You never want to hear a doctor state that a situation is “about as bad as it gets,” especially when not one but two lives are on the line. It turns out Dr. Michael “Robby” Robinavitch’s (Noah Wyle) mental health is not the only cause for concern in The Pitt’s second season finale.
After dealing with an endless stream of Fourth of July-related injuries, going old-school analog to prevent a cyberattack, ICE detaining a nurse who was trying to do his job, and a litany of personal crises, the day shift crew at Pittsburgh Trauma Medical Center only has to finish paperwork before they can leave after a monster 15-hour day.
But there is still time for one more life-or-death scenario involving a pregnant woman that had me on the edge of my seat throughout Thursday night’s finale.
When Judith Lastrade (Nicole Wolf) arrives by ambulance, Dr. Jack Abbot (Shawn Hatosy) is in the middle of telling Robby that many of his co-workers are concerned about Robby’s sabbatical plans. It is a conversation Robby does not want to have, so the arrival of a new patient is perfect timing in his eyes.
Judith’s symptoms—including an excruciating headache, swollen ankles, and high blood pressure—point to severe preeclampsia. The condition is fairly common in pregnancies (it affects 10 percent, Robby explains), but it is Judith’s lack of prenatal care that immediately raises eyebrows.
Before a two-day-long headache had Judith calling 911, she had seen zero medical professionals about her pregnancy. At 36 weeks pregnant, this is far from the norm; Judith explains she is having a “wild pregnancy” and wants a “free birth.”
I have to admit I was unaware of these terms and the online influencers who promote dangerous methods like them on podcasts and YouTube. At first, I thought she meant having a home birth. Nope, it means no doctors, hospitals, medicine, or midwives. She doesn’t even have a birth doula.
When Judith notes that women have been having children on their own for thousands of years without modern medicine, Abbot counters that the infant mortality rate was 30 percent for most of that timeframe. It might sound condescending, but given the events that follow, it is worth spelling out.
The Pitt has not been shy in depicting a variety of cases that speak to misinformation and trends that direct people away from traditional healthcare. Last season, the recent measles spike and its antivax roots took center stage. While that is a much-written-about issue, I was not aware of “sleepmaxxing” until The Pitt’s depiction a couple of weeks ago. What might seem like a frivolous movement can lead to severe health risks, like the patient who damaged her liver by taking too much turmeric as part of the “sleepmaxxing” recommendations.
Sometimes, The Pitt can lean a little PSA in its dialogue, but in the case of Judith, the explanation is as much for this character as it is for the audience. Judith says she doesn’t want an ultrasound because she thinks it will harm her baby, which the team explains is not true—in fact, it could harm the baby if she doesn’t have the ultrasound. When Judith begins seizing, both mother and baby are at risk of dying. Because it is a teaching hospital, procedures are explained without sounding clunky or out of place.
Each time the scene cuts back to Judith’s ongoing care, her condition deteriorates, and more doctors and nurses have entered the room to assist. Even before Robby returns and pulls McKay (Fiona Dourif) in to help, there are two attendings (Abbot and Shen) and two senior residents (Ellis and Crus). It is an all-hands-on-deck situation, with Robby rejoining mere moments before Judith needs resuscitation.
Throwing in a case this perilous late in the season is a reminder that The Pitt’s creative team is at the top of its game. I felt like I held my breath from the moment Abbot said, “Robby, it’s you and me,” coupled with the detail that they only have four minutes to save the baby after the mother goes into cardiac arrest. Abbot notes that they don’t call it a “postmortem C-section” anymore, and it is wild that they called it that in the first place. Instead, it is a “resuscitative hysterotomy” (try saying that three times fast).
Labor scenes on TV are often harrowing to the point of brutality (looking at you, House of the Dragon). Given its setting, The Pitt’s depiction does not fall into gratuitous or sensational traps. Last year’s groundbreaking birthing sequence took a realistic approach to complications that briefly sent me spiraling back to watching the Emmy-winning first-season episode of ER that ends with a baby but not the mother surviving.
I would’ve been 12 or 13 when I first saw “Love’s Labor Lost,” which begins with Dr. Mark Greene (Anthony Edwards) misdiagnosing a woman who has preeclampsia (he thinks she has a UTI). It is an exceptional hour of TV that holds up more than 30 years later.
That was even more on mind while watching the PTMC team perform life-saving measures in Season 2, adding to the tension of this nerve-shredding storyline. It is after nine o’clock at night, and Robby started work at seven that morning. Despite his deteriorating mental health, his medical skills are not dimmed. He makes the incision into Judith’s belly, and what follows is The Pitt’s prosthetic department demonstrating they continue to be the best in the business. As with the previous labor scene, the level of detail is unlike anything I have seen in scripted television.
While one team works on Judith, Shen, McKay, and new intern Nazely Toomarian (Sofia Hasmik) get to work on the baby girl, who is blue and flaccid. Even as the scene moves out of the trauma room, we can still see the team working in the background, making it the tensest medical procedure of the season, which kicked off with an eye-opening clamshell thoracotomy in the premiere.
That this comes the week after Robby told Langdon to “doctor the f--- up” so he could do a risky (but necessary) procedure that could paralyze the patient if done incorrectly shows there is no taking the foot off the gas. There has been no major incident to match the final stretch of intensity as last season, but The Pitt has maintained its high standards in the latter stages by turning up the pressure cooker on the staff as their boss’s psyche continues to fray.
It is such a relief when Judith is pulled back from the brink of death, and the now pink baby begins to cry. Even with a mask on, Wyle wears Robby’s emotions all over his face, and the camera lingers on him while Abbot talks to the OB doctor who has just arrived.
“S--t happens fast down here,” Abbot says when the doctor (who was in surgery) mentions he only got the text 12 minutes ago. Robby’s deep exhale when he leaves the trauma room, combined with the smile, matches my own, and I was only watching.
From start to finish, this case takes up a big chunk of the finale and is a reminder that, even when things go south, teamwork is crucial to saving lives. Robby and Jack having their heart-to-heart in this same trauma room later in the episode speaks volumes.
“That woman today—her baby, they’d both be in the morgue if you hadn’t been here,” Abbot tells him. “That’s us. That’s you and me. That’s what we’re here for.”
