‘The Pitt’ Delivers Gnarly Medical Drama, but Its Emotional Honesty Hits Harder

There are plenty of reasons to watch The Pitt — great performances, gnarly medical cases, and the incredibly effective hour-by-hour structure. But something else about this show struck me, hitting especially hard in episode 4 a few weeks back. Spoilers ahead for a few storylines (and an emotionally heavy topic).

Through the first three episodes, one of the ongoing medical stories follows the Spencers, siblings Helen and Jeremy, as they come to grips with their father’s decision to forego life support. In episode 4, after some quasi-spiritual guidance from Wyle’s Dr. Robby, they decide to let him go, camping out by his bedside as he’s extubated and prepared for a natural passing.

As I’ve written before, my mother died when I was thirteen. While my younger sister and I had a chance to say goodbye in the hospital, my parents understandably decided we shouldn’t be there at the very end. Since then, I’ve twice sat by a hospital bedside, watching loved ones pass after similarly painful decisions. Much has been written about The Pitt’s medical realism, but what stands out to me is how profoundly it captures the patient experience.

The Spencer siblings are in an impossible situation, and for the loved ones of a dying patient, everything hinges on the compassion and care of the hospital staff. While some moments from my experiences still haunt me, I take equal comfort in the kindness we were shown by doctors, nurses, and staff—people who could have seen us as just another case on a clipboard but didn’t. I remember making the final call to let a loved one go and being hugged by a nurse I had met mere hours earlier. It meant the world. Nobody gave me the Ho’oponopono mantra* that Dr. Robby shared with the Spencers, but I did hear other words of quiet support — encouragement to make whatever peace needed to be made before saying goodbye.

*In the show, Dr. Robby describes Ho’oponopono as saying, “I love you, thank you, I forgive you, please forgive me.” Such a simple concept, yet it felt like a gut punch. I had never heard of Ho’oponopono before, but it immediately brought me back to my own experiences, where I instinctively went through a similar process—even if I didn’t need to forgive either of them for anything. If you take one thing from this, I’d implore you to remember this mantra if you ever find yourself in this awful situation. It’s an emotional roadmap.

This past week’s episode hit me in a similar way when Dr. Robby brought in a grief counselor for the parents of a brain-dead boy. There’s no greater devastation than losing a child. While my situation was different, I remember that same emotional fog — utterly drained, unsure of what to do next. The way the grief counselor helped guide the parents through those steps felt so true, not just in what she said but in how she carried herself. The tone of voice — soft yet firm — rang especially real.

But The Pitt doesn’t just get the emotional weight right, it also nails the strange reality of these moments. In a hospital, so many different stories unfold simultaneously. During one of my experiences, we were in the coronary wing, not the ER. Having a private room was invaluable, but sometimes I’d step into the hallway, either to give others space or just to breathe. Next door, another family was celebrating a patriarch’s successful bypass surgery. I remember smiling at the contrast — their joy, our grief. Not in jealousy, but in recognition of the messy, overlapping stories that make up life. The way The Pitt follows its cast through these patient narratives—flitting between rooms, lives, and tragedies—feels exactly like that moment.

Of course, the show is also medically accurate, and that realism hits hard in the depictions of death. As the Spencers sit with their father, it’s the sounds. Man. The beeps, the air flows, the patient’s breathing, the wetness in it, and then—Jesus Christ—that last breath. This show should be mandatory viewing for all adults past a certain age because nobody prepares us for this experience. The Pitt gets closer to embodying it than anything I’ve seen.

One last thing: gallows humor. The show captures it from the doctors and staff, but not from the families. Understandably so—it’s structured as an ER drama with real-time pacing. But when you’re in these situations for days, sometimes weeks, dark humor creeps in. It has to. In both of my experiences, that humor became an outlet. I even bonded with a nurse over it—she seemed to appreciate the lens through which I processed things.

In an interesting bit of timing—if one believes in such things—I’m writing this between two days of Yahrzeit candle lighting, a Jewish tradition for remembering the dead. Both loved good television. I wish, instead of writing about them in connection to The Pitt, I could tell them they should be watching it. It’s compelling television for all the reasons other reviews have covered, but more than that, it uses its 24-esque real-time approach to explore patient stories with a depth most medical dramas can’t. And in doing so, it’s making something important, something heartbreakingly real.