Last season, one of the running gags was the torturing of poor Denis Whittaker, increasingly covered in various fluids and substances so often he ran out of suitable replacement scrubs to change into.
This time round, first day splatter has found its way to new med student Ogilvie instead – and Whittaker’s now savvy enough to get out of the way of what turns out to be an impressive, and satisfying, “assplosion” as he’s called upon to removed impacted fecal matter from an elderly woman who has been constipated for some time.
With an almighty rip – literally, and kudos to the sound department for truly impressive fart noise effects – Ogilvie takes one for the team, having already had to clear out by hand some of her blocked up passage.
It’s the capper on an hour that sees the hapless med student also exposed to TB – as Santos gleefully tells him 70 % of med students end up on medication from exposure during their time training in hospitals. Thankfully he’s clear, but his new role as torture victim seems secure.
The levity of poor Ogilvie is at odds with the rest of an episode where Dr Robby’s patience is clearly starting to fray at the edges. The presence of Langdon on the ward, rather than out in triage where he’d been exiled, is clearly getting under his skin – as is Dr Al Hashimi’s failure to communicate her intentions to him. As we noted last week, Dr Al seems to be slowly assembling her faction – this week that ramps up, with her expressing her support to Langdon despite Robby’s hostility, and then suggesting Santos use her AI tool to help with her charting backlog, to build on her existing relationships with Samira, Mel and last week’s partnership with Victoria Javadi.
It leads to a stand-off, of sorts, as Robby asks Dr Al for an update on her patients, and she asks why he’s treating her like a junior doctor rather than his co-attending.
His fraying temper also leads to Robby snapping as Langdon’s cellulitis patient from last week deteriorates rapidly. What presented as cellulitis turns out to be sepsis, and as her condition worsens necrotising fasciitis spreads up her leg. You’ll remember all the press horror stories about necfas a few years back – the flesh-eating superbug which packed the front pages of the redtops for a couple of weeks.
As a backlogged Garcia prevaricates – having already sent a surgeon down to look at it who’s only a fortnight graduated – Robby grabs a scalpel and slices the woman’s leg to expose the extent of the infection, making his point in the most brutal fashion possible.
Robby’s not just struggling at work, though, we learn. Clearly the suppressed trauma that’s driving his motorbiking mid-life crisis is affecting his Homelife as well, as Noelle Hastings – the case manager he’s seeing – lets slip to Dana he has to sleep with the television on.
To be fair, it’s no wonder – all the trauma, both vicarious and first-hand, that Robby’s experienced would damage even the most robust of psyches. But it’s becoming clear his is far from robust, and even Dana trying to intervene doesn’t seem to stabilise him.
Noelle is on hand, by the way, as the ongoing situation with the Garcia family and their medical bills from last week continues – and comes to a remarkable conclusion thanks to other med student Joy, who figures out a clever way to get round the fact the family are trapped in a hinterland between not qualifying for medicaid and not affording insurance.
Her solution, it turns out, comes from bitter experience, as her family tried to find cost-effective solutions for the ongoing care of her cancer-stricken grandmother before her death. As she tells Samira, “if the system doesn’t work for you, you’ve gotta work the system.”
Two contrasting cases of care complete the rest of the episode. One, a prisoner brought in who has been attacked and stomped by fellow inmates. The guards refuse to uncuff him, even if it makes treatment and manoeuvring him off around the gurney difficult. Worse, his skin is thin and his body suffering from malnourishment from prison that his open cuts refuse to suture closed, necessitating some improvisational needlework from Dr Al – even if it turns out the students are too young to appreciate the reference…
The other, heartbreaking story is a young mother dying of terminal cancer, brought in from her hospice at home care after a fall. Regular Pitt night nurse Lena is also her death doula – someone there to help provide emotional, practical, and spiritual support to those facing terminal illness, be it the sufferers or their families.
Clearly wracked with pain, she’s trying to find some independence for herself and her husband, but even the simple act of standing up to go to the loo rather than use a bedpan proves too difficult. Cassie’s issued her with a ‘morphine butler’, as Lena terms it – an automated dispenser of pain meds – to help with the recover from a fractured ankle over the next few weeks. ‘If I live that long,’ she grimly jokes.
It’s a difficult and moving subplot, as the challenges of providing care – both medical and spiritual – are balanced against the human need for dignity.
But as we close out the episode, things aren’t looking good for Louis. After four episodes of light hearted storytelling and jokes, Langdon comes in to check on him and finds him coding in his bed, just as Robby arrives – with a can of beer for the alcoholic hidden in his pocked. The pair work together as the credits roll, trying to resuscitate their regular visitor.
Grizzly factor: Asides from the literal shower of shot over Ogilvie, we’ve got a grizzly set of wounds on the prisoner which initially defy suturing, popping back open every time, while Robby’s gung-ho attempt to force Garcia into surgery by literally slicing the sepsis patient open with a scalpel is quick but wince inducing.
Best quote:
“Great. MacGyver move, go for it.”
“Does Dr MaGyver work at this hospital?”
“I don’t know.”
(Kids today, I despair!)
The Pitt – Season 2 Episode 5: “11:00am”
Written by Simran Baidwan
Directed by Damian Marcano
