SPOILER ALERT: This interview contains spoilers from “10:00 AM,” the fourth episode of the first season of Max’s “The Pitt.”
For Noah Wyle, everything old is new again. More than 30 years after rising to global fame as John Carter, a wide-eyed, fresh-faced intern, on the NBC smash-hit medical drama “ER,” Wyle has returned to the same genre as an overworked senior attending physician in a beleaguered emergency room in Max’s “The Pitt.”
But rather than reprising his beloved role as Carter, and rebooting or reviving the Chicago-set “ER” — a fact that has been legally disputed by the estate of series co-creator Michael Crichton — Wyle has reteamed with heavyweight “ER” producers John Wells and R. Scott Gemmill to develop a fresh take on a well-trodden genre for the HBO streamer.
“The Pitt,” which debuted earlier this month and drops on Thursdays, plays out over the course of a single shift inside the emergency department at Pittsburgh Trauma Medical Centre — with each of the 15 episodes representing a single hour on the job. Wyle plays Dr. Michael “Robby” Rabinavitch, who chooses to go to work against his better judgment on the anniversary of the death of his mentor, Dr. Adamson, whom he lost during the COVID-19 pandemic. (In addition to starring and executive producing, Wyle wrote Episodes 4 and 9.)
It was during the pandemic, when Wyle himself was “steeped in a depression of feeling pretty useless,” that he first considered donning scrubs again. Having received a lot of mail from first responders who expressed that “ER” had inspired them to pursue a career in healthcare, Wyle initially tried to redirect all of the compliments to Wells, the showrunner who oversaw the most successful early seasons of the show.
“I said, ‘If you ever want to revisit this world in any way and talk about what’s going on and you need a mouthpiece for that, I’m your man,’” Wyle tells Variety. “So, initially, it was just like, ‘Hey, I think these people that we used to honor and depict are hurting, and they could use a lifeline and a spotlighting again.’”
Gemmill, who joined “ER” as a writer and producer in the late ’90s, had long been adamant about never wanting to make another medical show. But during the pandemic, he, too, began to have second thoughts. “We realized that there was a reason to do it again, as long as we could find a way to do it that was fresh for both us and the audience so that we weren’t just retreading what we’d done in the past,” Gemmill says.
“We’ve stayed in touch with many of the doctors and writer-doctors we worked with, and they started telling all of us about what the problems are now — and there’s some significant problems,” Wells adds. “It seemed like within the context of trying to follow someone through an entire day, you could actually touch on just how difficult being in these urban medical settings are now.”
While they all joke that they can tell how much time has passed just by looking at each other’s faces, Wyle says reuniting with Wells and Gemmill has given him a renewed appreciation of what they were able to accomplish on “ER.”
“We were involved with something that was so unique, but I was very young and I didn’t have a lot to compare it to,” Wyle says. “I’ve spent the last 15 years looking to replicate the feeling that I had making that show, which was more than just the product of the show: It was the relationships that went into it, the buy-in, the professionalism, the sense of pushing ourselves and our talents every day in a healthy, competitive way. I think that really goes to the way that John runs his shows. And the second we got back in each other’s orbit, I just felt relaxed again in a way where I could be creative. It’s been like coming home.”
Below, Wyle, Wells and Gemmill open up about how, despite the inevitable comparisons, they wanted to differentiate “The Pitt” from “ER,” and why they have insisted on putting the focus squarely on the practice of medicine.
You may be shooting “The Pitt” a stone’s throw away from where you shot “ER” on the Warner Bros. lot, but medicine — and television — has changed considerably in the 15-plus years since “ER” went off the air. How has this filming experience compared to your days on “ER”?
John Wells: I think the thing that we absolutely wanted to do, and one of the advantages about doing this for streaming, is we could take it to entirely another level of verisimilitude. That’s not just about language — that’s about what we can show, what you can see. It gives us a real opportunity, because it’s a one-day shift, to not have to service the personal relationships on an ongoing basis, and you just see a single day in a workplace. I think what Scott and the writers, including Noah, have done brilliantly is to give us these little tastes of who everybody is through their interactions with everyone else, and to then do it in a very realistic fashion where you really feel like you’re getting to do the version of a ride-along, but in an emergency room. That, to me, was really exciting when Scott started to pitch it. Crazy, but exciting.
