The Pitt Gets Everything Right. That’s Exactly The Problem.
A TV Drama Is Doing What Medical Schools No Longer Can
There is so much going on in the world right now — which is precisely why I want to talk about a TV show.
Not for escapism. Because this particular show is doing something that medical schools across the country are now being required to stop doing.
The Pitt won Outstanding Drama Series at the 2025 Emmys. Season 2 just aired its finale. Season 3 is already confirmed. And if you want to understand why the show matters beyond its awards — why the medical community is embracing it, why researchers are studying it, and why it has attracted a specific and revealing kind of backlash — keep reading.
Critical and clinical acclaim
I could list a thousand reasons why The Pitt deserved every award and accolade. The hyper-realistic, nerve-wracking, at times physically sickening medical drama captures what it is actually like to work in an American emergency department right now: the grinding resource scarcity, the moral injury, the impossibly high stakes.
For those that don’t know, each season covers one emergency room day shift. Just one shift. 15 episodes. And anyone who thinks the writers crammed too many crazy cases and issues into a single shift has never worked in a busy urban ED. I documented the insanity in journal entries I turned into blog posts years ago, but I didn’t even capture a fraction of the clinical variety and human drama that one shift can hold. Shit is REAL, man.
Basically, The Pitt has absolutely nailed the shitstorm tsunami that is clinical medicine these days, with an impressively medically accurate plot and a cast of characters you will care about deeply.
But the show is much more than quality medical drama.
Narrative that reflects reality
The Pitt’s accurate storylines illustrate how social, environmental, and economic factors shape a person’s risk of getting sick or injured, and then also shape the care they receive once they arrive in the ER.
A partial list of factors that The Pitt covers across its two seasons: the opioid epidemic, gun violence and mass shootings, health insurance and the lack thereof, immigration and ICE, homelessness, mental illness, physician substance abuse, domestic violence, sexual assault, race- and gender-based health disparities and medical bias, the importance of cultural competence and compassion to the quality of care, AI, cyberattacks, burnout and depression, weight discrimination, climate change (unusual heat wave), violence against healthcare workers, and more.
These issues aren’t political choices by the writers. They are the daily reality of emergency medicine in the United States.
Here is a tiny handful of a few storylines from Season 2 that have illustrated the real issues facing patients and doctors these days:
Diabetes without insurance: A man with diabetes is working construction but is uninsured and cannot afford the insulin he needs. In a heat wave, his blood sugar spirals, his kidneys struggle, he collapses and is brought to the ER. He is being stabilized when he calculates the cost of admission (even after social workers intervene to cut it in half) and looks at his family, his wife who waitresses, his daughter who is trying to raise money to cover medical bills with a GoFundMe, and decides to leave against medical advice. He goes back to the job site, collapses again, this time from a height, and suffers a serious head injury. He is wheeled away to the ICU, toward an ending the show leaves unresolved, but which anyone can complete in their head without difficulty, because American patients declare medical bankruptcy every single day. Issues: The plight of the un- and underinsured, The high costs of healthcare.
