Noah Wyle Breaks Down The Pitt’s Biggest Moments

Hello GQ, I'm Noah Wyle,

and these are the biggest moments

from The Pitt season one.

[chill music]

COVID flashback.

[plastic rustles] [machine beeping]

[Doctor 1] Robby, we need to intubate here.

[Doctor 2] Dr. Adamson just went down

with a pulse ox of 65.

[ominous music] [machine beeping]

[child coughing]

This show really was born in the pandemic

in 2020

when I was sitting at home receiving a lot of mail

from first responders,

and people that are in the front lines

who had felt that ER was somehow inspirational

to them going into that line of work.

So they were touching base with Dr. Carter

and saying thank you,

or just telling me how hard it was out there

and what they were going through.

And I was really moved by all that mail

and I didn't really know how to participate

or be of service at that moment.

So I just pivoted it all to John Wells,

and I called him up and I said,

Hey, you know,

I'm getting a lot of interesting letters

that are telling me there's another story to tell

in the healthcare sphere.

And I know you don't want to do the old show

and I don't wanna do the old show,

but if you ever wanted to talk about

what's happening right now

and scream something from a mountaintop,

I'd volunteer to this agreement.

That started the whole conversation

of what this show eventually became,

which is, ostensibly, a love letter to first responders.

We wanted to analyze

what aggregate toll working in those jobs has been like

for those practitioners over the last five years,

and have that embodied by a single character

who had to work through that period of time

and hasn't had time to unpack any of it yet,

but has compartmentalized those traumas the way we all have

in order to get on with our daily lives

and show up for our coworkers or our families.

But this is the day that the demons come to call.

This is the day that's no longer sustainable.

And over the course of this shift,

for various reasons,

he's triggered into those traumatic flashbacks

that took place five years ago during COVID

when he had to take his mentor off life support

in order to save another patient.

And ultimately, everybody died.

That undealt with memory, that repressed guilt,

is what's coming up in these flashbacks

when Robby gets triggered.

When he comes into work,

he's fairly unaware of

how close to being a drowning man he is.

You know, the water is at his ankles when he walks to work,

and it progressively rises over the course of the shift

until by the end

when he's back in that Pitt's room showing Leah's dead body

to Jake

and recounting all the people that he's lost that day.

The waters are over his head and he's drowning.

This is the job that keeps on giving.

Nightmares,

ulcers,

suicidal tendencies.

Besides, if you jump on my shift,

that's just rude, man.

It's a funny thing when you go to a wardrobe fitting

to choose a season's costumes,

but you're only gonna wear one thing.

So it's almost overwhelming

when you're given that kind of choice.

So I remember thinking,

I can't put any more thought into this

than Robby would put into it on a given Tuesday.

So you grab what's clean,

grab that shirt, grab those pants, grab that hoodie,

grab those socks, grab those shoes, out the door.

So that's exactly as much thought

as I put into that costume.

So I got such a kick

out of seeing people wearing that hoodie for Halloween

and for people selling it.

It was such a random choice, but seemed to work.

I usually steal a piece of wardrobe for every show I made,

and that seemed to be the most representative piece

of clothing for Robby.

I am told that we had between six and eight of those.

There was always a clean one in my room [chuckles],

for the most part.

Pupils four millimeters and reactive.

Okay, that's encouraging.

[Nurse] What do you want for meds?

[Samira] 120 ketamine, 80 of rock.

That's a lot more blood than expected.

We pride ourselves on being the most medically accurate show

to date on television.

And we arrive at that

by having an incredible team of technical advisors

on our staff led by Dr. Joe Sachs and Dr. Mel Herbert,

who are both legends in the field of emergency medicine.

Joe was technical advisor on ER

and also a writer on this show as well.

Dr. Mel Herbert created EM:RAP,

the largest compendium of online knowledge

for medical students ever.

