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Welcome to Chasing Life.
This is hard to believe, but I finished medical school back in 1993, 32 years ago. I've spent more than half my life now as a physician. I was 24 years old at the time. I'm in my mid-50s now. It is really remarkable to reflect upon.
a lot of my formative years in hospitals. During my neurosurgery training, the hours were relentless, sometimes more than 100 hours every week. Spent a lot of time in operating rooms. Spent a lot of time in emergency rooms. And I got to tell you, there's nowhere else quite like it. You never know what's going to walk through the door in an emergency room. You can go from having a relatively quiet shift to complete pandemonium.
Within minutes, sometimes within seconds, you have to work with teams, people that you are shoulder to shoulder with as you're trying to revive patients who've come in after gunshot wounds, after car accidents, after some sort of trauma, after heart attacks, strokes, you name it. The sounds, the rapid pace of the work, the never-ending line of patients, you know that every day lives are going to be saved and sometimes lives will be lost.
Now, the thing about doing those types of shows for television is that most doctors and nurses have a little bit of an allergy to that. They will be the first to tell you that, look, my world is nothing like what you see on TV. And that's because medicine isn't glamorous. Scrubs get really dirty. Emergency rooms get really crowded.
Sometimes it's hard to take care of patients the way that you want to take care of patients. There is exhaustion. There is burnout. So I'll admit it, when I heard that there was a new show that was really supposedly going to capture the true nature of an emergency room, I was skeptical. And I'll tell you that I am someone who's watched these shows, many of them over the years, St. Elsewhere, Chicago Hope,
ER, obviously. I watched some Grey's Anatomy, especially with my teenage daughters. And then I heard about this show, The Pit. ♪
I didn't know what to make of it. I didn't even know what that meant. Did that mean the pit? Like you were inside a pit? Turns out it means Pittsburgh. That's where the show takes place. And I have to tell you, within one episode, I was just blown away by this. Why? Because the stories were so authentic. The stories were so real. It was almost like they were holding up a mirror to a real emergency room. I hadn't seen things like that on television before.
Oftentimes, you think when they're doing scripted dramas, there are certain lines they won't cross. There's children who will never die in a television show because the viewers can't handle that. That is not the way the creators of The Pit approach this show. As you're about to hear, nothing was off limits, which is incredible.
and very tough to do. Not only do they take on really, really tough issues that happen in emergency rooms, but somehow they sprinkle in issues of nursing shortages and health care policy discussions overall.
The Pit is a show that follows medical professionals. And if ER was a patient-centric sort of show, this is much more of a provider-centric sort of show, meaning it really is focused on the providers. If you want to know what the life is like of someone who works in an emergency room, this show is going to give you a really good idea.
They follow medical professionals. They follow students. They follow residents. And it's for one 15-hour shift in a Pittsburgh emergency room. It's streaming on Max, which is also owned by CNN's parent company, Warner Brothers Discovery. It is fiction, yes. But I got to tell you, again, after watching now all 15 episodes, and it's one of the few shows where I think I've actually made it through to the very end.
But after watching all 15 episodes, I can tell you that I think it's the most realistic portrayal of emergency medicine I've ever seen on television. And that's a statement. That is really, it's a statement. Because again, I've watched a lot of these things. I watched it with a critical eye. Now that the first season is wrapped, I decided I wanted to sit down with someone whose name I've heard for a long time.
John Wells. He's one of the show's executive producers. He is a veteran TV producer. You've heard of China Beach. You've heard of The West Wing. You've heard of ER. He has been one of the geniuses behind all those shows. One of the minds behind ER, which ran from 1994 to 2009, which, by the way, also starred Noah Wiley, who is the star of The Pit.
I wanted to talk about why they decided to do this show, coming out of COVID. How he managed to get so much of the show's medicine right. This is a fun one, guys. This is a fun Chasing Life today. I hope you enjoy it. I really did. I'm Dr. Sanjay Gupta, CNN's chief medical correspondent, and this is Chasing Life.
