6:00 P.M. with Brandon Mendez Homer, Laëtitia Hollard and Dr. Italo Brown

PTMC, go ahead, medic command.

Where are all the nurses?

“There is a code who will be in central 14.”

Oh, no. What's that? Hospital worker assault. Ooh. I had a new nurse, Emma.

Is she okay? I don't know. I think so. So welcome. If you got him, this place is going tits up.

[MUSIC PLAYING] Welcome to the Pit Podcast, the one and only official companion to the pit right here on HBO Max. I'm Dr. Lok Patel.

And I'm Hunter Harris. It's 6 o'clock in the pit this week or an episode 12. We will be joined by Brandon Ness Homer, who plays nurse Donahue, and Laticia Holler, who plays nurse Emma.

I'm super shy. I don't eat everybody I worked with for the last season. One didn't find out until season two. I went to Juilliard because of Laticia. And we were like, oh, really?

You guys, same time. But I also-- Oh, oh. [LAUGHTER] Today's shift starts now.

At the end of last week, cut to black. Nurse Emma is in a head block. Now we see the golfer, kind of co-cad who-- medical term, co-cad, co-cad, that he got very aggressive. Somehow we don't know what happened,

or seen it came into the room. The rescue was a cold, hula hoop, and the man ends up with the bloody nose. Dana had given him Versailles. Versailles?

Versailles.

“A tranquilizer of some, or a sedative of some sort?”

It's a Benzo, Benzo Diasopine. It call it a sedative, totally. And then now, Robbie is like, where did you get that? You can't prescribe that. And Dana's like, it was in my pocket.

And one of my supposed to do, just let this man choke nurse Emma. It's her first day. You just haven't had my grandmother said any pocket? It was extra from the medics, a good time, and I guess.

Are we ways to control substance we need a witness to sign off? I was on my way, too, when I spotted that asshole, attacking our girl, anything else, Nancy, drove? Where are you going?

Taking a peek. Do I need your permission to do that, too, now? This is a terrible situation, and I feel-- I feel this predicament where George Eugene is like, what do you want me to do?

You know, when people are running in there, this presumably situation where you hopefully had security jumping on this person, too. But then on the flip side, looking at where Dr. Robbie's coming from, what if this individual couldn't

get versed for whatever reason? What if it caused a medical complication? How is this going to hold up in court? And if you actually look up when someone can defend themselves in a hospital setting, it's like, yeah,

“if you have to defend yourself for your own safety”

cool, but everything gets different. If a patient is incapacitated, or they have confusion, or if they are agitated beyond their control, or if you do something unless their force could have been used, I mean, it's all these little shades of gray.

Yeah. But Charger's Dam is a good point where she's like, anyone else steps up, they're considered a hero, but nurses, health professionals, have to defend themselves. And it really sets off a series of little confrontations

between Charger's Dam and Dr. Robbie.

First, he says, OK, why did you have that on you?

Like, what were you thinking? She called to Nancy Drew. Which is so good, by the way. Which I know you love, yes. And then later she, you know, kind of corner some again.

And she's like, what is going on with you? You've been kind of on one all day. And then they talk again outside. And this is the part that I am like, very stuck on. Robbie telling Nurse Dana, like, how did you get,

what does it call to again? The verse said. Yeah, how did you get first said, like, you know, you can get your life and take it away, blah, blah, blah. I'm like, OK, so where was that energy?

One Dr. Lengden was doing kills from the ED. I just want to go back to one thing about the assault and the verse said. So I've been in the situation. Nurses are so badass.

They should not have to put up with this. But in real scenarios where Nurse gets assaulted one on one, you have a gang rushing in there. The nurses will basically, whatever they need to do, four on one, five on one, a bigger, aggressive patient.

You'll have anyone who's on the floor, Russian. Doctors, respiratory therapists, everyone. And usually, amidst holding somebody down is when they're calling out, we need something. We need a medication.

I've never had a nurse give something.

And then later on, we'll be like, oh, whoops, I gave a medication, just because I had my pocket. Sometimes we have as needed medications on the patient's chart. So we call PRN, like, if I wrote verse at PRN, that means that if this patient is agitated,

you can give a dose of this medication. You don't need to ask my permission because I already ordered it. But usually, like, I've seen nurses hold patients down and scream, I need something right now. And you know, and they have something called a pixis,

like an emergency, basically a place on hospital floor where you can go and get medications out. And so if I have a verbal order, or I put it in the computer, they can run and get a medication,

and it's into that patient in minutes,

So it's fresh in my memory. - Yeah, well, I mean, I don't know. I guess it is like, it makes me uneasy that like, nurse Dana was alone with Emma and that man and Emma didn't see anything.

The man said he didn't remember even choking her about what he was getting punched, I said, hmm. Right, I was like, you're making that up to it. - Interesting. - Trying to get out of trouble right now. - Interesting. - And he's like, oh, you're gonna ruin my life.

I was like, all right, dude. - I do want to take a moment and sort of compare and contrast what we're seeing between Robbie and torture and Dana and Robbie and Dr. Alhashwine, because kind of a reveal that I hadn't really considered before

is that Dr. Alhashwine does not know about LinkedIn's histories. - Yes. - Just knows that he came back from rehab

and it says, first day back and that San Francisco's

like really kind of raw, like, energy-wise with him. And Robbie says, okay, yes, he had a Benzo addiction, he was stealing drugs from the ED and just the look of, like, incredulousness on Dr. Alhashwine's face was like, oh, great.

