The second season tackles everything from the role of AI in medicine to Medicaid cuts. But above all, it is about burnout.
Ispent much of the final year of my internal medicine residency in a windowless workroom on the seventh floor of a hospital in Boston. The desks were sticky from spilled diet ginger ale. There were vulgar inside jokes scribbled on the dry-erase board near the entryway. There was cheap champagne in the mini fridge for mimosas we’d mix at the end of a string of night shifts. We hoarded sticks of epinephrine and 18-gauge needles in filing cabinets and stuffed them in our pockets as we ran to a Code Blue. When the night was slow, we’d watch movies or TV. One show everyone seemed to be watching in the hospital, or had an opinion on, was The Pitt, a medical drama inspired by the Emergency Department at Allegheny General Hospital, a trauma center in Pittsburgh.
A couple of my peers scoffed as they watched the actors running around in scrubs under fluorescent lights on my laptop screen: Why watch work while at work? Others couldn’t look away. We agreed with the chatter among doctors—the show was accurate from a medical standpoint. But verisimilitude wasn’t what made it novel; it captured something that once felt more private. The Pitt found a way to make evident the disquieting feeling of intubating a dying patient because a family member couldn’t let go. Then the sounds: the beeps of monitors that fade into a kind of white noise, the suctioning of secretions from a patient’s airway, a gurgling that always made my stomach turn. There was a tenderness to the show, too, one that managed to skirt the overly sentimental: the moment when a patient begins to trust you, laughs with you, or when you see yourself reflected in the person you’re taking care of.
And the show was unafraid to tackle the social dimensions of medicine, an aspect of care rarely depicted in medical TV dramas. Patient cases my co-residents and I ranted about—like racial disparities in Child Protective Services involvement or the hospital boarding crisis—were given their proper due, dramatized, in accurate fashion, for millions of viewers. The Pitt was committed to showing us doctoring uncensored.
Since I completed my medical residency, The Pitt has become a global phenomenon. When the show’s star Noah Wyle wore a tuxedo made by the scrubs brand FIGS on the red carpet for the 2025 Emmys, his outfit went viral. The second season premiered to an audience triple the size of the show’s pilot’s. Written and developed during Biden’s presidency, The Pitt’s first season responded to the trauma and polarization of a post-pandemic world. The second season is tasked with responding to the second Trump administration, where the building of a police state, the rise of Big Tech, and unprecedented cuts to health insurance threaten not only the practice of medicine but our entire social order.
The second season takes place on the Fourth of July, about 10 months after the mass casualty event—a shooting at a music festival—that drew the first season to a close. It adopts the same structure as the first season—each episode represents one hour over the course of a 15-hour shift. But things are different on this hot summer day. We encounter a darker version of protagonist Michael “Robby” Rabinovitch (Wyle)—he is exhausted, still reeling from the pandemic and the events of last season. We soon learn that Robby will be taking a three-month sabbatical at the end of this shift, a solo motorcycle trip across the country. He can’t wait for his shift to end; his passion for teaching, mentorship, even patient care has dimmed somewhat. Robby comes off as irritable, prone to snap at his colleagues, even Dana Evans (Katherine La Nasa), the head nurse and one of the characters whom he trusts the most. Robby’s detachment is, in essence, what physician burnout looks like.
Robby’s callousness is part of a larger problem with The Pitt’s second season, where the raw emotion of season one is replaced with something more muted. The show continues to emphasize the political aspects of medicine, this time covering almost every newsy topic out there, from the role of AI in medicine and Medicaid cuts to ICE raids in hospitals. While some of these vignettes still resonate, others feel more like talking points; as a whole, the narrative of the second season seems more dutiful than impactful. Was it just too challenging to replicate the magic of the show’s first season? Or is this shift in tone—perhaps a commentary on physician burnout—more deliberate?
Characters new and old are at the center of this season’s conflict: new attending Baran Al-Hashimi (Sepideh Moafi) and the return of senior resident Frank Langdon (Patrick Ball), newly sober and working the steps after five months in rehab for an addiction to benzodiazepines. Al-Hashimi is Robby’s foil, the head to Robby’s heart. A former attending at the nearby veteran’s hospital and clinical informatics expert, Al-Hashimi will cover for Robby while he’s on sabbatical. She is also insistent on the use of AI in medicine, with seemingly no qualms about the ethical and privacy concerns that come with untested AI-based healthcare tools. When Robby asks the overnight charge nurse to tell him about the new attending, she replies, “Pretty, divorced, one kid, can already tell she’s a strict rule-follower. I’m probably going to grow to hate her.”
Al-Hashimi wears a Lululemon zip-up over her scrubs, whipping around the Emergency Department with stick-straight posture as she reminds Trinity Santos (Isa Briones), a second-year resident, to finish her charting. “Timely documentation is essential. Let’s fix this before end of shift,” she tells Santos, her delivery as robotic as the generative AI app she’s pushing on the staff. It’s not even 8 am on her first day and Al-Hashimi has already distributed “patient passports”—brochures meant to inform patients on the timing of their labs and scans—to everyone registered in the waiting area (patients are customers and customers are always right).
She tells Robby she’s “launched a campaign” to stop referring to the department as “the Pitt,” because she believes it both “subconsciously affects those who work here” and “lowers expectations, which in turn lowers patient satisfaction scores.” Al-Hashimi’s crusade to sanitize the department’s name not only renders the work less human; it conceals the realities of a flawed medical system under a corporate sheen. This hits Robby where it hurts.