I'm such a big fan of the show. So congratulations, first of all. Thank you very much. And thank you. You were in my life every night through COVID for many, many years. So I appreciate all of that information and the work that you did to keep us all informed. Very important. Thank you. Thank you. I really appreciate that. John, this is the best medical show I've ever seen. It really is. And I hope you hear it a lot. I think you do because I've read articles about this. But
It's a lot harder to do than I think people realize. Yeah, we're very fortunate. We work with a number of physicians. We had done that on ER, but at that time, we were still having to do a certain amount of medical melodrama, which is a wonderful form, but not what we were interested in. We wanted to just talk about how difficult it is for a physician
in a major urban hospital to actually get through a shift, what we actually ask them to do that we're not aware of. And so we have a lot of medical personnel on the show. We have one of our senior writers, executive producers is Dr. Joe Sachs, who has been a 30-year emergency room attending at UCLA and other places. And then we have four other working emergency room physicians who are on set.
We have Dr. Mel Herbert, who's a very well-known ER doc, who's in the writer's room with Dr. Joe. And then we have nine working ER nurses who are in the show as all of our regulars. So when you see, you know, the medical procedures and it looks right, that's because they're actually the ones who are doing much of it. They're leaving shifts and coming in and working on our show. And we have a fantastic prop department, but we put a lot of care into
into trying to really show what that experience is for an emergency room physician and for the nurses in the emergency rooms. John, I'm curious, you know, you talk about this sort of coming out of COVID and, you know, I was very immersed in COVID and I get the sense that not only have people
many people moved on, there's almost a desire to not revisit. Was that a rate-limiting step at all as you were thinking about this show? Were there naysayers? No, there really weren't. There are scenes in the piece that show Dr. Robbie, he's played by Noah Wiley, in full COVID protective gear.
And those are all based on the photographs that Joe Sachs shared with us from UCLA Northridge where he was working through it. So all of that kind of attention to detail everyone was very supportive of. I like to talk about-- and I may sound a little overblown in this-- but I think the Kaiser Health News and Foundation found out that we lost 3,600 US healthcare workers during COVID. And they are our medical combat veterans.
They went and did something to save everybody else. And we've forgotten to take care of them in the way that we should. The PTSD, the trauma that many have experienced, the nursing shortages that have come out of it. You know, I think we have to take a moment to really think about what we asked them as our kind of our first responders to do. It was very heroic and we have tended to forget about it. So if we can bring a little bit more attention back to that on this show, that was a big part of what we set out to do.
Yeah, it's interesting. When you think about scripted drama versus documentaries or docuseries, you know, with documentaries, there's some point that you're trying to convey. Maybe even there's advocacy around it. With scripted dramas, the North Star seems to be you want to entertain people. How do you find that line? Because what you're describing sounds like, look, you wanted to pay respect and homage to these health care workers, right?
And yet you want to make a really engaging, entertaining, highly watchable show at the same time. I think we're curious about it. And one of the things that we've heard from the medical community is that it's been an opportunity for them
to simply show their families what it is they do. And I think that audiences are really curious about these positions, about the jobs and the way that it does. And they're very aware when it doesn't feel real. I mean, obviously this is artifice. We built a set on Warner Brothers and it's all props and it's, you know, prosthetics and, you know, all of the things that we do. But we wanted that authenticity, that feeling. And I think people, for the same reason they're attracted to
well-done documentaries that there's a space where you can live in narrative television and in film where you create a world that feels so real that the audience is drawn into it. At first people were very concerned about how graphic a lot of it is, because we're really showing the medicine and we brought it in kind of slowly so that the audience would get more
used to seeing it as it went on in the same way that you do if you're a physician. You come in and you start to see it, you start to feel it. People at the beginning had always told me they were putting their hands over their eyes in the first few episodes and by a few episodes in they were actually just realizing the emotional experience of what the physicians and nurses are going through. So you're trying to get at that but we're not doing an entertaining show but we're also not asking you to eat your vegetables. We're showing you some really fascinating characters
and what they do, which is an extraordinary skill set, very difficult, and deserves a lot of our admiration. Were there lines that would come up in the writer's room, certain things where you say we won't cross? I'll give an example. I remember when I was interviewing someone about a scripted drama some time ago, the idea of a child dying in a television show. That is a tough line to cross. That is tough sledding for the viewer. Were there lines like that that you thought about? And if so, can you share any of those?
