‘The Pitt’ Got a Diagnosis Right. It Got the Response Wrong.

Last week’s season finale of “The Pitt” generated significant discussion, particularly around one of its most emotionally charged scenes: Dr. Al-Hashimi’s disclosure to Dr. Robby that she has a seizure disorder causing brief, intermittent lapses in attention, and what that means for her ability to drive and practice emergency medicine.

After watching the episode, I spoke with Jeremy Faust, MD, editor-in-chief of MedPage Today, about how that scene landed. We both agreed it was powerful. The performances were extraordinary, and the weight of the moment, a physician confronting the possibility that her identity and livelihood may be at risk, was palpable and real.

But my takeaway diverged from what I’ve heard from most viewers.

Yes, Dr. Al-Hashimi’s diagnosis has implications for certain high-acuity clinical situations. But it does not, as the scene implied, disqualify her from practicing emergency medicine. She even said it herself: roughly 90% of the patients we see in the emergency department are not at risk if a provider has a brief, seconds-long pause in attention. The diagnosis may narrow her scope in some specific contexts. It does not erase her as a physician.

What struck me most about that scene wasn’t her disclosure. It was Dr. Robby’s response to it. He seemed to have no framework whatsoever for thinking about emergency medicine as a specialty that can flex around our evolving capacities. His entire identity as a physician appears to rest on a model in which every emergency physician must be able to do everything, at full intensity, all the time. That rigidity isn’t just a personal failing, it’s a structural one, and I’d argue it’s a direct contributor to the burnout we watch consume him throughout the series.

Our specialty has worked hard to make room for physicians like Dr. Al-Hashimi, even if Dr. Robby hadn’t cared to notice. We have colleagues who are diagnosed with chronic diseases after residency, who are pregnant in their third trimester, who are navigating the physical demands of aging, or who simply need a modified schedule for a period of time. These physicians are not liabilities. They are experienced, skilled clinicians who have invested years into this specialty, and we cannot afford to discard them because they no longer fit a narrow, idealized image of what an emergency physician is supposed to look like.

The workforce crisis in emergency medicine is real. Attrition is expensive. Burnout is endemic. And yet, when a physician raises her hand and says she needs something different, the suggestion that maybe this specialty isn’t for her anymore is both foolish and costly. New parenthood, late-term pregnancy, physical rehabilitation, chronic illness — none of these have to mean the end of a career. They just mean modifying the career you already have.

We have tools to do better: incorporating telehealth, working shifts that don’t include critical care, transitioning to urgent care or observation medicine. These are all clinical environments that have a slower pace than the way Dr. Robby moves through his world.

Physicians can teach or engage in policy work, non-clinical opportunities that rely on our deep clinical experience. Our specialty has a wide footprint, and not every role requires the same physical and cognitive output as an overnight sprint to the trauma bay.

I’ve had many of these conversations with colleagues navigating exactly these crossroads. Years ago, a physician who had just completed emergency medicine training called me after receiving a new multiple sclerosis diagnosis. She was trying to figure out what her career could look like going forward. We talked through her options carefully, and she ultimately transitioned to urgent care — not as a consolation prize, but as a deliberate and sustainable career path she could thrive in. She didn’t leave emergency medicine because she had to. She found a version of it that worked for her, because we made space for that conversation.

That is what Dr. Robby failed to offer Dr. Al-Hashimi. Not a solution, but a conversation. The acknowledgment that the diagnosis narrowed some doors without closing all of them. This is the reason behind our workplace policies at FemInEM: thinking about how our specialty can evolve to support physicians through every phase of their career, not just the years when everything is running at full capacity.

This is not a charity mission. It’s a workforce strategy. When we build systems that accommodate evolving capacity rather than demanding uniformity, we keep talented clinicians in the field longer and reduce the kind of burnout that’s driving attrition across emergency medicine.

Watching that scene, my instinct was simple: I wanted to be in the room with Dr. Al-Hashimi instead of Dr. Robby. Not to tell her nothing had changed; some things had. But to tell her that there were still paths forward, that her identity as an emergency physician was not gone, and that the work ahead was figuring out what form that identity would take. Instead, the scene left us all with the impression that she might simply be too broken to continue.

Emergency medicine is big enough to hold us all. We just need physicians, program directors, department chairs, and our favorite TV doctors who believe that too.

Dara Kass, MD, is a practicing emergency physician, and formerly a regional director at HHS. She is the founder and strategic director of FemInEM and a clinical affiliate at the Advancing Impact on Maternal and Reproductive Health (AIM) Lab at Brown University’s School of Public Health.