‘We gave it a name, writing about last week’s episode of The Pitt. A feature of any medical drama, the “Above Patient Scrum” is already an effective fixture in this one, with another great example in “Hour Three.” But before we get to the treatment of a guy with a drywall nail dangerously tickling the ventricles of his heart, let’s start with a different perspective on emergency medicine, as the camera gazes up, patient POV style, at Whitaker doing lost cause chest compressions. Soon enough, Dr. Robby has to call it, and the med student has lost his first patient. It’s no one’s fault; they did all they could. It’s just that today, this morning, at 9am in the ER, “was this guy’s day to leave this mortal coil.” It’s a fact of their work that Robby says requires balance, balance he admits can be difficult to achieve. But as doctors of emergency medicine, they must endure. Aim to save the next life.

The thing about Dr. Santos, though? She seems less than into Robby’s resulting call for a moment of reflection over this current loss of life. The intern will declare herself a fiend for action, badgering Dr. Collins for the chance to conduct a tricky procedure like chest tube insertion. But she cares much less about patient context. Santos has already proven to be sarcastic, even cynical. But it’s also reading as insensitive. She scoffs when Mel remarks how everyone on the staff seems like family. “You see a family, I see every man for himself.” She continues to needle Javadi with the nickname of Crash while asking her to be friends in an overbearing way. She even doubles down, admitting their theoretical friendship would be an inroad to a surgical rotation with Dr. Shamsi (Deepti Gupta), Javadi’s mother and a senior attending at the hospital. Santos is capable, prepared, and sure-handed in an ER scrum. She’s fascinated with the rock star doctor skill set. But on this trauma floor, her temperament stands out sharply. We’re curious about what drives her. And Isa Briones is making her character one to watch.

The guy with a nail poked dangerously near his heart gets the full treatment. Collins is in there, and resident surgeon Dr. Yolanda Garcia (Alexandra Metz), and Santos – “Glove up, girl, you’re on suction” – and a host of nurses who hover and flit about above the patient. He’s soon stable, with the foreign object removed and his chest cavity opened by a retractor right there in the ER. And that speaks to another feature of this episode, which emphasizes the simultaneity of its patients’ journeys. While Nail Man’s beating heart is open to the air, another guy having a heart attack is saved in time to reverse its effects. As the flatline tone from Whitaker’s patient resonates, a newly-arrived patient sits straight up on her gurney, literally forced back to coherence by McKay and Javadi administering Narcan. Her life was saved, while others submitted to that mortal coil.

Others like the young man whose parents can’t bring themselves to accept that their only son is gone. Robby has refused to move him to another floor, and run more tests as the parents cling to hope, even as he gently tells them that brain death is the same as actual death. But is this fentanyl overdose an unfortunate trend in the Pitt? Recognizing a college friend of his son, the dad accosts the young woman recovering after the Narcan dose. “You killed my fucking son!” He’s hysterical, and nearly knocks over Dana Evans. Worse, the new patient says his son gave her the laced Xanax that almost killed her. It’s only hour three of Dr. Robby’s shift. Even more college kids suffering from fentanyl overdoses could very well arrive at the hospital. After all, medical dramas love a mass casualty event.

The Pitt’s carousel of existing traumas is not reserved for its patients. Remember the lady from episode 1, whose foot was crushed? Speaking with Collins via an interpreter who appears on a bedside monitor, she smiles and touches the doctor’s belly. “When are you due?” she asks in Nepali. “I can always tell.” Collins is gracious toward her patient, but shaken. She checks her profile in a reflection, because as we have learned, her pregnancy is not public knowledge. We also get a kind of update on Dr. McKay. While Javadi unsuccessfully fishes for information about her personal life from Langdon, McKay implores Dr. Robby to follow up with the patient whose high school age son ran off, taking a suspicious list of female students with him. Robby bristles when McKay calls the kid an incel, and a threat to cause harm. But she says she’s been on the receiving end of someone who hates women. Could that be part of why she wears an ankle monitor? For now, Robby huddles with staff social worker Kiara Alfaro (Krystel V. McNeil) to inquire about ethics, and how the hospital could lure the student back to the Pitt under the guise of his mother needing medical attention.

Maybe in the next episode, Dr. Robby will finally get a chance to sneak away to pee. He tries twice in episode 2, unsuccessfully, in a bit that feels like a way for The Pitt to emphasize its passage of real time. (Similarly, Robby references a conversation he had with Collins “a couple hours ago,” aka episode 1.) The series needs to get better at this. Stress it more. Because it’s a cool idea, but it’s getting lost in the flow of action. In the meantime, we’ll focus on the attending surgeon’s veteran words to his med students and residents. Whitaker will get over losing his first patient – the best way is to check the patient board and dive right back in. And it’s the same with Robby’s R3, Dr. Samira “slow-mo” Mohan. Be faster, he tells her. It’s more efficient for the department, and more educational for her. “Being here means no matter how good you are, or how hard you try, you’re gonna make another mistake. Someone might even die. It’s part of being an emergency medicine doctor. Now go save some lives.”

Johnny Loftus (@glennganges) is an independent writer and editor living at large in Chicagoland. His work has appeared in The Village Voice, All Music Guide, Pitchfork Media, and Nicki Swift.