A Devastating Loss at ‘12:00 p.m.’

The Pitt is starting to feel like a bit of a powder keg. Maybe it’s the Fourth of July of it all — the American Revolution, fireworks, you get it. The tension is rising slowly, but in hour six, we’re starting to see some areas where the pressure might become a little too much to contain.

The Westbridge situation still remains a mystery — no winners on Ahmad’s board yet — but it is certainly escalating. The flood of patients into PTMC is only growing. Robby, Dana, and Dr. Al are fighting for their lives, trying to make room for more patients in the ER. All of the surgeons seem tied up. We haven’t seen the waiting room in a while, but if it was that crowded and full of cranks at 7 a.m., let’s assume it’s gotten much worse. The system can’t hold at this rate. And that’s just the powder keg that is the hospital itself. There are several other emotional powder kegs that need one little spark, and those babies are going all the way off. I’m mostly giving a side-eye to Robby and Langdon because Robby can attempt to ignore his former mentee all he wants, but that ER is small and their shift is long, and Langdon seems insistent on making amends. There is also that constant friction between Robby and Dr. Al-Hashimi to keep our eyes on. And Santos is already tossing back a five-hour energy drink while beginning to annoy both of her attendings with her inability to multitask? That could turn into something bigger, too. We haven’t even talked about how hot it is outside. I don’t want to speak for the group, but I know that when I start sweating simply because I decided to wake up and exist, I’m a grade-A, top-notch dick. To be sick and hot? Forget it. All of this is brewing inside PTMC. The system simply cannot hold.

To pile just a little more on to everyone’s slowly fraying emotional state: Louie, beloved frequent flier of the ER, dies. Robby and Langdon do as much as they can, but almost as soon as they intubate, blood starts gushing out of that tube, and you know where this is headed. When Dana peeks in and Robby simply shakes his head no? That’s tough. Perlah unable to hold back her tears? Devastating. Louie’s body got him through a lot, but in the end, he cannot come back from a pulmonary hemorrhage.

Much of the staff is affected by the news. Except for Ogilvie, I guess. It’s not like he has a relationship with Louie, but, like, respect the dead, man! Have some empathy for your colleagues! When you see Perlah trying to gently tell Whitaker the news about a patient he cares for, maybe don’t just blurt out “He croaked” while you get a stretch in. It seems like an easy personality tweak. Alas. Anyway, Ogilvie still sucks the big one, in case you were wondering. Even when he earnestly says that working in this ER feels like he’s found his true calling, I couldn’t help but wish there was another exploding ass nearby to do us all a favor.

Langdon, not surprisingly, is pretty torn up about losing Louie. And that loss on top of the whole cellulitis-turned-nec-fasc thing is making it a rough reentry for the guy. (Not to dump more onto his tender shoulders, but we’ve learned that the nec fasc waitress is having her leg amputated.) Dana finds him sulking in the lunch room and has to remind him that neither of those outcomes are his fault. They get a little time to catch up in the aftermath: Langdon can’t believe his wife stayed with him through all of this. No one at the hospital really reached out to him while he was in rehab. Dana decided not to press charges against Doug Driscoll — the POS who cold clocked her last season — and after a few weeks away, she simply couldn’t help herself but come back. Dana knows Langdon is deserving of a second chance, and when he goes to officially make amends with her, she stops him before he can get too far into his speech: “Check me off your list, kid, we’re good.”

While Dana and Langdon are good — I’m glad we’re still getting glimpses of the bond they have this season — Dana herself might not be doing so hot. At the beginning of the season, she had that conversation with Robby that intimated she was going to treat work like work and that she was looking out for number one. Even then, it didn’t seem like Dana would ever be able to not get involved or not give her all to her patients, and we already see her plans for boundaries crumbling. She doesn’t speak it as much as other doctors and nurses, but she is obviously and deeply affected by Louie’s death. She uses it as an excuse to teach Emma how to clean a dead body (and let Perlah off the hook), but you know Dana wanted to do this one last thing for Louie. The care she takes as they set him up in the viewing room for people to pay their respects, the note about tucking him in tight but leaving one hand out so people can hold it if they want, it is quiet and moving. The Pitt excels at making chaotic choreography look controlled, but quiet moments like these are so effective and potent — I’m thinking about you, “Kiara and Lupe identify bodies in the pediatrics room” scene.

