The Best New Medical Drama In Years Has Shades Of Two TV Classics

This article contains mild spoilers for "The Pitt."

If you haven't yet stepped into "The Pitt," the safest way to do so is by starting early in the day. The new Max medical drama can be dangerously addictive, and if you're not careful, you might find yourself pulling an all-nighter catching up on the riveting series. The show itself starts at 7am on a seemingly average day in the emergency department of a fictional Pittsburgh hospital. Each episode then follows an hour in the life of a team of doctors, nurses, and interns as they triage and diagnose their way through an endless crowd of sick and injured people.

Episodes clock in at under an hour, so they don't exactly take place in real time, but they're close. The show, which was created by "JAG" and "ER" alum R. Scott Gemmill, maintains a steady drum beat of action throughout, building its tension like the squeeze of a heart attack and — much less often — giving audiences brief breathers that last only as long as the hospital staff is able to rest. The overall impression of "The Pitt" is one of coordinated, artful, high-wire chaos. In terms of pacing, it's a bit like if the pulse-pounding, Emmy-winning one-shot episode of "The Bear" lasted for over 10 hours. It's no wonder the show works like gangbusters, either, given the two TV classics that served as its primary inspiration.

With its breathless structure and life-or-death drama, "The Pitt" might suck you in so completely that you forget to pause for a bathroom break until Dr. Robby (Noah Wyle) — the show's hyper-competent, perpetually on-edge protagonist — finally takes one too. Along with its deep humanity, cleverly intersecting storylines, and Wyle's painfully expressive eyes, the best part of "The Pitt" may be its ability to manipulate time. Rarely has an hour ever sped by as fast as when we're watching this emergency department team save (and occasionally end) lives. But the show also makes some of its life-changing moments feel excruciatingly, realistically drawn out; when a family refuses to accept that their son is brain-dead after an accidental overdose, Robby breaks the news to them slowly throughout the day, while a mother worried about her angry teen son gets stuck in limbo when Robby can't decide whether or not to call the police.

Rarely, if ever, has a show worked so hard to convey the moment-to-moment stresses of the medical profession; even "ER," the gold standard of medical dramas, focused less on the overwhelming toll of the job, according to producer and star Wyle. In an interview with Rolling Stone's Alan Sepinwall, he, Gemmill, and producer John Wells (another "ER" alum) noted that they planned the new series with the intention of, as Wyle put it, "being almost a metaphor for what we've all been in in the last five years, trying to figure out our own way out." The actor also noted that Dr. Robby is "an avatar for a lot of people to project onto about how it feels to be beset by responsibilities without any kind of break and no time to process, no time to analyze," and a depleted ability to compartmentalize grief and trauma.

The differences between "The Pitt" and "ER" are pretty clear. As its creators told Rolling Stone, they include the show's hour-by-hour structure, near-complete lack of music, gore and nudity, and a unique production style featuring lots of live choreography and documentary-style shooting. Dr. Robby also doesn't seem to have the same backstory or baggage as his "ER" counterpart, the heroically named newbie turned hospital veteran John Carter. Still, there are storylines and moments that rhyme with "ER," a show that ran for 15 seasons and has been widely, wildly influential. Poignant patient backstories will leave you sobbing, while the new interns at Pittsburgh Trauma Medical Hospital stumble through many of the same moments of shock and naivety that Wyle's Carter faced on "ER."

Comparisons and contrasts between the two shows are more than just a water-cooler talking point, though; they're also the basis for a lawsuit lobbied at the team behind "The Pitt" by the estate of Michael Crichton, who penned the screenplay that became the "ER" pilot and was credited as that show's creator. Per a report by Today, Crichton's estate alleged that an "ER" revival that later became "The Pitt" was in the works at Max beginning in 2020, but that the estate did not consent to it (something the series' creators have denied). Lawsuits aside, it's clear that "The Pitt" sucks audiences in regardless of their attachment to (or even awareness of) "ER." Moreover, it only took a few episodes for the show to begin sharply calling to mind an even more influential medical series from an earlier time in TV history: "M*A*S*H."