They both bring over 100 years of combined expertise

to our show,

in addition to real-life trauma nurses in ER,

physicians who are on set all the time,

explaining pronunciation, explaining procedures,

but maybe even more significantly,

explaining the specificity of emotional reaction

to a case depending on what level of year you are

in your education.

So if we're in a trauma room

and there's a patient on the table,

and I'm in the room,

and Samira is in the room,

and Whitaker's in the room,

those are three very different perspectives

on the same case.

One is a student, one is an R3, and one is an attending.

And each one of those brings a different level of anxiety

and a different level of problem-solving skills.

So we rely really heavily on our technical advisors,

not just for the physicality,

but also the emotionality as well.

Whitaker's first patient dying.

[Donnie] Five minutes since the last epi.

Okay, that's it.

Hold compressions.

[Donnie panting]

Everybody loses a patient for the first time

and it's a significant event in medical education,

and it happens to Whitaker on his first day.

And it was a patient

that he had started to build a personal rapport with,

which often hits harder.

And it's significant for Whitaker.

It's significant for Robby being the attending, you know?

When these things happen to your staff,

you need to be able to help them contextualize,

compartmentalize, analyze,

and hopefully move on from in the healthiest way possible.

And imparting that advice to Whitaker in the beginning,

saying these things are random.

It's a numbers game.

A lot of people die every day.

This one happened to show up on your watch,

this one happened to show up on your table.

It's no fault.

You know, maybe two

or three people in the world could have caught this case.

I'm not one of 'em either.

It's all geared towards saying,

we play the percentages here,

we do the best we can,

and we get bogged down in our mistakes

at the detriment of treating our next patient.

We don't walk into the room

still treating the patient we just came from,

we have to walk in objective and clear.

That's easier said than done.

And over the course of the season,

what you begin to see is that Robby preaches

what he can't practice.

His advice to move on

and not let things debilitate is exactly his issue.

He was your patient, Dr. Whitaker.

Would you like to say something

before we all take a brief moment of silent reflection?

Um.

[sighs] He, he liked Kentucky bourbon.

[chuckles] Okay.

Good. Me too.

We shoot with two cameras.

We have two operators in the first season

who shot the entire season simultaneously.

We have an operator named Aymae

who wears a handheld camera on her shoulder.

And then we have an operator named Erdem

who uses a device called a ZG,

which is sort of analogous to a steady camera.

It's not exactly a steady image,

and it's not exactly Easyrig bounce.

It gives a kind of a texture that's really specific.

We tend to shoot only with about two lenses.

We shoot with a 50-millimeter lens and a 75-millimeter lens.

Those are the two lenses that are most comparable

to a human eyes perspective.

We never put a camera

on a gurney wheel going down the hallway.

We never put a camera on a ceiling

shooting an overhead shot.

All the photography is subjective

to a character's point of view

and to somebody who's in the room, voyeuristically,

which gives this sense of presence for the viewer

that you aren't a passive viewer in this experience,

you're sort of a participant

and you're being asked to be on the same endurance test

that these characters are.

Can you stay in your feet?

Can you sit through all these cases

and make it to the end of the shift?

In your attempt to try

to create a show that breaks through the noise

and differentiates itself from every other show

that's come before it,

you think about ways you could shake up the form.

And Scott Gemmill had two really interesting ideas

to try for this one.

One is to play the show in real time

and limit the entire structure to 15 consecutive hours,

and the others to strip away all the artifice as possible,

especially the music and the sound design.

And let the environment and the beeps on the machines,

and the sound of a ventilator,

and the sound of a baby crying,

and a man screaming be the soundtrack for the show.

Those were all really speculative ventures

that we were really gratified

to see worked exactly the way we had hoped,

which is the lack of music and the lack of manipulation.

And telling a viewer how to feel

actually increases the degree of engagement,

because when you're on your phone and you're,

Oh, the violins.

Oh, sad scene, I get it,

then suddenly you don't hear the violins,

you don't know quite how you're supposed to feel about

what you're watching.

