The Pitt—Closer to Palliative Care Than It Seems

The Pitt—Closer to Palliative Care Than It Seems
January 16, 2026 | 1 Comment
Categories: Opinion.
The Pitt is a medical drama, but unlike typical ‘hospital soap operas’, it shows not only how difficult it is to be a doctor but also how vital it is to remain compassionate in a system where each day hangs between life and death. The Pitt emphasises caring for patients, colleagues, and oneself. That’s why we chose to write about it.

Image: Warrick Page/MAX – Author: Uliana Pavlovskaia, PACED

A medical drama often depicts how challenging it is to be a doctor—a hero saving lives, resolving conflicts, and bound by schedules and overwhelming responsibilities for others’ futures. Its protagonists constantly endure emotional, physical, and financial pressures. And all of this is true and significant: doctors genuinely face these difficulties every day.

The Pitt is no exception. It tells the same story but adds a new perspective—one on doctors and their relationships with patients. That’s what caught our attention and inspired this article. We believe that palliative care professionals will find this series particularly meaningful. (Mild spoilers ahead!)

Image:  Warrick Page/MAX
The Plot
The story unfolds over a single shift in the emergency department of a Pittsburgh trauma hospital. The main character, Dr Michael ‘Robbie’ Robinavich, a senior attending physician, ironically refers to his workplace as ’the Pitt’—a name derived from Pittsburgh and ‘a pit’.

Image:  Warrick Page/MAX
The series consists of 15 episodes, each representing an hour of a 15-hour shift. It’s astonishing how many events, emotions, and decisions can occur within a single working day. Although all the action takes place within just a few square metres, it feels vast—filled with stories, characters, and emotions that create a complete world.

We follow not only Robbie but the entire team—residents, nurses, administrators, and students on rotation. Robbie is portrayed as a doctor with extensive experience and a deep understanding, both of medicine and ethics, attentive to patients and colleagues—a moral compass for his team. At the same time, he bears unprocessed grief: two years earlier, his mentor died of COVID-19 in this very department. Robbie works to the point of exhaustion, balancing on the edge of emotional and physical burnout.

Thus, The Pitt is not just a hospital chronicle but a journey into the psychology of its staff. For perhaps the first time, we see doctors portrayed so convincingly as vulnerable human beings, just like everyone else.

Caring for the Patient
From the first episode, it’s clear that patient care here is not just a slogan but a way of practice. Dr McKay, confident and slightly cynical, shifts instantly when she enters the room of a burn patient: the urgency fades, her voice softens, and her gaze concentrates. She shares something personal — ‘My son loves s’mores too’ — fostering a space of trust.
Image: Scene from The Pitt © HBO Max
    Images:  Warrick Page/MAX
In another scene, a doctor tries to communicate with a patient who does not speak English. She resolves this by asking the patient to point to her country on a map. These are just two examples of how the doctors in this series aim to connect not only with a diagnosis but also with a person—restoring a patient’s voice and agency during a vulnerable moment. One of the fundamental ideas of palliative care unexpectedly appears in a series about emergency medicine.

 

Caring for Oneself
As mentioned, Robbie doesn’t manage self-care well, but he’s attentive to his team’s well-being. Imagine a scene: a resuscitation is underway, with several people working intensely—giving injections, performing intubation, and chest compressions. The room is filled with shouts, alarms, tension, and hope. Suddenly, the attending physician announces the time of death—and everything ceases.

The team has lost the battle. They can walk away, carrying the trauma inside, or they can pause for a moment of silence, recognising the loss. And it helps. I asked a friend, an ER doctor in Chicago, whether this happens in real life. ‘Yes, it happens,’ she said. ‘Especially when a child dies.’

That moment will resonate with many hospice and palliative care professionals. Even knowing that a patient will die doesn’t exempt them from grief—it still needs to be felt, ideally within the safety of a team and with psychological support. In The Pitt, such a person exists—a social worker providing urgent emotional support not only to patients but also to the staff.

Medical Ethics
In one episode, an elderly patient with pneumonia has an advance directive: antibiotics and fluids—yes; intubation—no. When the condition worsens, his children cannot accept this decision. The doctor, although he agrees with the patient’s wishes, does not impose his view. He simply says, ‘I can’t make that decision for you,’ and steps aside—remaining nearby. It’s a moment of greatest ethical clarity: the doctor stays present but does not take on a responsibility that isn’t his.

Image:  Warrick Page/MAX
Teaching and Learning
Training remains a recurring theme. Young doctors and students learn by observing their senior colleagues—not only medical procedures but also ethics and communication. In one episode, a student questions the high dose of morphine prescribed to a terminally ill patient. The experienced doctor replies calmly: ‘A little empathy goes a long way with those suffering pain.’ It’s almost the series’ manifesto: empathy isn’t weakness, but a professional tool and a measure of competence.
Caring for Caregivers
The series also highlights another important aspect of healthcare—the exhaustion faced by those caring for patients with long-term conditions. In one episode, an elderly woman with a fracture arrives, accompanied by her daughter, who has been caring for her for years. The daughter conceals her state, but the doctor gently discusses caregiver fatigue—that ongoing care is draining, and rest is not selfish but an essential part of care itself. It serves as a simple reminder: support should extend to families just as much as to patients.
Communication
The show emphasises communication. In a powerful scene, the chief physician walks past a consultation room and notices a young doctor standing while speaking to a patient. With a small gesture, he signals: sit down. This silent gesture conveys a philosophy—communication as equals. Looking down on someone is unacceptable, not just metaphorically, but literally.

Images: 1 – Scene from The Pitt © HBO Max; 2 –  Warrick Page/MAX

Social Issues
Alongside personal stories, the series regularly revisits broader social themes: staff shortages, the aftermath of the pandemic, societal fatigue, and violence. These do not divert from the narrative but enrich it, illustrating that medical culture cannot exist in isolation from the realities faced by doctors and patients. This, too, makes the series particularly resonant for those in palliative care.
In The Pitt, medical empathy is not at odds with professionalism—it completes it. This is not a story about illness and cure, but about the lives of doctors for whom care is a professional norm. Its strength lies in how it restores a human face to medicine and reminds us: doctors are not demi-gods hardened by knowledge and cynicism, but people who work every day to save others while respecting their dignity. And the same, without a doubt, can be said about palliative care professionals.
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This article first appeared in the PACED website and is republished here with permission.

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Comments

  1. Dr. Vivian Papaiz

    I am really enjoying this series. Noah Wyle’s portrayal of Dr. Robbie reflects exceptional leadership in an emergency department that is chaotic, distracting, and under pressure from every possible angle—very representative of the medical system we find ourselves in today. Immersed in the story and its characters, it has been a long time since a show has moved me to this degree.

    The creators have done a remarkable job of capturing the true reality of the environments so many of us work in every day. Kudos to all of the healthcare professionals doing this incredibly challenging and essential work. We are a better society because of what you do. Thank you.

    Reply

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