Well, there's always been a, and in fact that was a case on ER all those years ago in 1994 with Michael Crichton. One of the things we talked about was that there was concerns at NBC that people were dying in the emergency room. And we said, well, people die in the emergency room and the audience knows it. So let's respect the audience's intelligence.
and their willingness, so no, we didn't get pushback but we also didn't want it to be so overwhelmingly bleak that you didn't also see successes, you didn't also see what the characters are going through. But we really tell the stories purely from the point of view of the physicians, we don't ever follow any of the patients when they're not connected with the physicians and that allows us I think to kind of tell
the arc of what a day is like and the emotions of that day, and particularly for the younger interns and med students who are in there, what they're learning. So it gives you more latitude. But no, nobody ever told us not to do it, but we knew not to
kill, you know, a child at an episode for 15 episodes. Right. I mean, it's a lot, and yet it's the reality of what happens in ERs. There was a particular scene, and I think it's a little different than the ones that I've seen written about, that really struck me. And it has to do with a child who's found at the bottom of a pool.
And it's tragic, but it's also the story of that child's grandmother who was to have been watching that child. And it's also the story of the fact that there are certain markers in the emergency room, in this case, a potassium level in one's blood from which one is irrecoverable. You can't survive that.
And it was so gripping, the entire scene, and then the way Noah basically tells the parents what happened. I mean, even as I'm talking to you about it now, it conjures up a lot of emotions in me. As a neurosurgeon, there's been times when I've had to go down to the emergency room and deliver the worst news to somebody. They were having a perfectly fine day just a few hours earlier, and now it is the worst day of their lives. It is hard to convey that, I feel,
in a television show and yet you guys have done it. Again, the quality of the writing, Dr. Joe Sachs, Scott Gemmel, the entire writing staff spends a lot of time talking to physicians and nurses about how they have to deliver these news, what the feelings are that they go through. And we're really just trying to accurately portray that difficulty.
interestingly, a couple of the scenes or stories that go over a number of episodes that we've heard a tremendous amount about, in addition to that, our end of life story and making the decisions about your parents, which all of us go through. And I think it gives the audience an opportunity to think about it. We heard from a lot of people that they wanted to have conversations. We've gotten a lot of emails and texts and things and seeing things online that it
spurred people to talk to their parents and to talk to their children about what they want. Noah wrote a beautiful episode, he's also a wonderful writer, that episode in which he tells the children, the adult children, the parent who's dying or should be taken off life support, a way in which to deal with that, which was beautiful, I'd never heard it before, a Hawaiian saying. And those kinds of things when we can-- that gets us into this human experience, that's what we're trying to do.
Has it surprised you, the response to this show? Yeah, completely. All of us. Yeah. No, we had no idea. And part of that is because we took a risk and Max took a risk with us.
to say we were going to just take you through a shift. Now obviously it's a very dramatic shift and not every emergency room shift is like this shift, but we're going to try and take you through a shift and see what happens to the people and that you can get to know them over in the way that you would get to know someone over 14 or 15 hours, not over months.
It's not about their relationships outside of the hospital. It's about their work life. And we all have these work families where we spend so much time with the people we work with. They become our other group of people that we share with. But we had no idea that actually the audience would want to come along in that journey. But they let us do what it is that we were actually set out to do. When did you sort of get the sense that, hey, look, this was really catching fire?
I don't know, I got a call that maybe I could do a podcast with Dr. Sanjay Gupta. That might have been part of it. No, look-- No, it takes a while, you don't know, you really don't know. We're sort of the last to know a lot of times because we're in the writers room or on stage, we're working and you start to hear people sending texts saying, "I really loved your show" or "I'm really into it" or...
You know, but it's all still settling in on us that there's an audience that's responded to what we're trying to do. I mean, hugely so, John. Again, I just don't want to blow smoke up your skirt. But I talk to a lot of doctors and I work in a hospital and that people are really responding to it. I am curious, though, about something you just said. When you did ER, obviously that was a broadcast NBC show 30 years ago. Now this is streaming now.