Something about the way that Dr. Robbie is defending LinkedIn, Dr. Alhashwine. And the way that torture and Dana is like,

“you need to own up to your part in this.”

You have an issue with yourself not with LinkedIn anymore. - I knew about you said last week that Dr. Robbie has to really take some accountability himself about what went down with LinkedIn. - Dr. Alhashwine would call us him out.

- Yeah. - The thing that's fascinating too is that Dr. Alhashwine can fully be changed as how she treats him after she finds out. - Yeah, no, true.

But again, I mean, you know, it's ironic then, it's very dewy as I say not as I do,

that this is an episode where Robbie tells Santos.

Okay, like, you know, you need to work out your stuff of length and he's here to stay, whatever, where I want you to go to therapy or like, see the trauma-conservant gone, I'm like, oh, my goodness. So you should actually take the call coming from inside the house,

bring off the hook act, in fact. - This department is clearly too much for one person to handle. It's not healthy for you or the patients. And I'm very concerned by what I've witnessed today with some of the staff.

What is going on with LinkedIn and Santos? I saw them having it out like it was fight night. Dr. Alhashwine didn't even be near for 10 months and you told me this morning there was nothing to worry about with your Santos.

- There isn't Santos in landed have beef because she's the one to turn it in for taking man's. - I'm sorry, what? - Santos is responsible for revealing Blandon's bends of a dish.

- Was he stealing drugs from this ED? - This ED is the best and the best. And I would put it up against any emergency department in the country and it is going to be yours to fuck up. So don't fuck it up.

- Any emergency department and challenge me on this viewers and listeners. Any emergency department that's this busy is going to have more than one attending on staff. But she's like we need two and he's like whoa,

we got a good thing going, I was like no, no, no, no, no, no, no, no, dude. You're gonna have two, you're gonna have three. - It goes back to Dana being like you're actually like a martyr. You are making your life intentionally so difficult. You're suffering when you don't really have two.

Just because he is very controlling and wants eyes on everything. But it's like to whose detriment the patients and the staff. There are multiple moments in this episode

that hint at Dr. Robby's breaking point or walking to the edge. - Yeah. - Like McCame makes that comment. So I've got that many people kind of flirt with this line

and Duke makes references to it as well. Characters, Dana makes references to it. Like we're the darkness is coming in, Dr. Robby. - I wonder who can like get clarity. Make him see clearly like this is off of you.

Maybe it's gonna be Abbot, make it all speech about he.

“I think she kind of has a way in with him”

that I like, but we'll see. - Or it's Duke. 'Cause he doesn't give a shit. - I had Duke said I'm tired. I've been here all day, take me home.

- And so I'm so many if you stop it. - You stop it. - Say it and I won't move out, okay? I'm not gonna be doing much of Robby's gonna be taking in his mail

and we're watering his plants. - Say what? - It meant that you like having me as your roommate. - You are such a fuckelberry. How fun with Robby's plants.

- I'm so happy that Whitaker soon on his ground on this one. Why am I not surprised at Sanders? Wouldn't just say she enjoys having around, even like, what does it call some fuckelberry? That's not nice.

- Well, I mean, of course, look at how the day has gone for her. She tried to, you know, talk to Dr. Russia, tell her how she feels and she was rejected, low key twice. So I'm understand her being a little bit more cautious.

But they have a funny, like, you know,

“brother, sister, Danny, have like that I think it's fun.”

- We've got a couple of bad ones. How does he? - He's a 24. - Mecklesian pervert ago, anti-colonorgic effects and cost drownsiness.

His parents, maybe he doesn't take it all the time. He's also been prescribed metocarbomal, another anti-colonorgic. - Could definitely impaired driving.

- And metocloper might first stomach.

- That could cause gate problems. - Exactly. - Thank you. There was a pharmacist in the mercy department, making an appearance.

I'm just so happy because pharmacists are so incredibly important in hospitals.

“This is just one of the many times we rely on them”

to look through patients medicationless, other interactions, other side effects, you know, help with dosing, like whatever it may be, and even if they're not in the person, like this fabulous pharmacist was,

they are available on the phone. And she immediately says, like, hey, metocarbomal, metocloper might, these are medications that may cause confusion, issues with drowsiness,

basically things that would put this person at risk

of following or not being able to drive a car, clutch. It's almost like they responded to our viewer questions who were like, hey, where are the pharmacists? And I was like, you're with you. - That was your question. - That was your question.

- And viewers, I brought it out. I've definitely brought it up, but we've had viewers also chime in and being like, what up, pharmacists, where you at? - Okay, interesting.

I, this was one of my favorite cases. I think this whole season. I felt very personally like, I just became very emotional watching these two elderly people trying to stay independent,

“but like the daughter saying they can't,”

like half of their houses inaccessible to them, was so, so sad. And they're like stubbornness and resistance to having any type of help.

But I want to focus specifically on a moment

where Dr. Mohan and Dr. King present this case, Dr. Robby, that like, okay, we have some opportunities with me, some options for them. And then Dr. Robby, almost as a slight said, Dr. Mohan.