Missed diagnosis: A middle-aged woman is brought in with chest pain. It’s a heart attack, but the initial EKG missed it, because the leads were placed too low by male paramedics didn’t lift her breast out of the way. Why did they screw up? Could be because they didn’t really think it was her heart, or perhaps they were too embarrassed or afraid to properly place the leads. Dr. Robby calls out the paramedics on this, with the full support of the female staff. After all, heart attacks in women are missed far, far more often than in men. Issues: Gender bias in medical care and diagnosis
Body shaming: A man with morbid obesity is brought in with a life-threatening condition. He has avoided care for years out of fear and shame, having been met with negative judgment in medical settings before. He is too large for their CT scanner and needs ambulance transport to another facility. Though an ignorant medical student makes rude statements that exemplify the unconscious bias these patients routinely face, the attendings and senior residents model empathy and excellent care, and the man is deeply grateful. Issues: Weight discrimination, Judgment in medicine
Medical gaslighting: A Black woman with Polycystic Ovarian Syndrome (PCOS) comes in with lower abdominal pain. We learn that her pain has not been taken seriously elsewhere and she has been dismissed and discharged home without a diagnosis. The intern is about to repeat history, but the senior resident believes her and decides to keep her for observation. When the pain escalates, they are able to perform an ultrasound and catch the ovarian torsion in real time (the ovary is twisting and the blood supply is getting cut off, which without emergency surgery, can result in a dead ovary). That decision — to simply believe her — is what cultural competency looks like in practice. With an accurate diagnosis, the woman is now able to get the care she needs. Issues: Race and/or gender bias in medicine
Earning a patient’s trust: A man who is homeless arrives with a maggot-infested injury. He appears grimy and filthy. In order to be able to treat him, the team arranges a bath and grooming. They treat him with great dignity, and the charge nurse listens to him describe why he’s let his injury fester for so long– his fear of medical institutions. He grows to trust them, and he accepts their care. Issues: The intersection of homelessness and healthcare, Compassion and empathy as clinical tools
These are not “politically motivated” storylines. These exemplify existent, well-researched social, environmental and economic issues that are impacting real people and providers every day.
These (and, really, all the patient care storylines in The Pitt) make the case that knowing who your patient is — their background, their fears, their circumstances — is inseparable from knowing how to treat them.
Narrative that matters
Researchers at the USC Norman Lear Center’s Media Impact Project conducted a qualitative study of viewers after Season 1. Of note, key storylines that were examined centered around opioid overdose and organ donation (a heartbreaking story of a college student’s unintentional opioid overdose resulting in brain death, and the family’s wrenching decision to donate his organs) as well as end of life discussions and decisions (an elderly man with pneumonia who had made his end of life Do Not Rescuscitate wishes known, but whose daughter insists on intubation; she eventually realizes she is prolonging his suffering and allows him to pass peacefully.)
The researchers’ findings are both predictable, and unexpected:
As has been consistent across the board, physicians and other healthcare provider viewers rated the show’s portrayals of social and structural issues as highly realistic and validating of their own experiences.
But there was a surprise finding: among lay viewers, the storylines involving organ donation, end-of-life care and advance directives did more than just entertain or even inform. These storylines moved people to action. Viewers reported having conversations with their families about their wishes on these topics that they had never had before.
This matters enormously, because it demonstrates something that good clinician-communicators have always known: narrative is a clinical tool.
Story changes beliefs and behavior at a population level, in ways that pamphlets and public health campaigns often can’t.
A minority view, with outsize consequences
I have yet to see any physician commentary that seriously questions the accuracy or relevance of The Pitt‘s storylines from a clinical standpoint. The show’s depictions are simply too recognizable to anyone who has practiced medicine in an urban environment.
But there absolutely exists a minority who object on a philosophical level. These are people who believe that “politics” — by which they mean anything beyond pure human biology and pathophysiology — has no legitimate place in healthcare or medical education. Everything about The Pitt is antithetical to their beliefs.
The most prominent voice in this movement has been retired physician Stanley Goldfarb, who penned an infamous Wall Street Journal op-ed with the snarky title “Take Two Aspirin and Call Me by My Pronouns,” followed by an eponymous book subtitled “Why Turning Doctors into Social Justice Warriors is Destroying American Medicine,” in which he rails against “‘socially relevant’ curricula that have nothing to do with the care of actual patients.”
When I first encountered Goldfarb’s views, I found them as disorienting as, say, encountering a scientist who insists the earth is flat, or a biologist who thinks HIV is a myth. How can someone in the field get it so wrong?, I wondered.
I still think that. But I am no longer surprised — and I am much, much more alarmed — because what was once a fringe view from an irritating, out-of-touch retiree is now federal policy.
Do No Harm is doing great harm
In 2022, Goldfarb founded an organization called Do No Harm which has accumulated followers in the current administration’s anti-science, public health-protesting crowd. Read: not alot of followers, but followers who now have resources and power.