So when you did a broadcast show, you had ratings, I guess. You knew how many people were showing up to watch. The next morning at 7 a.m. With this, do you get any sense of ratings or is it just literally this word of mouth that you're describing? Word of mouth and some silly things like on the Max site, you can see the top 10 of who's watching. Yeah.
So every morning I'd get up and check and see where we were in the top 10 of what people were watching. But mostly, yeah, it's word of mouth. And we get word of mouth the same way that everybody else does. The first time I started to really hear it truthfully was on the set with our nurses who were working shifts and our doctors who were working shifts who were then coming to the set, who were talking about how everybody at their hospitals was talking about the show. And that's very meaningful for us.
That sense of reality, again, for a lot of people. And I imagine, you know, we're talking about this sort of after the fact, but what you did is hard. Just having, again, being a viewer, but also talking to a lot of people to really bring reality to the screen like that is challenging. I mean, I really congratulate you for it because I think there's a tendency to want to pull punches, especially when it comes to medical shows.
Like, oh, we can't show them that. We can't get that deep into it. That'll turn them off. It's too graphic. Whatever it might be. But I get the sense there were no punches that were pulled. We didn't have those restrictions. And I would also say that I think the audience is very sophisticated and video literate, have seen narrative, have seen it. They've watched a lot of documentaries. It's not the same world that we were in 30, 40 years ago.
It's a world in which people have seen these things, they have access to... You can look up right now, you can look up a thoracotomy on YouTube and people do and there are lots of photos and there's actually videos of it. The audience is not to be underestimated and I think oftentimes we do underestimate their intelligence and their interest. We started the show in the first few minutes with a degloved foot from a subway accident and that was very intentionally done to say
This is what's going to be like. We understand you may not want to be part of that and we want to tell you early in case this show isn't for you.
Dr. Joe tells a funny story, Dr. Joe Sachs, where he heard from another physician who was angry because he felt that we had violated some HIPAA protections by showing real footage that we had gotten someone to give us. And we said, no, no, no, it's all photographed on set. It's all prosthetics and done in camera. Wow, that real. It's that real. So, yeah. Okay, we're going to take a short break here. When we come back,
More of my conversation with John Wells, executive producer of the new Max medical drama, The Pit.
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I think a lot of people will draw comparisons to ER, but there's another show that you worked on as well, The West Wing, which in some ways was very real as well. I mean, it felt like you were in The West Wing and it was around the time of the Clinton White House. Are there parallels? Again, I hesitate to use the word advocacy because these are supposed to be entertaining shows, scripted dramas, right?
And yet I think there's these messages that you're trying to impart, certainly with The Pit. Is West Wing a good comparison in this regard? Yeah, I think I actually, the first show that I worked on that did well, that I was very proud of being involved with, was China Beach. And that was about nurses and doctors in Vietnam. And John Young and a number of people who worked on that show, Bill Broyles, insisted upon us actually talking to real vets and getting their real stories out.
And so what I've discovered is you don't need to do advocacy because the stories that you get from the people who really do something, who really do the thing, whether they be on the West Wing with all of the various political advisors that we had that worked on the show throughout or on ER or The Pit or China Beach,
They tell you the stories and you don't have to reach for advocacy. You don't have to try and find a theme in the room that we're then going to try and do because in the case of the PIP, the medicine itself...
And what the experiences are that people tell you turn towards that advocacy. You know, one of the examples on the pit is that one of the things we started to hear very early on was about violence against nurses. And that became one of our themes that we wanted to write about. So, you know, you didn't have to do it. We never wanted to write about gun control. And yet what we did want to write about was the people who have to clean up after gun violence.
And the people in emergency rooms, the paramedics who bring them in and the people in the emergency rooms are the people who have the unenviable job of actually trying to save people who've been, you know. And so you don't have to be, we're not, we've never said gun control. We never talked about it. We're just saying there are people who actually have to deal with the consequences of some of our actions. And we did that a lot on West Wing. There was a lot about talking about issues. Who does it really impact?
And I have a lot of examples of sitting in rooms with political consultants, people who'd worked in the White House or who were working in the White House, and I would very cavalierly bring up something that I wanted to do and then
they would get into an argument about what the problems are with it. Like raising the Social Security age, which seemed like an easy thing for me. And then I just absolutely got destroyed by someone who had worked with the Sheet Metal Workers Union for years who said like, well, okay, your intellectual workers can take a 67 or 70-year-old retirement, but my 60-year-old who spent his entire life or her entire life on her knees, you know, installing carpet or cutting sheet metal, they're done at 60.