It forces you to kind of look for clues within the frame

and abandon

that other screen that you had in your hand.

As you get more immersed in the storytelling,

hopefully you realize very quickly

that you don't have the objectivity of looking down

on this pit.

You're inside this pit with everybody else.

The four things that matter most.

Basically just a few key things that we can say

when we're saying goodbye

to a loved one that can really help.

What are they?

They're gonna sound really simple,

but I swear I've seen them work.

[Patient's Relative] Okay.

I love you.

Thank you.

I forgive you.

Please forgive me.

They're the four most important things.

The Ho'oponopono ritual that we borrowed

in pre-production.

And I met a man named Dr. Ira Byock

who wrote a book called The Four Things That Matter Most.

And his specialty is sort of end-of-life care,

palliative care.

And he had adopted this Hawaiian ritual called Ho'oponopono

to his practice

where, basically, he found that if you could say thank you,

I love you,

I forgive you,

please forgive me,

it had an unbelievably catalytic effect

in beginning the grief process on a healthy road.

And even with somebody that you don't have the opportunity

to have closure with,

just saying those out loud seems to give a sense of peace

and closure to somebody witnessing an end-of-life event.

And so I was really taken with it

and we thought, Well, let's put that on the show somehow.

And then I was lucky enough to get assigned episode four

where that was on the board

and it fit beautifully

as a piece of architecture to work through

for the whole episode.

And it was a really lovely piece of messaging

to put out there.

And I've received a lot of mail back from people

since that episode aired,

saying that that has been a real aid

in their own grief process.

What were those four things again?

I love you, thank you, I forgive you, please forgive me.

I love you, dad.

I've loved every minute we've gotten to spend together.

Interestingly enough,

this was the first time I think this has maybe ever happened

where we hired a production designer

before we'd even written a word on the page

because we needed to have a set to write to.

Because this all takes place in real time,

we needed to know how long it took to get from trauma one

to central 14,

and how long it took from central 14 to north four

so that we could write dialogue that would take up exactly

that period of time.

And we could begin to plot these characters

in a three-dimensional space

and have their journey not repeat itself

over the 15-hour shift.

So we hired Nina Ruscio,

who's just a brilliant art director and production designer.

And she did a lot of research

on an emergency room design

and optimum flow and sight lines.

And we told her kind of what we needed.

We needed an arena space

that you could shoot 360 degrees in,

but we also needed some private spaces for conversations

to feel like they were slightly tucked away.

We wanted some exam rooms to have doors,

and we needed some curtained areas

where you would feel very public.

We needed a doctor's lounge, we needed a bathroom,

we needed this, we needed that.

And then we said, we need this other room,

we need this room.

The room where it all happens.

It's the Pitt's room,

it's in the northeast corner of the hospital.

We need it to feel incongruously pleasant.

The imagery in there should feel almost sickly positive,

you know, cartoony in a way

that feels reassuring when you're first in there,

but then almost becomes a macabre sense of dissonance

when you see what actually happens in that room.

This is happening like now?

He just decided that dad is gonna die in this room,

in a room with cartoon forest animals all over it?

God, if you think about it,

it's kind of perfect.

So we talked a lot about animals,

and maybe it's a zoo motif or a circus motif.

I don't know why we landed on that fox

as being the emblematic sort of iconic image in that room,

but that's what we landed on.

And so it became a touchstone room for me.

When we were constructing the set,

I would go in there when it was just plywood

and think to myself,

This is the room where it all happened.

This is the room where it's all going to happen.

This is the room where the backstory took place

and this is the room where we're gonna tell our story in.

And then as it came together,

I'd go in there and just spend even more time in there,

more time in there.

To the point where that room

and I had an intimate relationship

before we got to shooting those scenes.

And then once we came to shoot in at that place was,

and still is, a very alive environment for me.

The drowning victim.

Thank you for saving me.

When you come home,

I promise I won't touch your toys without asking.

And I try not to fight

because you are my best friend in the whole entire world.