- Hey, Dr. Mohan, I heard a rumor that you were looking for an elective that you considered cherry etwas. It's much of an art as a science. There's usually an opening in the scene

of a disposition to pace. - It's like, oh, my goodness. Dr. Robby is really putting on her Mohan through this shift and it's like, making me a bit bad.

- Anyways, it was almost like a not to slow-mo from last season. - No, it was 100% less. I think it was very shady. - Dr. Robby came across a little too fast on it.

Again, this is a shift when he's been talking about her anxiety. And can you handle the walls in here? And she says, maybe this place isn't for me. So maybe he's trying to steer her in a different direction

from a nurturing standpoint, but it's coming across as harsh. - Yeah. - Because she does have this like TLC with the elderly. She's like nicely takes the gentleman's shoes off

and she's like, let's do an examination and she's patient with them. Great little medical prologue is when she mentions a rhombur test. Again, there's big assessment,

like Ken needs to actually live safely. And the rhombur test, you're essentially going to have someone stand up barefoot feet together and can they balance with your eyes open? You have this extra sensation of your body

being on the center because you can look around. When you close your eyes, it becomes harder for people. And so if you close your eyes and all of a sudden you lose your balance, that's something people like, hey, this person might have some type of nervous system

issue that's causing them to lose balance. - Oh, wow. - If anybody listening wants to try it out, the next time if you do become inebriated, close your eyes and stand up and see how well you can balance.

- Interesting. Okay, yeah. - So all these tests are important to see if somebody needs assisted living if they need a caretaker. - So we can go home.

- That, you take care of more by yourself. - Oh, well managed. - You guys, you need to be realistic. - I don't want strangers hanging around in that house. - It's not strangers, it's helpers.

- No, no thanks. - Dr. Splees, please. And like the conversation that this couple has with their daughter is a very realistic one as having a passion in population. - How about you, Tom Ganesha? - Oh, my goodness. Like the stubbornness

with some elderly people not wanting to receive care, especially I think in black families, as my family is like a sort of systemic distrust of systems, of medicine even that it makes it a lot more emotional to try to talk someone out of wanting to live alone.

“- And you should talk me through this case with Oliver”

who drove his dad what an hour to find him in emergency room because he missed a dialysis treatment. What was going on there? - So like there's the medical side and then there's the larger statement about rural health care.

So medical side shows up the guys having really difficulty and he's coughing up that I immediately saw it. And I was like, oh, pink sputum, which tells us that there's fluid backed up in his lungs that's mixed with the fluid in your little air sac.

So it has that like bubbly pink look to it. And that is sign you, restorators says we have an issue. Think about this. So the mentions this guy, Mr. dialysis treatment, then Whitaker very astutely notices.

He says there's a left arm dialysis shunt. So what some people will have is they'll have a shunt on an arm usually a non-dominant arm.

Where surgeons can basically connect an artery in a vein

and create very easy access for dialysis. So it's a reliable place to get that dialysis going. Sun says we missed dialysis treatment. You now have him coughing up liquid from his lungs. This is called flash pulmonary edema

Meaning if you can't get rid of fluid from your kidneys, it's gotta go somewhere. You get a fluid backup.

“We worry that it's gonna wind up in your lungs.”

So you've got a bunch of fluid in his lungs, which is why they're now trying to get fluid off of his body. They make that joke about medieval bloodletting

where they're basically pulling fluid off of him.

They're giving him restory support than high pressure that by-pap to kind of push some of that fluid out while they're essentially looking at the fact that this guy has kidney failure. So your kidneys are not only pulling fluid out of your body,

but they're also makes sure that your body has good eye-on balance. So his potassium levels really high. So then you have this other conversation about dropping down his potassium levels.

You can do that with insulin and glucose, which will shift potassium into your cells, albuterol, which is a medication used for asthma, dilators, bronchodilators, that'll also push potassium into your cell and all this conversation is happening

in the span of minutes. Like this is a great kind of case report that's happening in the pit in real time. - Can I pause for a second? I'm stuck on pink, pink, spewed, spewed up?

- Frothy, pink, spewed 'em. - I wish I could be in your brain. - That's so crazy. - I wish I could be in your brain

“and have these like one line or such a thing.”

- And incredible. - Flap handle. - Pink, spewed 'em. Okay, so, but then there's the other issue, which is that there wasn't a hospital closer to them

that their hospitals are shut down and not just because of the good black. - I was just like, I'm nodding my head with disappointment at the spot.

So, the reality is, is hundreds of rural hospitals

across the country are at risk of closing. A lot of rural hospitals are operating at a negative margin. And then when you have cuts to government programs like Medicare and Medicaid, they squeeze rural hospitals even more.

So you start losing necessary services for patients who live out there. And we've already seen rural hospitals close, we've seen emergency departments close, we've seen primary care, close,

and we've seen birthing centers close. So you have this growing amount of a rural healthcare gap. You also have way too many counties in this country that don't have a birthing center. There's no maternity care.