Noah Wyle: It’s somewhat analogous to being like a combat correspondent, embedding yourself within a unit for a period of time. That fully realized experience is only going to be had that way.
Courtesy of Max
Robby seems to be the calm, empathetic eye of the storm; he’s always trying to de-escalate issues among patients and doctors, even when he seems to have moments of spiralling internally. Given that we get to see him only on this one bad day of work, how did you think about building him as a character?
Wyle: It’s a really interesting question. There was a moment when we started with him walking to work. There was the question, “Maybe he should wake up in his apartment or where he lives,” and then it’s like, “OK, well, is he next to a dog or a blonde, or is he alone? Does he take a shot of whiskey or a shower?” Every choice you make from the second you establish him is going to define him in a way that will either relate him or not relate him to an audience member.
So, in a way, if you want the eyes and ears to be put through the protagonist, you don’t over-define him in a way, and you don’t under-define him in a way. You just have to present them and let the circumstances play themselves out. So there are a thousand little details, and then there were a thousand exercises in discretion and restraint that we exercised at the same time so that you can stay on this journey and identify with him trying to do the best he can while the circumstances get harder and harder and more complex, and his ability to compartmentalize gets harder and harder to maintain.
Scott and John, following up on that, how did you want to distinguish Robby from Carter on “ER”? Was that ever a major concern of yours in the writers’ room?
Gemmill: Oh, absolutely. If I was going to do another medical show, it would have to be completely different and new, because I don’t want to do the same thing over again. I don’t think the audience — I mean, there are some who would [want to revive “ER”] for nostalgia’s sake, but that’s no fun for me and I don’t know how much fun it is for Noah.
In terms of the Robby character, the people that suffered in some ways the most during COVID were the frontline workers who had to deal with it while we were all huddled in our houses. Lives were lost not just from the disease — but from the workers who had to deal with it, who also succumbed, and some who couldn’t handle the mental anguish and took their own lives. So that was a really important part of who this character was.
What we came up with was that he’s from a generation and a profession that traditionally doesn’t acknowledge their mental health challenges. That’s changing, thank goodness. But sometimes, back in the day, that would be a mark on someone’s record. So he’s the kind of guy who won’t show weakness to anyone around him, and because of that, he hasn’t dealt with what he went through. As you well know, you can only push that stuff down so long before it finds a way out. And this turns out to be a day where it starts to find its way out.
Wells: There have been many, many wonderful shows about medicine. I worked on one before “ER,” which was about emergency medicine — “China Beach,” which was combat medicine in Vietnam. “St. Elsewhere,” which is an extraordinary show in the ’80s. “Casualty,” which has been on forever. So we wanted to put people into a world in which they are not comfortable. In other words, as an audience member, you bring all different kinds of memories of other medical shows, but you’re thrown into a very different experience than what you’re expecting. Noah, as an actor, is leading us into this world. And then boom, we’re in a very real place.
The show is extremely realistic, very well-researched. Lots of physicians are involved, and the response that we’re getting from all of the people who work in emergency medicine is, “This is exactly what it’s like.” What we’re trying to tell [viewers] is, “This is what we ask these people to do, and we need to be conscious of what their needs are because we’re ignoring a lot of the things that are going on. We need to provide them with the tools to do this job, because we’re asking them to do something that’s very difficult.”
So there’s an attempt to avoid the comfortable in the show. There’s no music telling you how to feel. There is no telling you exactly what every procedure is. We are just going to show you what the procedures are. You want to see an arm which has been badly burned in electrocution? Probably not, but you better realize that there’s somebody there who’s going to do it, and that we ask them to do it, and they’re there when we need them. It’s a really conscious thing to throw you into what you think will be a medical show that you’ve seen before — [when] it’s really not.