I love you.

That was a script written by Dr. Joe Sachs.

That anecdote came to us from a woman who's a,

I think she's a charge nurse

that Joe works with at Northridge.

And she came in

and we were interviewing her just anecdotally,

and she told us a story about a child that had died.

And in an effort to break the news to the sibling,

she'd gone to the gift store and bought a stuffed animal,

and come back and said,

Whisper whatever you want to tell your sister

into this stuffy's ear.

And I'll take it in there and she'll tell 'em.

And as soon as she told us that story, we all were like,

Oh my God, that may be the saddest thing we've ever heard.

Then all of us were like, I want that story. [laughs]

I hope I get that one.

And Joe got it.

And you know, Joe got nominated for that episode.

He got nominated for an Emmy for that episode.

And it's a beautifully written episode,

but it's so unrelentingly sad.

You have this 8-year-old girl

who drowns in the attempt of trying to save her sister,

which she does,

while the grandmother's vacuuming in the house

and can't hear any of it.

Then you have the parents showing up,

and obviously,

you don't wanna be the grandmother in that situation.

You don't wanna be the little girl on the table

and you certainly don't wanna be the little sister.

You look at this and you go,

I don't wanna be anybody in this story.

I don't wanna be anybody in this room.

This is horrible.

Obviously, they're gonna save this child.

And then we don't.

And you're like, How can you betray my faith

in television happy endings this way?

Are you telling me

that this isn't gonna have a happy ending?

And the only happy ending I'm gonna see is

this holistic honor walk that honors the organ donation

that this 18-year-old kid is going to go through

on the other side of a fentanyl overdose.

Wow. His own family's falling apart.

Like it was such a one-two punch.

One storyline you'd been invested in

since the first episode.

One, you're just getting hit with, you know, immediately.

The fentanyl patient.

That kid gonna make it?

Didn't he respond to Narcan?

I think his pinpoint pupils

just grew into blown pupils from brainstem death.

Shit.

There was something really beautiful

about Robby knowing in episode one that this kid was dead,

but not wanting the parents to have to face that reality

before they were ready.

So it's the way that he says we could still do these tests

to confirm,

and then we'll know more,

and I'll come back in a little while.

We can talk about where we'll be at that point.

It's this slow and steady acclimation to really hard news.

That is, I think,

what differentiates Robby from a lot of other physicians.

That sensitivity and that understanding that, you know,

you don't compound tragedy with tragedy.

You gotta give people a little bit of a sense of hope

in order to be able to come to a place of closure.

That's what I think he was trying to do.

And that brain image is the very last step on that

towards acceptance.

It is so conclusive when you see

what a healthy brain looks like when it's being perfused

with blood and oxygen,

and then what's going on

with their son is just the opposite.

It shows it in very stark relief the reality.

At that point, they are willing to accept

their son's death,

but they aren't anywhere near ready

to accept the concept of organ donations.

So that becomes the next set of chapters.

I remember seeing an interview once with Sir Ben Kingsley

who talked about the funniest set he was ever on

was Schindler's List.

[laughs] I was like, What?

And he said that because everything they did all day long

was so heavy and so depressing,

they would go out at night

and they would dance, and they would sing,

and they would play music.

And they engender these wonderful relationships

with each other just out of necessity,

just to reaffirm something positive.

Life-affirming.

The same is true in a hospital situation, you know?

You get some really funny people saying

some really funny things in really harrowing circumstances.

Therapeutically, medicinally.

You owe me a dance.

Well, I am a little rusty,

but let's give it a go, shall we?

[Patient] Mm-hmm.

Ready?

Mm-hmm.

Whoo. [patient laughing]

That's something we've tried to weave into our show,

not just because it's real,

but because audiences need to have a little bit of relief

from that tragedy.

They need to kind of go positive, negative,

positive, negative,

in order to appreciate and enjoy the ride.

The Pittfest tragedy.

[phone rings]

Oh god.