So this was almost a very scary symptom of a massive problem that's happening, which they pick up on immediately. When they say like, "Hey, Medicaid cuts are doing this right now." So like, unfortunately,

there are going to be more situations like all of us dead unless something changes in this country. So this show is just touching on all these massive issues with healthcare policy and the economics in a country that spends more per capita on healthcare

than any developing nation without better outcomes. - Over talking about costs, I mean, we have to talk about what this episode ends, which is who comes back into the ED, but Orlando Diaz, who left earlier,

Dr. Mohan said, "Please don't leave. I'll get you everything you need." I mean, is that not the same symptom or Orlando Diaz was afraid of the medical costs, and so he left and now look what's happened.

- Yes. - Now he's found his way back in. - He's found his way back in, and it's awful. The fact that he was even thinking, it's insulin versus, I think he said, "Close and food."

It's something that people having to make these decisions, and you've got this selfless father, who's like, "No, I'm going to take care of my family before I take care of myself." I'm going to put their oxygen mask on first, before I pull my own oxygen mask down,

which is awful. This is the situation people are in. (gentle music) So much went down in the pit this week.

“I think we should go a little bit deeper inside the pit,”

and hear from some people who were boots on the ground, on the front lines, nurses who were really making the day happen. - I love the cast of characters with the nurses on the show. You've got Nirstana Hew, who has these really great heart-filled moments, and then really funny one, Liners, he's been through some training,

he's now got a new kid, he's all over the place, and you have Nirstana Hew has the craziest first day, ever. So without further ado, let's talk to Nirstana Hew, aka Laticia Hollard in Brandon, Mendez Homer.

- Let's do it. (gentle music) - Lucky this was just a Pope, spirit of the muscle. See, it could have been worse. - No, shit, Chairman.

The triangular bandets they created back then were designally rooms that are nearly impossible to stitch,

and the bandets that never met me.

- Laticia and Brandon, thank you so much for joining us. This is going to be great. - Thank you for having us. - I'm not used to saying Laticia and Brandon, I want to be like, Nirstana, Nirstana Hew,

what's good, but no, it's awesome to have you here. You both add so much dimension, and you know, a highs and lows to the season to the show. Brandon, I want to start with you. Fun parallel, as I guess I will admit,

I was stalking your Instagram, but I saw that you became a new father, congratulations, but also Nirstana Hew became a new father in between seasons one and two. Like, I'm not sure if this is just the most brilliant

method acting ever, but can you tell us a little bit about how you become a new father informed your work and what you brought to set? - Yeah, you're all. - It's method acting, I didn't have to fake anything.

It's all real. I'm actually tired. You know, we shoot over the course of several months, so I just completed my wife was saying,

because she's very much still in it, but our daughter just turned one yesterday. - Wow, so awesome. - Yeah, the show was marking the journey of a parenthood.

So yeah, it's been an incredible journey

to kind of mirror that with Donnie,

“because I think the character also is stepping into new territory”

and the uneven terrain of being a nurse practitioner and trying to show it more fully professionally, as well as a father at home. So I mean, we're trading notes all the time, you know, when I'm working on the character.

So yeah, I was really honored by that, that the show decided to do that, and that the writers have brought it into the character, so yeah, this makes it so real. - Let's see, see, you are new to this show this season. I wanna know, how did your first day

compared to Nurse Emma's first day and what was it like joining this big ensemble? - Oh, I took so much inspiration from Emma's first day from my first day doing medical boot camp. I got there, I was ready to see Kristen,

Amy Lynn, and Katherine, and I thought that was it. I wouldn't see anybody else. I got there, there was Noah on his little swiveley chair chilling in a cool kid's table, and there was Patrick and like the whole main cast, and I was like,

yeah, Kristen literally said to me, she's like, you look like a deer and headlights. And I was like, oh, this is probably what Emma feels like.

So especially that first episode,

I was like, we're gonna really take from what it was to come to set for the first time in a big TV show. - So cool. - That is the real life experience, me, sir character. - Yeah.

- Now, I got a fun question. We talked to Lucas Iverson, Ogilvay, and you know, he was telling us about his first kind of takes and how he was told you're not being enough of a jerk. And so some of those character notes,

I'm curious what notes you both got when you were filming Nurse Emma and Nurse Donnie. - Actually, yeah, I did get a note, it was for this actual assault case.

“I think that Emma's a very caring person.”

So a lot of times when we first met our patient, I was smiling and I was like really like feeling like me as Laticia, when I'm talking to someone, I'm like, oh, I'm like making all these types of faces and they're like, the thing Nurse is like, don't do that.

She's like, we can't make them feel any type of way because you just have to be as scientific and just help them, don't make them feel bad or don't make them feel any type of way just give them help.

So. - Yeah, I got two notes. The first was in my final call back from John Wells. He told me my character changed drastically as they met me as a person.

I think they started to write closer to who I am. But in my final call back, he was like,

these newbies are always fucking shit up.

(audience laughs) You're always like on top of them. And then my character became a little less aggressive and demanding as the story developed.

