salty charge nurse played to Emmy-winning effect by Katherine LaNasa<\/a>. During this hour, Dana, like many healthcare professionals, is forced to restrain a physically aggressive patient \u2013 a commotion that forces Dr Robby and co to sprint across the set.<\/p>\n In between takes, LaNasa jogs on the spot to stay breathless (\u201cIt\u2019s an exercise in respect for the profession, to try to do it accurately,\u201d she says), while numerous extras, languishing as patients, scroll their phones. Cast and crew on The Pitt<\/a> are nearly indistinguishable; everyone, including myself, wears scrubs. This is both a necessity for filming on a set full of reflective surfaces and a way to build, Wyle tells me, an \u201cesprit de corps\u201d: a sense that \u201cwe\u2019re all in this together to tell this story and we\u2019re going to commit to being here for the next nine months.\u201d<\/p>\n Team work\u2026 Taylor Dearden, Gerran Howell, Patrick Ball, Noah Wyle in The Pitt. Photograph: HBO<\/p>\n That sense of camaraderie and decency in the face of systemic decay is a large part of what has made The Pitt a surprise sensation<\/a> in the country it so unglamorously depicts. The workers in the basement emergency room at PTMC (hence, \u201cthe Pitt\u201d) may swear, spar, flirt, misjudge, tangle with belligerent patients or lose their cool. They may, in the case of Dr Robby, experience debilitating flashbacks to Covid. They may very relatably pass out at the sight of a \u201cdegloved foot\u201d (don\u2019t Google). They may be horrified by rats in the ER or furious with a vaccine sceptic. But they\u2019re all trying their best to care for people \u2013 to keep, as Wyle puts it, \u201cthe light of humanity and decency and caring alive in what seem to be very dark times\u201d.<\/p>\n The response has been largely ecstatic. Viewers, myself included, have gleefully strapped into the show\u2019s rollercoaster rhythm, collage of American social ills \u2013 state abortion bans! medical racism! hospital profit motives! \u2013 and voyeuristic pleasures of, as LaNasa puts it, \u201cthe heartbreaking, disgusting and funny.\u201d (People are even being challenged online to watch the 15-episode seasons in one sitting<\/a>, as if living the worst ER shift of all time in solidarity.) Medical professionals such as my mother have heralded its accuracy and competency. The Emmys awarded it best drama over far more expensive, ambitious entries such as Severance, Andor and The White Lotus.<\/p>\n Now, both the newly launched second season and its first air for the first time in the UK (as part of the launch of streaming service HBO Max) \u2013 a country perhaps unfamiliar and understandably baffled by the capriciousness of privatised US healthcare, though no stranger to an overstretched health system struggling to cope. \u201cThese are really confusing times,\u201d says Wyle. \u201cAnd when you can tune in to something that feels vetted and representative of some semblance of reality, it\u2019s like: \u2018Oh, there\u2019s a North Star.\u2019 You can start to orient in a time where it\u2019s very difficult to find your orientation.\u2019\u201d<\/p>\n<\/p>\n \u201cWe don\u2019t come at it from having read the headlines,\u201d exec producer John Wells tells me. It comes, they say, from real-world experience and expertise. The writers\u2019 room boasts two emergency room physicians, plus another four on set, as well as eight to 10 full-time nurses. \u201cWe\u2019ve listened to what they say,\u201d says Wells. \u201cWhat are they concerned about? What are their worries? What are their fears?\u201d Hence, a show that deals as sensitively with the methods for relieving impaction (Google, if you dare) as the very American problem of mass shootings. (The most eerie part of the set tour are the \u201cblood mats\u201d \u2013 plasticised rugs that mimic puddles of blood \u2013 to keep mass casualty filming mess to a minimum.)<\/p>\n One thing that healthcare providers in the US and UK do share? Lingering trauma from the Covid-19 pandemic, whose ripple effects are what inspired its creator R\u00a0Scott Gemmill, Wells and Wyle to take a stab at a long-desired ER reboot. \u201cI didn\u2019t want to do [a medical drama]. John didn\u2019t want to do it,\u201d Gemmill tells me. But during Covid, when healthcare misinformation went, well, viral, \u201cwe started to talk to medical professionals, and a lot of them felt unheard. There wasn\u2019t a show that was realistic.\u201d<\/p>\n \u201cThe idea of messing up our own legacy [with ER] scared us enough that we went our separate ways for a full year,\u201d Wyle recalls. \u201cA\u00a0lot of shows try to come back and reinvent themselves. There were a lot of reboots at that time. That wasn\u2019t what we were interested in.\u201d The first idea, catching up with Wyle\u2019s ER character John Carter, fell apart in a dispute with Sherri Crichton, the wife of late creator Michael Crichton<\/a> and executor of his estate. Crichton has since sued<\/a> Warner Bros TV, Wells, Gemmill and Wyle on copyright grounds, claiming The Pitt is essentially a reboot of the 90s show \u2013 prompting Warner Bros to shoot back: <\/a>\u201cThe lawsuit is baseless: The Pitt is no more a \u2018derivative work\u2019 of ER than is any other hospital drama.\u201d<\/p>\n When I ask for an update, Wyle replies that \u201conce I realised it wasn\u2019t going to impede the ability to produce and do this show, I\u00a0kind of stopped caring and let the Warner Brothers lawyers work all that out.\u201d Still, he adds, \u201cthe most gratifying reviews we got were the ones that blasted in the headline: \u2018This is not an ER reboot.\u2019\u201d<\/p>\n In treatment \u2026 A scene from season two of The Pitt. Photograph: HBO<\/p>\n