JON LAPOOK:
00:00:12
Hello. Pleasure. Pleasure is mine. Thank you so much. My pleasure. Where are we sitting? You're over there. You get the two cameras. I get one camera. All right. Sounds fair. How you doing? Now? Phenomenal. Days in the can. About an hour ago, I was pulling my hair out. Really? Long day? Long-ish. You know, I wonder if you were actually a physician, how would you be handling, do you think, the physical and emotional toll of it all? I'd be compartmentalizing it like you guys do. I'm-- I vacillate between feeling 54 years old and feeling like I'm in a situation that I've dreamt of and prayed for and hoped for so long that it mitigates exhaustion. It mitigates everything just being able to be here and play with these people. How long have you been praying for it? For an experience that was as creatively and as energetically satisfying as ERwas? A long time. And I've found aspects of what that show gave me on other jobs with other casts in other places but not quite the same, not quite like this. When ERended, if I had come to you and said, What are the odds that someday you're going to do another medical show? what would you have said? Bam. 0%. What changed? COVID. COVID changed everything, certainly for me, in thinking about there being another story to tell in health care, a contemporary story, a contemporary American story, and one that was being reported on but wasn't really being embraced, which is to play up the fact that we have two different health care systems in this country, depending on where you live and how much money you have. And that showed itself in stark relief when you looked at the numbers of who was most affected by COVID. And on top of that, essential workers, people who were forced to go to work every day because we couldn't function as a country without them, all those people going to work every day, putting themselves and their families at risk by doing the jobs that were being asked of them, I found it to be incredibly poignant. And those were the same people who had been inspired to go into those jobs by watching ER10 years earlier. So I was getting a lot of mail from people on the front lines saying, you know, we could sure use Dr. Carter out here, or this is really awful. And I come home at night and thank you for giving me something to watch or think about other than my day. And I just was really overwhelmed by getting that kind of mail from people that I thought were doing such heroic work while I was at home feeling totally useless. I took care of hospitalized patients on the COVID wards in April of 2020. And I remember back then, you walked out at 7 o'clock. Clang, clang, clang, and everybody was ringing bells. That changed at some point, didn't it? It did. And that-- I'm sure some people in the beginning felt honored by that kind of attention. But at a certain point, I think that became a really annoying sound to hear as you were leaving your shift. But it was also that the public's opinion about health care, health care workers shifted. And that was the other thing is that ERat one point commanded such a large percentage of the American viewing audience that you felt that, if you put a medical fact on that show, you could pretty much take it to the bank that that would be embraced as a medical fact. And you could go to your doctor and say, hey, I saw this on ER. Is this true? And they would say, absolutely because that's how it happens. And it would be a point of conversation and a point of accessibility between a physician and a patient to be able to reference a piece of drama on TV. And that became less and less credible as shows played fast and loose with medicine and played fast and loose with some facts. And then we get into COVID, where misinformation is being spouted all over the place, and nobody's really putting a circle around an objective medical fact anymore and saying, no, this is real. Like, vaccinations work. They're working really well, and they're saving a lot of lives right now. Or masks really work. Germ theory is a real thing. This isn't up for debate. We don't have two opinions on this. This is science. That was super frustrating to sit home and watch all that get called into question. So I just sort of felt like, wouldn't it be nice if we could do a show that became a little bit of a standard bearer for the medical community again and reestablished what it looks and feels and smells like to be in this environment and what a medical fact is? How does The Pitt help that problem? I mean, you're mapping it out. You have 15 episodes. What was the strategy? The thesis at the heart of it was, let's focus on a really great doctor who is unaware of how in trouble he is. He's been doing