SPOILER ALERT: The below contains major spoilers about tonight’s episode of HBO Max‘s The Pitt titled “5:00 p.m.”
Tonight’s episode of HBO Max’s The Pitt deals with the issues and realities hospitals and medical staff are facing when ICE, the U.S. Immigration and Customs Enforcement, embed themselves into emergency rooms all over the country.
Producer John Wells spoke to Deadline about the episode, which he says was inspired by real-life situations that have happened in ED, about the show’s decision to tackle the controversial yet timely topic, which can be found below.
But first, to set the scene from the episode, a woman is in the custody of ICE, and two agents bring her into the ED to be treated after she experienced a nasty fall and injured her shoulder. An agent tells Dana Evans (Katherine LaNasa) about her situation, saying the woman screamed in pain when they put the ties on her. Before she could respond, Dr. Robby (Noah Wyle) stepped in and introduced himself to Agents Carrera and Russo.
Robby explains that the woman they’ve taken into custody needs to be examined before they can process her. She tells Dr. Cassie McKay (Fiona Dourif) that her name is Pranita (Ramona DuBarry). McKay examines her as the agents tell Robby that they were doing a sweep of Pranita’s restaurant when everyone in the kitchen took off. As a result, she was shoved down some alley stairs. McKay, at first glance, believes it could be a rotator cuff tear or an AC separation.
The ICE agents are impatient when told Pranita will require X-rays to determine the cause of her pain. When one goes to the restroom, Robby tells McKay, “I do not want these guys here any longer than they need to be, so let’s find X-ray and fast-track this one.”
Back in the waiting room, at least 10 people are fleeing the hospital after seeing or hearing that ICE was there. Thus, their presence creates greater chaos and brings danger to people who need medical attention.
“Can’t we just tell the agents to f**k off?” Dana asks Robby.
Josell Mariano, Fiona Dourif, Ned Brower, Shabana Azeez, Ramona DuBarry
Warrick Page/HBO Max
Elsewhere, a student questions whether they should treat a patient who is potentially undocumented. Dana explained, “All patients, regardless of immigration status, have the right to emergency care under EMTALA (Emergency Medical Treatment and Active Labor Act).”
Pranita’s result shows there’s no fracture. So, Dr. Robby tells McKay to fit her with a sling and discharge her. McKay is uncomfortable with doing so, but Robby is following the law, and he’s anxious to have ICE out of his ED.
“Ok, time for you to go,” Robby tells one of the agents. “You can see how busy this department is, right? You’ve been nothing but a distraction and a disruption since you’ve been here. I’m already short-staffed, and I just lost 5 nurses and half my environmental services team because you walked in. You know, patients come in here for help because they’re either sick or injured. Documented or undocumented, they have a right to emergency care. TB, measles, fractures, none of it is getting treated because everybody is too scared to come in,” Robby tells the agent.
He added, “But they come here anyway, but then it’s too f**king late. So please, for the love of God, can you please go wait in the room with your detail so I don’t lose any more patients or staff?”
“No problem, doc,” said the agent.
Moments later, the agents hear that Pranita has been cleared to leave, and they rush to get her out of there aggressively. Nurse Jesse Van Horn (Ned Brower) stands up for her and asks for a minute to fit Pranita with a sling. Jesse also gets between the agent and Pranita because he’s lifting her out of a wheelchair when she’s injured. A melee ensues, and both Pranita and Jesse are taken into custody by ICE.
Robby tries to bring calm to the ED and encourages the staff to get back to work. In the background, Dana is working to find out where the agents have taken Jesse. The answers will be revealed in a later episode.
Below is our Q&A with Wells.
Ned Brower, JuJu Alexander
Warrick Page/HBO Max
DEADLINE: We have learned on this season of The Pitt about this bubble that is meant to protect doctors and nurses from making any mistakes while they’re trying to save lives. What can you share about putting this bubble technique in action in Episode 11 when the chaos of the ICE agents didn’t keep other doctors from being focused on their patients?
JOHN WELLS: The bubble blocks out noise and the other things that are going on in the world so that you’re just caring for the people who are right in front of you. It’s very difficult to do. You have to shut down everything in your personal life so that you’re only focusing on your patient and the medicine and what you’re trying to do. They talk about it almost in athletic terms, in the sense of you have to get into the zone where everything else fades away, and it’s just your training and your experience. If there’s other noise or distractions or other things happening, you can’t do your best work and take care of the people around you. This can be extremely difficult for them, as other things are going on.
So in that episode, ICE brought a patient in from an enforcement action, which caused all kinds of ramifications within the hospital. We were just trying to get to this issue of why it’s important that immigration enforcement doesn’t happen in certain kinds of public spaces, like where we have to be able to provide services regardless of whether or not someone is an unauthorized person in the country or not. We can’t be frightening people away from basic care, primary care, and preventative care, which are necessary for all. We all have to at least be able to agree that there are spaces that have to be free of that kind of pressure.
DEADLINE: When it was recently announced that there would be an episode tackling ICE, there were so many comments from all sides hoping that it would be handled “correctly,” which means different things to different people. How did the team avoid picking one side over another?
WELLS: Just by trying to stay truthful to the people that we talked to who were going through the experiences in the hospitals where they work. Unfortunately, when there’s any rumor that there might be ICE enforcement activity, true or untrue, many people don’t seek medical care. Or if they’re already in the hospital, they stand up and walk out. We heard stories of people where just a rumor alone meant that dozens of people left the facility who were in need of help. And if someone’s there with an infectious disease and they leave, or they have an injury, that’s likely to get progressively worse or much worse, or an emergency situation, that’s not in the best interest of the community as a whole.
We were just trying to tell the very specific story of why it’s not a good idea for these sorts of enforcement actions to happen near certain places in which all of our safety as a community can be compromised. We were just trying to stick with that story, and talked to people who’d had Immigration and Customs Enforcement agents bring people into their emergency rooms, and what happened when they did. We’re just trying to be truthful. And if we can be truthful, it’s not left or right, it’s just our telling of what’s factually happening without trying to take a side.
DEADLINE: Was this shot before or after what happened in Minnesota?
WELLS: We shot this before what happened in Minneapolis. So we had been asking ourselves a lot of questions about how realistic this is, or not. And then, by the time we shot it, we’re like, “Oh, my God, yeah, okay.” So we were pretty mild.”
DEADLINE: Was there any fear that the episode might be too controversial or alienate any viewers?
WELLS: Almost anything you do, and I don’t want to just talk about this in terms of immigration policy, there’s almost anything that you do, there will be people who have different opinions. And if it alienates them enough to stop watching and gets them so angry that they stop watching… I think if you’re trying to be truthful on either side of these questions, you run the risk of that. The only thing you can try to do is stand behind your storytelling if you’re telling the truth about what you’ve heard. And if someone disagrees with that truth, you can say, “Well, this is what happened.” And we’re not trying to politicize it. We’re simply trying to put forward what sometimes are uncomfortable truths, but are truths nonetheless.
We used to get this question a lot on the West Wing, like what would happen with the viewers who didn’t agree with the opinions of the characters? We found that it started debates. I used to get a regular, kind of Friday morning letter from Senator Ted Stevens, who was a Republican senator from Alaska, arguing with what we got wrong the night before, or that our policy position was wrong. But we were having an argument about it, right? We were having a debate. But he kept watching, and he wanted a hat. We’re trying to talk about things that need to be talked about.
