I did not watch ER in the 1990s because it was too gross. Or, at least, I assumed it would be. I’m a pretty squeamish person so, despite the fact that the show had become a watercooler series even among some of my friends in high school, I took a pass on all the scalpels and sutures and stats. The first serial drama I truly loved was The West Wing. I loved the speed of it, the energy, the way they all talked with such high-wire fluency and casual erudition. It was, like ER, and like so many of the other series I’d come to love over the next decade, a fantasy of competence. Just a little less gross.
ER and The West Wing—these ambitious, impeccably crafted, incredibly popular network drama series, occupy a kind of strange place in the mythology of contemporary television, overshadowed by the premium cable prestige series that were soon to come. If The Sopranos, The Wire, and Deadwood would be crowned the Olympians of serial television, then ER, The West Wing, and other network series like The X-Files and NYPD Blue were the Titans, the powerful elder divinities who serve as ancestor and prelude to the gods who ended up getting all the attention.
These network shows of the ’90s and even the 2000s (ER and The West Wing both ran well into the premium cable revolution) perfected a virtuosic balance between episodic storytelling—case of the week, etc.,—and serial narrative that could sustain itself for two dozen episodes per season. They told a gripping, ongoing story while simultaneously crafting individual episodes with discrete, unique narrative attractions. What they did to synthesize the network procedural and the soap opera is what allowed network veterans like David Chase and David Simon to experiment with that form.
While that premium cable boom set the stage for today’s streaming landscape, something has been lost in translation. Many contemporary streaming series seem to have learned the lessons of mood and mayhem from their premium cable ancestors without picking up the formal balance those shows had taken from their network roots. If commentators dubbed The Sopranos a “13-hour movie” to signal its difference from network television, contemporary streaming series are actually built that way, less as TV series and more as long, serialized films. Moving further and further away from the constraints that shaped network television—commercial breaks, time slots, even network censors—new streaming series are increasingly meandering in narrative terms, alternately barren or bloated affairs. Episodes of Stranger Things reel into feature length, while seasons of brisk, crowd-pleasing thrillers like The Diplomat or Black Doves top out at a disappointingly brief six episodes. The crowded writers rooms that once helped plot out those massive seasons have been gutted, sometimes only housing a single writer in the role of auteur. Having neither radically reinvented the form nor meaningfully hewed to its traditions, streaming series, at their worst, don’t even seem like television. There’s way too much, and not enough.
But, just as all hope might seem gone, ER is back. Its name is The Pitt. It’s streaming on Max. It’s incredibly gross, but, for once, I’m happy to see it.
Legally speaking, ER is not technically back. Yes, The Pitt is executive-produced by John Wells, an original producer of ER; yes, it’s a serial drama about the high-intensity environment of a hospital emergency room; yes, it stars a grizzled and gentle Noah Wyle who, as a younger, wider-eyed actor, was also one of the stars of ER; and, yes, it was recently subject to a lawsuit from the widow of Michael Crichton—the creator of ER—claiming that it’s an unlawful “derivative work” of that series. But, other than that, it is indeed a totally different thing.
Set in the chaotic, underfunded emergency wing of a trauma hospital in Pittsburgh, The Pitt’s first season tells the story of a single shift in, mostly, real time. (Each of its 15 episodes covers the better part of an hour, though episodes mostly clock in at a breezy, classic 45 minutes.) This particular day is both special and ordinary. Our main character is Wyle’s Dr. Rabinavitch—everyone calls him Dr. Robby—who is the senior attending doctor of the E.R. He’s come into work today despite the fact that it’s the anniversary of the death of his predecessor and mentor, who passed during the pandemic. Alongside the tough-talking charge nurse Dana (Katherine LaNasa), Dr. Robby manages a department full of residents, all of whom are undergoing personal crises of varying intensities, and a new crop of interns and med students who’ve shown up for their first day, totally unprepared for the pace—and splatter—of life in the E.R.
