By Kristin Marguerite Doidge
When the HBO Max drama series “The Pitt” premiered last January, audiences and critics sensed almost immediately that something special was happening on screen. From the sounds of the stuffy crowded waiting room to the looks of fear and sheer exhaustion on the characters’ faces, it was almost as if you were right there beside them. For many viewers, the adrenaline rush that comes with making split-second life-changing decisions became just as addicting for them as it was for the hardworking staff in the fictional Pittsburgh Trauma Medical Hospital’s emergency room.
The show’s creator, R. Scott Gemmill, wanted to show the most realistic examination of the challenges facing healthcare workers in today’s post-COVID America through their eyes — and with each episode following one hour of an intense 15-hour shift. It’s become one of the most watched series of all time for the streaming platform. Noah Wyle plays chief attending physician Dr. Michael “Robby” Robinavitch and leads a talented cast playing physicians, nurses, and medical students.
Picture editors Mark Strand, ACE and Annie Eifrig, as well as supervising sound editor Bryan Parker, already had an existing relationship with the show’s legendary executive producer John Wells, while picture editors Lauren Pendergrass and Joey Reinisch came on board to round out the team. Strand, Parker, and Reinisch will return for Season 2, which will premiere on HBO Max in January of next year.
CineMontage caught up with some of the LA-based team to find out how they worked together to create such an immersive, emotional, authentic experience for the audience.
CineMontage: Tell us about how your relationship with John Wells helped you land this job?
Strand: John and I have worked together on and off for about eight years now. The first series we worked on was “Animal Kingdom.” We also worked on “Shameless” together and we worked on “Emperor ofnOcean Park.”
Co-executive producer Terri Murphy — John’s post producer and my friend — invited me to join “The Pitt” and work on this with him. Having John ask for me specifically is always a really, really nice boost. We are both connected to the same style of storytelling. “ER” came
out when I was in college, when I was fully examining and watching television and movies with the notion that it would be my career, so it’s interesting that John’s show was such a big part of that and my growth. And then to finally come around and start working with him and some of those sensibilities, playing a part in creating it, has been great.
Eifrig: I got involved with the show having worked with John and Terri previously on “Maid.”
Parker: The first thing I worked on under the John Wells umbrella was the pilot for “Rescue: HI-Surf [sic].” Terri Murphy brought me on to that and we worked well together. From there, Terri and I did “Mrs. Davis” together, then she brought me back for “Emperor of Ocean Park,” and we continued to get along well.
There’s a sort of alignment of values with everyone on this team — for instance, what’s our tolerance for noise versus our tolerance for ADR — and for Terri, that ended up being a big thing. One of the reasons we got along well is we’re similarly calibrated that way. When “The Pitt” came up as a potential project, and with the sound opportunities she saw in that, she thought of me and brought me on board.
Reinisch: I have worked with people in John’s orbit, but I never worked with him before this show. I had interviewed with him for another show he was doing, and during that interview, “The Pitt” came up. That’s when Terri reached out to me. She and I have some mutual post-production acquaintances, and through interviews and then talking to Scott, I ended up on the show.
CineMontage: The action in “The Pitt” feels chaotic at times, but I understand the prep for the show was quite meticulous?
Strand: While some of our shooting is untraditional, it is not even close to chaotic. One of the great things about working at John Wells Productions — for John, Scott, [producer] Mike Hissrich, and Joe Sachs, who is the medical advisor on the show — is that those guys have done a lot of work together. They created a system for how to write the medical stuff effectively and get the actors on board with it before they show up on set.
Because this setting is one huge space in which everybody has to be there all the time, and because all these things are going on in the background, everything has to be meticulously planned. When they start shooting, in order to get everybody aligned so the extras will be falling in the same place and all the behavioral action will still be matching, rather than do more traditional pickups during the middle of scenes, they started doing full resets. The shooting approach was designed for the fastest way to make this work in order to get a show that is this kinetic, this energetic, and that many people feel is more authentic and less “TV.” It isn’t shot the same way TV is, so there is more energy to it.
My assistant editor, Emily Merriman, was critical in building the temp soundscape to define what the show would feel like in the pilot episode. Specifically, when Robby enters the hospital for the first time and removes his headset to reveal the chaos of the waiting area, and then transitions into the ER space for the first time, it was a particularly important sound transition that needed to quickly establish the never-ending workload that waits just outside the doors.
Parker: What Mark’s talking about aided our sound department immensely because instead of camera setup C starting with a line halfway through a scene, we’ve got full scene takes for almost all scenes and setups. So pulling takes to avoid ADR, pulling a clean syllable here, a clean word here, meant I had a lot more options to work with.
CineMontage: Can you talk about the COVID flashbacks from a sound- and picture-editing perspective?
Strand: These flashbacks push themselves forward and confront Robby throughout the day, so editorially speaking, that’s what we’re doing. We’re trying to make it a sudden departure from those soundscapes and sound bases, which feel very real and of that moment; suddenly, we’re pushed into this other space where a lot of the atmosphere, tone, and mood defining that departure have been created by Bryan and his team in a very big way.
