“Are you fucking kidding me?” That is both Dr. Abbot reacting to ICE’s ED invasion and Jesse’s subsequent arrest and the day shift response to the nighttime attending’s first set of directives. They’ll have to electronically enter every chart from the five dark hours of the Pitt’s lo-fi era. So while Kwon bailed last episode, and Ogilvie is still upstairs scrubbing in on his patient’s surgery, Whitaker and Santos start the scanning slog while Pitt night fever faves like doctors Ellis and Shen start their work on patients. Abbot’s also happy to see R4 Dr. Crus Henderson (Luke Tennie) as his shift’s senior resident. Mess? What mess? “Night shift’s on ‘Crus’ control.”

Orlando Diaz has also returned to the ED, even worse for wear. The laborer with a diabetes flare-up had “eloped,” despite Dr. Mohan’s protestations, and reported to his second job as a security guard. But he passed out, fell 20 feet, and is now in a trauma bay with a serious brain injury. And as treatment begins, despite his circumstances, Orlando’s might be one of the most interesting cases presented on this season of The Pitt. Mary McCormack enters the fray as Dr. Linda Conley, chief of neurosurgery, and though she balks – still dwelling on “Not good enough, nepo baby” – Robby pushes Victoria Javadi to assist. (He wants her to believe in her emergency medicine skills, not take a residency in dermatology.) The brain surgeon who says it’s not brain surgery hands her a manual skull drill. Javadi’s eyes are wide as she begins and Dr. Conley does play-by-play.

Opening an access point on Mr. Diaz’s skull, feeding in a tube to treat intracranial pressure, and stabilizing his condition: it’s sensitive, crazy-looking, and totally fascinating. But it will be weeks until they know whether Orlando will recover, or be permanently disabled. Noelle Hastings appears and says this weighty development could bump the Diaz family back onto Medicaid coverage. But Samira is hurt she couldn’t do more, and frustrated it came to this. “He said he couldn’t afford to lose a paycheck.” Look at the mess he’s in now.

Ogilvie is dazed, crying, and covered in blood. Nurse Emma is departing for the day when she discovers him slumped in the loading dock. Austin Green (Johnny Sneed), the English teacher who the med student connected with over a James Baldwin Penguin paperback, died in surgery upstairs, and it totally broke him. He tells Whitaker the Pitt’s relentless onslaught of death and suffering isn’t for him; maybe pedes, or private practice. But Whitaker tells him to go home and reconsider. As careworkers, they do their best, but the fact is people die. You try to accept it, but there is no getting used to it. And maybe, like him, Ogilvie will learn to steer into it. “I like being here for people on the worst days of their lives.”

Dr. Al-Hashimi has drifted again. She’s in an Above Patient Scrum and recommending treatment when staffers notice her latest unexplained freeze, including Robby. He quizzes Mohan on her time with Dr. Al at the VA, and learns about her similar episode from the start of their shift. But when Robby asks the incoming attending directly – “Anything I need to know?” – she is not forthcoming.

And as we all probably suspected, there is bad news about Duke. Robby’s consult with Dr. Clay Barrett (Geoffrey Owens) over the CT results for his mechanic pal indicates a potentially fatal ascending aortic aneurysm, and this sets him off. “Fuck!” This, as he’s still lingering in the central work area and in no way preparing to ride off for months. But it’s not just Duke’s plight. It never was. In her latest Robby intervention, Dana shifts from the tough talk of their ambulance bay throwdown to speechless worry, as it all tumbles out of the senior attending. The past 12 hours of managing a mess that is made still larger because of his own flagging mental health.

“It’s not just Duke. I’m not sure that Dr. Al-Hashimi is fit to run this place. I also don’t know if Langdon is going to relapse. I don’t know if Whitaker is gonna to be able to take care of my shit. I don’t know if Javadi‘s gonna give up on what she’s good at, or if Samira’s gonna flame out because of some bullshit with her mother.” There is more. “I don’t know about you – running around with a full syringe of Versed in your pocket. I’m worried about the people I care about.”

They’ll manage! They always do! But Robby’s not hearing Dana. And he’s tearing up as he walks off. What happens to the people he cares about if never comes back? And does he mean to the ED, or life in general?

Nurse’s Desk for Season 2 Episode 13 of The Pitt (“7:00PM”):

• Robby also hugs it out with Noelle. Even if what she calls his “vision quest” is currently stuck in park. He flips Abbot the bird as his friend notes their flirtatious farewells.

• McKay knows Santos “has a way of figuring out the weird stuff,” and sure enough, she traces a new patient’s liver issues back to her healthmaxxing mass amounts of turmeric. Fast fact: the patient, Ashley Davis, is played by actress Sara Wyle, Noah Wyle’s real-life wife.

• Dignitymaxxing for Mr. Digby! Dana and young Nurse Emma give him a shave and a haircut, and listen as he shares stories of his life, which is fuller than his unhoused status might suggest.

• And Mel King is there again for her favorite colleague. “That which does not kill me makes me stronger,” she answers to Frank Langdon’s self-doubt, that he returned too soon. He attributes her encouraging quote to Friedrich Nietzsche. And Mel – Mel! – is like sure, but also Kelly Clarkson.

Johnny Loftus (@johnnyloftus.bsky.social) is a Chicago-based writer. A veteran of the alternative weekly trenches, his work has also appeared in Entertainment Weekly, Pitchfork, The All Music Guide, and The Village Voice.