IF ER PHYSICIANS’ EXHAUSTING WORKLOADS  and skillful use of high-tech tools on the TV show The Pitt seem real, it’s because they are. 

Fiercely focused on accuracy for the HBOMax show are creator and showrunner R. Scott Gemmill and executive producer and writer Joe Sachs, M.D., who worked on the 1994-2009 hit ER. 

Their star is former ER actor Noah Wyle as Dr. Michael “Robby” Robinavitch, chief attending physician of a Pittsburgh emergency room. He committed to the show after learning how short-staffed and overburdened physicians had been since the pandemic, some being forced to leave patients in hallways, awaiting beds. 

“Wyle was hesitant to take another role as a doctor after ER, but he knew physicians desperately needed to be seen and understood,” says Kate Folb, director of Hollywood, Health & Society (HH&S) for the Norman Lear Center at USC Annenberg School for Communication and Journalism. 

Wyle and The Pitt’s creators “wanted this to be a very accurate show about how hard ER doctors and nurses work,” says Folb. “That’s why they don’t get into love affairs in the broom closet.” 

The procedures and devices are cutting-edge—and the actors know how to use them. 

”I’ve heard from other shows that they feel they have to up their game because of The Pitt,” Folb says. 

The tools of the trade 

The latest high-tech tools include bedside ultrasound, fiberoptic airway devices, rolling ventilators, portable high-def digital ophthalmoscopes and otoscopes that ship data to phones. 

“Experts tell us what they would use, and manufacturers loan it to us,” says Mel Herbert, M.D., professor of emergency medicine at UCLA School of Medicine and CEO/founder of continuing medical education organization EM:RAP. He’s among seven physicians who contribute to the scripts. 

How is it so real? 

The Pitt’s realism starts when physicians report for duty in its writing rooms, delving into research and contributing to the scripts. 

Besides Herbert, other contributors include Greg Moran, M.D., who was a practicing ER physician for many years before he retired as chair of emergency medicine at Olive View-UCLA Medical Center. Sachs and Herbert also will work on scripts for Season 2, which will air starting next January. Sachs took a leave of absence from Northridge in 2023 to focus on The Pitt. He works weekends in urgent care. 

When the writers need to speak with experts to fill out the medical aspects of their plots, they call on HH&S. 

The Pitt’s first season had 12 consultations on everything from death and dying to abortion, racism, health care disparities, psychology, social work, autism, neurology, respite care, caregiving and EMS department coordination. 

“We were delighted they cared so much about making it an authentic show,” Folb says. “They’re dedicated to being as thorough and accurate as they can. 

“But we’d never tell them what to write,” she says. “They’re the storytelling geniuses. We respond to what they’ve already decided to write about.” 

That has included equipment, diagnosis, treatment and sometimes procedures that required demonstrations in person or via video conference. 

The right stuff 

The actors are part of the reality bent. For Season 1, they underwent two weeks of bootcamp to learn how to intubate, suture, perform CPR and exhibit other essential skills. 

“We work on mannequins,” Herbert says. “No one is going to die.” 

Some actors also shadowed real physicians and nurses, including Katherine LaNasa, who plays charge nurse Dana Evans. 

“They’ve really enjoyed that experience,” Herbert says. “We’ve also met with doctors and residents to talk about the job, their burnout, their emotions, actual cases and how they manage it all.” 

On the set 

A half-dozen real nurses and physician assistants put in IVs and stitch up patients in the background of scenes—including Ned Brower, who plays Jesse van Horn and is a practicing pediatric ER nurse at Children’s Hospital Los Angeles. “He makes sure all IVs and blood transfusions run at the right rates,” Herbert says. 

To ensure accuracy, The Pitt also hires longtime ER physicians who rotate, with each one overseeing the two weeks it takes to film a one-hour episode representing one hour of an ER shift. 

“They make sure the medical care is as accurate as possible,” Herbert says. “It takes having worked in emergency rooms for years to teach the actors to convey how their body would move while doing a risky or rare procedure so the show looks real.” 

As for the sometimes-gruesome wounds on the show which actual surgeons have mistaken for real? “They’re fake,” Herbert says. “The art department is amazing.” 

“We’ve heard anecdotally that many medical professionals perceive The Pitt to be the most accurate representation of emergency medicine they›ve ever seen,” says Erica Lynn Rosenthal, Ph.D., director of research at USC Annenberg’s The Norman Lear Center. “The Pitt’s medical professionals on screen can serve as trusted messengers.” •