If you haven’t watched HBO MAX’s medical drama “The Pitt” yet, stop what you’re doing right now, binge two seasons, and thank me later.
In its second season, the show follows the staff of an incredibly busy Pittsburgh emergency department through one long, brutal shift. What sets “The Pitt” apart from its other loosely medical-based counterparts is its willingness to tackle real issues head-on. From medically accurate portrayals of procedures like a “clamshell” thoracic surgery, to end-of-life care decisions, the show doesn’t shy away from the harsh realities of the healthcare world.
As someone who spends a lot of time thinking about aging and the systems that are (or aren’t) built to support older adults in this country, here are the things that I think the show gets right.
Spoiler warning: the following references spoilers from seasons 1 and 2. If you are not caught up on the latest season, continue at your own risk.
Drama: “The Pitt” returns again and again to caregiver burden, and it’s one of the most accurately portrayed representations of caregiving on television. The adult child trying to care for her aging parents, a husband keeping his family together through his wife’s terminal cancer, an elderly couple who want to maintain their independence and stay in their home despite chronic conditions.
More specifically, one episode in season 1 features a mother/daughter duo navigating an increasing demanding caregiving journey. The adult daughter is exhausted and overwhelmed, and at the prospect of more intense needs and dependency from her aging mother, she goes missing for several hours, just to have fallen asleep in her car trying to get some rest.
But these aren’t empty, filler characters that give main character Dr. Robby more lessons to teach his med students: they represent the reality of everyday Americans.
Reality: According to Caregiver Action Network, more than 63 million U.S. adults are caring for a spouse, elderly parent, relative, or special-needs child, one of five of which are also managing a job at the same time. This can lead to higher rates of depression, anxiety, and increased risk for having multiple chronic diseases as they may neglect their own personal health needs while providing care to others.
Drama: In a contentious exchange with Dr. Robby, another physician, Dr. Mohan, is recommended for a geriatrics fellowship. While the comment was meant as a slight dig (with the implication being the pace is slower and maybe even easier), it poignantly raised the issue of the dire need for more geriatricians.
Reality: By 2030, every single baby boomer, or one in five Americans, will be 65 or older. To date, the U.S. only has roughly 7,000 board-certified geriatricians. Compare that to the over 60,000 pediatricians in this country, and you’ll understand the shortage. Worse yet, the U.S. Department of Health and Human Services projected a shortage of nearly 27,000 geriatric providers; a deadline that has basically already arrived. Only one in 10 U.S. medical schools even requires a geriatrics clinical rotation, even though every doctor will spend a large portion of their career treating older adults.
Drama: A hallmark of the show is that the waiting room is perpetually overwhelmed, doctors are pulled in every direction, and charting gets pushed to after a shift just to keep up. In one telling moment, Dr. Langdon admits to seeing 16 patients in a single morning, and doesn’t recognize a woman he treated just four hours earlier.
Reality: According to the American Medical Association, emergency medicine leads all specialties in physician burnout, with older adults particularly vulnerable in these overwhelmed environments. This means longer emergency room stays, higher likelihood to “boomerang” or be readmitted, and to face higher rates of adverse health outcomes after discharge.
Drama: When older patient Vera is discharged with instructions and technically cleared to go home, she realizes she has no way to get there. Her neighbor drove her in but can’t drive at night, and she can’t afford a cab. It takes a medical student (Dr. Whittaker) personally paying out of pocket for a ride-share, and walking her to the ambulance bay to meet her driver, to get her safely home.
Reality: Transportation is one of the most persistent and underreported obstacles to healthcare access for older adults. An estimated 3.6 million Americans reported missing or delaying their necessary healthcare appointments because of difficulty getting there. While some older adults have not missed medical care, 50% reported they may have to in the future due to lack of transportation.
Drama: The season also weaves in the theme of financial dread that follows older patients and their families through the system. Patients having to ask themselves if they can afford the care they desperately need. Cuts to Medicaid cause the doctors of Pittsburgh Trauma Medical Center to have to navigate care for their patients, even if that means finding workarounds. In one episode, Dr. Mohan’s patient leaves the hospital in the hope of not burdening his family with more medical debt, only to immediately be brought back when his condition worsens, with no hope of recovery. His daughter starts a “Go Fund Me” account to raise money to cover his medical expenses.
Reality: While “The Pitt” may be a fictional show, caregiver burnout, a geriatrician shortage, and the rising costs of healthcare are not. These are decisions getting made right now: in Congress, in medical schools, in coverage determinations. What we decide will shape what aging looks like for the largest generation of older adults this country has ever seen, and those to come.
Let’s make sure those decisions are good ones.
Katrin Werner-Perez is the Director of Health Programs at the Alliance for Aging Research.