this for so long, and he probably should have left a couple of years ago. But the need kept him working, the fear that he'd be keeping-- his team would be at risk if he quit. All those reasons that make you stay on a little longer than you maybe should, past the point of burnout, he's there. And I wanted to-- we wanted to show the fragility of the medical system and personified by one practitioner who's at his breaking point, to underscore the fragility of the system is commensurate with the fragility of our health workers' mental attitudes. And then when he goes down, the whole system goes down, so to speak. So that was the exercise. Can we just reduce this whole problem to being one hospital, one physician on his worst day when the [BLEEP] hits the fan? And from there, you know, it branched out into, let's talk to every expert we can talk to right now in every aspect of the medical spectrum and find out what's happening, find out what they're up against, find out what would be beneficial to put on television to help them in their work, find out what would be really bad to put on TV that would be counterproductive to their work. And let's tackle some storylines that we weren't able to do on ERbecause these weren't part of our lexicon 15 years ago. We weren't talking about fentanyl overdoses. We weren't talking about trans rights. We weren't talking about mass shootings. Let's see if we can bring this into the 21st century. So the authenticity shows. The research shows. I mean, as a physician, I was just blown away by how real it was, the specificity of it. How important-- I mean, you have this emergency room. I walked in there. I said, well, I'm in a hospital. I'm in an emergency room. Where's my first patient? How important was it to you to have that authenticity? I mean, it served as a canvas upon which to paint your stories. Because of the nature of this storytelling, 15 consecutive hours of one shift-- and we barely ever leave the footprint of our soundstage-- it became really important to have the entire set feel like a totally immersive experience, that when you go in there, you open a drawer, everything that's supposed to be in the drawer is there. You open a closet, everything that's supposed to be in the closet is there. So there's no imagination necessary. There's no pretend. Everything feels real and is exactly where it should go. And there's also no music, right? And to me, I found that fascinating because, in a scary movie, how do you know it's scary? Well, the music changes and there's a close up. But when, in life, there's no music changing, there's no close up, you have to do that all yourself. That was a big fight. That was one of the largest creative hurdles that we had to overcome because it was a speculative move. Nobody knew whether or not if you take the music out, you're going to have the ability to create tension or drama or anything else. Scott Gemmill, to his credit, had written two ERepisodes back in the '90s, where he'd pulled the soundtrack out and knew that it worked really well. So he was the only one that had confidence that this was going to work. And it wasn't until we saw the very first episode fully cut, fully mixed without music that we realized, oh, no, the tension in the doctor's voices, the ambient sounds, the sounds of crying, the sounds of screaming, that creates tension environmentally. And we do a little bit of a sound score, a little bit of an industrial kind of noise that comes in and out every once in a while. But that's it. That's all the augmentation. I read that you had a boot camp? Yeah, we-- we-- well, because this is a fairly young ensemble, and certainly none of us have ever been doctors before, and we all had to start at a pretty high level of proficiency, it was really important that we came in a few weeks before we started shooting-- learn how to put on your gloves, learn how to say the words, learn how to hold the instruments, learn how to move and think like a doctor, talk to doctors, go to the hospital. I will say that if this had been the ERcast and we'd asked him to do three weeks of boot camp, you would have gotten six class clowns screwing around, not listening, playing with the gloves, making them into balloons, doing all sorts of crazy stuff. These guys, these were not class clowns. These were first students. They were top students. Well, it all shows. They picked this stuff up so fast that as the old veteran who thought, I've got such an advantage, I was like, oh, wow. Hey, I got to pick it up a little bit. These guys are really adept. I would love to go into your character because you have a whole spectrum of behavior. I talked to the medical students about there's a wall between