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This article contains spoilers for THE PITT season 2 episode 5.
We’re five hours into Dr. Frank Langdon’s (Patrick Ball) first shift back at the Pitt, and the prodigal son’s return is not proceeding how he hoped.
Sure, Langdon probably expected a lukewarm reception at best, given how severe his infraction was. But the muted response of his peers combined with the freezing cold shoulder from his former friend and mentor Dr. Robby (Noah Wyle) is starting to take its toll. Now with the arrival of “11:00 A.M.,” some of these microaggressions against Langdon finally begin to blossom into macroaggressions.
Fittingly, the inciting incident here is the return of a prodigal patient. First introduced in the season 2 premiere, harried office worker Debbie Cohen (Mara Klein) initially presented with some acute leg pain, a condition harmless enough that Robby relegated her to Langdon in triage. It doesn’t seem so simple now though, with the rash having extended beyond the Sharpie borders that Langdon drew on Debbie’s shin. If Langdon and nurse Donnie’s pained reactions in the closing moments of episode 4 weren’t revealing enough, the opening moments of episode 5 confirm that this advancing cellulitis is Very Bad. To borrow a euphemism I love from nurses on TikTok: Ms. Cohen is about to meet everyone in the hospital.
While no one would accuse any episode of The Pitt of dragging its feet, the ticking clock nature of Debbie’s rapidly spreading rash imbues this installment with an even more intense sense of urgency than usual. Langdon, Robby, and a host of other doctors, nurses, and surgeons rush in and out of Ms. Cohen’s trauma room no fewer than seven times. And each time, we learn something more troubling about her condition. The cellulitis was on the dorsum of the foot and now it’s spreading to the leg. Her maximum heart rate is good…until it’s not. Suddenly the patient has a bulla (blister) developing and is entering into septic shock.
In a morning already marked by multiple “zebra” cases, the Pitt is now home to necrotizing fasciitis a.k.a. honest-to-goodness flesh-eating bacteria.
“You ever see nec fash?” Robby asks the young surgeon who finally comes downstairs to investigate. The man has not, having just graduated medical school two weeks ago. And few of us have probably seen it either, on television or anywhere else. Robby promptly asks for another surgeon.
In addition to operating as a tension-ratcheting narrative device, Ms. Cohen’s leg also serves to force Robby and Langdon in the same room for an extended period of time, with predictably disappointing results. Robby is still fuming over his acolyte’s betrayal and is displaying little effort in hiding his loathing. At the moment though, Robby might be just as frustrated with himself for failing in his primary goal of the day: to keep Langdon away from him.
“Did you bring Langdon back here?” he asks Dana.
“No, Al-Hashimi did. You banished him to scut purgatory. He did everything you would have done with that cellulitis patient. If you think he missed something, tell him.”
There is almost certainly nothing Robby would have done differently than Langdon. Very few doctors would see a simple foot rash and jump to the conclusion that, within hours, it will evolve into a condition so gnarly that a stunned surgical resident will take photos of it like he’s at a concert. Indeed Nurgle’s blessings rarely arrive when expected. Robby might have sent Langdon to scut purgatory but the Pitt itself might is the real purgatory – a liminal space where larger-than-life forces conscript mortals to confront the same problems over and over.
For his part, Langdon is clearly starting to feel the restricting weight of it all. (It’s probably not a coincidence that one of the patients introduced in this episode is literally handcuffed.) The most heartbreaking moment for him isn’t Robby’s disgust – that’s personal, it’s understandable, it’s even potentially fixable. What hurts worse is Whitaker (Gerran Howell) reflexively logging in to the hospital computer to order meds for a patient before Langdon can. Realizing the questionable optics, Whitaker swears he hastily put in the order because the patient was technically assigned to him, not because he was afraid of Langdon abusing the drugs. Still, it’s a sign that Langon’s “junkie” brand isn’t going away any time soon.
Elsewhere in the Pitt, the doctors start to come up against their respective brands for better or worse. Ogilvie (Lucas Iverson) continues to shed his early goldenboy status and gets a (literally) shitty lesson that medicine isn’t all the reciting of facts from med school. Sometimes it’s disimpacting an old woman’s stools…and then not getting out of the way of the ensuing poop-alanche. After coming off a particularly tough hour that saw her poked with broken glass, Joy (Irene Choi) comes through with a clutch suggestion to lower the uninsured Mr. Diaz’ untenable hospital bill.
“If the system doesn’t work for you, you’ve gotta work the system,” she tells Dr. Garcia after revealing her family did a similar trick when her grandmother fell ill.
Even Dr. Robby’s medicine ubermensch brand begins to take some hits this hour. While he has his usual “hell yeah” moments of heroism (his hopping on the phone with Ms. Cohen’s employer to report, in no uncertain terms, that she will not be coming to work that day and she will not be fired for that is awesome), his clear disdain for Langdon, Al-Hashimi (Sepideh Moafi), and anyone keeping him from his beloved motorcycle trip is an increasingly bad look. So much so that his current hospital lady friend Noelle Hastings (Meta Golding) playfully dubs him “Motorcycle Mike.”
Unshakeable as some of these labels may seem, the ER always provides many an opportunity to rise above them. This hour alone sees the arrival of new patients Gus Varney, a prisoner severely wounded in an assault; Alex, a dumbass kid burned with dry-ice by his brother; and Roxie Hamler, a home hospice patient with a history of lung cancer who just suffered a seizure. Alex, bless him, provides a rare moment of comedic relief for Langdon and the audience, revealing that he was trying to get branded with the family crest (literally just the Pittsburgh Penguins hockey team logo). He also says “You goonin’ me?” to his brother, accidentally revealing that the show’s writers’ room has no contact with any members of Gen Z.
Of the new crop, Roxie undoubtedly provides the biggest potential for dramatic resonance going forward. She also might prove to be a redemptive tool for the doctors assigned to treat her. For now, that’s Dr. McKay (Fiona Dourif) and night shift nurse Lena (Lesley Boone), who is moonlighting as Roxie’s “death doula” for her family. But one would hope that Robby and Langdon at least stop by to meet her and get some much-needed perspective.
Based on the final moments of “11:00 A.M.,” however, it might not even take Robby and Langdon that long to reconcile or at least work better together. If the two can’t put aside their differences to save a flatlining Louie (Ernest Harden Jr.), then Motorcycle Mike might need that sabbatical even more than previously realized.
New episodes of The Pitt season 2 premiere Thursdays at 9 p.m. ET on HBO Max.
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