The Pitt Showrunner Needed One Condition Fulfilled Before Writing The Show

Max's "The Pitt" is the best medical drama in years, with the show being praised for its accuracy and bringing the stress of emergency rooms to the screen. "The Pitt" follows the frontline healthcare workers in a Pittsburgh-based hospital as they deal with all manner of incidents in real time, leaving them with very little room to relax. What's more, the cast of the Noah Wyle-led series had to follow strict rules on the set to ensure that every episode felt like a living, breathing hospital environment, further adding to the series' sense of verisimilitude.

While the show is very meticulous in some ways, it also had a somewhat unconventional journey to the screen. For example, one of the best scenes in "The Pitt" season 1 was shot before the series was fully written, but the creators made it work all the same. Not only that, but the show's writers also refused to lift their pens until they had a set to work with, as showrunner John Wells explained in an interview with IndieWire. In his own words:

"Before anything was written, we had to know where we were going to go. It's so interwoven. [Production designer] Nina [Ruscio] designed a floor plan for us that we all then agreed upon, and then the writers worked seven months from around Christmas time of 2023, and then we're in production. I directed the pilot in July. You had to know exactly what was going to happen."

With the set locked down, the writers were able to start crafting stories that made great use of the environment. At the same time, creating compelling TV shows is a challenging process, and some episodes of "The Pitt" required some experimentation and modifications to the series' set in order to work.

"The Pitt" season 1, episode 12 sees the staff of the Pittsburgh Trauma Medical Hospital tend to the victims of a mass shooting. Given the sensitive nature of the subject matter, the show's creators made sure that they honored real-life hospital protocols for such situations. This led to them separating the set into colored zones, all of which reflected the different levels of severity for the patients who had to be treated.

In an interview with Variety, Nina Ruscio recalled traveling to hospitals for ideas on how to reconstruct the set on "The Pitt" for this episode. The production designer also spoke with doctors who'd worked in hospitals following the Pulse nightclub shooting in 2016, who opened up about using every available space in their hospitals to make sure every patient could be treated. To quote Ruscio:

"The actual architecture of the space was inversed like a black and white image, and we changed the physical dynamic of the space to be able to handle multiple victims at once — imagine it like the center of a wheel, and there would be patients in gurneys all around the doctors. I speak about it in a very detached way, but the level of horror of it all is very much like a war."

This episode only solidifies the show's commitment to detail, accuracy, and willingness to explore the horrors healthcare workers deal with everyday. By no means does it make for pleasant viewing, but the craft on display in "The Pitt" is undeniable.

"The Pitt" is now streaming on Max.