The Pitt, Season 2

[Anonymous]

Anonymous wrote:Does anyone know what the medical story line is with the obese patient? I understand the fat phobia and discrimination overweight (esp obese) patients experience in medical care is the story line but I couldn’t figure out what his medical issue was that brought him into the ER in the first place. Can someone explain?

His symptoms were vague and he doesn't have a diagnosis yet because they couldn't take all the tests they needed (that's why he's being transferred). His main symptom was abdominal pain. That's a super common thing that brings people to the ER and there are tons of possible explanations. It's very standard to take scans for abdominal pain because there are so many organs that could be impacted. They are looking at appendix, kidneys, bowels, gallbladder, just to name a few. That's why his story ultimately revolves around how to get him a CT scan because his size means they cannot use a standard machine.

The reason they intubate him is because he tells them he cannot lie flat on his back without shortness of breath. You have to be able to lie flat for a CT. So they put in a breathing tube to enable them to do the CT.

[Anonymous]

He came in with severe abdominal pain and a fever. He can’t lay flat to be weighed (to figure out if they could use their CT machine) so they had to insert breathing tube while he was upright. At one point I think one of the interns said something about one possible diagnosis that could have a higher fatality, but I don’t recall what that was. The odd thing to me was that despite the patient saying he had no close family he could call, only a sister who he was estranged from, the staff then took it upon themselves to track down this sister. That seems a little bit of an overstep to assume he would want her notified without his direct consent.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Does anyone know what the medical story line is with the obese patient? I understand the fat phobia and discrimination overweight (esp obese) patients experience in medical care is the story line but I couldn’t figure out what his medical issue was that brought him into the ER in the first place. Can someone explain?

His symptoms were vague and he doesn't have a diagnosis yet because they couldn't take all the tests they needed (that's why he's being transferred). His main symptom was abdominal pain. That's a super common thing that brings people to the ER and there are tons of possible explanations. It's very standard to take scans for abdominal pain because there are so many organs that could be impacted. They are looking at appendix, kidneys, bowels, gallbladder, just to name a few. That's why his story ultimately revolves around how to get him a CT scan because his size means they cannot use a standard machine.

The reason they intubate him is because he tells them he cannot lie flat on his back without shortness of breath. You have to be able to lie flat for a CT. So they put in a breathing tube to enable them to do the CT.

If he has to go somewhere else for the CT scan, why not wait until he gets there to intubate him?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Does anyone know what the medical story line is with the obese patient? I understand the fat phobia and discrimination overweight (esp obese) patients experience in medical care is the story line but I couldn’t figure out what his medical issue was that brought him into the ER in the first place. Can someone explain?

His symptoms were vague and he doesn't have a diagnosis yet because they couldn't take all the tests they needed (that's why he's being transferred). His main symptom was abdominal pain. That's a super common thing that brings people to the ER and there are tons of possible explanations. It's very standard to take scans for abdominal pain because there are so many organs that could be impacted. They are looking at appendix, kidneys, bowels, gallbladder, just to name a few. That's why his story ultimately revolves around how to get him a CT scan because his size means they cannot use a standard machine.

The reason they intubate him is because he tells them he cannot lie flat on his back without shortness of breath. You have to be able to lie flat for a CT. So they put in a breathing tube to enable them to do the CT.

If he has to go somewhere else for the CT scan, why not wait until he gets there to intubate him?

Being able to lie him flat will make it easier to transfer him.

Also the Pitt is a trauma center with staff trained to handle a tricky intubation or any complications that could arise from it. It's unlikely the facility he's being moved to is a trauma 1 center, especially since a major plot point this season is that several of the trauma centers in the city are shit down.

[Anonymous]

Anonymous wrote:He came in with severe abdominal pain and a fever. He can’t lay flat to be weighed (to figure out if they could use their CT machine) so they had to insert breathing tube while he was upright. At one point I think one of the interns said something about one possible diagnosis that could have a higher fatality, but I don’t recall what that was. The odd thing to me was that despite the patient saying he had no close family he could call, only a sister who he was estranged from, the staff then took it upon themselves to track down this sister. That seems a little bit of an overstep to assume he would want her notified without his direct consent.

The comment about fatality rates was just about surgery generally -- obesity can cause surgical complications and leads to much higher fatality rates in general.

I did think that comment was transparently stupid because (1) it was made within earshot of the patient before they even knew if he needed surgery so it's going to cause perhaps unnecessary anxiety, and (2) different surgeries have different risks depending on how they are done. Saying he has a "50% fatality" rate for surgery, generally, is pointless when you still have no idea whether this is bowel obstruction, burst appendix, gall stone, tumor, or what. His chances vary greatly depending on his diagnosis. Yes, his weight makes his treatment harder and means almost any diagnosis is going to be trickier for him than a normal weight person. But asserting that there is a 50% fatality rate for surgery, generally, is just a useless factoid during the diagnostic process.

