BONUS: Behind the Scenes of The Pitt with Gemmill, Sachs, and Herbert
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What inspired Emily to create a bonus episode about The Pit?
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This is The Nocturnist Conversations. I'm Emily Silverman. As you may know, we recently launched our Uncertainty series here at The Nocturnists, and those episodes will continue to drop on Thursdays, as planned. But today, Tuesday, we're bringing you a special bonus episode, because this conversation was just too fun to postpone. Today, I sit down with the creative minds behind the HBO Max television show, The Pit. A new medical drama that has captivated so many of us in the healthcare world. At the time of this interview, the first 11 episodes of The Pit had aired, and since then, the stakes have only grown higher. The characters on The Pit feel so incredibly real. My personal favorite is Dana, the charge nurse.
And the medical cases on the show also hit close to home, which just goes to show how much the writing team understands what it's really like to work in an emergency department. And part of why they nail the authenticity of the show is that they have a lot of doctors involved in the creative process. Which brings me to today's three extraordinary guests. R. Scott Gemmel, longtime television writer and producer, known for his work on ER, NCIS Los Angeles, and now the creator and showrunner of The Pit. Joe Sachs, an emergency physician and TV writer who worked on ER for years and now brings his clinical expertise to The Pit. And Mel Herbert, a beloved educator in emergency medicine, the founder of the MRAP podcast and consultant on season one of The Pit.
As someone who works at the intersection of medicine and storytelling, I have to say, I was a little starstruck to be in conversation with these legends. We talked about everything from how they set out to make a medical show unlike anything we've seen before, how they write to the moment, bringing in real-world crises from healthcare like burnout, boarding, even press Ganey scores, why they chose to tell the story in real time with each episode covering one hour of the shift, how they nailed the realism of the show from a hand-designed airway that they built and can intubate to a fake toilet on set that may have been a little too convincing, and what they hope The Pit will mean to clinicians and the culture at large.
I hope you enjoy this conversation as much as I did, but before we dive in, take a listen to the trailer for The Pit, streaming now on HBO Max.
Good morning, Jack. What are you doing here? Working. And if you jump on my shift, that's just rude, man. I hope I'm never one of your patients. Makes two of us, my friend. Hey, D, what's the good word? We're . 52 in the waiting room, and it's not even 7. Robbie's working the shift, by the way. Got him a little slack today. It's the anniversary of Dr. Adamson's death. Who left this mess? Nothing like a little challenge every now and then. We've got some new faces with us today. Hi, come on over. I'm so happy to be here. Talk to me at the end of the day. Clear. Forceps.
Little
suction. Med student down.
Welcome to the pit. Let's go save some lives.
Systolic's only 80, 14
days. Alex, you've lost a lot of blood. You need to go to surgery right away. Am I gonna die? Not now that I'm here. Easy, easy. I'm in. Good, well done. That
was awesome.
Is it always this busy?
No, it gets a lot busier. There's a nursing shortage across the country.
That is bullshit. If you paid them a living wage, they'd line up to work here.
Other hospitals are managing this crisis. Either step up or step aside.
Are you okay? Why wouldn't I be? It's five years ago today. You can't block your feelings forever. Whoa, you'd be surprised. CrashCon, let's go! EpiVepi. No pulse.
Clear.
Hold compressions. Are we ready to call this? 150,000 people die every day in the world. Today you got one of them. And we're gonna get more of them before the shift is over.
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Chapters
4 chapters
1
What inspired Emily to create a bonus episode about The Pit?
0:00–11:34
2
How does the trailer set the tone for the series?
11:34–13:33
3
Why did the creators prioritize medical authenticity from the start?
13:33–31:14
4
How do the writers balance character arcs with real‑world medical cases?
31:14–53:35