Courtesy of Max
The real-time nature of the show is a clever way to dig into the inner lives of these characters, but this premise also presents a unique set of logistical challenges. How exactly have you navigated shooting this show? Are you block-shooting the cases and assembling them in post?
Gemmill: We’re shooting in continuity. The first day is the first page, and the last day is the last page — that was the only way it would work. We designed the set before we started writing so that we could write to it. I’ve spent many times in the ER with loved ones, and it’s hard to capture what that feels like. Part of it’s monotony. Part of it’s just waiting for a doctor to come back and tell you what’s going on. You’re beside people who are screaming, who are wandering around. You never really get to know your doctors. They just work there. You’re there and then you’re gone. You’ll never see those people again. So trying to capture that was really important.
I think one of the things that separates the emergency department from other forms of medicine is the time factor — not just the amount of time you wait to be seen, but also the patients that are brought in who only have moments to live if these guys don’t work fast enough. The real-time aspect seemed to be the best way to capture this world that we’d never seen before, and we weren’t sure it was going to work, even up until we started shooting. It wasn’t really until we saw the first cut that I knew that we had something — because it was just crazy. We have a whole AD department who’s just doing background, and we’ve tracked all those background characters in terms of what their journey is through the day. So it was a lot of logistics, but I think it worked.
A lot of viewers have already remarked that the authenticity of medicine on this show is unlike anything else they’ve ever seen before — which was something that was also said about your last medical show. What specifically do you think you are doing differently here than on “ER”?
Wyle: In a lot of ways, “ER” was a patient-centric show, and this is more of a provider-centric show, which puts the focus of the medicine and the current way that it’s practiced in first position. I would highlight the contributions of Dr. Joe Sachs, who was a technical advisor on “ER” and is very much the advisor of this show, an executive producer on the writing staff. He puts everything into making sure that the realism is on the page, on the stage, and making sure that the community that he comes from is being honored and the stories that they want told are being depicted.
Wells: Doing it in continuity is plotted out in the scripts. The rooms are decided. So when you come in, when you’re directing, you’re picking up literally the minute after the previous episode finished. Everyone’s in a place, so you basically receive a full set that’s already set, and then you’ve got to work your way through everything that’s been plotted out within that episode.
People come in and they’re in the emergency room waiting room for seven, eight episodes, with a line or not a line at all. And then we see them come back and they might have two or three lines. And then an episode later, they have a huge scene. So we had to have buy-in from everyone — including all of our primary cast — that they’re going to be background [for other actors]. “You’re going to be moving through things. We’re going to see you every which way.” Noah sent a wonderful letter that went to all the actors as we started to give a sense of what they were doing. We’ve got background artists who’ve been in the same bed for seven months reading books, and in the same makeup hair for seven months. The buy-in to it is what’s been so important.
Wyle: I was probably speaking to the wrong generation, but I made the analogy that this is something like early Altman films like “McCabe & Mrs. Miller,” “M*A*S*H,” “Nashville.” We’re creating a tapestry, and the tapestry has got a thousand threads running through it. Sometimes the camera’s going to be focused on that thread, and sometimes it’s going to be focused on the thread next to it or on the other side of the room. But you need to stay in your character in real time, all the time, in order for the camera to come back and find you where we need you for the storytelling.
This is much more like being part of a repertory theater company or going to summer camp than doing TV, but bring your knitting, bring your enthusiasm, bring your creativity, check your ego, and come to play. It was amazing how that letter went out and how it resonated with people who were just craving a sense of buy-in and a sense of ownership, and to really stretch that muscle and to do it in L.A., and to do it for John and still be able to go home and have dinner with your family every night and have it be a fulfilling experience — it’s really great.
Courtesy of Max
Noah, you wrote this week’s episode, which features a particularly moving storyline involving the end-of-life care of Mr. Spencer (Madison Mason), with his two middle-aged children sitting at his bedside and saying their goodbyes. What did you want to accomplish with that hour in particular?
