In an effective The Pitt, tensions finally and totally combust

When a young partygoer at PittFest is carried in, stuck in a dire condition after overdosing on MDMA, Santos displays a deeper knowledge of how the drug works, suggesting that, instead of pumping her with another kind of drug, the team give her saline because she’s dealing with low sodium after dancing all night without hydrating. Langdon is enraged that he wasn’t called into the room when the patient began seizing, acting as though his presence could have saved her, despite the fact that she’s safe now. He’s so enraged, and below the belt in his comments, that Robby pulls him aside with a lecture of his own about how harassment and belittling aren’t teaching tools. Ball lets the blow to Langdon’s ego settle over his face; clearly, he’s valued himself as a good teacher, somebody everybody likes. 

And he does seem emotionally attuned, at least enough to know that, after Amber’s drowning, Dr. King needs a break—which she’ll spend petting a patient’s dog, the perfect kind of therapy. “You’re a sensitive person. This is a tough place for sensitive people, but we need them badly,” he tells her. He’s not wrong about Mel, about the ER, about the world itself—even if, deep down, he’s mostly talking to himself. 

As much as the episode is about tensions erupting, it’s also about people coming to see new sides of themselves, virtues and shortcomings alike. One of the running gags of the show so far is how many bodily fluids poor Whitaker can get on his scrubs, starting with the homeless man who urinated on him while having a mental-health episode. When the man returns to apologize, Whitaker initially dons a mask and gown atop his scrubs, armoring himself in PPE before even this benign interaction. He’s clearly scared of his patients, not only the immediate fear of being peed on (admittedly, a reasonable one), but the existential dread of being reminded of his own failures as a physician. 

Yet as the man explains his situation—he doesn’t take his medication because he’s “between houses‚—the farm boy begins taking off layers, literally, seeing the patient as so much more than an avatar of his humiliation, of how hard it’s been to try and be a doctor, but as a man desperately in need of help. And he makes plans to join the street team that gives care and medication to poor and vulnerable populations, all so he can ensure that the man gets his meds. In these moments, he’s becoming aware of what it means to be a doctor, to take solace in saving who he can, even if the gesture feels as small and simple as listening. 

He’s not the only provider who’s called upon to listen better, or at least more compassionately. Two of the hour’s other major cases involve a woman who passed out behind the wheel and dragged a man walking his dog. While the man and his pooch are going to be just fine, despite some bad road rash, the woman is in dire shape. Looking up the woman’s medical history, Dr. Collins finds that the woman, a new mother, was seen earlier by Dr. McKay, who diagnosed her with a bladder infection. 

It turns out she had an endometrial infection that made her sick and dazed enough to lose control of her car. It’s an infection that Dr. McKay missed because her examination of the woman was rather perfunctory. Dr. Collins points out that she didn’t even do a pelvic exam, gently yet firmly suggesting that McKay may have overlooked it, perhaps, because of the patient’s weight. 

It’s refreshing to see the show address weight bias in healthcare so directly and with an unexpected character. Dr. McKay is a proud member of the street team, an advocate for vulnerable patients who struggle with drug addiction or who may have been lured into trafficking; she’s been ostracized and seen as unworthy because of her own issues with substance abuse. And yet, despite her best intentions, she still can’t fully see a plus-size woman as someone who merits a full work-up, who might have something wrong beyond the obvious. 

The episode ends with another sad reversal, with Dana outside, enjoying a long, meditative drag off her cigarette—only to feel a punch come whistling out of nowhere, connecting hard on her face. The man who hit her is a disgruntled patient, enraged at his wait time and looking to take that hurt out on someone literally. The powerful charge nurse, who joked about being terrifying and shaming, is then leveled in the same ambulance bay where her patients come in. 

Stray observations 

• • At least the saga of the rat in the ER is over, thanks to Crosby, the goodest boy, with an assist from Whitaker.
• • Next time you feel down about your own dating life, just remember poor Javadi and her attempts at asking out Matteo.