[Warning: The below contains MAJOR spoilers for The Pitt Season 1 Episode 10 “4:00 P.M.”]
The Pitt shines a light on the pressure and mental health issues medical professionals deal with in the latest episode, with a major reveal about Langdon (Patrick Ball).
To say he and Santos (Isa Briones) have been clashing all shift would be an understatement, but it turns out she was right not to let an issue with drugs go. Langdon has been stealing pills, to Robby’s (Noah Wyle) shock, and when he confronts the resident about inconsistencies with meds intended for his patients, Langdon tries to brush it off as Santos is trouble. But Robby forces him to open his locker and finds pills for a patient inside. Langdon tries to make excuses — he hurt his back helping his parents move, and he’s weaning himself off — then acknowledges he messed up but he’s not high and a drug addict couldn’t do what he does. Robby throws his stuff at him and tells him he’s done.
Robby is angry, but he’s also not doing well, Wyle tells TV Insider. “In the Jobian tale that we’re telling. this is a big one to put on him — protégé, friend, kindred spirit, perhaps a younger version of himself that he’s trying to mentor up in the way that he was mentored by Adamson. So he’s a link in the chain character. When Robby finds out about pills, the last thing he wants to do is believe it. And yet there’s this sneaking suspicion that if he really goes back and replays a lot of those conversations and moments, all of the signs are there that are there when you’re treating somebody who’s coming in and drug seeking; they say those same things and now Robby’s realizing he’s heard all the same things from Langdon and there’s an embarrassment, there’s a disappointment, there’s a liability. It’s an evisceration.”
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Wyle admits that his initial approach to the scene was very different than what ended up being the final product. “My instincts were we should get the stunt coordinator to be there because it probably is going to get physical,” he shares. “I kept thinking of it as being a fight scene where Robby’s going to really unload on this guy for this breach of ethic. And then it came time to shoot it and something entirely different happened. It became more of a breakup scene. It just became incredibly sad, and violence didn’t seem appropriate at all. It just seems like this is going to put this character so alone now.”
For Ball, filming the scene “was amazing,” he says. “I got to dance with a champ. Noah’s the champ. He’s just an incredible actor, and he’s been doing this a long time. He’s also just an incredible person and an incredible mentor. My relationship with Noah has really, really reflected Langdon’s relationship with Robby. Noah has been so generous with me from day one. This is my first TV show, this is my first time doing this, and he’s really all along taken me in and shown me the ropes and been really down to play with me, which has been amazing. So I knew that scene was coming, and it was the big giant scary boogeyman under the sink for a long time. Then when we got there, it was just so easy and it was so much fun because Noah was just so game. It was just like kids in the sandbox playing pretend.”
He calls the storyline “an incredible, incredible blessing and responsibility. I think drug use and self-medication is something that this community deals with a lot.” His parents are lifelong emergency workers — his father’s a paramedic and his mother an ER nurse — as were their family friends when he was growing up. “The work that these people do, it leaves a mark,” says Ball. “I think not enough conversations are had around that. Luckily, a lot more resources have been made available recently for helping emergency workers process things that happen in the workplace.”
He points out that one of the toughest patients of the season so far, a six-year-old girl who drowns in a swimming pool saving her sister and the doctors subsequently watching the parents deal with the loss would be the “most traumatic singular event” in many people’s lives. For emergency workers, that happens on a regular basis. “I don’t think it’s uncommon for people to turn to various forms of self-medicating. And so to be able to be part of telling that story and bringing awareness to that, I think it was an incredible responsibility and honor and something that I think everybody involved was really committed to doing with as much integrity and dignity as possible,” he adds.
Executive producer R. Scott Gemmill echoes that. “There’s a real stigma with mental health and the opioid use or drug use or alcoholism, and a lot of doctors think that they can’t ever get help because if they do, they’ll lose their license. And that’s not true anymore,” he explains. “That’s part of the story we want to tell because these people are under so much pressure and so much stress every day. It’s like being in a combat unit that you go to day after day, year after year, and they suffer a lot of mental health issues. Suicide rates are very high for them, alcohol and drug use. And so we just want to shine a light on that.”
If Langdon were to come back from this, he does have to prove he’s “worthy of being a physician again,” Gemmill warns. And it would be a long road ahead for him. He’d have to go into an in-person facility for at least 30 days, then attend two to three narcotics anonymous meetings a week for three years. “It’s a five-year process, to be honest, to be where you are no longer being watched or given drug tests. So that’s an interesting story to see in the future.”
But in the immediate aftermath, Robby is now down a resident and executive producer John Wells teases that Robby and Langdon “are not done yet.” Gemmill adds, “They have another confrontation actually.”
Robby’s counting down the minutes until his shift is over, according to Wyle. He’s thinking, “I’m so close to being out of here, and then it won’t be my problem. And I’ve got time off next week and I’m going to get out of here and I’m going to clear my head,” the star and executive producer says. “I think he just wants to make it to the finish line at this point and he has no idea how far the finish line really is.”
While Santos was right and it would be “very her to enjoy that, the nice thing about this moment is it’s not that simple,” notes Briones. “She’s obviously in the right, but also when there’s someone beloved at work in a position of power and someone comes forward and reveals something, there’s often a lot of victim blaming that can happen. [And] she doesn’t necessarily feel amazing about it, even though she was correct. There’s a lot of complicated feelings. She probably wants to feel vindicated by it, but there’s some guilt and it being your first day and [getting] someone in trouble is kind of a heavy thing to deal with.”
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Elsewhere in the episode, in the aftermath of Doug Driscoll (Drew Powell), an impatient man in the waiting room, punching Dana (Katherine LaNasa), the charge nurse shocks everyone by walking into the ER bleeding. Once she’s cleared medically, however, she insists on getting back to work rather than leave early and go home.
“I think that Dana did the same thing that I would do,” LaNasa admits. “Have you ever had something really go down or someone kind of go into a rage in front of you or get in a car wreck and you’re like, oh, I hope I can still make my trip on Thursday? That part of our brain that kind of goes into denial. We don’t want to deal with what’s going on right in the present. We get focused on something like that. I think going back to work allowed Dana not to deal with the repercussions of getting hit and the existential crisis that got started inside her by being hit: How can I continue to do this? Is this worth this to me?”
What did you think of the Langdon reveal and subsequent confrontation with Robby? Let us know in the comments section below.
The Pitt, Thursdays, 9/8c, Max
If you or someone you know has addiction issues, contact the Substance Abuse and Mental Health Services Administration‘s National Helpline at 1-800-662-HELP (4357). If you or a loved one are in immediate danger, call 911.