Wyle: Initially, I just wanted to pick an early episode so I could get my script in before we started production. And there was something about the four things that matter most, the Ho’oponopono Hawaiian ritual, that I was really moved by, and also the ambulance chase. The ambulance chase and the four things that mattered most lend themselves really well to pacing out that storyline over the course of the episode, so I saw the structure in that right off the bat.
I like the messaging so much in the four things that matter most — to be able to say, “I love you. Thank you. Please forgive me. I forgive you.” The simplicity of that, the profundity of that, in terms of coming to terms with a relationship that is finite, is really important. The idea of being able to put that kind of messaging in an entertaining and engaging hour of TV out there so that it could just bleed into the consciousness is one of the most exciting things about working in this medium, because it can have an impact.
Noah, you also wrote episodes of “The Librarians” and “Leverage: Redemption.” Writing on a medical show can be particularly challenging, but if any actor could do it, it’s you. Do you leave the technical stuff all up to your medical advisor, or do you have an idea at this point of what kinds of cases you want to make up to reveal more about the characters? What does that collaboration actually look like?
Wyle: Somewhere between a third and a half of these scripts get farmed out to Dr. Joe Sachs, who puts the medical terminology and who does what in the scene based on the hierarchy and the level of expertise of the character, and the internal friction between the characters. It comes almost on a silver platter with a cloche on it, and then you take these pieces and put them into the narrative that you’re building. But I give him a tremendous amount of credit for the contributions he makes, which are not just technical. I mean, yes, to be honest, all three of us have a collective knowledge of emergency medicine that most average people don’t have because we’ve been dealing with this for a very long time.
Gemmill: Just enough to know when things are really bad and they’re not telling you!
Wells: You really don’t want to know what all the terms mean. You really don’t want to know what all the Latin is, because you’re just sitting there going, “Wait, I don’t think I need that. What? What were you saying?”
Courtesy of Max
Robby gets close to his breaking point in Episode 4 after getting flashbacks to Adamson dying in the same room as Mr. Spencer. How much do you think the loss of Adamson has been weighing on Robby over the years?
Wyle: [Adamson] serves as the epitome of a kind of Sophie’s choice that a lot of practitioners had to make when they had limited resources and ever-increasing need. You’re basically having to make allocation decisions on where to better use a piece of lifesaving equipment. You’re making a judgment call — hopefully, not based on too much emotion. And in this situation, Robby had to basically pull the plug on his own mentor to give this piece of equipment to someone who had a better chance of survival. The compounded tragedy of that is one of those things he’s never been able to really sift through, analyze, process, come to terms with. He could talk about the four things that matter most, but he has not said them to that particular man yet, or forgiven himself.
We were given such unbelievable access through a guy named Dr. Mel Herbert to the EM:RAP group, and we got to sit there and talk to these guys. They wear their educations and their careers on their skin, and it gets thinner and thinner the older they get. It takes a toll. You cannot see and do this every day for 35, 40 years and not have it take a toll. So the fragility of our system is in the strength of our practitioners and the support that we give them measures the quality of our civilization, in some ways.
Courtesy of Max
The upside of the premise of “The Pitt” is that you could theoretically drop back into Pittsburgh Trauma Medical Centre at any time. Have you given much thought to how long you would like this show to last? Do you have another decade-plus run left in you?
Gemmill: I don’t know about that, man! The one thing that’s really great about television is it’s a real group effort. There are hundreds of people that bring their best to the show so that what we end up with is greater than any one of us could’ve done alone. These days, just providing jobs for people in this industry, in this town, is so important. So you’re just not thinking about yourself, but thinking about how important it is to keep a show running as long as possible, to keep people employed as long as possible. For that very reason alone, you keep going. Even maybe when you think, “Maybe I’d like to do something else,” or “I’m burned out,” you have to think of everyone else who relies on this as a source of income. That’s a very important part of the job.
Wells: I think there’s a possibility to do more. We haven’t really talked about it. We are going to see how it continues to do, but so far, so good. The reviews have been very strong, and it seems to be doing well on Max, so they will tell us at some point whether they would like more. I think we would probably be excited to try and figure it out.
This interview has been edited and condensed.
