Dr. Robby (Noah Wyle) tends to an overdose patient in 'The Pitt.' Warrick Page/HBO Max Share on Facebook Share on X Share to Flipboard Send an Email Show additional share options Share on LinkedIn Share on Pinterest Share on Reddit Share on Tumblr Share on Whats App Print the Article Post a Comment [Warning: This story contains spoilers for Season one of The Pitt.] Boasting 13 Emmy nominations and four recent TV Critics Association Award wins, HBO Max's breakout medical drama The Pitt has been widely lauded for its hyperrealistic portrayal of a chaotic, underfunded hospital emergency department. Among the many things the show has been credited for getting right is its nuanced depiction of death and dying. The Pitt cuts deep into the heart of harrowing end-of-life decisions and conversations faced by patients, family members and physicians, as well as the messy emotional aftermath. The upside is the show's positive real-life impact, which initially surprised executive producer and writer Joe Sachs. Related Stories TV Creative Arts Emmys: Shawn Hatosy and Merritt Wever Win for Best Guest Acting in a Drama TV Norman Lear Awards to Honor 'The Pitt,' 'Dying for Sex,' 'Shrinking' and More Having worked for over 30 years in Northridge Hospital's trauma center, Sachs tells The Hollywood Reporter that he brings his own expertise on death and dying to the writing table first. "But when I want to really make sure things are good and right, we reach for consultants," he says. "The deeper you dig, the more interesting details you get that people are unaware of and that makes for fresh storytelling. USC Norman Lear Center's Hollywood, Health & Society is our lifeblood and I email the most bizarre requests to [HH&S senior outreach specialist] Roberta Cruger, who I've worked with since my ER days." HH&S program director Kate Fob tells THR that for season one's death and dying narratives, the organization connected The Pitt to organ donation programs and to palliative care expert Dr. Ira Byock. Now deep into season two, Fob says the show has tapped into a death doula's expertise for an upcoming storyline. "We had a lot of expert input from OneLegacy, the Southern California organ procurement organization, and CORE in Pittsburgh, about what is needed to help family members accept their loved one's wishes for organ donation," says Sachs, referring to the unintentional fentanyl overdose by a college student, a registered donor, and his parents' struggle with the decision. "It shouldn't have been an issue, because he was over 18 years old. But Dr. Robby [Noah Wyle] was wise enough to know that the parents needed to process this and have every test done to be absolutely certain that their son was brain dead. To have a counselor from the organ procurement organization and a priest brought in to get the parents to that place of acceptance was done with a lot of accuracy." In episode 8, parents witness unsuccessful efforts to resuscitate their six-year-old daughter, who drowned. "In the old days, parents were told, 'Wait in the waiting room. You're going to be freaked out. You shouldn't see this.'" says Sachs. "But to be there and see what's happening, they understand that everything possible is being done until the pronouncement of the time of death." The scene addresses the heartbreak of death and loss on multiple levels. Senior resident Heather Collins (Tracy Ifeachor) has just miscarried, while resident Mel King (Taylor Dearden), a caregiver for her own sister, asks the girl's four-year-old sister, who can't be in the room, to "say everything you want to tell your sister to the teddy bear and I'll go put the bear on her bed." Sachs tells THR he learned that teddy bear technique from emergency department social worker Thu Phung while working at LA's Northridge Hospital. The Pitt Warrick Page/HBO Max A third end-of-life plotline features an elderly man with Alzheimer's, pneumonia and sepsis, whose two adult children share durable power of attorney but choose to ignore their father's advanced directive and request intubation. Explaining how "each step causes more suffering and minimal benefit," Dr. Robby gently guides them to extubate and say final goodbyes in episode 4. "This medical story fit great because it's topical and hasn't been portrayed realistically [on TV]," says Sachs. "We wanted to show the downside of overly aggressive resuscitation in the elderly when there was not much chance for a quality outcome, and then deal with what you might call a 'good death,' meaning that families come together in a comforting way to express what they should at the time of death. And that relates to The Four Things That Matter Most, a book by Ira Byock, who we talked to." The Pitt Warrick Page/HBO Max Byock joined a Zoom with The Pitt writers' room to discuss tensions and storylines the team had in mind. Then he pitched his own experience, as an emergency department physician, when an older patient with a leaking abdominal aortic aneurys