yourself and the patient. You don't want to make it too thick because then you can miss out on all the good stuff, and so do the patients. If you make it too thin and porous, you can get nailed emotionally. And over the 15 episodes, I saw it like an accordion with you. Did-- did you do that intentionally? Yeah. You want-- I mean, his mask is slipping all day long, and he's getting triggered all day long by some pretty horrific flashbacks. And that mask gets harder and harder to maintain. That professional distance that you're referring to gets harder and harder to calibrate until you just feel naked to the world. But what comes across, especially to me, because I've had those emotional moments, is you're a human being. You're vulnerable. And it's hard to be a human being. When you're in a leadership position, when you're-- you know, when everybody's looking at you to know literally how to set the tone, right-- How should we feel, doctor?-- you-- you can't lose it in those moments. It's so unfair to have to keep that professional demeanor intact in those situations. And, you know, it was fun to try to play. Your mother did keep it intact. Yeah. She was a nurse, right? Yes, once and always, like marines. And my mother, who's now 80, still keeps her skills and her-- and her license up, just in case. My mom was a-- 10 years OR nurse, 10 years head orthopedic nurse at Kaiser Hospital in Hollywood all through my growing up. And mom's at the hospital all day. I got to walk home from school till mom gets home. Hey, mom. Can you drive me to practice? Hey, mom. What's for dinner? That was mom. Mom was always there when she was there. And then, 35 years later, she's watching an episode of The Pitt and comes over and says, that rocked me. I was listening to you name those names of the patients that you had lost, and it triggered something. I started remembering the four-year-old kid and the gangbanger and the mother of two. And she just starts listing all these names of patients that she had seen die when she was practicing. And I said, mom, I've never heard these stories before. And she goes, oh, yeah. And I said, when the four-year-old died, when was that? She goes, oh, your brother was probably four at the time. I think that's probably why it hit me so hard. And I just remember thinking, like, so, you know, you did that and then you came home and made us dinner and didn't talk about it? You did that and then drove us to baseball practice? Like, how do you do that? How did you do that? And she'd say, well, that's what you do. Why do you think she didn't bring it home? It might have helped her. I think-- and you could probably speak to this better than I can-- we don't have a frame of reference for that at home. That is something that she shared with her professional colleagues, the people who understood what she was doing all day, who were doing it as well. That was her club. Those were her people. We were her kids, and she didn't show us that stuff. In the old days, it was kind of, suck it up. And it was a little bit of like, I went through it, so you got to go through it. This is your training. Days of the giants. We were up for four days straight. Yeah, in the old days, we'd be-- yeah, exactly. Exactly. And it became a badge of honor to survive it. 100%. And you didn't want to admit that you were not up to the task or afraid or suffering under the weight load. That would have been, you know, admitting failure or cowardice or weakness. And I think, to a certain extent, that stigma still exists. This huge stigma. So that brings us to your meltdown. Can you bring me along that journey that led to the meltdown? Because I thought that was a very, very important moment, because it did show that you were vulnerable, that you could-- you're a human being. This could happen. It's OK. You can recover from that and still function. So tell me about-- because that was a carefully planned-out journey. We wanted it to be the-- everything's going crazy. We need the hero to come in on his white horse and save the day. And then suddenly the horse comes in without its rider. Where's the rider? He's on the floor. Like, the hero is on the floor. How can that be? Well, it's not hard to figure out when you watch it. Like, it's-- it's the deconstruction of our hero to show the vulnerability of the human being, which underscores the heroism of the fact that he's going out and doing it again with all of these Achilles heels, you know. And I loved the theme throughout-- to me, the entire 15-episode series-- empathy, empathy, empathy. And you-- you show it at all levels. You have to have empathy for your colleagues, empathy for the patient. Tell me about that. Empathy for yourself.