Yep.

Code triage.

Multiple GSWs.

There's an active shooter at Pittfest.

At the end of episode 11, I believe,

we get a call over the radio

that there's an active shooter at Pittfest,

and that as the nearest trauma center,

we're going to be getting the bulk of the cases

that are coming,

and they are going to be horrific.

And knowing that my stepson and his girlfriend are there

puts a personal spin on it for Robby,

but it's such a community event

that everybody feels somehow connected to this,

and it's going to be the last thing

that this hospital needs right now.

And so in the structure of the season, it was like,

okay, let's create a pressure cooker

where we add ingredients and heat,

and pressure over a period of time,

like 10, 11 hours until this thing's ready to explode.

And just at the moment when it's about to explode,

we'll drop a piano on top of it.

And that's what Pittfest represented to the staff.

We defined the whole series from that point forward.

Everybody that you'd seen experiencing their first day

on the job was about to get tested mightily.

A protagonist that you expect to be the white knight

that's gonna come charging in on his horse and save the day.

Suddenly, that horse comes in without its rider

because the rider's on the floor

of the Pitt's room having a breakdown,

having lost his number one

mentor, student

in Dr. Langdon

who was just kicked out an hour earlier

for a revealed drug addiction,

having lost his charge nurse

who just got punched in the face

by an aggressive patient two hours ago.

He lost his other best fourth year resident,

in Dr. Collins who's gone home,

and suddenly finds himself

without any of the architecture apparatus

that would sustain him in this moment.

Completely alone right when he needs everybody the most.

And then the shit really hits the fan.

[people chattering]

Larry, Larry!

Head wounds don't go to yellow.

Wait, what? Triage says yellow.

Hold on.

Go. I've got this.

We modeled it after the Las Vegas shooting.

The hospital that received the bulk

of those trauma cases did an unbelievable job.

Everybody that went into that hospital

with a lifesaving injury went upstairs to surgery alive,

and they saved so many people

because of the protocols that they put into place

in the event of a mass casualty event.

What were those protocols?

They didn't exist in that hospital

until one of the doctors

who happened to be on shift that night,

months earlier, had decided that they were ill-equipped

to handle a mass casualty event.

And so he himself went to Israel and went to a hospital,

and studied how they do it there

when they are on the receiving end of a terrorist attack.

And he copied all the notebooks and brought them all back,

and stuck them on the shelf in the hospital.

And they just happened to be there when this happened.

And they pulled the binders off the shelves and said,

This is what we're doing.

And because they did that when they did that,

they saved a lot of lives.

So we wanted to replicate that

and add to it in a way.

And so, again, Dr. Joe Sachs came up

with this really interesting protocol

of using slap bands that are color-coordinated

to determine degree of severity of case.

Up until that point,

usually, they do kind of tags, colored tags,

but this idea of slap bands was something

that Joe came up with

and is now being marketed and implemented in hospitals.

So we've actually contributed

to these protocols with our show.

But yeah, it's the moment when all of the medicine

that we've been practicing to that moment,

and all the tools and diagnostic equipment

that we have at our disposal

is all going out the window right now.

We are gonna do frontline war zone medicine

where it's live or die.

Dying in the first hour, dying in the next hour,

dying in the next five minutes.

This is what we're treating first.

It's a trial by a fire for all the characters

and it just worked really, really well.

But we also kind of invented this really cool,

Nina Ruscio, again,

came up with this wonderful idea of modular blood

that was like a,

it's plastic, it's a synthetic,

but we could lay it out almost like a carpet.

And it could come in all these different forms.

It could be a spill

or it could be a spill

with gurney wheel tracks going through it.

Or it could be a splatter,

or it could be a spill that's in the process

of being mopped up by a janitorial service.

But at the end of the day,

you could pick these things up

and you could move them around.

And best of all, if you walked through them,

you didn't track blood prints everywhere

unless we wanted to.

So the times when we're walking through it

and leaving tracks is super specific.