[Anonymous]

Anonymous wrote:I could not look at the tongue laceration with all the blood. Including the repair. I had to cover the screen.

It was two in the afternoon, she was blackout drunk early in the afternoon on the Fourth?

[Anonymous]

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Anonymous wrote:I thought the story in this most recent episode about Dana serving as a SANE to the rape survivor was riveting. I'm a rape survivor and worked for a time on a crisis hotline for sexual violence. The actress who played Ilana was phenomenal and the writing of that storyline was obviously very well researched. I'm not sure I've ever seen that situation portrayed as accurately and honestly as that.

I also love how that story was paired with the scenes in the last episode where Dana cleaned Louie's body. In both situations, she brought the new nurse, Emma, along and narrated what she was doing, and why. These are activities nurses do but few people talk about. People think about nurses taking your BP, administering meds, assisting doctors. But this -- a nurse wiping the blood and fluids off a man who just died and is unlikely to be claimed by loved ones, walking a rape victim through evidence gathering -- people don't think about this. And this is set against the backdrop of Dana being assaulted last season and saying she was done, and then returning to work. You're thinking about why she came back, and also why she wanted to quit. And you're looking at Emma who is on the far other end of a nursing career and thinking about what is ahead of her too.

Also Emma saying "let's go find the good snacks" to Ilana.

If this is "slow" or "disjointed" or "not enough happening" for you, you are entitled to your opinion. But I think that's very compelling storytelling, about people and events that don't ever get told with this much factual accuracy or tenderness.

Did you find the way they were talking to her to be condescending? I realize it was supposed to be super compassionate but I just wondered.

I thought it sounded like the script that SANEs are trained to follow, said with real compassion by someone who definitely wants to help. I also thought that Ilana's reaction, of being annoyed, impatient, and frustrated by the situation, was completely spot on to how many rape survivors behave when engaging with any institution to report their rape. One of the hardest aspects of being a rape survivor, and helping rape survivors, is that nothing about the process is really designed to give people what they actually need, which is true agency. Dana was administering the rape kit professionally and correctly, AND she was clearly sensitive to Ilana's state of mind (it was obviously not Dana's first rape kit). However, the clinical nature of a rape exam is horrible. And really think about this. Think about what it is like to be raped and violated in that way, and then to place yourself in a hospital gown in a sterile hospital exam room with multiple strangers who will examine your body, take photos, and collect evidence. They will take your clothes away.

The moment where Dana is doing the blue light test and then takes a swab of Ilana's arm? Dana does it right, by explaining exactly what she is doing and why. But Ilana is still in a state of physical and mental shock. She is not processing, or she's processing through trauma. When Dana uses the cold swab, Ilana in theory knows it's coming, but her whole body is on high alert. SANE exams are incredibly stressful, even when the nurse is amazing, even when there is an advocate there.

Our society doesn't know how to deal with what rape does to people. And I have worked in rape crisis and I am a rape survivor myself, and I don't know the answers either. The SANE exam is designed to try and facilitate a criminal justice solution. It still places survivors in situations that can be traumatizing and degrading. Plus that rape kit? It gets sent off to a lab where it may be delayed in processing or processed incorrectly. Ilana's friends may side with her rapist (who is also their friend) against her. If Ilana chooses to press charges, she may face not only her rapist but her friends sharing information about her (her drinking habits, her sexual history, her relationship with the rapist) that will be mortifying to have disclosed to the police, much less discussed in court. And in the end, there may be no conviction, or a plead out to lesser charge due to lack of evidence. And in the process, she will lose friends and change the way everyone in her life sees her.

Obviously the show isn't getting into all of that, but I honestly can feel this in how they are treating the storyline. I think Dana knows and understands all this, even as she also hopes Ilana decides to finish the exam and press charges.

People rarely understand what rape really does to you. It's not talked about enough and when rape is portrayed on television and in movies, it is sensationalized and the emphasis is on the act itself. The aftermath of rape, sometimes for the rest of your life, is so much bigger than the act in the moment. The Pitt seems to get this, they must have consulted with survivor who has worked in rape intervention or recovery. This is what it is like.

I said to my husband while we were watching this: "It would be a whole lot more impressive if all this evidence weren't going on a shelf somewhere, never to be touched again."

And they showed that tonight with the older kit that was way overdue for pickup. Loved Dana’s call to the police about that!

Did she say there was another, older kit waiting? I thought she was just referring to the one she's just collected.