So what are you talking about? Right, right. So, yeah, so you've got to get – if you start to have the conversations with the people who really do it, you get all these different points of view and you don't have to try and – you just present what the ramifications are of some of the decisions we make and let the audience draw their own conclusions. Did any of that happen on this show? I mean you deal with –
vaccination for measles. You deal with medication abortion. You do deal with mass shootings and all that. Were there deliberate discussions or debates even about some of these issues in the writers' room? All of them. And we bring in people who work in that field, both in medicine and public policy, and they talk to us. So, you know, right now we're preparing the next season for
Congratulations, by the way. Thank you very much. And we had two different lengthy conversations yesterday in the writer's room with public health advocates for various issues. And part of what we're asking is what's the counterargument?
People felt very strongly in all of our conversation about masks and the one story that came out that we ended up playing was, if you don't believe in masks, do you want the surgeons to wear masks in surgery? Right. Which was just too delicious to not put it in the show.
These are contentious issues, some of them. Do you get blowback from members of the audience at all? Not so far. We've been anticipating it, and I assume at some point we will. Anti-vaxxers or Second Amendment folks, anything? Haven't so far, but that doesn't mean it won't happen. You know, I mean, one of the things about these shows now is this show is going to be on max now for years. Right. And so people are going to start to catch up to it more and—
You know, when we were doing West Wing almost every Friday morning, I got a letter from Senator Ted Stevens of Alaska's office who never missed an episode and then would argue with me about whatever we had on the show. But his position was, I'm going to tell you what my position is on this. Wow. I'm not telling you wrong. I'm just saying there is another point of view and I want to tell you what that other point of view is. And I do worry that we've moved just...
as a country and part of this may be the trauma of COVID and the stress and the way in which everybody lives through that process, that we are in an era where we don't discuss this much. Right. And so part of our intent on this in this show was to just show what these workers do, what these wonderful health care workers do. You make your argument from their point of view with what they have to go through.
So many scenes are very procedural, like you see as you talked about someone putting in a chest tube for a pleural effusion, someone getting a gunshot wound, whatever it might be. How hard is it to train the actors to do these things? Noah did it for 15 years on ER. So he's actually, if you have a facial laceration, Noah's the person you want to sew it up. He's great at suturing. But...
But the other actors and Noah, for kind of a refresher, we did two weeks with all the physicians came in and trained them on the basic procedures. You know, full basically kind of, you know, the obvious things like the CPR, which is the hardest thing to do on television because you really can't break any of the actors' ribs that you're trying to do CPR with. So that's the biggest criticism we always get is, you know, we're not heartbreaking, right, or whatever, but we're also not hurting any of it.
the actors who are on the show. But yeah, they came in for two weeks, two full weeks, full days with all the doctors and nurses and they trained them on all those basic procedures and then we do full medical rehearsals as we go for each procedure where the doctors come in, whoever is the doctor on that episode comes in with full ground plans and everything and they do it all before we, I'm one of the directors and so before the directors step in the doctors have actually
made it exactly the way it's supposed to be. And then it's our responsibility to shoot around what it actually looks like. Not to try and conform the medicine to what we need to do with the camera, but to make the camera show what the medicine actually is. Was it ever too much for any of the actors?
The dexterity of it was a lot sometimes. You know, there's a lot of medical dialogue and we try really hard not to dumb down that medical dialogue. So it's doctors talking to doctors or nurses talking to nurses and doctors. But you're doing that and you're also trying to do some very specific medical procedure, which involves a lot of trauma.
a lot of kind of trauma triage stuff. So, yeah, sometimes it's like, wait a second, I'm trying to rub the top of my head and chew gum and do medical dialogue at the same time. But they're really great and everybody jumped into it really excited about it. We kid that we all know just enough to be terrified in an emergency room. We don't actually know how to really do anything.
