I can’t recall the first episode of ER I watched. It might have been “The Long Way Around”, a bottle episode where Carol Hathaway, a nurse played by Julianna Margulies, is trapped in a corner store with a gun-wielding thief played by guest star Ewan McGregor. I loved that episode when I was younger. It showed the complexity of Carol, who was tough and sensitive and, above all, a good nurse. Or maybe it was the episode where Dr. Mark Greene battles to deliver a baby. He makes a mistake at the beginning of the delivery, which unravels into a series of catastrophes. That episode makes my heart pound, still, when I watch it. 

ER was my mother’s favorite television show. We watched reruns together if I was home sick with a stomach ache. I often had stomach aches. I remember lying on the couch with a quilt pulled to my chin, listening to ER’s opening credits. The theme sounded like an ambulance siren. It was comforting, as the sound of an ambulance can be. It means, whatever else, that someone is coming for you. My stomach aches grew worse. A doctor told me I had anxiety and handed me antacids. I became sick enough to go to the hospital. I was diagnosed, eventually, with a rare disease no one had heard of and fewer could spell. I needed surgery. I was eleven. A year later, I needed another surgery. During one of these many hospital stays I remember lying in a bed and watching ER on a television mounted to the ceiling. The nurse who was checking my temperature laughed. She asked me why I would want to watch a show about sick people when I was already sick. I don’t think I answered her. But it made perfect sense to me. 

ER has been on my mind lately because of a new medical drama called The Pitt. Maybe you’ve heard of it. The show has averaged a staggering 10 million viewers per episode. It’s felt impossible to avoid headlines and tweets praising the show, and, for better or worse, comparing it to ER. An article in The New Republic declared: “…ER is back. Its name is The Pitt.” It’s true the shows share a producer in John Wells, and a lead actor in Noah Wyle. I skimmed these reviews, hoping to find a reason to not watch. I felt protective of ER. Would people say The Pitt was better? Would it replace ER in the canon of great medical shows? My friends told me how fantastic it was. That both shows could exist, separate but equal. I knew that was true. I still made excuses not to watch. 

I thought about it, though, more than is normal for a show I wasn’t watching. I was stuck on a certain endorsement I had noticed while reading those reviews: The Pitt, they said, was the return of a medical show dedicated to “realism.” In an article that explores how real doctors are responding to the show, The New York Times labeled The Pitt “unusually accurate.” Doctors almost universally seem to love it. ER, in its heyday, was praised just as thoroughly for being true to life. In a gushing review of the pilot episode, Time called ER “…probably the most realistic fictional treatment of the medical profession TV has ever presented.”     

These compliments serve in contrast to how we speak about “unrealistic” medical shows, such as House or Grey’s Anatomy. Bowen Yang was recently asked to sum up his feelings about Grey’s Anatomy between rounds of chicken wings on Hot Ones. “Imagine the unluckiest people in the world, all in one place,” he said. I’ve never watched more than a handful of episodes, but I laughed at this, and I understood. Grey’s is shorthand for the sort of medical show that is more soap opera than docudrama. Patients die of rare and absurd ailments, or, just as unbelievably, are saved. They reach emotional catharsis during a montage set to Coldplay. The doctors cross boundaries. Their lives are threatened by sinkholes and hospital fires and bombs, the most extreme tragedies we can dream up and solve in an hour, with a few deaths sprinkled in for shock value. There is a voyeuristic appeal in the show’s formula. While reviewing Grey’s most memorable disasters, I stumbled across a Reddit thread where users compared their favorite episodes. BasicAsparagus0 said, bluntly enough, “The shooting episodes”. No-Shoe-1528 agreed. “exactly my opinion. idk why i like the tragic ones the most lol.” 

Some people want to see a version of medical trauma on steroids. I don’t blame them; we’ve been fetishizing the concept since General Hospital first aired in 1963. Perhaps, if people are lucky, they don’t know how the real thing looks and sounds. I do, and I still fell victim to House when I was fifteen. I have no excuse except that Hugh Laurie made me laugh, and I thought the blonde doctor was handsome. I kept watching after a brief return to the hospital. There was so much scar tissue in my stomach it twisted through my bowels and caused an obstruction. I left the hospital and my brain seemed filmed over. I thought I would stop watching House, and television in general, and I thought I would stop writing. It had happened before, after one of my surgeries. I hadn’t known, until I knew, that trauma could suck the color out of the sky. None of that happened this time. I went back to school, and I watched House until the final, outrageous episode. 

I relented and started The Pitt after the finale aired and the fervor of the discourse had slowed. I noticed, right away, that The Pitt’s aesthetic style differs greatly from ER. ER was famous for shooting trauma scenes with a whirling Steadicam and pulsating score. The Pitt, on the other hand, uses cinematic techniques I recognized as a modern shorthand for a show trying to achieve a lived-in grittiness. There are no opening credits. A handheld camera jerks around the actors as they deliver dialogue full of medical jargon. The emergency room is white and bleach-bright. And there is no score at all, only the cacophony of background chatter. 

