aAfter a wait longer than most in A&E reception areas, medical drama The Pit finally arrived on UK screens last month with the arrival of streaming service HBO Max. Almost everyone I know spent the next few weeks getting ready. In fact, some of us have already caught up on Season 2 (the final episode aired on US TV last night) and are trying very hard not to blurt out important story points at office tea points, public transport, and actual hospital waiting rooms. Remember, we are in a post-spoiler era.
I’ve strayed a bit from the mark, mainly because it took me so long to figure out whether I could actually access HBO Max as part of the mysteriously arcane Sky TV package, but I’m rushing through it now and ready to share the same observations that others made a few weeks ago, or in the case of the US, a year ago. The big question is, why didn’t a TV producer come up with the idea of combining ER and 24 before? it was right thereI’m looking at your faces! (Jed Mercurio, whose forgotten 2015 medical drama Critical also had real-time elements, might disagree at this point.)
Beyond The Pitt‘s formal innovation (each season lasts, until the second season, a 15-hour shift at an under-resourced teaching hospital in Pittsburgh), what’s surprising is how accessible it is. That’s partly due to the comforting presence of the show’s star, Noah Wyle, the big-hearted, sad-eyed senior attending physician Dr. Michael “Robbie” Robinavich, essentially playing a sequel to John Carter, the fumbling junior doctor character from ER who became the show’s inspirational icon. But familiarity doesn’t start and end with Weil. It’s at the very heart of the show. With its jarring tonal shifts between gentle interpersonal drama and intense claret-splattered surgical scenes, The Pit unapologetically inserts itself into the lineage of modern medical dramas, making a strange stew of feel-good television and high-tension discomfort that viewers seem to find endlessly fascinating.
In Britain and America, early medical dramas were often melodramas, a genre that tended to prioritize formula and familiarity over formal boldness. (That doesn’t mean they were conservative; one of the first interracial kisses on British television occurred on the ITV drama Emergency Ward 10.) But in the 1980s, medical dramas began to evolve on both sides of the Atlantic. In the United States, a new generation of multi-layered workplace dramas has emerged, including the hospital-set series St. Elsewhere. Now widely remembered for its absolutely cracker ending, it was innovative in its use of multiple storylines and topical themes, most notably being the first show to feature an AIDS storyline.
Meanwhile, in the UK, the BBC launched Casualty in 1986. The show may seem hopelessly traditional to today’s viewers, but it was anything but when it debuted. The show’s creators, Paul Unwin and Jeremy Block, envisioned it as an unflinching look at how Thatcherite reforms are destroying the original vision of the NHS. “In 1948, a dream was born. In 1985, that dream was in tatters,” read the first line of the manifesto they wrote for the show. The casualties caused some heckling complaints from the then Conservative government. (“What do the Tories want us to do? Make our blood blue, not red?” was the response host on BBC1 Michael Grade.) The show rarely seemed to stay out of the headlines during its first decade. The most famous was a 1993 episode in which a group of violent youths burned down a hospital, which had to be moved across the watershed, but received record complaints for its violent scenes.
Around the same time, ER came along in the United States and changed everything. A blockbuster medical drama that completely modernizes the genre. The storylines, which included opioid addiction, the mental health crisis, and systemic racism, were surprisingly bold for the time. And with its high commitment to medical accuracy, truthful filming style, myriad cast, sudden tonal shifts, and more, it set the template for all like-minded shows that followed. You can see ER’s influence in everything from gentler works like Grey’s Anatomy and The Good Doctor to more exciting takes on the format like House (pictured above), as well as simple long-forgotten knockoffs like Code Black, Chicago Med, and The Resident.
And, of course, The Pit was reportedly conceived as a reboot of ER and is currently the subject of a lawsuit from the estate of ER creator Michael Crichton. So why did it resonate with viewers when so many others like ER-a are about amnesia? Much of its success is due to the conceit of small storylines in early episodes spiraling into something unexpectedly large, turning the procedural format of a medical drama into something of satisfying length. But The Pit also has the same nettle-grabbing spirit as the groundbreaking medical drama. They are unafraid to tackle real issues, such as rushing hospital workers to hospitals and restrictions on abortion after Roe’s repeal, as one grim storyline about the impact of insulin rationing on patients shows, and are reluctant to ignore the dangerous state of American health care, such as the NHS deaths and injuries.
So perhaps my last observation of the year is actually: “The Pit” is a show that captures medical drama at its best and makes the genre safe.
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