A review of this week's The Pitt — with spoilers — coming up just as soon as I fall off a motorcycle pyramid...
Alan Sepinwall
Oh, Louie.
It was clear at the end of the previous episode that things weren't going to end well for PTMC's most popular frequent flier. Still, this week's Noah Wyle-directed episode wrings every bit of pathos out of Louie's demise.
Whether by choice or by coincidence, Wyle has often worked behind the scenes on episodes where the staff is confronted by the rawness of death. In the first season, he wrote the one where Robby helped the adult children of the man who built sets for Mr. Rogers say goodbye to him, and also the one set in the aftermath of the drowning case. Here, he's again depicting how even this jaded staff of medical professionals have a harder time accepting some deaths than others.
It wasn't just that Louie was in the ED constantly(*). It's that he was so cheerful, so pleasant, and such good company, to the point where people like Langdon shared details of their personal lives with him. Louie drinking himself to death objectively doesn't feel like a tragedy on the same level as a little girl dying to save her younger sister's life, or a college student overdosing on Fentanyl, or any of the PittFest victims. The doctors and nurses warned him again and again about the dangers of what he was doing to himself, and he very politely declined all of their advice.
(*) In that way, while it's a contrivance to have him show up, and die, on Langdon's first day back, it's not that big a contrivance.
But that doesn't matter, because he was Louie. He felt like a friend to so many of them, as we see in how devastated people like Whitaker and Perlah are to hear the news. This season has very smartly leaned more on the nurses, both to advance stories and to sell the emotions of the job. Here, the burden falls on Amielynn Abellera as Perlah. She's obviously a caring provider, whom we once saw literally jump on top of a patient to prevent her from being shot at a second time. But she and Princess primarily serve as a comic Greek chorus, gossiping about everything in Tagalog. So to see Perlah this stunned and broken up about Louie really sells just how sad this is for the whole group(*).
(*) Well, not the whole group. Ogilvie is an asshole about it, because 1)It's his first day, and he has no history with Louie, and 2)He's Ogilvie. Mostly, it's the latter, as we're reminded when fellow newbie Emma takes Louie's hand in hers after she learns more about his past.
The ED doesn't exactly calm down in the wake of this loss, but you do see all the doctors and nurses who know about it working a little slower, trying to get their bearings, and being ever so slightly kinder to one another. (Robby even leaves Langdon alone for a bit.) Dana uses his death — and Perlah's obvious difficulty with it — as an excuse to teach Emma another aspect of the job, as she shows her how to clean a dead body to make him suitable for family to see. As it turns out, the ED was Louie's family — if not literally, close enough. He actually has their phone number listed in his chart as his emergency contact! Langdon spends a little while trying to track down the woman in the photo he finds in Louie's effects. But when Robby is able to gather the staff in the visiting room for a debrief, he explains the tragic backstory behind the photo, and behind the condition that brought them to this moment. Louie was a happily married man, with a steady job as a groundskeeper for the Steelers and Pirates, who wasn't necessarily eager to have kids, but gradually let his wife win him over on the subject. When his wife and unborn child died in a car accident, Louie climbed into a bottle and never came back out(*).
(*) This was also the backstory of a recurring alcoholic character on ER, Stan, who in one episode gets quarantined in the emergency room along with Carter and a few others for several weeks after a smallpox outbreak. The situation forces him to sober up, and we find out he was a teacher in his former life. When the docs suggest he could start going to meetings now that he's been through physical detox, he politely explains that he killed his wife and daughter in a drunk driving accident, and sees no way to deal with that other than through drinking. Like a lot of situations where Pitt and ER plots overlap, I suspect it's less a case of the writers thinking back to ideas they used before than to certain real-life stories unfortunately come up again and again in the world of emergency medicine.
Robby's conducting of the impromptu service — concluding it with the traditional Jewish phrase, "May his memory be a blessing" — is a rare moment of empathy and leadership for him in what's been a pretty ugly shift/season for him to this point.
Earlier, he gets into it with Al-Hashimi about her desire to admit the malnourished Gus so he can receive better care than he can get back in prison. Robby, burnt out, struggling to keep his head above water as the influx of Westbridge patients threatens to drown the whole hospital, and suspicious of his new colleague, wants no part of this. In the most condescending, obnoxious manner, he dismisses her attempt to help this man as "social justice." Earlier in the episode, Al-Hashimi's not contrite in any way when her AI app hallucinates a condition for one of Santos' patients. This should in and of itself make it impossible to empathize with her, at least for the rest of the hour. There's a reasonable version of the argument he's making: they can't help everyone, and Gus is in position to get better medical care than someone like Louie or Digby would be if they got discharged with a serious condition. But he is so abrasive and unprofessional with her that it doesn't matter. He's somehow going through this season with even more Clerks-style "I'm not even supposed to be here today!" energy than he did last season, when he literally wasn't scheduled to cover that the PittFest shift.
It's impressive that Wyle and the other writers would lean so hard into their hero's weaknesses this early in the series. At least, if it is intentional. I hope so, because they're so savvy and empathetic on almost every subject. But there are times when it feels like the staff has the same blind spots Robby does, like when R. Scott Gemmill discussed the whole Robby/McKay mess from the end of Season One.
The closing scene reminds us of the Robby we came to love so much last year. But it stands out in part because moments like it haven't been as frequent so far this year. That's how much everybody cared about Louie: his death is even able to snap Robby out of his worst instincts for a few minutes.
Some other thoughts:
- Dana reveals to Langdon that she opted against pressing assault charges against Doug Driscoll. Yet she remains incredibly on edge about nurses being assaulted, going HAM on a cranky patient who grabs Emma's arm to get her attention.
- Roxie's story seems headed for a sad end during this shift, since she decides she'd rather stay in the hospital than go home to die. Her husband and sons have been through too much, and have had to devote themselves too much to her care, and she wants to spare them having this one last awful thing happen in the place where they live.
- We don't always get updates on patients when they leave the ED, but we hear that the waitress with sepsis from the previous episode is going to lose her leg.
- Javadi is more experienced, but still socially clumsy, inadvertently sending Jackson's sister Jada into a spiral by suggesting they're going to figure out "what's wrong with him."
- There seems to be trouble in paradise — or however they define their relationship — between Santos and Garcia.
- Projectile vomit doesn't feel quite as transgressive as projectile diarrhea or the priapism case. Nonetheless, Pitt Season Two remains committed to depicting just how gross a shift in the ED can be.
- Harlow the deaf patient finally makes it into an exam room, but the translator who was helping her earlier has to move to another case. That leaves the multilingual Princess to take over, even though her ASL is iffy, and Santos is too impatient to sit through that. I know using a phone, or even a pen and paper, is slower than talking, but it would still be faster than waiting for another translation option to present itself.
- Awww, Donnie's tattoos are from PittFest Day, and from the day his daughter was born.
What did everybody else think?