"M*A*S*H" was a watershed moment for American television — if you can call an 11-year run that ended with the emotive, artistic, record (and water pipe)-busting high note that was the "M*A*S*H" series finale a "moment." The comedic wartime drama (which was based on a movie that was based on a book) starred Alan Alda as Hawkeye Pierce, a doctor who was as jaded as he was brilliant. The character was funny, haunted, talented, and above all else, deeply passionate about doing the right thing for his patients — even (and often) when it involved breaking the rules. Dr. Robby, with his excellent rat jokes, soul-crushing grief, and tendency to do things like fudge a sonogram date to allow a pregnant teen an abortion, feels like a direct descendant of Alda's Hawkeye.

The parallels don't end there. Perpetually put-upon medical student Whitaker (Gerran Howell) is a corn-fed Nebraska boy with eyes the size of saucers and a seemingly endless sense of good-hearted naivety. He's a lot like Radar O'Reilly, the hapless and innocent youngster played by Gary Burghoff in both the film and TV versions of "M*A*S*H." Similarly, when the former combat doctor Abbott (Shawn Hatosy) returns for the night shift, he slides into place like the Trapper (Wayne Rogers) to Robby's Hawkeye. Meanwhile, charge nurse Dana (Katherine LaNasa) holds the emergency department together with strength and grace, much like Loretta Swit's Margaret in the later, less sexist seasons of "M*A*S*H."

Stylistically and thematically, "The Pitt" also continues the mission of "M*A*S*H," a show that expanded the limits of its medium in various ways as its popularity grew. An early, excellent episode of "M*A*S*H" surprised audiences by promptly killing off a new character, inspiring the first of many searingly anti-war tirades from the tear-stained Hawkeye. Later episodes also boldly broke sitcom format rules. Season 8's "Life Time," for example, takes place in real time, complete with a countdown clock in the corner of the screen. Likewise, season 4's "The Interview" allows the "M*A*S*H" cast to drop their sitcom personas for an emotionally shattering confessional-style presentation.

Echoes of these and other episodes of "M*A*S*H" ripple through "The Pitt." The Max series also uses minimal music, a choice that calls to mind "M*A*S*H" creator Larry Gelbart's endless fight against the show's network-mandated laugh track. Both shows play with time, with "M*A*S*H" drawing a three-year war out into a decade's worth of storylines. Perhaps most importantly, they both feature deeply compassionate, keenly political storylines that draw from the real-life experiences of overworked medical professionals and everyday people trapped in an American-made hellscape. "The Pitt" has earned kudos for the hyper-realism it's cultivated thanks to on-set ER healthcare workers, while the writers of "M*A*S*H" talked to wartime doctors (the show was set in Korea but commented on Vietnam) and borrowed storylines from the front lines.

In a season 1 episode of "The Pitt" titled "6:00 P.M.," a mass casualty event takes over the hospital's emergency department, leading Dr. Abbott to instruct the doctors to run it like a Mobile Army Surgical Hospital — also known as a MASH unit. With this harrowing and timely storyline, the show finally goes full "M*A*S*H," calling to mind particularly relentless episodes of that show like "Deluge " and "O.R." It's a symphony of life, death, chaos, and deep humanity — one that zooms in on the questions that Wells told Rolling Stone the whole show is about. "How do you actually deal with having to see so much of other people's grief and anxiety?" he asked. "What's that cost? What do we actually ask these physicians and health professionals to shoulder for us?"

There doesn't seem to be an answer to this question, whether it's asked during the Korean War, Vietnam, or in a post-COVID landscape rife with conspiracy, violence, and gutted hospital budgets. "The Pitt" is still admirable for asking it, though, just like "ER" and "M*A*S*H" did before it. I don't know if "The Pitt" is too much like "ER," but I know we're lucky it's a lot like "M*A*S*H." I also know these shows offer at least one answer: that time ticks on, piling sadness onto happiness onto sadness. There will always be another shift, just as long as we can get through this one.