In any case, it was definitely meant to highlight how often those kits go ignored or abandoned, and to show why it's so frustrating. It took so much courage for Ilana to come in for the exam, it was hard for her to go through, and doing the kit took real resources from an already taxed healthcare system. But then the police regularly drop the ball on the next step. It's infuriating. Dana's shooting at the cop on the phone was satisfying when you know what's behavior and it. A while category of horrible, violating crime that police routinely just refuse to investigate even when the victims have gone through hell to come forward.

Yes, a kit had been there for two weeks. They’re supposed to be picked up with 72 hours.

Dana threatened the cops not to treat them immediately when they come in for treatment. But she sat on that kit too. It was right there in the room in a fridge with a glass door. The hospital should have been tracking those kits until they were picked up.

[Anonymous]

Anonymous wrote:

Anonymous wrote:I could not look at the tongue laceration with all the blood. Including the repair. I had to cover the screen.

It was two in the afternoon, she was blackout drunk early in the afternoon on the Fourth?

You can’t drink all day if you don’t start in the morning.

[Anonymous]

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Anonymous wrote:So, I'm still stuck on a few things here after last night...

1) Mel's anxiety about the deposition is understandable. But, again, who is having a deposition on the Fourth of July? In what world?

2) It's pretty clear that Abbot is going to be balls deep in al-Hashimi soon. Holy cow. Assuming Mohan doesn't throw herself at him first. The way she treated that bullet graze ... oh boy.

3) I was really worried with the rape SANE scene there that they were going to depict this as some kind of regretted sex incident. On the one hand, it was fascinating to see how they process victims of SA, OTOH some of the compassion came across as a little condescending. And then when she refused the genital swab... Also, we're seven hours in to the episode, which makes it about 2 p.m. I'm trying to understand how she got sexually assaulted at a 4th of a July BBQ by a drunk friend in the middle of the day?

4) Cyberattack? Really? Come on, now.

5) To that end, what was with the goofy CEO summoning al-Hashimi but not Robby? Robby looked Big Mad.

6) Where the hell was Whitacker/Huckleberry last night? And what's with this "he spends all his time at this widow's farm" storyline? Are we to believe he's balls deep in the widow and raising a dead man's child?

At least not motorcycles sans helmet talk in this episode. They were starting to lay the foreshadowing on thick earlier.

I still love this show but I agree that the reality of the timing of the incidents is weird, case in point the depo on July Fourth or the kid studying in the college library in July?

I also feel like the scenes jump around much more this season so we are getting less of each player - like Whittacker last night and McKay has hardly been in this season at all.

studying for the bar exam on July 4th totally tracks

Maybe at home, but not in the library at 7am.

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My kid doesn’t study at home. He’s always in library, lab, some other building on campus to study. And yes at 7am in summer.

I don't think the library would be open at 7am on July 4.

Some campuses have 24/7 libraries (my school had one).

And studying at 7am may be on purpose to show something is off with his mental state.

Even the Harvard Law library doesn't open until 8 a.m. and is closed all day on the Fourth of July.

But we're talking about Pitt. It's open 24/7.

Incorrect. Pitt’s law library, the Barco, also opens at 8 a.m. and is closed on July 4th. https://www.library.law.pitt.edu/about/library-service-desk-hours

Who cares? It is an insignificant detail to a fictional show to introduce a story line.

Because one of the things that made season 1 good was its attention to details and being accurate. The second season didn't need to take place specifically on July 4, but once the writers made that decision, they should have followed through on the details.

+1. Did you notice the rape survivor says she was preparing the bbq - then the rape - but it’s only 12 p.m. in the ER. She should have been out later in the “day”.

Maybe she went to a bbq on July 3rd evening? WHO CARES! Just watch the show!

Well, obviously a lot of people do, based upon the remarks here. Why can’t people talk about flaws in the story line? Tonight’s was using the term “photographic memory”. That term has been out of use for at least two decades. It’s now called “eidetic memory” and there are many types.

Who made you forum police?

I doubt most viewers are familiar with the term “ eidetic memory.”

No, but doctors would know it. I guess this is the challenge for the show's writers, although they use medical terminology viewers wouldn't understand all the time.

Nurses wouldn't necessarily know it, nor would admins or other hospital personnel. It was said in a crisis situation where the person speaking wanted to convey that she could help with a critical problem. She wasn't bragging about her special skill, and was actually sharing the info reluctantly.

I know it's hard for DCUM know-it-alls to understand this, but there are actually people in the world who choose to speak in a way to be understood, not to impress people with their vocabulary.

Bunch of Ogilvies in this thread.

The Oglilvie character is such an over the top doofus that it makes me think that the writers only created him to defect from Santos and McKay.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I could not look at the tongue laceration with all the blood. Including the repair. I had to cover the screen.