The Pitt is a considerably grittier affair than its (alleged) grandparent. Watching ER today, it’s incredible how clean everything is, how slowly even fast-moving operations unfurl, and, more than anything, how many breaks these people get during their shift. In the pilot of ER, there’s a scene in which all of the major doctor characters hang out together in a break room for an extended period of time like it’s Central Perk, just drinking coffee and shooting the shit. In The Pitt, several interns are chastised for trying to eat lunch. One doctor announces he desperately has to pee, and we follow him for a genuinely excruciating amount of time before he’s able to make it safely to a urinal. And then there’s the gore. As the show airs on Max, it gets a blank check for blood and guts. In the first handful of episodes alone, we see a woman with a degloved (skinned) foot, a man with a collapsed palate that makes his face as floppy as a Halloween mask, and a burn victim who has to have his torso scored like a ham in order to relieve the pressure on his swollen lungs. I’ve seen roughly half of this show from behind my own fingers. ER, which had a reputation for graphic medical procedures, cuts away from stitches.
All of which is to say that The Pitt is a show for a different time. ER was a workplace romance; The Pitt is a workplace catastrophe. Post-Covid-19, doctors and nurses have become even more heroic figures in pop culture, but the health care system is straining. Hospital administrators want to juice numbers and hire management consultants, departments are woefully understaffed, facilities are crumbling, and, high above this sorry scene, insurance company vultures circle. While the show doesn’t necessarily put forward too strong of a systemic critique, it tells a very clear story about the way that the infrastructure of health care routinely fails its practitioners and patients alike.
So, The Pitt is not ER, but, in many important ways, it is a throwback. It is profoundly ironic that the first streaming series in a long time that so strongly recalls—at the level of form—the network serial drama heyday of the ’90s was probably ordered on the strength of its “real time” episodic gimmick. Streamers famously don’t like to order long seasons these days. Six, eight, 10 tops. Netflix even split the third season of Bridgerton into two four-episode clusters. But The Pitt clocks in at a luxurious 15 episodes. That’s quite shy, of course, of ER’s average 22, and only a hair above The Sopranos’ 13, but, compared to its peers, this show is approaching epic scale. The show’s creator, R. Scott Gemmell, probably didn’t sell Warner Bros Discovery on reviving Clinton-era episode counts out of moral principle; it’s more likely he justified his show’s length in literal terms: That’s just how long the shift is.
The fantasy of a “real-time” film or show is that the text is wholly at the mercy of the events, that the plot itself supersedes any directorial or writerly mediations. No montages, no monkey business, minimal use of flashbacks—the moment dictates its form. But, of course, that’s not how it works.
Gemmell and his staff of writers do remarkable work shaping discrete and overlapping stories within these time slots, deliberately pacing some developments quickly and others slowly, building up false or misleading characterizations over multi-episode arcs only to dramatically reverse them. Some patients who get wheeled into the E.R. go out fast in spectacular fashion; others linger and develop. Some cases last the length of an episode, some straddle from one episode to another, some wrap up and return, some cases grow knottier and knottier, some change over time.
The ward is littered with rewarding runners: a new intern who keeps getting splattered by bodily fluids every time he enters a room; the cast of regulars who keep comically interjecting into the more dramatic proceedings; the hotshot surgeon who keeps trying to slice open every patient who comes through the doors. Some characters are instantly beloved favorites who only grow in depth—Taylor Dearden’s Dr. Mel King is a standout—while others grate initially and grow on you (Isa Briones’s cocky Dr. Santos). Some episodes—including one that centers around the unrelated deaths of both a small child and a college student—sink themselves in grief, while others play almost as farce. The point is that this show has time to build its world in this way, to vary its tone, to explore its world, to give its characters the episodes they need to unfurl.
The Pitt is not the only streaming series to take its cue from those halcyon days at the end of the millennium. Robert and Michelle King, in shows like The Good Fight and Evil, have brought those network values to the streaming landscape. Shows like Netflix’s immensely popular The Night Agent have a kind of old-school procedural feel. Tony Gilroy built Andor around a series of multi-episode arcs in a way only a student of the medium could.
But still, it is peculiarly fitting that Max, the streaming arm of HBO, has produced an heir to ER nearly 30 years after that show’s network debut. It feels like a reappraisal of what exactly that TV revolution meant or means today—a reckoning with the medium of television itself, not as an inconvenient series of tubes, but as a set of forms and constraints with a history and a magic all their own. The Pitt isn’t going to revolutionize the streaming landscape, but getting swept along with its quick, confident beats, it feels defiantly different. Maybe it’s the start of a new shift.