“And then in season two, looking at the scope”

of the Nurse Practitioner role, I had a lot of conversations with our MP and PA on set who kind of took me through my boot camp. And she said, look, this is a practice that is important in the country,

but it's different from being a doctor. And there's a lot of conversation around what that role is and what the scope of that work is while also respecting the scope of what it means to be a doctor. And how those teams come together,

especially when throughout the country, hospitals are on short supply and everybody's trying to achieve the same thing. So it was just an navigate that and try to sprinkle that into some of the scenes

and relationships throughout the season. So that was fun. - That's cool. - Depth to this. - Yeah. - Okay, I have a question for both of you

because the correct way for me from what both of you went to Juleard. Is there a sort of short hand between two drilled actors or just, you know, commenting, you really have some kind of relationship

or vocabulary together, how does that work? - Yeah. - Well, Brandon pretends he didn't go to Juleard. (laughing) - I'll be upset and I'll be like, hey, we went to the same

on the modern and he's like this in the corner like I have those patterns on for the same school. I informed a lot of people on said that he went to Juleard and he's the person like anytime I'm having difficulty,

he's the person I will talk to first and then Catherine second. (laughing) From my go-to's and I tease Brandon all the time because there is that familiarity

from being from the same school and yeah. - Yeah. No, this literature is a lot of kiss should be between us and like I'm super shy. I don't even everybody I worked with once season one

didn't find out so season two I went to Juleard because I went to TCA, it was like, oh, really? You guys, same time, but I was so full. (laughing)

it makes you really resourceful as an artist. You know, like I often use the analogy that like you're put on an island with a knife of artistry, you have to make fire, food, shelter, through Shakespeare, tragedy, check-off and you create a lot

out of nothing, no costumes, no said dressing and so coming to the pit when I saw the TCA was coming on. I was like, oh, she's gonna be able to carry any story

here forward and that's just always what I told her

and the journey of what we were working on was like, look, you have everything that you need. So, you know, when we joke and everything, we play a lot between takes because I know that like when the camera's rolling, we both have that short end

of like, oh, now it's time to drop in, now it's time to deliver. So it was really nice, really fun to build that relationship on set, it was good. - Well, one of the things that Brandon would do as Donnie

is him and Patrick actually, Patrick has lined in. They would say, hey, Emily, how is it? (laughing) We were like, they would change like my name every time and it would make me like genuinely mad.

I was like, I hope they don't see any of these takes of me being like, guys don't say that to me. (laughing)

- I love that. - I feel like this constant,

like Laticia, you constantly roasting Brandon is part of the Juliard vibe or the fact that you two have this kinship, it's hilarious, but I got a question though, Laticia. So, we're talking about episode 12.

- Yeah. - There's been many moments when Hunter and I have wanted to jump into the screen fight somebody. We see a patient put Laticia into a headlock, dramatic. How did you prepare for that scene?

What was that like? - Um, yeah, I actually was part of my audition. And I put a lot of care and thought into it

“and I think it's really important that a show”

about a hospital shows that nurses do often, like get assaulted by patients and hopefully it leads to a conversation about how we can help mitigate that. Most nurses I've talked to have had some sort of bad

interaction if it's even verbal assault or no someone who has. - Far too often. - Yeah, I want to ask about the relationship between nurse Emma and Tartner's Dana because I love that they're kind of paired together

through most of the season where nurse Emma is so excited and happy and Tartner's Dana, it kind of gives her a good perspective shift that it's good for her, I think to teach someone and be like a mentor, how do you see the relationship

and what is the dynamic between you and Tartner? - I think it's beautiful, I think it's really great writing that I think Emma allows is like a mirror for Dana can see herself as a young nurse and you can kind of as an audience member

through the journey of like, we like Robby at one point says that you're not that type of nurse anymore, like how maybe Dana used to have a lot of care and go the extra mile and what makes it happen so that she stops doing that.

- Oh. - And is that going to happen to Emma? Is Gen Z do Gen Z have a better whole grasp of mental health that's not gonna happen to Emma?

“I think there's a lot of interesting conversations”

that you get when you put us right next to each other. - Earlier in the season, there's just great kind of like bro dad bonding moment with nurse Donnie, Langton and the father who brings his child in

and I wanna ask you what it was like filming that scene and also how nurse Donnie feels about Langton's return is there some momentary bonding of being fathers, is he also have tension? I don't know, what are your thoughts?

- Yeah, first of all, it was great working with Patrick, like we immediately dropped in. I mean, my North Star was like kind of lethal weapon. I was like we kind of have like a dominant level of mouth Gibson like thing going there.

But yeah, when he working specifically in the storytelling of it, his return at the same time is the start of my journey with the nurse practitioner part.

And I always say like at the end of the mass casuality,

I think that Donnie experiencing a lot of shame actually about how much he can do for the team, right? Because he's surrounded by Whittaker who's new, surrounded by Santos who's new. And these people are on fire for their job.

“And I think it's the story of many people”

that when you're working in an environment for a period of time, you somehow just kind of flow underneath the radar and not give it to your all. And I think in that nine months spanned, after he left that haven't had that experience,

he comes back on fire to do more, to take on triage, to kind of lighten the load for his team members. And then here comes Patrick, basically trying to be become a part of the team and heal and repair. So for us to both have that collision course,

I think it is in fact the moment he shares that in a doubt about being a father that brings them together and he kind of gives them the green light of like,

but I didn't even know you had this emotional canvas to you.

So that was really sort of exciting for me to kind of find that with Patrick and find that shorthand because we didn't have much season one at all. - Wow, what a great answer. Both of you.