Robby and Al-Hashimi’s sparring continues. One function of Al-Hashimi’s generative AI app is to assist residents with their documentation. When the app makes a mistake that ends up impacting the care of a patient, Robby feels vindicated. While their dynamic at times feels playful, even flirtatious, Robby is rude to Al-Hashimi and undercuts her expertise. It’s a predictable type of antagonism that isn’t particularly fun to watch.
There’s something stereotypical about the way Al-Hashimi is characterized: She’s ambitious and clinically competent, but these qualities are tempered by her tendency to micromanage her residents and play it safe, tropes of female doctors in charge. Al-Hashimi is two-dimensional, standing in contrast to the female residents under her command: Samira Mohan (Supriya Ganesh) and Melissa “Mel” King (Taylor Dearden), who are more fully fleshed-out characters that feel less scripted. It’s a rare miss—The Pitt perpetuates the stereotype of a female attending physician rather than challenging it.
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Another central conflict of the season revolves around Robby and Langdon, who is back at work after Robby kicked him out of the ER for pocketing Librium tablets from a patient to stave off withdrawal. On his return, Langdon dutifully follows the 12 steps and owns up to his addiction; he apologizes not only to his colleagues but also the patient from whom he stole. Everyone is supportive of Langdon’s sobriety and homecoming—even Al-Hashimi, whom he has just met—except for Robby. Robby either ignores Langdon or hazes him, questioning his management of patients at every turn.
In a tense scene on the hospital’s rooftop, Langdon levels with Robby, acknowledging how hard it will be for him to regain everyone’s trust. Robby’s response is almost unfeeling: “I’m really glad you got the help that you need, but I don’t want you working in my ER.” Langdon is gutted, struggling to take care of the next patient in front of him as he realizes his mentor may never forgive him. Robby’s resentment toward Langdon is yet another manifestation of his burnout. This is effective, but an emotional complexity is missing here: Why is Robby being such a hard ass? He’s rarely this black-and-white about anything, and we never learn why he is unwilling to forgive one of his best residents. Does it have something to do with addiction? Does he not believe in second chances? At least for now, the show declines to give us a reason.
Despite stiff new characters and Robby’s turn toward the callous, The Pitt retains its appeal. At its best, the show captures how a hospital functions as a microcosm of our political climate, where societal conflicts play out on the bodies of patients during every shift. Amid all the political issues The Pitt tackles, a scene that deals with the presence of immigration enforcement in the hospital—no longer a protected area under Trump—is one of the best. When two masked ICE agents bring a woman they’ve battered and detained to the ER, everything stops. Characters don’t spout statistics or proselytize—we are simply confronted with the horror of social injustice. After the scene, I couldn’t stop thinking about Minneapolis: Renee Good and Alex Pretti and Hennepin Hospital where ICE agents roam the halls. Robby barks at one of the agents, and we see a flicker of our old hero.
Another patient vignette is ripped from the headlines—this time it’s about xylazine, or tranq, a veterinary tranquilizer that has contaminated the illicit drug supply. Cassie McKay (Fiona Dourif), a third-year resident and recovering drug user, briefly exits the ER’s four walls to tend to an unhoused patient’s necrotic skin wound in an adjacent park. The purpose of this scene is to humanize people who use drugs and educate viewers about xylazine. This didacticism is now a hallmark of the show, and it can both inspire and annoy. But when I realize that this may be the first time most viewers will see a doctor treat with care a person who uses drugs, I recognize the deeper impact of the scene. Healthcare providers don’t work just inside hospitals or clinics but on the street and in outreach vans, too, caring for people who do not feel comfortable entering the institutions that have historically oppressed them. When a medical student says he can’t understand why someone with any degree of intelligence would ever inject drugs, McKay suggests he work on his empathy: “We’re healers, not judges.”
The Pitt’s second season continues to capture the quieter parts of caring for others. In an episode directed by Noah Wyle, Dana teaches Emma Nolan (Laëtitia Hollard), a new nursing school graduate, how to clean a patient’s dead body. Dana instructs Emma on steps to ensure the body is presentable for public viewing, almost as if they were in a police procedural:
You pull off the gown, you wipe him down with towels, then we’ll roll him on his side, clean his back, stuff the sheet under him, wipe down the bed, roll him the other way, pull out the sheet and repeat…. Put the head of the gurney up so people can see him but not so high that his head flops to the side.
After watching this scene, I remembered the first time I pronounced a patient dead. There is an awkward choreography to the “death exam”: I listened for heart sounds with my stethoscope, checked for pupillary reflexes with my pen light, and felt for a pulse on a still warm yet lifeless body, a patient whom I barely knew. I was also supposed to press deep and hard on the patient’s nail bed—testing for a pain response—but this felt cruel, so I skipped this step. It was a spooky form of responsibility—the patient was not considered dead unless I declared their death as fact. The Pitt renders a moving and realistic portrait of the less heroic side of medicine—the smells, sounds, and textures that come with caring for those who have died. In this way, The Pitt still feels vital in its commitment to showcasing medicine uncensored. Hospitals are not fortresses of healing but porous sites of political conflict, loss, and unexpected joy—all that mess inside four walls.
Zoe AdamsZoe Adams is an internist and addiction medicine fellow in New York City. Her writing has appeared in The Washington Post, Scientific American, and Guernica.