The Pitt Recap: A Tale of Two Intubations

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11:00 a.m., and true to form, Pittsburgh Trauma Medical Hospital is bustling with activity. It’s organized chaos, if you will, with “In Dana We Trust” as the guiding principle. As the hours tick by, there’s a lot to manage, but each thread of the story we’re following unfolds seamlessly, much like the patients moving through the E.R. The writing on this show is exceptional, with each episode’s script being skillfully handled by the week’s writer – this time around, it’s Simran Baidwan, orchestrating the narrative flow like a seasoned charge nurse directing traffic.

Regarding The Pitt, it primarily focuses on portraying an authentic hospital environment without strong thematic connections between patients or plotlines as compared to other medical dramas. However, this week’s episode was particularly engaging because it contrasted two very distinct intubation procedures. Although the treatment was the same, the methods used could not have been more different.

In one room, there’s Travis, a teenager who’s experiencing a post-tonsillectomy hemorrhage – an event I never contemplated prior to this situation. Now, I’ll always associate tonsillectomies with this potential complication. As Whitaker assists Travis by removing some blood from his mouth, suddenly, the situation escalates dramatically. The boy starts bleeding profusely. Due to the heavy flow of blood, Langdon can’t see properly and is unable to intubate Travis to provide him an airway. Dr. Garcia suggests a cricoid pressure, but Langdon and Robby, the Emergency Medical team, are determined to avoid surgery. Instead, Robby proposes a retrograde intubation: he will insert a guard wire from the bottom of Travis’s throat to help Langdon navigate from above for the intubation. Although it’s an unconventional method, they believe it’s necessary in this critical situation.

During this critical situation, we frequently switched between Dr. Mohan’s efforts to intubate his sickle cell patient, Joyce. The transfusion intended to aid oxygenation in her blood wasn’t effective, and she was rapidly becoming hypoxic, putting her at risk for stroke, heart attack, and even death. Although the intubation process isn’t as complicated as improvising one or causing excessive bleeding, it still presents its own challenges. Primarily, the fear of waking up with a tube in your throat after being put to sleep can be overwhelming. Understandably, Joyce and her wife, Ondine, feel apprehensive but are comforted by Dr. Mohan’s guidance throughout this ordeal. However, Robby, a fellow resident under Samira, isn’t particularly pleased with their friendship. Once more, he criticizes Samira for being too close to Joyce as a friend instead of maintaining a professional distance as her doctor. In the face of Joyce’s dwindling time, Samira must exert more pressure to persuade her to consent to the intubation.

Indeed, it was Dr. Collins’ patience and care in making Joyce and Ondine comfortable that ultimately led them to consent to the procedure and endure the ordeal without panicking. It was Dr. Collins who took over during the intubation when Robby assisted with the tonsillectomy hemorrhage, and she even complimented Samira on her compassion for patients – a trait that truly defines a good doctor. This episode’s portrayal of Samira and Heather’s relationship added valuable insights to the various mentor-mentee dynamics presented by The Pitt.

The dynamic between them appears more amicable compared to McKay and Javadi, whose interaction with Sherry, the homeless mother who accidentally burned herself on a sterno, becomes strained. Seeing how distressed Sherry is, McKay empathizes, sharing her own challenging past to provide comfort. She’s an addict who temporarily lost custody of her son but has been sober for nine years and aims to regain joint custody when her ankle monitor is removed next week – she doesn’t go into specifics with Sherry, only referring to it as a “misunderstanding.” Similarly, Cass attempts to establish rapport with Sherry to foster trust. Eventually, Sherry breaks down, confessing her hardships, and Cass encourages her to show herself some grace. However, just as trust is being established, Javadi enters the scene and begins discussing meeting with a social worker with Sherry. Although Javadi intends to help, Sherry perceives it as an invasion – she can’t comprehend ever trusting Dr. McKay, and she leaves. McKay offers some criticism to Javadi, emphasizing the importance of “impact over intent” and the need to listen to patients rather than judge them. Javadi defends herself, insisting she isn’t judgmental, but McKay skeptically remarks: She’s witnessed how Javadi has been observing her throughout the day. Despite becoming angry, McKay doesn’t storm off, instead reminding the medical student that she’s not scolding her; she’s simply trying to guide her towards becoming a better doctor. Javadi would be fortunate to have McKay as a mentor and should remember this!

Perhaps one day, those two might share a bond similar to Robby and Langdon, whose friendship has been established but in this instance, we delve deeper into the mentor-mentee dynamic. When they successfully perform the retrograde intubation, their excitement is palpable. It’s worth noting that this is the first time we’ve seen Robby express such pride in one of his doctors. Much like Heather and Samira, Robby enthusiastically praises Langdon for handling the crisis admirably. In fact, he goes as far as suggesting him for an Emergency Medicine Fellowship. Even their little, awkward fist bump is endearing.

