“The Pitt” is known for always keeping it real, no matter how gory the situation. HBO Max’s hyperrealistic hit medical show details the intensity of hospital life, putting blood, sweat, and tears on full display. Working medical professionals have praised its realism, thanks in part to the series’ stellar (and sometimes slightly too realistic) SFX work. The show’s dedication to shedding light on important medical topics, no matter how disturbing, is key to its success.
In its first two seasons, “The Pitt” has showcased numerous medical cases, all within the span of only two full work shifts for Dr. Michael “Robby” Robinavitch, Dr. Trinity Santos, Dr. Cassie McKay, and the rest of the emergency department staff. We’ve scoured them all and chosen the five most disturbing.
The patient interactions below aren’t necessarily the most bloody, but they are the ones that leave a deep impact — sometimes more for their distressing backstories than for what’s shown on screen. And if you don’t personally find our choices troubling, great! Make sure to list “The PItt” cases that make you shudder in the comments below. Finally, please note a Spoiler Alert!: This list covers events from Seasons 1 and 2. If you haven’t watched, make sure to bookmark and come back when you’ve seen it all… if you’re not too squeamish.
A woman’s degloving injury is a bloody mess, but the reason it happened is truly horrific
“The Pitt” premiere wastes no time grabbing viewers and tugging them into a terrifying case. After falling from a train platform onto the tracks, patient Minu Agrawal arrives at the hospital with a degloved foot — meaning that her skin has been completely torn away from the muscle beneath. (“The Pitt” shows the injury in detail.) Even worse, Minu only speaks a language that no one else in emergency room can understand.
Minu’s case is followed throughout the first couple of episodes, eventually revealing that she was pushed in a violent hate crime. Thanks to the doctors we know and love, Minu survives, but this isn’t always the outcome for this type of attack in real life. For example, in New York City in 2012, Erica Menendez pushed Sunando Sen onto subway tracks, where he was hit and killed by an oncoming train. She allegedly told police she did so because she hates Hindu and Muslim people. These attacks continue to occur, making Minu’s case a haunting reminder of what hate can bring.
A surprise reveal inside an arm cast is worse than you think
John Digby arrives in the Season 2 premiere of “The Pitt” smelling foul and sporting a cast on his arm. The unhoused patient is showered and cared for before the plaster is removed, revealing an array of maggots eating away at his skin. Dana and Dr. Mohan both put on brave faces as they assess the situation, while recent nursing graduate Emma Nolan struggles with the sight. The grisly visual is certainly haunting and likely left some hypochondriac viewers itchy. But could something like that actually happen?
Short answer: Yes. Maggots are stellar decomposers and arrive when flesh is actively dying. They’ve been known to infect human skin, a process known as myiasis, which occurs when flies lay eggs on an open wound. Real maggots were used in the scene; none were harmed. Charles Baker, who played Digby, wore a prosthetic arm.
How a belief led to sad consequences for a young patient
In Season 1, Episode 14, patient Flynn Edwards is brought into the hospital with measles, a modern rarity. Most people these days are vaccinated against the illness, but Flynn isn’t. Robby explains to Flynn’s frantic mother, Hillary, that they’ll have to perform a spinal tap to check if the infection has spread to his brain. Hillary is vehemently against the procedure and references online platforms to back her up, which enrages Robby. She insists on holding off giving Flynn the spinal tap, wasting precious time.
Robby convinces Flynn’s father, Larry, to agree to the spinal tap without Hillary’s consent. After the fluid has been retrieved, Hillary announces that she’s checking Flynn out of the hospital. The case is referenced again in Season 2, when Hillary names Drs. King and Ellis in a malpractice lawsuit after Flynn suffered cognitive decline from the measles. Ellis later informs King that Flynn’s decline wasn’t due to any form of medical malpractice, but rather the delay in getting him the treatment he needed when it was necessary. By the end of the season, the suit remains unresolved.
The disturbing truth behind a seemingly routine medical case
When patient Piper Fisher arrives in Season 1, Episode 6, her symptoms display as a standard sexually transmitted infection. What makes the case unsettling is how close Piper is to her boss, Laura, who accompanies her to the visit. Laura answers many of Dr. McKay’s questions for Piper, insists on being with her for a pelvic exam, and even is listed as Piper’s emergency contact. McKay finds the whole situation incredibly suspicious, leading her to have a one-on-one conversation with Piper about her safety. Despite all the red flags, Piper insists that nothing is wrong.
“The Pitt” heavily implies that Piper might be a human trafficking victim. What makes this case haunting is the lack of conclusion. Piper is diagnosed with a bad case of chlamydia. While McKay wants to keep her at the hospital, there’s only so much she can do. Piper leaves with Laura, leaving the audience to wonder — and worry — about her future.
Behind the scenes of a mass tragedy
In the final hours of their Season 1 workday, the emergency department staff tends to 112 mass shooting victims. The final four episodes of the series’ freshman season detail the aftermath of a mass casualty event at a music festival called “PittFest.” The already overpacked emergency room starts to look like a war zone. While treating patients left and right, Robby has to hold in his fear that Jake, his ex-girlfriend’s son, might be one of the concertgoers coming into the hospital.
The horror in this event is knowing that saving all lives might not be possible. And the fact that this event is etched in reality makes it hit even harder, as viewers get an inside look into what emergency room doctors go through when dealing with the effects of gun violence.