I finished the first episode. Then I watched fourteen more. I felt a certain relief as I realized the show was objectively good. I began the series on a Thursday and finished on Friday morning. I thought first about all the ways this show was, as promised, real. It features some of the more advanced medical techniques employed in real ERs, including a scene of a patient arriving on a gurney, an automated chest compression device effortlessly pumping away at his body. And just like ER, The Pitt is willing to confront contemporary issues as honestly as possible. ER tackled HIV, gang violence, racial bias in medicine, and homophobia in the workplace; The Pitt takes on hot-button topics like fentanyl-laced party drugs, human trafficking, grooming of minors, and incels. It handles these issues with a sensible lack of hysteria or judgment. It is also primarily from the perspective of the doctors, which is where The Pitt faltered for me, not because of a fault in the show, but a divergence between the realistic perspective it’s courting and the one I’m most eager to see.

The doctors of The Pitt are kind. Their burnout manifests as a bone-deep tiredness they ignore. They tend to bereaved parents. They have flashbacks to the trauma of Covid. They take a moment of silence when somebody dies. I don’t know if real doctors do this. I know I had a surgeon who once paced the room when he thought I was about to die, clenching his fists in worry. The Pitt reflects the reality of our best doctors and the collective effort it takes to save even a fraction of the patients they encounter. It also tends to pass over these patients like slabs of meat on the table. Perhaps this is real for ER physicians. Not because they don’t care, but because their work demands they view us as bodies, first and foremost, with parts they understand and can reassemble.

Anyone who has experienced medical trauma looks to see their reality reflected and understood. I found that in ER. I can’t imagine how isolated doctors felt during Covid, but I know I felt alone at night in the ICU, my skin itching under dried blood and surgical tape. Who else felt like this? What other kids were willing themselves to live each minute, each day? I know I felt less alone, later, when I re-watched ER after college. In Season 4, PA Jeanie Boulet forms a bond with a young cancer patient, Scott. Scott is sick, then healthy, then sicker. Jeanie asks if he wants his school friends to visit. No, he tells her. “They’re, I don’t know, just kids,” he says. I burst into tears then, mainly from shock. How could some writer know how it felt to be a kid and yet not a kid?      

ER showed the lull between crises and the games shoved in front of our faces. They showed Scott watching a daytime soap with Jeanie, sucked into the habits of adults due to his circumstance. They showed how these adults will bribe us, beyond sense, like when my mother offered me an iPod in exchange for my continued survival. Scott is angry, obstinate, refusing tests and medicine, and ready to die. I was all of those things. I cursed my parents and every nurse in the hospital. I did want to die, from the pain, and what came after. 

That was my reality. You have a different one, I’m sure, as do doctors, and nurses, and parents who watch their children suffer. It’s not always possible to gather these realities into one coherent vision. Real doctors may wince at the languid pace of ER, but feel seen by The Pitt’s Dr. Robbie, played by Noah Wyle, who is too frantic to even take a bathroom break. In Episode 15, Dr. Robbie, broken by the effort of treating mass shooting survivors, gives a speech to his colleagues. He tells them that the worst in humanity has brought out the best in them. I’m sure my worst day was some doctor’s finest hour. I don’t say this to belittle doctors, who are the only reason I am alive. I say it because this scene makes clear that our emotional truths are sometimes at odds with each other. My mother tells stories from my time in the hospital that sound like fiction to me. But she might see herself in the wailing parents of Episode 2 on The Pitt, or in the adult children who must allow their terminal father to die. She did that recently, with her sister, for their mother. The Pitt has likely helped people looking for reassurance that the hardest decision they ever made was the right one. We all want to be known, but it is often difficult to take up the burden of articulating the story. I’ve let ER speak for me when I could not, even as a writer, explain my history, even to myself.      

While the idea of a universally “real” medical show may be a pipe dream, it’s still fascinating to see how the shared creatives of ER and The Pitt have refracted hospital life through two unique lenses. And on rare occasions, the writing can transcend those fractured realities with something so essentially true it touches everyone. I’m thinking not of the first ER episode I saw, nor the one I watched in the hospital, but my favorite: Season 2, Episode 10, “A Miracle Happens Here.” Dr. Greene treats an elderly carjacking victim, a woman who is also a holocaust survivor. Her granddaughter is taken in the carjacking. Dr. Greene assures her everything will be alright. These people who took her car wouldn’t hurt a baby. “But they would,” she says. I’ve never made it through this scene without weeping. I’m not a holocaust survivor, nor do I have a grandchild, but I know what it’s like to see a perceived safety in the world vanish, and never return. So do doctors. Later, the woman and Dr. Greene pray, and she says the real miracle is that they could pray. Faith, of any kind, is hard to sustain after loss.      

ER is a miracle of a show, and so is The Pitt. Neither can be everything to everyone, but they keep our faith that we can interpret life’s unfathomable moments through art. At least, they show us that we still have enough faith to try.