Do No Harm has since drafted model legislation that has been adopted in dozens of states, and in addition, is filing lawsuits against medical institutions over diversity practices and educational curricula. In September 2025, the group launched the Center for Accountability in Medicine, which published a ranking of U.S. medical schools based in part on their rejection of what the organization calls “woke ideology” and “divisive politics”
And just weeks ago came the moment that should alarm every clinician and patient in this country: the Liaison Committee on Medical Education (the LCME, which is the main accrediting body for U.S. medical schools) quietly removed from its 2027–2028 standards the requirement that medical students be taught about how social, environmental, and economic factors shape patient health and healthcare systems.
What does this mean? It means that all the real issues facing patients and doctors, like those that are illustrated so realistically in The Pitt, are being completely disregarded.
Structural competency — and why removing it is policy malpractice
Teaching medical students to understand how major issues outside the exam room affect their patients seems pretty basic to me. Things like lack of health insurance, homelessness, the medical implications of race and gender bias. You don’t need a medical degree to grasp this. In fact, it should be obvious to anyone who has watched a single episode of The Pitt.
This is called structural competency. It is the expectation that a future doctor can answer the question: Do you understand the social, environmental, and economic realities affecting your patient right now?
Having this understanding shapes diagnosis, treatment plans, and outcomes.
And the requirement to teach it is now gone.
This didn’t happen in a vacuum. In May 2025, the Trump administration issued an executive order targeting LCME’s diversity, equity, and inclusion-related accreditation standards. Do No Harm’s leadership publicly has celebrated the changes, calling it “a renewed commitment to high-quality clinical care over political ideology.” Let that sink in: teaching a future doctor how their uninsured patient’s poverty affects their health outcomes is now framed as irrelevant political ideology.
I want to be precise here, because the flat-earth analogy I used earlier, while emotionally satisfying, may be too simple. This isn’t just denial of observable facts. It’s a diagnostic error.
Attributing illness exclusively to biology and individual behavior, when the evidence for multifactorial, systemic causes is overwhelming and decades old, is a failure of clinical reasoning. Social, environmental, and economic factors are not political opinions. They are upstream causes of disease, injury, and death, documented in the medical literature as rigorously as any drug trial.
The man who left the ED against medical advice to protect his family from financial ruin is not a political story. He is a patient whose economic reality was a direct pathophysiological variable. A physician trained to ignore that variable will provide worse care. Full stop.
The Pitt understands this, and dramatizes it episode by episode. And here’s what makes the show’s timing so remarkable: it is doing this at population scale at the exact moment medical schools are being required to stop doing it.
The USC Lear Center data suggests the show produces measurable belief and behavior change. The Pitt is, in a very real sense, functioning as a public health intervention — delivered not by a government agency or a medical school, but by a prestige drama on HBO.
On the “woke” criticism
Season 2 has attracted the predictable chorus of “woke” complaints on social media, on Metacritic, on forums. The ICE storyline in particular, in which agents enter the ER with an injured woman and violently detain a nurse who tries to provide her the sling she needs for her shoulder, has generated comments calling it “woke bullshit” and “things that only happen in commie cities.” These responses are genuinely interesting, not because they’re persuasive, but because of what they reveal.
The people making those comments are not denying that ICE conducts immigration enforcement. They’re not claiming that uninsured construction workers don’t exist, or that homeless patients don’t have infected wounds. What they’re objecting to is the show’s insistence that these things matter to medicine. They do not believe that a physician’s job description includes caring about what happens to a patient in the system around them, not just within the four walls of the exam room.
That is a philosophical objection, and it is the same one at the heart of the Do No Harm movement. And it is now being institutionalized in medical education policy at the federal level.
So if The Pitt feels urgent, if it feels like something more than a very good drama, maybe that’s because it is. In this moment we are living through, even just liking the show and recommending it is a small act of rebellion. Why? Because The Pitt is showing us, in the most human terms possible, exactly what is being dismantled in real time, while we still have time to do something about it.
If you liked this post, share it with someone who makes health policy or works in medical education — or at least enjoys good television.