HBO’s “ER Meets 24” Show Is The Best Medical Drama Of The 21st Century

While HBO’s greatest medical drama in years is an entirely original series, its ingenious premise is built on a combination of two existing classic shows, namely ER and 24. The age-old maxim that there are no new ideas in existence can sometimes feel particularly true in the world of television. Even the best new shows, like the Netflix thriller The Sinner, are often sold as “Mindhunter meets True Detective,” or, in the case of HBO’s short-lived historical sci-fi The Nevers, “His Dark Materials crossed with The Magicians.”

While this type of shorthand allows new viewers to get an idea of whether a show will appeal to them without committing to watching the pilot episode, this type of categorization also runs the risk of making truly innovative shows a harder sell. It is tough to compare Netflix’s sci-fi masterpiece Sense8 to any earlier small-screen effort in the genre, and this might be part of the reason that the Wachowskis’ show underperformed despite its stellar reviews.

That said, there are some instances where this form of comparison is simply too accurate to avoid. HBO’s medical drama The Pitt owes some of its inspiration to St. Elsewhere, Grey’s Anatomy, and even MASH, but the show’s biggest inspiration is clearly the ‘90s classic ER, while its unique approach means that The Pitt also borrows heavily from the early 2000s political thriller 24. While the politics of 24 have aged terribly and ER’s once cutting-edge style has been copied endlessly over the decades, The Pitt’s combination of its respective premises created something truly new and exciting.

The Pitt’s Real-Time Storytelling Revolutionizes The Medical Drama Genre

Actor Noah Wyle is well known for his roles in The Librarians franchise and Falling Skies, as well as his supporting parts in movies like Donnie Darko, Enough, and A Few Good Men. However, for the vast majority of viewers, Wyle’s most recognizable role is that of Dr. John Carter in ER. The groundbreaking medical drama ran from 1994 until 2009, and Wyle was, alongside Laura Innes and Goran Višnjić, one of its most consistent stars.

Viewers followed Carter on his journey from an inexperienced but eager medical student to the proud operator of the Joshua Carter Center. While ER launched the careers of stars like George Clooney, Julianna Marguiles, Mekhi Phifer, and Linda Cardellini, it is notable that Wyle’s character was the one who received the most sustained, long-term focus from the show. This explains why Wyle’s starring role as The Pitt’s attending Dr. Michael Robinavitch is so pivotal to the show’s success.

Like ER, The Pitt focuses on the daily life of the denizens of an emergency room, specifically the understaffed, under-resourced Pittsburgh Trauma Medical Center’s ER. Nicknamed “The Pitt” due to its constant overcrowding, this chaotic setting is overseen by Dr. Robby and hosts a diverse array of nurses, residents, student doctors, interns, and surgeons. So far, it would be tough to differentiate The Pitt from many medical dramas like Grey’s Anatomy, Chicago Med, New Amsterdam, The Resident and, more pointedly, from their shared inspiration, ER.

However, while The Pitt’s cast of characters might sometimes call to mind these earlier hits, the show has a huge secret weapon inspired by 24 that makes the HBOMax series entirely original. Like that intense action show, The Pitt takes place in real time, with each episode covering a single hour in Dr. Robby’s seemingly never-ending day from hell. Instead of jumping days ahead or weeks ahead between episodes, The Pitt’s storytelling moves from one character to another, but always remains in real time.

The Pitt’s Setting Makes Real-Time Storytelling An Ingenious Choice

With minimal non-diegetic music, few interpersonal interactions that take place away from the prying eyes of patients, and only a handful of scenes set outside the ER itself, The Pitt feels nothing like ER thanks to its real-time approach. The verisimilitude of the series is striking, with its fast-paced real-time plotting ensuring that one of TV’s most perennially popular settings ends up feeling fresh, original, and under-explored. The Pitt’s real-time storytelling also sidesteps the biggest problem with 24’s storytelling, ironically using the show’s central gimmick to better effect than the original series did.

24’s biggest problem was always the idea that all the show’s action could be happening to one guy in the span of one day, and, as the series wore on, its plots became increasingly ludicrous as every second of the luckless Jack Bauer’s life was packed with unlikely incidents. With a massive, sprawling cast of over a dozen main characters, The Pitt always has someone else to focus on, meaning the show never needs to dump undue trauma on one protagonist.

There are a handful of moments in The Pitt season 1 that feel a little convenient or questionable, where people arrive in the right place at the right time for maximum dramatic effect. This would have easily been excused by the show’s desire to remain entertaining and engaging as well as being realistic and believable, but The Pitt season 2’s changes saw the show slow down and invest even further in believability instead of simply chalking up plot contrivances to a necessity of TV writing.

The Pitt Could Last Forever

There’s no denying the reality that, at its worst, later seasons of ER could be as silly and unrealistic as Grey’s Anatomy. In contrast, The Pitt strives for a level of believability that makes the series feel like a more sincere tribute to the thousands of essential workers laboring in America’s broken healthcare system. Fortunately, Wyle’s medical drama doesn’t seem to be going anywhere anytime soon, with The Pitt season 2 earning an even higher Rotten Tomatoes rating from critics than its near-perfect predecessor.

Since The Pitt’s rotating cast of residents, interns, and students includes characters who are entering a new rotation or moving departments, the show’s future seasons can perpetually welcome new arrivals and drop existing characters without these changes feeling unrealistic or inexplicable. Much like the chaotic, intense environment of an ER is a naturally fitting location for a series that aims to grip viewers, The Pitt’s blend of ER and 24 is an ideal setup for an ever-changing cast whose new characters and sudden exits don’t require exhaustive onscreen explanation.