Parker: That departure happens specifically because the picture and sound do get pretty disconnected there. It’s a memory — and it’s a precursor to the use of the isolated sound of the ECMO [heart-lung machine] or the sound of this other patient flatlining. So there’s an emotional distance, and the gap between the picture and sound makes them fundamentally feel different. Hopefully, our audience will be able to tell this is some other thing. Even if they were to drop in in the middle of it, it doesn’t feel like the rest of the show.
When we were building those scenes, sound-wise, and when we were getting cuts and finishing off those episodes before it started airing, I thought, “OK, I think that achieved our goals here.” I felt successful. Fast-forward a month [to] when it starts airing, and we start seeing comments from folks, particularly from healthcare workers who were working during that time. Apparently it hit them like a ton of bricks. I didn’t realize the extent to which we were portraying something so subjective and experiential with such accuracy. I suppose for some of those folks, it really landed. And that means a lot.
Reinisch: It’s the only time during the entire pilot that we break from pure reality. In one of the quicker COVID flashbacks, I actually did jump cuts, which is not something we would ever do in the show itself because it is presented as being so grounded and realistic. Like Bryan was saying, we have more of an ethereal vibe to the jump cuts, and I think it’s just enough to make you pay attention. Even a passing glance at that moment in the show would convey that this is not where we normally spend our time.
This is one of the first shows I’ve seen that has acknowledged how hard that was for healthcare workers — how traumatizing it was, or just the fact that it existed. I know some shows during that time period just pretended it wasn’t happening, but these people are still very much living with the horror of all of that.
CineMontage: What was the most meaningful sequence or episode each of you edited?
Reinisch: This season, I ended up with a weird amount of cases that hit very close to home. I have two six-year-olds, and I cut Episode 8, which is where the six-year-old drowns. The drama and the stakes in this show are so much more relatable than other things I’ve worked on, which makes those days very tough.
On the more fun side was Episode 11, the realistic birth sequence. I thought it was so cool that HBO was willing to go as far as they did to show the whole process. And in that particular episode, Robby is being pulled between the cirrhotic patient in one trauma room and the delivery in the other room. It’s back and forth, and it’s right before we go into the last chapter of the season, with the mass casualty and all of that. So Robby’s already super-heightened. Dr. Langdon (Patrick Ball) is already gone, and the back-and-forth push-pull of those two traumas at the same time — you could feel the pressure.
That stuff is really fun to work on because I was cutting it almost like a music video or an action sequence. Everybody is off-book and on their game: The camera is on it, the direction is meticulously planned with the background action, and I get to make it feel overwhelming. And that is very fun to do.
Parker: Sometimes I just get out of the way. Probably my favorite sequence is one of the quiet moments. In Episode 4, a young woman who unknowingly overdosed on fentanyl and had Narcan comes back to life, and she goes to talk to the parent of the kid who took the same fentanyl and didn’t make it.
There’s a moment going into in that sequence that has real tension, and then the release of this slower pacing — “Hey, here’s what happened with your son, and if you want to talk, here’s my email address.” And the dead kid’s dad, seeing the young woman’s parents maybe 20 feet behind her, says, “OK, well, thank you so much. I’m sure that your parents want to take you home.” Then we see a long shot of the boy’s mom and we cut back to the daughter, and man, it floors me…. It didn’t have a lot to do with my department. I’m sure the background sounds fine, but we got way out of the way.
Strand: What’s hugely important to us is that we’re allowing that temporal space to make room for that emotional space. For that moment to land in Episode 4, with the young woman apologizing to the father — which choked me up; even you describing it, Bryan — and then also the adult children saying goodbye to their father in the same episode, I would say I’m making my greatest choices within those scenes in order to make that all land. But really, it’s landing because of all the work we did in Episodes 1, 2, and 3 — getting to know the people in a slow emotional build, getting to know these families, so that it really lands.
The first season of “The Pitt” is 15 episodes, each one depicting an hour within a single 15-hour ER shift. The whole season, binged, would run much longer than a feature film, but at this point, Episode 4, it’s a four-hour story. Now these emotional payoffs are coming, and that is a combination of terrific writing, great performances, strong editing and sound design, all working together to tell the same story, which is: this is really happening. These could be your neighbors, and hopefully you’re connecting with these people so that when the emotional plane lands, it’s satisfying.
Eifrig: My favorite episode to edit was Episode 13 because it was such a rollercoaster of chaos that ends in an extremely emotional breakdown [for Robby], so the pacing and intercutting of everything was the best dance. My favorite part of editing is finding the absolute breaking point of an emotional journey because it mirrors what we all go through in life. Grabbing a viewer and not letting them wiggle away from discomfort while still letting them know you’re not going to abandon them in it… that’s the stuff of my dreams.
This interview has been edited for length and clarity.