This was faux bashing. Thank you for taking the time. - No, thank you. - Why is this was so fun? - And when you're a natural place, I feel,

for people to fact-check the pit or look for accuracy as in the actual medical procedures, in the terminology and the pathophysiology, but there's a whole other arc. Our characters go through as it relates to these

systemic and social issues, mental illness, workplace violence, not having a moment to decompress, carrying all that energy with you from patient to patient, all of that. And so let's get the real deal.

- About what it's really like to work in a busy ER, we'll talk to Dr. Italow Brown, a board certified emergency medicine doctor at Stanford and see what it's all about in that crazy place called the ER.

- I'm ready. - It's almost over the street, also this schulfnashbick, just over the street and then, hopefully, this is stupid.

- No, not at all. This street is so my safe space. - Hmm, do you have anything to say? - Yeah, exactly. - This street is so deep-steuer app that I just understand.

Egalobstudium, job, or on-so- - Casteem. - Cras, I don't feel like I'm a steuer. - Steuer is an elite. - Safe.

- With this steuer. - Dr. Italow Brown, legend. It's honor to have you here. Thanks for taking the time. - And it's a pleasure to be with you both.

- You know what people don't know is, Atalow and I have been friends on social media for years, but met each other, IRL, in the airport, which is kind of funny. (laughs)

Anyway. (laughs)

“It's all something that probably doesn't surprise you, right?”

Is how fast-paced, you know, the show really is and how many times these doctors are going for room to room, and they don't get time to really decompress

or kind of sit with their thoughts for a second.

Now, you trained in the Bronx at two of the busiest ERs. What was it experience for you like and having to run for room to room? And not if you get a second to think. - Rooms.

(laughs) That's funny. Honestly, a lot of times it's just a curtain drawn in between and sometimes patients are right next to each other, sometimes they're staggered and triplicate.

And so it wasn't really a run from room to room, but really just wherever the space was in the patient was. But that experience is something that I remember, even when I first interviewed there, I remember saying, if I can manage this,

then I could probably go anywhere. The emergency department is just such a unique environment where we have so many different types of pathology or problems in the same space. And the ability to try to like think through it

is something that we rely upon. The speed, the fact that there can be a code one minute and then next minute somebody chuck in some urine and a urine along to the ground. The department is just such a very interesting environment.

A lot of things that are unpredictable

“and you have to keep a presence of mine at all times”

like know what's urgent, who's sick, who's kind of sick and who needs to get out as fast as possible. And so that's kind of how I navigated it. And really got good at relying upon all resources, nursing, our support staff, techs, unit secretaries, X-ray techs,

anybody who can move a patient, anybody who can see a person sick and yell out help is someone who I wanted on the team. - I am curious, like what are some helpful tools when you're going back to back

between difficult patients and difficult cases? - A lot of times the most helpful tool is making sure that you have working differentials, right? So this list of diagnoses that you're working up for a person being able to really hone in on them two

or the three things that you're trying to address and then keeping that in the forefront as you move to the next patient. The other thing that I thought was extremely helpful is like constantly going through mental checklist

like are the labs back is the imaging back. Did this person get the pain medication? Are the antibiotics started for the septic patient? Did we get fluids on board? Did we call this consult?

Have they call back yet? Like constantly running through this checklist

“and then moving things based upon the prioritization, right?”

So super sick person, top priority. Somebody who's had the same issue for a year, little lower on the list, still important, but definitely not somebody who I'm worried about in terms of like turning the corner really quickly.

- Mm, master of the multi task, incredible.

- Spinning all the plates at the same time and making sure that none crash, that's all it is. - But what we've seen on the show and in real life is sometimes spinning all those plates does not involve paying attention to collective mental health.

all over health care.

We see it show up in this show for different characters.

We're starting to learn a little bit more about each character is kind of personal mental health journey. How do you see mental health show up and for your team, for your residents? Are we making progress and being able to talk about it

and spot it?

“- What I have learned to rely upon is this team environment, right?”

Just because we're friendly, we're a family. We spend a lot more time with each other than we do, sometimes with our own families. I think one of the greatest changes that's happened recently is the development of like a wellness initiative

across emergency medicine. Where we see wellness fellowships, we see a lot of importance placed on balance and making sure that our lives outside of the hospital are as good as possible

so that we can perform at a high level within the hospital.

And then finally, like this change in the stigma around therapy.

So a lot of people used to not wanna say I'm a doctor and I go to therapy or I'm a doctor and I take medication or I'm a doctor and I talk to somebody about the trauma and the struggles that I experience on the shift.

This space has now shifted to where these are encouraged, welcomed and we celebrate it. And so that to me has been one of the greatest things that's changed in the last like 10, 15 years. - So you are an assistant professor

of emergency medicine at Stanford and I wanna know like how realistic are you with students when they're going into this line of work about the mental health risks

“or how to take care of the mental health in these positions?”

- I sugar code nothing, they know. I will tell you the absolute truth, 10 times out of 10. I start off by asking them like, what do you want out of this career? It's a lifelong career, you sign up to be a physician but signing up to be an emergency physician means

that you're going to be imprinted upon constantly by people's personal struggles, things that are social and structural, systemic failures. And you're gonna see some of the most vivid, gruesome and sometimes very unbearable things.