The other times, all that stuff is plastic

and laid down on the ground,

and you could pick it up and move it at wherever you want.

And that was a really exciting kind of novel approach

to doing it.

I'd never seen that done before.

I don't know how many people I've helped today,

but I can tell you every other person who has died.

There was a man named Mr. Spencer

who died in front of his children

and an 18-year-old

who was brain-dead from a fentanyl overdose,

and then a little girl

who drowned trying to save her sister.

And I'm gonna remember Leah long after you've forgotten her.

I'm wired, kind of funny.

It sounds funny to describe it this way,

but to me those are really

wonderful days,

because that feeling that comes out in that breakdown,

I had been carrying since pre-production

and kindling like a little fire in my stomach

so that I could be at a brunch with friends and go,

Is it there?

Yeah, it's still there. I could do it right now.

And I'd be in bed with my wife and I'd go, Is it there?

Yeah, it's there. I could do it right now.

And I'd be making breakfast with my kids and I'd say,

Is it there?

Yeah, it's right there right now.

And I would just keep checking in with it over weeks,

over months.

And then, finally, we got to close that day and I was like,

You know what?

Today is the day you don't have to carry this anymore.

[Noah sighs]

You get to let it go today.

And it becomes sort of a liberation moment

where you get to put it down

and, Oh my God, I loved it, loved it.

I'm a little emotional now

because we're shooting episode 13 currently.

We finish it tomorrow.

Start episode 14 on Tuesday.

We're in the championship rounds of season two

when all of the same attendant,

emotional baggages coming up for the character.

It's easier for me to stay in it

than to try to come out of it.

So again, I'm kindling it as we speak.

But it is also full of miracles,

and that is a testament to all of you coming together

and doing what we do best.

Thank you for everything you did here today.

We were looking for a very specific type

of performer for this.

It sounds funny to say,

but a lot of the intentionality behind this show was born.

The idea was born in pandemic,

how to make this show

or the way I wanted to make this show was born

during the strike.

198 days, two labor unions in solidarity,

shutting the industry down.

All of us with picket signs walking around in circles,

thinking about what work should mean,

could mean, used to mean,

what would we want it to be like

if we got the privilege of doing it again.

And I kept thinking about ER.

I kept thinking about how the first 15 years

of my career were spent in this lovely,

hermetically sealed environment

where we worked hard and played hard,

and made a great show that felt inclusive and relevant,

and resonance all over the world.

Why can't we do that again?

Well, how did we do it the first time?

Did we really do it the first time?

All that stuff was going through my head.

And then this show presented itself

and I found myself again with John Wells and Scott Gemmill.

And we started to say, Hey, we could try to do this again.

And early on, I sent a letter to our casting director,

Cathy Sandrich, and I said,

This is kind of what we're doing.

I said, It's kind of like an Altman movie.

It's kinda like 'Nashville.'

It's kinda like 'M*A*S*H.'

it's kinda like 'McCabe & Mrs. Miller.'

It's an immersive experience.

The camera's gonna be shooting 360 degrees.

You may be in the deep background for four hours

and then find yourself in the main part of the narrative

for the next three.

You may only be in the deep background,

but when the camera finds you,

you have to be at the apex of your storyline.

It's gonna require total focus, total dedication,

total buy-in for an extended period of time.

This is an ensemble piece.

And if it's gonna succeed,

it needs to be almost egoless in its approach.

So I basically said,

bring your creativity, bring your imagination,

leave your ego.

This is a different animal and it's gonna move fast,

but it's gonna be really rewarding.

And it was like, if you build it, they will come.

Like people just kept showing up saying,

This is what I've been craving.

This is what I've wanted to do.

This is this meaning I've been missing in my work

or the sense of community, or family, or solidarity.

And I feel like we threw a really great party for ourselves.

And then the world was like, That looks like fun.

I wanna come to that party.

And so we're throwing it again,

and hopefully, they'll feel the same way about season two.