The chitchat Dana makes with Emma about working through COVID is also revealing. She laments how they were not able to give the dead the proper send-off they deserved, how people died alone. She laments how many of her friends simply had to walk away from the job after that. Working during the PittFest shooting was her breaking point, but remember that Dana’s grief runs deep. When Emma asks why Dana came back to work when her friends did not, she won’t answer. She doesn’t want to attend the debrief for Louie.

But while she is perhaps showing a little more of the pain she’s in this season, our girl isn’t broken. She can attempt boundaries all she wants, but Dana is always gonna Dana, and she shows us — and Robby — that in the way she handles the inmate Gus situation. Gus’s CT scan doesn’t show anything that can’t be taken care of at the prison facility hospital, and fight as Dr. Al does to admit him so they can treat his debilitating malnutrition, at least for a few days, Robby doesn’t want to give up the space. (And for a person who is supposed to give all patients the same level of care, his prejudices toward Gus are showing.) But when Dana hears about the situation and learns that not only is Gus a Pittsburgh native, but he used to tend bar at a spot she used to frequent — where she had her first kiss — she goes full Dana mode. Whoopsie, Gus was stable, but wouldn’t you know, after Dana is in there, his oxygen levels drop just enough that Robby is going to have to keep him for observation. Dana won’t answer Robby’s questions about what happened, but her face when he knowingly asks, “I thought you didn’t go the extra distance for patients anymore?” says enough. There’s our girl.

Maybe it’s a good thing that Dana doesn’t attend the debrief — not many dry eyes in that room. Earlier, Langdon found a picture of Louie with a woman in his wallet and Robby explains that Louie was married at one time. And he was a groundskeeper at Three Rivers Stadium. His wife wanted a child so badly that she got pregnant, and not long before she was due, she and the baby died in a car accident. Louie never really recovered from that, Robby says. I hope Ogilvie feels like a real piece of shit right about now. (He won’t.)

But speaking of treating all patients with dignity, Roxie is having a tough time dealing with her current situation. She is in so much physical pain — when Robby tells McKay to give her 200 milligrams of MS Contin since her at-home morphine drip is going to be delayed, McKay is shocked by the dose — but perhaps even more debilitating is the emotional pain she’s in watching her husband give all of himself to taking care of her. She tells Princess that she’s “watched the light go out of him” as he’s carried every burden and responsibility for their family. When they start to prep her for the transport ambulance back home, she is overwhelmed by how much more Paul will have to take on because of her injury. He is adamant that he can handle it, that he wants to handle it, that he is happy to do this for her because he loves her. Still, Roxie can’t take it. She wants him to go home first, and she’ll wait for the ambulance with Lena. She wants him to have a break. (And maybe she needs a break from the guilt.) He can’t read the room, but all the women standing around him can and they assure him this is a good plan. Paul goes and Roxie stays and I am still dreading seeing where this goes.

• Something new for Robby to be annoyed about regarding Dr. Al: The AI program she pushes on Santos to help with her charting backfires when an exhausted Santos doesn’t proofread what she sent with a patient and the doctor upstairs comes down pissed at Robby for inaccurate notes and medical history. That’s much more on Santos than Dr. Al, but Robby has enough aggravation to go around.

• There’s another victim of a motorcycle accident coming through? Brandon is mostly fine, but is this like the motorcycle version of A Christmas Carol? Is Robby our Scrooge and he’s going to be visited by three biker ghosts? We’ve already established how grumpy he is, so this tracks.

• The Jackson Davis situation is getting worse. He’s awake and Dr. Jefferson can get a better idea of what’s going on, but that means now we know he’s having auditory hallucinations and paranoid thoughts. He’s on an involuntary psych hold and his sister Jada, realizing how bad this really is, is beside herself.

• The situation with Harlow, our deaf patient, is incredibly frustrating. She’s experiencing headaches and nausea and when the one ASL interpreter at the hospital gets pulled away — Princess can only do so much — Santos basically refuses to engage in any meaningful way. Harlow is left waiting around, again. Can’t they at least write back and forth and help this woman out?

• You’d think Landgon’s barfing hot dogs patient would gross me out but nope, the impacted bowel from last week has fully desensitized me to The Pitt’s attempts to gross us out.

• We’re learning so much more about our nurses this season and I welcome every tidbit. Donnie has “D” and “C” on one wrist for “death and chaos,” which he got after PittFest, and “M” and “B” on the other, for “miracle and blessings.” He got that one after his daughter was born. I love that Donnie is very sweet about being a new dad, but also will not shut up about it. Like, we get it. The Pitt is so real for that.

• Dana calling the patient who grabs Emma’s arm a jag-off. That’s art.