It was two in the afternoon, she was blackout drunk early in the afternoon on the Fourth?

You can’t drink all day if you don’t start in the morning.

Sure, but you can pace yourself to make it to the fireworks. Seems like they are trying to make us forget this show is set on the Fourth until the last couple episodes when they get the flood of fingers blown off.

[Anonymous]

Anonymous wrote:

Anonymous wrote:I could not look at the tongue laceration with all the blood. Including the repair. I had to cover the screen.

It was two in the afternoon, she was blackout drunk early in the afternoon on the Fourth?

This didn't seem weird to me because both she and her friend were obviously big partiers and day drinking is a BIG thing for certain demographics, especially on holidays. Bottomless brunch, you know.

Also the doctors were clearly alarmed by her level of inebriation and even talked about recommending rehab programs because of the amount of drinking she was talking about and the fact that she was blacking out. Yes, that conversation existed more to give Santos and Langdon a chance to exchange meaningful looks over the word "rehab" but the show was also portraying realistic drinking behavior in context.

[Anonymous]

Anonymous wrote:

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Anonymous wrote:I could not look at the tongue laceration with all the blood. Including the repair. I had to cover the screen.

It was two in the afternoon, she was blackout drunk early in the afternoon on the Fourth?

This didn't seem weird to me because both she and her friend were obviously big partiers and day drinking is a BIG thing for certain demographics, especially on holidays. Bottomless brunch, you know.

Also the doctors were clearly alarmed by her level of inebriation and even talked about recommending rehab programs because of the amount of drinking she was talking about and the fact that she was blacking out. Yes, that conversation existed more to give Santos and Langdon a chance to exchange meaningful looks over the word "rehab" but the show was also portraying realistic drinking behavior in context.

Certain demographics being skanky hos?

[Anonymous]

Anonymous wrote:I sometimes feel like I'm watching a totally different show than people on here.

Dr. Ellis wasn't necessarily dictating to Mel what to say in her deposition. She was also trying to reassure Mel that she hadn't done anything wrong.

The measles case happened at the end of last scene and involved an anti-vax mom whose kid is brought into the ER with the measles. The doctors wanted to do a spinal tap to save her kids life, but the mom wanted to "do her own research." The dad, who was not an idiot, gave permission for the spinal tap. Apparently that mom is now suing the hospital and Mel over the spinal tap, claiming it has caused "intellectual disabilities", which is a BS injury, since spinal taps do not cause intellectual disability and are actually safe, routine procedures that doctors do all the time (I have had a spinal tap).

Dr. Ellis knows they aren't supposed to talk about the depositions but she also knows that Mel is freaking out and that, since Mel is a deeply empathetic person who is also neurodivergent, may be distracted by her own sense of responsibility for her own patients into admitting fault for something that not only isn't Mel's fault, but isn't even real.

Earlier in the season, we saw Robby do the same thing, not talking specifically about the case but just explaining that doctor's get sued and you just have to go and tell the truth, which is that you did your job.

The fact that the depo is on the afternoon of July 4th is silly, but if you let that go, the rest of the plot line makes sense and is interesting.

I hated that scene, Mel is one of the few characters on the show really worth rooting for her, I just don't see her standing there and listening to information she is not supposed to hear.

[Anonymous]

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Anonymous wrote:I could not look at the tongue laceration with all the blood. Including the repair. I had to cover the screen.

It was two in the afternoon, she was blackout drunk early in the afternoon on the Fourth?

You can’t drink all day if you don’t start in the morning.

Sure, but you can pace yourself to make it to the fireworks. Seems like they are trying to make us forget this show is set on the Fourth until the last couple episodes when they get the flood of fingers blown off.

The girl was an alcoholic. The person who paces themselves so they can make it to the fireworks is unlikely to also drink so much they black out and bite through their own tongue. ERs tend to be full of people who do irresponsible, inadvisable things, especially on holidays.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I could not look at the tongue laceration with all the blood. Including the repair. I had to cover the screen.

It was two in the afternoon, she was blackout drunk early in the afternoon on the Fourth?

This didn't seem weird to me because both she and her friend were obviously big partiers and day drinking is a BIG thing for certain demographics, especially on holidays. Bottomless brunch, you know.

Also the doctors were clearly alarmed by her level of inebriation and even talked about recommending rehab programs because of the amount of drinking she was talking about and the fact that she was blacking out. Yes, that conversation existed more to give Santos and Langdon a chance to exchange meaningful looks over the word "rehab" but the show was also portraying realistic drinking behavior in context.

I knew plenty of hard drinkers in college days and beyond, they weren't blacking out mid afternoon, particularly when the big event was later that night.