‘The Pitt’ Team Talks Episode 7’s Tragic Ending, Santos’ Past, and More

[Warning: The below contains MAJOR spoilers for The Pitt Season 1 Episode 7 “1:00 P.M.”]

The Pitt has not shied away from graphically showing the realities of what brings people to the emergency room (the foot of the woman caught between the train and the platform), nor has it ignored the doctors dealing with their own traumas. Notably, Robby (Noah Wyle) is dealing with the fact that he’s working on the anniversary of his mentor’s death (a day he usually takes off). Episode 7 continues to address that while also touching on the other doctors’ pain.

It was back in the first episode, as Robby’s shift started, that charge nurse Dana (Katherine LaNasa) called out senior resident Collins (Tracy Ifeachor) on her pregnancy. Collins then even used her winnings from a bet to buy a stroller. But at the end of Episode 7, she has a miscarriage. (Ifeachor playing that realization is one of the best performances of the season so far.)

“She’s a really great actress, and she was extremely brave in that particular sequence,” Wyle (who also serves as an executive producer and writer) tells TV Insider. “Miscarriages happen a lot to women and a lot of times they happen in the workplace on the job and a lot of times women don’t have the option of going home. I’ve known several actresses that have miscarried in their trailers and gone back to work for another six or seven hours through a shooting day. There’s a woman that works on this show who had a very similar experience, and it was one that we felt like we wanted to tell.”

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It’s even more tragic for Collins because what she really wants is to be a mom. “She’s got her life worked out. [Having a baby] is the missing piece to the life that she wants to build,” Wyle notes. “And because it’s a solitary life that she’s building, it makes it even sadder. And I thought she did a great job doing it.”

Adds executive producer R. Scott Gemmill, “The reality [is] many women have multiple miscarriages sometimes before they have a family, and [we’re showing] how that affects them and how that affects someone who’s working in medicine and seeing children all the time.”

He also teases an upcoming “powerful” revelation. Furthermore, there’s now the “question of whether that’s something she will try again, or is she giving up? And what does that feel like where you start to feel like maybe I wasn’t meant to be a mom? You can go down that sort of rabbit hole. For us, it’s just about exploring human emotions and in this group that are put under extreme pressure because of their vocation.”

It’s been revealed that Robby and Collins do have a past — they briefly dated — so might he notice what’s going on? “Whether or other she wants to tell me is a totally other thing, and she’s got very specific reasons for not wanting to tell me that this is going on,” previews Wyle.
“I think these shows about doctors or lawyers or policemen are successful when they show how much is going on in their personal life and how much they have to forget that in order to be of service, of use, on call, on duty for the jobs that they have. And when you’re never leaving the hospital on this exercise, which is what we’re doing, those personal lives have to somehow come into the workplace and reverberate in a way that’s extremely uncomfortable at times,” Wyle says. “And Collins finds herself attending an abortion case, a birth, all on the day that she is grappling with her own desire to be a mother and disappointment of that probably not being the case for a while.”

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Elsewhere in the episode, Santos (Isa Briones) learns that a woman gave her husband progesterone because she thinks he’s been molesting their daughter. She tries to talk to the daughter, who’s confused, then she talks to the man. She knows men like him, men you trust and look up to, she says. It starts with a kiss on the head, then the lips, then goes from there. She warns him that he’s never touching his daughter again, or she’ll make sure he’s arrested and he’ll be raped in prison.

Briones calls that one of those “beautiful” scenes wherein you start to get pieces about the characters’ pasts. “For Robby, you get more of an explanation, but everyone else, you’re just getting just hints of their past because in one day, no one would just be like, ‘Here’s all my trauma.'”

She says that’s the “most vulnerable” you’ll see Santos “because she’s alone basically with a man who can’t speak. It’s that moment of, I have all of this bottled up, I have a wall up, and finally, I have someone I can point all of that anger toward and all of that frustration and sadness and everything that she doesn’t let show to anyone else.”

Santos sees herself in the young girl. “You can see that she must have experienced something very similar to this,” says Briones. “Maybe she’s not just a coldhearted bitch inside. Maybe there’s a reason for her walls, and she does care about something, the right people. She cares about this little girl. She sees this is wrong. She has those demons and they come out in our most vulnerable moments.”

This episode also continues to show flashbacks to what happened to Adamson during COVID. After he’d been on ECMO (extracorporeal membrane oxygenation) for 17 days, a 12-year-old girl needed the machine. Rolling out the flashbacks like they are showcases how difficult the day is for Robby.

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“What Robby’s going through is an aggregate compounding of tragedy that he has not had any time to really sift through, synthesize, process, or come to any kind of closure with,” explains Wyle. “It’s less one-to-one with the death of Adamson or this being the anniversary and more to do with that lowers the guard and makes him vulnerable to what comes throughout the course of the day and giving the audience a little bit of puzzle piece backstory to how he made the decision to take his mentor off life support to try to give it to somebody else and then have that not work either. It is the sort of perfect Sophie’s choice moment that so many physicians had to make.”

With the limited resources available and the need at the time, doctors had to make difficult decisions that had life-and-death consequences. “Then you have to live with them on the other side of it,” Wyle says. “And that’s not always easy, especially if you are the kind of person who bottles it up and doesn’t like to talk about it.” In other words, Robby.

Gemmill says they’re showing those flashbacks like they are because “in Robby’s mind, it’s very quick. He doesn’t have the luxury of spending a lot of time in those moments because ER physicians get pulled away to a new patient every three minutes. He also doesn’t want to be there. That’s part of his problem is he’s suffering from a massive amount of PTSD that he’s not acknowledging and has never sought help to deal with. So he just keeps pushing it down and pushing it down so when it pops up, it’s quick and then he pushes it back down, and eventually this is the day where he’s no longer going to be able to push it back down. It’s going to find its way out one way or the other.”

Executive producer John Wells points out that “traumatic moments are in fragments. You don’t remember it as a whole. You remember things — sound, a quick image of something, almost like snapshots or little five-second movies.”

The Pitt, Thursdays, 9/8c, Max