JON LAPOOK:
00:15:52
Mel King. And after another physician doesn't do so well in an encounter with an autistic patient, she comes in and she knows the difference between empathy and sympathy. She knows that the sound is distracting. She turns-- closes the door. She turns down the lights. I thought that was stunning. And he responds. Yeah. Yeah. That's unfortunate. There's so many terrible stories of people that are severely autistic or non-verbal being violently assaulted by police officers and people that don't understand quite what their behaviors are, misinterpreting behaviors. And a lot of the things that are taught to law enforcement about how to dominate a situation and how to put somebody on their back foot are all the wrong things you would do with somebody who's neurodivergent. So sometimes you can create a really horrible situation very quickly by not having that knowledge at your fingertips. But yeah, we also wanted to show that neurodivergent people, like Dr. King, have a wonderful role to play in our society, in our hospitals and many, many professions. And sometimes that actually becomes a little bit of a superpower in terms of focus, in terms of connection, in terms of data, research, a lot of different things. You talk about a superpower. I always think, you know, empathy is your superpower as a physician. And if you actually listen to a patient long enough, they'll actually tell you what's the matter. That's the problem with getting to spend less and less time with patients. The more patients you have to treat per hour because of the billing cycle and because of the overload of patients coming in, the less you're able to make those connections. The more you're going to be missing those clues and the moral injury of wanting to perform a certain type of medicine a certain way and not being able to because the deck is stacked against you, not just today but tomorrow and the next day and the next day with no hope in sight. I think that that is soul crushing. How do you maintain a sense of empathy without a sense of hope, that you're getting ahead of the problem in some way? If it's this tide that can never be stemmed, I don't know that you can keep your empathy intact without a sense of-- yeah, of hope. Well, it's not just physicians and the health care profession. The entire world is aching for empathy. And I wonder if there's a message for the world in The Pitt. I mean, not to be too grandiose, but I think there is. I think there's a message in putting a spotlight back on people who, for a living, do service and angelic work. It-- it's not everybody that can go to work and-- for not a lot of money-- spend 12 to 14 hours cleaning, wiping, caring, bandaging, consoling people at their worst moment. You're seeing everybody's worst day four times an hour, 12 hours a day, five days a week. And the aggregate total of being witness to that is extreme. And yet the willingness to go back day in and day out is so heroic. So to make a show that isn't about a mob boss or a crystal meth dealer or a kingpin but everyday individuals going to work trying to do the best they can with all the personal problems, with their own aging parents, with their own problematic children, with their own bills to pay, still showing up every day, I think that's just prime for great drama and been lacking in television. So happy to put the show back on that spotlights those people. I want to turn to season two. I want you to be able to tease season two. I mean, you hit the target very well predicting measles. I mean-- We did well last year. We talked to a lot of infectious disease experts. They were telling us about vaccination rates dropping and what we might see more incidents of, and we got lucky with measles. That was easier to do last year. How bad for this year, then? This year it's harder. This year, these cuts in Medicaid and Medicare are going to be crazy, as I'm sure you're well aware. The closures of rural hospitals are going to overpopulate urban hospitals. People are going to lose their health insurance. People are going to delay care. People are going to continue to come in sicker-- higher acuity cases. They're going to be more volatile when they come in. That's going to put more of a burden on staff. We have a nursing shortage. We've got a boarding crisis. All this stuff is moving towards this perfect storm of unsustainability. You're an executive producer. You are a director. You are a writer. Do you do food services also? Only at home. I wash dishes, too, at home. Is this about control? This is about me recognizing that there were two points in my career, during the pandemic and during this last work stoppage for the writers' and actors' strike. Those were the two moments when the flow of my career were interrupted. And I wasn't used to it. I've spent most of my life working on sets, and that's a big part of who I am, I have become to realize. And when I couldn't work and didn't have a place to be creative and didn't have a community of people to share my experience with, it really rattled me in a way that-- that rattled me. And I remember saying to my wife, I don't think I work for money. I think I work for health, my own health. I think this is where I get my orientation. And without it, I'm not sure I know what I do on this Earth. And so in those moments, I just started thinking, wow, if I never get to work again, or if I do get to work again, what do I want that work to feel like? What would I want it to be like? And all I could think about was ER and how great those first 15 years of my career were, because it felt like I was with a group of people that really cared about what we were doing. We were doing work that was very meaningful. It was resonating not just throughout the country but throughout the world. And I loved coming to this studio every day and make believing. And suddenly, that's what I just wanted to do again. So I feel like to answer the question in a long-winded way-- yes, I'm wearing a lot of hats, but it's only because I'm so [BLEEP] excited to be here. And I don't want to give it up. And I just love doing all the jobs, and I love telling stories. Someone asked me today how I was feeling, and I thought, I don't know that-- I don't remember feeling this happy recently. I'm the happiest I've been in a long time. Does that surprise you? It just confirms. It confirms all my worst suspicions about myself, which is that I really need all this. [LAUGHS] Wow. [MUSIC PLAYING]
