What Does The Pitt Have Against Otolaryngologists?

One of my absolute favorite TV series is The Pitt. I’m sure many of you feel similarly. It came on quietly in Season 1, but once word got out, I streamed the first several episodes to catch up and then waited each week not so patiently for the following episode—and waited even less patiently for the start of Season 2.

You with me on that? Maybe you are. And if you’re a physician “of a certain age” like me, you might have been a medical student, resident, or young attending when the groundbreaking show ER aired, getting to know each character, marveling at a lot of their accuracy in terminology, communication, diagnosis, and treatment. But more likely, as did I, you got to poke fun at some of the cast’s faux pas. They intubated while ogling across the room; they had specialists of all kinds, somehow magically appearing at the bedside, who would resuscitate everyone. We all knew it was entertainment, but we couldn’t help but critique some of their work.

I met a cast member years later and asked her how she did it. Did she learn some medicine? She really did pull off pushing adenosine, shocking patients back to life, and even managed to look like a tired doc, albeit better coiffed and manicured. “No,” she said, “we didn’t really know what we meant when we pushed adenosine. But we learned the terms, and learned how to put it all together to make it sound real.” As a physician who lives and works in Los Angeles, I found this to be a great homage to physicians, bridging Hollywood and medicine with genuine effort and sentiment.

And a few decades later, along comes The Pitt with even more accuracy, a more genuine portrayal of a real urban emergency room, and it somehow manages to weave in a multitude of challenges in healthcare, including social issues, medical issues, and issues impacting healthcare professionals. The popularity of the show has brought a revived appreciation for those in healthcare, hearkening back to New Yorkers banging pots and pans together at the edge of their open windows in the early months of the COVID-19 pandemic, as a means of recognizing the arduous work of frontline workers. Alas, this recognition faded quickly, and disdain took over. Until The Pitt came around.

The Pitt has succeeded in demonstrating how hard it is to be a patient. We can all feel it. It has also succeeded in communicating how hard it is to be an attending physician, nurse, student, intern, resident, administrator, medical assistant, social worker, and respiratory therapist, to name a few. It has succeeded in letting the human side of all of this come through.

But there’s been one issue in this groundbreaking show, as we euphemistically say to trainees, where there is quite a bit of room for improvement, and that’s the interaction not among, but between, specialties. And by specialties, I mean ours. Otolaryngology, a tiny but mighty field, where we so often keep to ourselves, but, when needed, swoop in to save an airway or stop the bleeding. Yes, we get teased. Some of the hospitals across town referred to my training institution as “The Cerumen Palace” or “The Wax Museum,” usually in jest. We all poke fun at each other, but it’s usually done tongue-in-cheek, with a well-known deep respect for our colleagues in other fields. Many specialties even tease themselves. I’ve heard anesthesiologists refer to the airway ABCs as “Airway, Bagel, Cream Cheese,” and orthopedists describe the function of the heart as the organ that pumps antibiotics to the bones. But when The Pitt has done this, it is not in jest.

In Season 1, when a patient with a massive post-tonsillectomy bleed came in, the focus was that the on-call ENT physician refused to come down because it wasn’t their patient. And in Season 2, when ENT didn’t come evaluate a mandible fracture (I might add, before the CT scan), the snide remark was that they must be busy at a BMW sale. Funny? Well, not really. Yes, it’s a show, and maybe I’ve become too Hollywood-aware, having practiced here for nearly three decades.

But an award-winning and truly terrific show that highlights all of the good that we as healthcare professionals do, including how the system is broken yet works in countless ways, should also show that we do, indeed, have grace for one another. We treat a tonsil bleed. Regardless of who did the surgery. We evaluate facial trauma. Our field is perhaps one of the most mutually collegial, respectful, and attentive specialties out there. We help each other out, and we also help others out. That’s how it works. In real life and hopefully someday on television.   

Dr. Shapiro is a pediatric otolaryngologist at Westside Head and Neck in Los Angeles and professor emerita in the department of head and neck surgery at UCLA. She is the author of HYPE, The Ultimate Kids’ Guide to Being Super Healthy, and Take a Deep Breath.