It could be as bad as someone being shot in the chest or talking to a patient who's been sexually assaulted. All of this gets imprinted on your soul. And so I try to make sure they understand that this specialty requires a lot of self-awareness

and that if they want to step into this that not only are you gonna be literally tasked with a lot of things but you won't be left alone. We have a lot of support. And by support I mean we have a lot of individuals

who experience the same things and they're open to sharing it. So you won't feel like you're on a team by yourself but it is a commitment. And every single time you do this it demands its pound of flesh. So it's an undertaking but I think that the reward

is extremely high and we see that experienced over and over again with people coming back to the field. People making sure that they show up at our meetings that they do research, they are under compensated and still give a hundred and ten percent.

You know I really like how you phrased these experiences are imprinted on your soul, the good and the bad. And you know the pit does a great job of highlighting many of the struggles that doctors, nurses, texts, all of us go through and one of them

is violence in the workplace. And you know people shots hurt around the world when charged in our state and it was punched in season one. And the show really illuminated for a lot of people who did know just how prevalent workplace violence

is against healthcare professionals. Do you have any personal stories? Have you been through something with workplace violence

and in second part of the question,

do you feel like we are finally making progress in terms of addressing it and protecting ourselves in our colleagues against these acts of violence in the hospital in the clinic and healthcare? - I unfortunately do have stories.

And I share them first out of honor for all of the healthcare workers who have sustained an injury or been assaulted on the job verbally or physically. And I wanna just acknowledge a whole space for them because this again has its own levels of trauma

“that you have to work through and sift through.”

And you don't get two, three days to figure it out. You actually get less than a few minutes, sometimes seconds to figure it out. And so I remember I was a resident. You know, I felt like I knew what I was doing.

I was a senior at that time and I had a patient who was having like a brief iconic episode and thought that everyone who was trying to help her was hurting her and she was screaming out, she dropped to the floor.

Now a patient dropped to the floor in front of you. You're like, all right, hold on. Let me either try to help them up, let's stabilize them. And so when we try to help her up, she started thrashing. And we're trying to make sure now we get her into a stretcher

or into a gurney appropriately, take her to a room and then try to either verbally de-escalator and if not, we were gonna chemically de-escalate. So by the time we get her into the room in she's in the stretcher, I have my hands on the rail.

She just like reaches up and grabs this part of my arm. Now, I don't know if you can see it, but it's like a really deep kind of gash there.

I was like, man, that's crazy.

“Went to the bathroom, washed off, no problem.”

Two days later, what start off is just a cut. Now is about two to three centimeters circumferentially. Hertz, not too bad. But I'm like, all right, it's cool, by Friday. That happened on the Monday by Friday.

My whole arm is on Hillboy. Just straight, swole and I mean this when I say like, I could not suture a patient's face without every single maneuver hurting my arm. I come back down and sit next to my chief.

She's just like, how's the patient doing? And oh my god, it looks at my arm and sees how large it is. She's like, you tell me, are you okay? I say, yeah, I'm cool, what's up? She literally takes me into the trauma bay,

puts an ultrasound on it, nothing but plus underneath it. Now, yeah, yeah. So then the attending cut into my arm and took out about 20 cc's of pus because I had essentially started to have more than just a regular infection,

but a systemic infection. I share that story, not as a cautionary tale,

but to say like one, you never know.

Small things can become big things.

“Two, my team members recognized before I cared”

to recognize because I didn't think that the culture was to admit when I had been assaulted or the culture was to admit that I needed help. And so we worked significantly to make the space safe enough for people to talk about things,

without fear of retaliation, without fear of being looked down upon because you were assaulted. And finally, the way that we've now shifted those types of things, the reporting,

those barriers are a lot lower. A lot of times, it was hard to report incidents of assault, partially because of the process being very kind of convoluted. But also, you knew nothing was going to happen. And so now we have legislation that is

in process largely being driven by our nurses and our nurse unions who are trying to make sure that there are ways that we can protect all healthcare workers and that there are consequences for assaulting us. - Oh, thank you so much for sharing that story.

Oh, my goodness. - That is wild. - I'm curious how you've seen stress in the workplace show up for medical professionals and for doctors.

We have a doctor on the show who has some self-harm scars. And I wonder how have you seen stress show up amongst the medical community? - That's really a good question. I've seen it in sometimes the signs are really difficult

to catch. It can be substance use, it can be self or injurious behavior. And a lot of times it can just be toxicity, like the way they behave in the department, a little bit more sharper snappy to their colleagues

than the normal. And what I've tried to do is to establish relationships that are bidirectional with everyone that I work with. Not only do I ask you for help, I mean, ask you to do something or ask for help

or try to help a patient. I try to make sure that you feel safe enough to come to me and talk to me about things that are going in your world. One of the tasks that I have as an attending

is to be able to pick up on these types of changes in behavior. And what we don't do a great job of is having individuals like check in just because.

We think that it's always all you're in trouble

or your charts are late. It's always this kind of structure of, I'm checking in on this person because they owe me something or they need to do something not just,

I care about you and I'm worried about you. So leading with that type of energy has yielded a lot of these kind of like, people in my life who've shared that information and I've been able to help them as best as possible.

- Yeah, Dr. Robby needs some of that till, you know? Both. (laughs) - The person who's the poor but also the push to go and be like, hey, Razzi.