Additionally, do they seem affectionate? Yes, Robby and Collins appear to be exchanging glances at each other. This suggests that, as we had guessed, Robby and Heather were once in a relationship. When Dana notices this flirtatious behavior and shares our curiosity, she queries Collins about it. Collins flatly denies any possibility of revisiting that past. “Calm down, Jane Austen,” she tells Dana, hinting at the unpredictability of future events. By the end of their shift, we can’t help but wonder if Robby will discover Collins’s pregnancy beforehand, and I, for one, am eagerly anticipating his reaction, whatever it may be.

It seems there’s a mystery as to why Dr. Abbott may have manipulated the ultrasound results for Kristi, a 17-year-old patient seeking a medical abortion. Previously, Collins had to redo the ultrasound due to some discrepancies before administering the mifepristone. It was later discovered that Kristi was 11 weeks and a few days pregnant, while Dr. Abbott’s measurements put her at around 10 weeks. This is crucial because they can only perform a medical abortion up to 11 weeks. Unfortunately, Kristi had missed the deadline by just a few days. When Heather presents this issue to Robby, they both understand that Abbott possibly altered the data to assist Kristi in terminating her pregnancy. However, they are torn between helping their patient and the potential consequences of altering hospital records, such as Heather potentially losing her residency position, while Robby, being tenured, has more freedom in this situation.

Without any second thoughts, Robby steps up to handle the task that was originally with Dr. Collins. Consequently, he has to perform another ultrasound on Kristi, which pushes back her treatment. However, he informs Kristi and her mother that there was a technical issue with the computer system causing them to lose Dr. Collins’ note. Fortunately, Kristi is almost 11 weeks pregnant, allowing them to proceed with the medical abortion. The gratitude on Kristi’s face is evident. This situation is why Dana observes Robby and Collins reconcile. In essence, Robby has shown great commitment towards helping both Dr. Collins and Kristi.

As Collins is about to give the medication and explain the process to Kristi and her mother, another woman rushes in, shouting for Kristi. It turns out that this woman is actually Kristi’s aunt, while the person Kristi thought was her mother is actually her grandmother. The situation becomes more complicated when Kristi’s mother objects to the abortion plan. Clearly, this story is far from over.

Discharge Papers

It appears that Robby and his 17-year-old son, Jake, share a warm relationship. Although they were initially planning to attend a music festival together, Jake is instead taking his girlfriend to the event, indicating a certain level of understanding between them. Additionally, it seems that Robby and Jake’s mother are no longer in a romantic relationship, but their communication suggests a degree of amicability, as evidenced by her asking Robby about his well-being on Adamson’s anniversary.

As a movie enthusiast, I’m thrilled that everyone at the hospital seems genuinely concerned about Jake practicing safe sex, and the running joke where they keep passing him condoms? Absolutely hilarious and heartwarming!

Ah, right then, Princess indeed! She reminisced with Jake about attending Lollapalooza in her youth and experiencing what she considered the most remarkable intimacy with someone resembling Dave Navarro, all hidden under a blanket. Indeed, Princess is quite exceptional.

I’m hoping against hope that Ginger’s situation with her daughter, Rita, isn’t as it appears. It seems that due to exhaustion and being overwhelmed, Rita, who has the responsibility of caring for Ginger (who suffers from schizophrenia), left Ginger after she fell and broke her arm. Mel, who previously took care of her sister in a nearby facility, advises Rita to rest, as Caretaker Burnout can be severe and risky. When Rita didn’t come back from parking her car, Mel fears that Rita may have misunderstood her advice and left when the opportunity presented itself.

With each ticking hour, my worry towards Doug Driscoll escalates as he seems ready to erupt into violence without a moment’s pause. However, I must give credit to Earl, the seasoned traveler, who skillfully silences Doug’s complaints in the waiting room by reminding him that medical staff need to assess his vitals every four hours, which is simply common procedure, old chap.

An ongoing issue is the strained relationship between Trinity Santos and Frank Langdon, which recently escalated during a work incident involving a patient experiencing seizures in the waiting room. In the previous episode, they disagreed on a treatment approach, with Trinity suggesting switching to new medications when the standard dose of lorazepam failed, while Langdon recommended administering more. Additionally, Trinity encountered difficulties opening the vial of anti-seizure medication and suspected it might indicate a bigger problem. Langdon’s additional lorazepam prescription worked, but he once again criticized Trinity for not trusting her junior residents. Trinity remains adamant about her concerns regarding that vial, refusing to let the matter rest. It seems this situation may not have a favorable outcome for either Trinity, Langdon, or the patient.

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2025-01-31 06:55