And it's a 15-hour shift, so it's 15, you know, one hours. How did that decision get made? We wanted to show the reality of how patients move through the ER and why when you wait for eight hours in the waiting room, there's a reason you're waiting for eight hours in the waiting room. That when we were only going to deal with the medicine in the time period that it takes—
We have a wonderful onset nurse, Tim Van Pelt, who ran one of the major emergency rooms here in Los Angeles, retired recently, came to us and he actually blocks out all of the patients, every single one along with Dr. Joe Sachs, every single one of our background artists has a diagnosis, has a diagnosis.
a schedule on every hour of when their meal is going to come, when their x-rays are coming back, when they'll get it, you know. So we're trying to get across this idea of what really happens when you're frustrated out there, what they're doing in the back, then nobody's playing back there, they're just trying to get through the day and so that was really intent like here's how do you survive and so by the time we were shooting episodes,
10, 11, 12, we were talking about being tired on our feet and when you haven't really had a chance to eat and do you ever get to go to the bathroom and just try to really show what these experiences are for these healthcare workers we depend upon. There's relationships, obviously, between the physicians and the patients. There's relationships between the physicians, trainees and attendings.
And it's just so spot on. There's the issue of the nursing shortage, which comes up over and over again. There's significant health care policy discussions that are happening in the context of an emergency room. I really, again, it's amazing how you were able to get that all in there. And it doesn't feel crammed in that regard. It feels very active, like that is a full hour discussion.
And yet it seems like it's a very plausible hour of what would happen in an emergency room. You covered a lot in season one. And what I already know about season two is that it's supposed to take place over July 4th weekend, if I remember correctly. Yeah, we asked what the least favorite times were in the emergency rooms, and it was Halloween and the 4th of July.
I imagine we'll see some fireworks, quite literally, and injuries. Any other scoop you can give us on what you've got planned? You know, I'm not trying to be coy. We just really are back in the writers' room, and Scott Gemmel, who's the executive producer and creator of the show, is working with the writers right now, and we're just starting to lay it out. It will be another shift, just a summer shift instead of a...
you know, fall shift which is what we had last time. And so we'll have that 10 months or so in between so people have changed, things will happen in their lives, we'll learn a little bit more about them but again we're just going to be--
Clocking in at 7 a.m. Is it airing in July? Is that when you're going to release it? No, the intent is to be on the same time, which is in mid to early January, which is when we premiered this year. Fantastic. Anything else you want to tell us about that you got going on in your life? No, just this has been a real pleasure. And I just can't thank enough all of the medical people who work with us and the people we've heard from in the medical community who are now telling us things about their lives and
Just the next time you go into an emergency room, be patient because there's a lot going on. And remember that most of the people there saved lives all through COVID and took risk their own life every day. Yeah. And as you pointed out, you know, there was a lot of banging of the pans and a lot of celebration of those health care workers early on. But then, you know, it got tough. It got really tough. It's almost like people's patients wore out despite the fact that the virus was still there. And
I don't know, I think the show resonates with people for so many reasons, but the idea that you guys decided to dive right back into something that a lot of people would just as soon have forgotten, I think is very admirable. And it worked. I appreciate it. Thank you. It worked for you guys.
Chasing Life is a production of CNN Audio. Our podcast is produced by Aaron Mathewson, Jennifer Lai, Grace Walker, Lori Gallaretta, Jesse Remedios, Sophia Sanchez, and Kira Dering. Andrea Kane is our medical writer. Our senior producer is Dan Bloom. Amanda Seeley is our showrunner. Dan DeZula is our technical director. And the executive producer of CNN Audio is Steve Liktai.
With support from Jamis Andrest, John D'Onora, Haley Thomas, Alex Manasseri, Robert Mathers, Lainey Steinhardt, Nicole Pesaru, and Lisa Namara. Special thanks to Ben Tinker and Nadia Kanang of CNN Health and Wendy Brundage.
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This week on The Assignment with me, Adi Cornish. This week is the White House Correspondents' Dinner, and needless to say, with the decision to cancel the traditional comedy roast from the program, the vibes are off. What is even funny anymore when it comes to politics? Who gets to decide which comedians are the truth-tellers of the moment? And who's laughing now?
Listen to The Assignment with me, Audie Cornish, streaming now on your favorite podcast app.