- You can see, come to me. - Man, I know he tries. And from Washington's character arc, it's almost as though. I mean, you could tell he's a little tapped out but I think that deep down he has that desire

to like connect with everybody that he's helping, he's training, he's educating and they view him in a certain way, right? Like, they see him as like this decided ill of knowledge and they understand that he can make decisions

and do things that most of the doctors don't do,

“but I think that you have to layer in a little bit more”

of that vulnerability. And you gotta show him that you're friable too. - Yeah, that's a good point. - But, tell it, it's interesting. I, earlier this season, I was talking to some colleagues

and one of them had mentioned this frustration to me that he heard med students saying, oh my gosh, like we watch the pit, we want to go into ER medicine 'cause it seems so cool and these other doctors are like, no, it's not really that crazy.

You're not gonna get this many wild traumas or zebra cases sort of say in one shift,

And I'm like, obviously it's television guys, like, calm down a bit, but I want to ask you as the real deal, what is your favorite part about being an ER doctor? Like, what gets you up when you're kind of tired,

you don't want it to work and gets you motivated to get into the hospital and take on a shift?

“- It's honestly the non-stop problem solving.”

It's like a Rubik's Cube every time you walk into the department. And I like the idea of every time I meet a patient,

first of all, I'm meeting more people

than anyone typically on a standard day, right? You're talking about 30 to 50 people that you just meet every day and they have back stories, they have real problems and your job is to get the most information possible.

And if it's in a small amount of time to try to help them move from point A to point B. Now, I'm not gonna lie. I originally was brought to it because of the cool stuff. Like, oh man, you put in chest tubes

or interbade patients. We're seeing someone who fell through a roof or whatever, like those stories make for great bar conversation. You walk in, it's like, oh, I got a story for you. Let me tell you what I extracted from this patient

the other day. But at the end of the day, it's really about these patients and making sure that they're talking about their experience

with you in such a high regard that you feel like you honor

the specialty and the many other people who came before you. - So I just have to know, like, practically, you know, meeting all of these people in a shift, like, what is your social battery, like,

at the end of a shift? - Cooked. - That's right. (laughs)

“I think what I've learned to do is spend that first hour”

in reflection, right? So I put on some music, try to vibe out and think about the cases and like what I could have done better and criticize myself harder than anybody else. But once I hit the threshold of the door of my apartment,

I'm done, I have nothing left to do. I literally turn that off and turn on the, in deering side, the side that has funded jokes and can appreciate everything non-medical.

It is fun to me to be able to be that have that duality

to go into intensive environments and think very surgically and precise to talk and communicate at a high level, but then also joke and have fun and be like a tangible, palpable person

with dimension. - So how, I mean, that's very instructive. If I have an emergency, I'm coming to you. So you've really inspired me. - Amen.

- Thank you so much. - Thank you for the world of freeer patients, my guy. - And I appreciate both of you for bringing this to the forefront for honoring our work in a way that is exemplary.

Thank you. (gentle music) - Look, I loved that conversation and I was so moved by Dr. Brown telling us about this gas that turned into

like full of dust and how he didn't realize, you know, how he could prioritize his own health in that moment, but that took a coworker saying, hey, I think we need to look at this a little bit further. Like, your arm is crazy right now.

And I think that really applies to a lot of the doctors that we see on the pit. - It really felt like a storyline that could have shown up in the pit. As you mentioned, like putting your work

and ignoring your own strategies, your own symptoms, I really appreciate how eloquent and how open it was with us on this conversation. You can tell that he not only shows up for his patients, but he's probably a phenomenal mentor

and attending. I really appreciate him distinguishing between the cool bar stories, but then the actual motivation of being there for people on what might be an awful day in their life.

And you know, trying to treat the entire individual and not just the disease of the condition. - Yeah, and I mean, I think that, in my head, it seems so stressful and so tense to make a hundred medical decisions in, you know,

this ban of a few minutes. But I like that he described it as being so energizing and almost empowering to do that. And like you said, showing up for someone and also showing up for your coworkers and colleagues.

- For sure, for sure, I feel like he's the right person where I can call when I'm having a bad day and be like, Coach Brown, what do I do to get back in the game? But this is also the person

“any aspiring ER doctors who you should reach out to,”

because he's clear of the real deal. That's it for today's episode of the Pit Podcast, but you know where to find us right here on Thursday after each new episode. - And we want to hear from you.

Leave us a comment or a question and we'd love to talk about it in a future episode. You can watch us on HBO Max or listen wherever you get your podcasts. The Pit Podcast is a production of HBO Max

and collaboration with PRX. The Executive Producer of PRX is Jocelyn Gonzalez. Our managing producer is Courtney Florentine.

Our production managers are Ebuda Choa and Tony Carlson.

“Our video producer and editor is Anthony Q. artists”

with Assistant Editor Damon D'Rale Henson.

This shows engineered by Tommy Bizarrean,

special thanks to Joe Carlino.

“- The Executive Producer of HBO Podcast is Michael Gluckstatt.”

The Senior Producer is Allison Cohen Sorrowcotch and the Associate Producer is Aaron Kelly. Technical Director is Insang Quang. I'm Alok Patel. - And I'm Hunter Harris.

We'll see you next week in the Pit.