The Pitt‘s first season follows one single fifteen hour shift for senior attending emergency department Dr. Michael “Robby” Robinavitch (Noah Wyle). Since Episode 1 of the MAX show, we’ve watched as Dr. Robby deals with the pain of losing patients, the grief of unconsolable parents grabbling with their children’s deaths, the revelation that one of his closest friends has been stealing drugs from patients, a violent attack on senior charge nurse Dana Evans (Katherine LaNasa), and the fact that it’s the five year anniversary of his mentor’s death during the COVID pandemic. Oh, and since last week, Robby’s also been working as a makeshift MASH doc after a mass shooting event at a local music festival.

At the end of The Pitt Episode 13 “7 PM,” the inevitable occurs: Dr. Robby breaks.

**Spoilers for The Pitt Episode 13 “7 PM,” now streaming on MAX**

The Pitt Episode 13 “7 PM” ends with our fearless leader finally crumpling under the weight of all he’s been carrying all day. After emotionally running through all the lives he’s lost today, he begins to sob. He cordons himself off in the makeshift morgue — back in pediatrics, again — and collapses onto the floore.

It’s a tragic moment that’s completely understandable as Dr. Robby has just lost yet another patient: his (sort of) stepson Jake’s (Taj Speights) girlfriend, Leah.

So what precisely triggered Dr. Robby’s emotional breakdown? Can he bounce back? What’s next for The Pitt? Here’s what you need to know about the end of The Pitt Episode 13 “7 PM” on MAX…

The Pitt Episode 13 “7 PM” Ending Explained: Why Does Dr. Robby Finally Break Down?

We’ve known since the very first episode of The Pitt that Dr. Robby was coming into work rather raw. Today’s shift coincides with the five year anniversary of the death of his mentor, Dr. Adamson, from complications from COVID. In early episodes, Dr. Robby found himself triggered by key memories of his dark days on the front lines of the pandemic. However, for a hot minute, or at least a couple episodes, it seemed like he’d manage to push these haunting thoughts down.

Then he lost Leah.

Part way through The Pitt Episode 13 “7 PM,” Robby visits their outdoor triage area just in time to see his ex-girlfriend’s son Jake arrive in the back of a pickup truck with wounded girlfriend Leah. Jake has only been shot in the leg, but Leah was shot in the chest.

Dr. Robby quickly goes to work trying to save Jake’s girlfriend. He is so determined to save Leah’s life that he goes through four bags of blood, prompting criticism from ally Dr. Abbot (Shawn Hatosy). (The plan was to only use one bag per person.)

Leah eventually does die. Robby is forced to let her go. He emotionally explains to Jake what has happened. When Robby takes Jake into the hospital’s makeshift morgue — the same pediatrics room where Dr. Adamson died — the teenager blames the noble doctor for Leah’s death. An emotionally fraught Robby begins flashing back to his mentor’s death and starts unloading all of his burdens of the day.

“And I don’t know how many people I’ve helped today, but I can tell you every other person who has died,” Robby says. “There was a man named Mr. Spencer who died in front of his children and an 18-year-old who was brain dead from a fentanyl overdose and a guy with a heart condition and little girl who drowned trying to save her sister. And I’m gonna remember Leah long after you’ve forgotten her.”

Robby immediately catches himself, cursing, and pleading that he’s sorry. He pushes Jake out of the room and collapses against the colorful cartoon murals. He has once again not only failed a patient, but one that he cares about.

It’s unclear how long Dr. Robby will be in this state of crisis, but there are two more full episodes of The Pitt still to come. The hospital is still in mass casualty mode. We can only hope that Dr. Robby finds a way to rally so he can keep on saving lives.