Spoilers follow for The Pitt through the tenth episode “4:00 P.M.,” which premiered on Max on March 6.
All ten episodes of The Pitt so far have pushed us toward a certain idea: Who the hell does Dr. Trinity Santos think she is?
Of all the characters in the Max medical drama’s deep ensemble, the big-talking, shit-stirring first-year resident is tailor-made to get on our nerves. Santos bullies her fellow trainees at Pittsburgh Trauma Medical Center with condescending nicknames and treats patients like game pieces. She leverages surgeon Dr. Yolanda Garcia’s (possibly romantic) interest in her to perform procedures she shouldn’t be doing this early in her career and then proves she’s not prepared enough by dropping a scalpel into Garcia’s foot. She goes behind the back of her supervising senior resident, Dr. Frank Langdon, over and over, acting as if she knows better than nearly everyone else when it’s just her first day.
One of the most consistent things about The Pitt, as dependable as fourth-year med student Dennis Whitaker getting gross stuff splashed on him, is that Santos will be a pain in the ass. And that consistency is incredibly clever because, by stoking viewers’ dislike of Santos — she’s too rude, too young, too ambitious, too much — and then proving her right about Langdon’s drug thieving, The Pitt turns around its thematic interest in bias so that it also implicates us. Now PTMC’s doctors aren’t the only people dealing with their own prejudices, distortions, and preconceived notions. In being led so easily into doubting Santos, we’re put on blast for our own innate ageism, sexism, and “Jeez, she’s a lot”–ism, too.
The Pitt attempts a level of accuracy that has been praised as “absolutely” reflective of how actual emergency departments run, and that fast-paced, real-time nature lets the show take on a variety of cases, and their accompanying biases, per episode. One of its recurrent tensions is how much time doctors spend with patients: The hospital administrators simultaneously want doctors to see sick people more quickly and still receive higher patient-satisfaction scores, and that impossible demand weighs on “the pit” and its backed-up waiting room. And because hospitals are denying doctors necessary resources and rushing them through their diagnoses, The Pitt argues, doctors are going to make mistakes and missteps that hurt patients. No doctor is immune from a wrong judgment call, either because they’re denied time or they’re falling into the same rote patterns of detection, investigation, and determination that have worked for them before. What matters is how the doctors respond to being called out by their superiors and peers for those errors and how they act with their next patient. Reciting the Hippocratic Oath isn’t enough — they have to live it.
Because The Pitt focuses on its characters’ growth, those bias arcs usually end with someone vowing to do better; PTMC is a teaching hospital, after all. The Pitt has routinely emphasized how much being a doctor involves subjective decision-making against objective data and how that subjectivity can be swayed by opinions doctors may not even realize they have. Sometimes these lessons are taught top-down: Third-year resident Dr. Samira Mohan teaches Whitaker to challenge his assumptions when a Black woman who is initially dismissed as an addict is actually in sickle-cell crisis, and Mohan firmly corrects Whitaker when he tries to lowball the woman’s morphine intake because he doesn’t take seriously how much pain she’s in. In a later episode, senior resident Dr. Heather Collins gently chastises second-year resident Dr. Cassie McKay for not doing a thorough enough exam of a larger woman experiencing abdominal pain and for missing her widespread infection. “I raise it as a possibility, not as an accusation” is Collins’s measured answer when McKay asks, “Are you saying I was biased against the patient because of her weight?”
To extend the idea that PTMC is a teaching hospital where everyone can learn, sometimes the series’ corrections flow the other way. Third-year medical student Victoria Javadi proactively changes a trans patient’s incorrect gender pronouns in her medical file, drawing praise from McKay. Second-year resident Dr. Mel King questions Langdon’s bluntness with an autistic patient and pushes against his declaration that the patient’s autism has nothing to do with his current diagnosis. And sometimes the biases feel like setups for a later narrative payoff, such as Robby’s and McKay’s differing reactions to possible homicidal incel David, who’s still in the wind after fleeing PTMC and his concerned mother. Robby thought McKay was overreacting by calling the cops on the teen, but as he admits to her after David goes missing, “I did not think enough about those girls” David had threatened to harm. How much Robby may come to regret his own soft-handed reaction to David’s menace we’ll have to wait to find out.
For the most part, these professionals accept correction with a certain amount of humility and resolve to do better — which is very much not how Santos has acted for most of the season. Even with her admission early on that she uses “sarcasm and comedy as a shield,” it has been hard as a viewer not to get irritated with her constantly cringe behavior: her flustered defensiveness when Mohan criticizes her flippant small talk with a college student whose friend died of a drug overdose; her unpolished questioning of a young girl about whether her father is sexually abusing her; and her ordering medical tests without Langdon’s approval. Santos usually means well, but she can’t seem to break away from insubordination, either.
Of course, it’s possible two things can be true at the same time: that Santos can be pushy and rude and that she was right about Langdon helping himself to the hospital’s drugs and stealing patients’ prescriptions. But with hindsight, it becomes clear how much The Pitt guided us down the anti-Santos path almost as a test, intentionally amping up her prickly qualities and the resistance from her more experienced colleagues to see how willing we were to fall into the same traps of misconception as The Pitt’s own characters. Would we have been so quick to turn on Santos if she were nicer to her fellow trainees or more faithfully followed the rules? If she smiled more? If Langdon weren’t so handsome? If Santos were male and Langdon female? If either of them were a different race or closer in age? If Langdon slid into twitchy paranoia more quickly? Was it only after Robby found those pills in Langdon’s locker that you finally accepted she was right, and if so, is that the only thing that could have convinced you?
When it comes to its doctors’ biases, The Pitt reveals most of them after they have already affected a patient, so we settle into a pattern of being surprised by the disclosure and then soothed by the character’s humble vow to do better. In presenting Santos as more bristly than deferential, The Pitt conditions us to suspect her motives and treat her differently from other characters, toward whom we may be more inclined to extend grace. It created in us the bias it asks us to recognize in others — trapped us in the pit, you might say, and then helped us climb out by making us admit our own preconceptions. When Collins tells Robby, “Leave your baggage at the door like everyone else,” that’s also The Pitt telling all of us how to watch.