Fans and critics alike are praising the HBO Max television show “The Pitt” for its realistic portrayal of the inner workings of a busy urban emergency department, the patients it serves, the bureaucratic limitations of emergency medicine, and the physical and emotional toll the profession can take on its practitioners.

The show, which recently completed its second season, has garnered a host of awards, including the primetime Emmy Award for outstanding drama series.

Auna Leatham, an emergency physician at UCHealth Memorial Hospital Central, generally steers clear of television shows about hospitals. As a career emergency specialist, she has a hard time watching televised depictions of what she sees every day on the job.

From the moment Leatham began watching “The Pitt,” though, she found a level of accuracy and detail that could only come from a show written and produced by medical personnel. The series portrays difficult conversations with family members, communication between staff members, and occasional administrative battles that have less to do with medicine than the financial bottom line – all of which rang true for Leatham.

In fact, she initially wondered why anyone outside her profession would enjoy the show.

“It’s so medically and technically correct, I’m surprised people enjoy it as much as they do,” she said.

According to Leatham, who has been practicing emergency medicine for 14 years, “The Pitt” gets it right far more often than not.

“We feel totally seen by this show,” she said. “Our whole job is to get to know a patient really quickly, do what we can to help that person, and then end that relationship and move on quickly to the next one. That emotional intensity is captured really well in ‘The Pitt.’”

Set in the fictional Pittsburgh Trauma Medical Center, each season of the show is split into 15 episodes, each depicting one hour of a particularly busy day in an urban Level 1 trauma center. The highest-level designation in U.S. trauma centers, Level 1 hospitals treat the most serious and complex injuries.

As the only Level I trauma center in southern Colorado, Memorial Central sees “all kinds of bad stuff,” Leatham said.

“We are a busy emergency department,” she said. “I’ll put somebody’s (dislocated) shoulder back in the socket, then walk into a room for a cardiac arrest, then call surgery for a gallbladder, then move on to a rollover crash where three people got ejected. That’s normal.”

Gunshot wounds, depicted with gruesome accuracy in the HBO Max drama, are also a grim reality for Memorial Central staffers. On Nov. 19, 2022, when a gunman opened fire with a rifle inside Club Q, killing five people and wounding dozens more, the emergency department treated 12 gunshot victims, all of whom survived their injuries.

When all the patients were stabilized and taken to surgery, the staff members didn’t have time to decompress, or to contemplate the violence that brought a dozen shooting victims to their emergency department. As always, other patients needed their help.

“So I took a deep breath, and I got back to work,” said former Memorial Central physician Dr. Katy Picard in a 2022 interview with The Gazette.

The near-constant movement between patients in varying degrees of distress — from, say, a patient in cardiac arrest to a child with a persistent runny nose — can induce a kind of psychological whiplash that can lead to burnout among health care professionals, Leatham said.

“(Our staff members) give a piece of themselves to every patient they see,” she said. “All of us have told somebody that their child is dead, and then walked into the next room to talk to someone else about their belly pain. It can be difficult to take.”

Julianna Thede, an emergency department charge nurse, agrees.

“There’s a lot of burnout in this job because of how busy we are,” Thede said. “We see people 24/7, whether we have beds or not. It can be a lot.”

Like Leatham, Thede has made a habit of avoiding most medical shows because “they get a lot of things wrong.” But “The Pitt” has become appointment television for her and her daughter.

“She didn’t believe a lot of the stuff that we do until she watched the show,” Thede said. “’The Pitt’ gets a lot of things right, from the way doctors talk to patients and family members, to the teamwork aspect of emergency medicine. It also deals with workplace violence, which is very real.”

According to the Bureau of Labor Statistics, about 1 in 4 nurses has been physically assaulted. Leatham and Thede believe those numbers are low, because they only represent assaults that have been reported.

“You often see patients on the worst day of their lives,” Thede said. “Many of them are scared, confused, and in pain. Unfortunately, sometimes they lash out.”

“To have people attack them physically and verbally is truly disheartening,” Leatham said. “People have left medicine because of it.”

The show also depicts the sheer volume of patients in an urban ER setting, including packed triage rooms, patients on gurneys in hallways, and patients complaining that they have been waiting for eight hours or more without being seen.

Overcrowding has been a nationwide problem for years, according to the American College of Emergency Physicians. More than 90% of emergency departments in the U.S. report crowded conditions.

When Leatham underwent training at Parkland Hospital in Dallas, patients sometimes waited more than 12 hours to be seen by a physician, she said.

“If you’re waiting, that’s good news,” she said. “You don’t want to be the person who gets rushed into the ER. That means you’re in trouble. But if you’ve been sitting in triage for 12 hours, you probably don’t want to hear that.”

On a typical day, the emergency room at Memorial Central sees an average of 270 patients a day, and Leatham herself sees roughly 4,000 patients a year, she said.

“We are lucky to have a really supportive team, and processes in place to get people where they need to go,” she said. “For instance, we have a doctor out front who sees patients within 10 minutes of arrival. So we don’t have patients languishing in the waiting room for eight to 10 hours like they do on the show.”

Even a detail-oriented show like “The Pitt” doesn’t always get it right, Thede and Leatham said.

In the first season, a charge nurse is violently assaulted by an angry patient. In season two, the nurse returns to work, but carries a syringe in her pocket to defend herself, or other staffers, from aggressive patients.

According to Thede, that would never happen in real life.

“Do we carry meds in our pocket? No. Never,” she said. “That’s how you lose your nursing license.”

To Leatham, the doctors on the show seem unusually adept at diagnosing illnesses, which doesn’t often happen in a real ER.

“That is not realistic,” she said. “We fix people, but we don’t diagnose. I often have to tell someone, ‘I’m so sorry I don’t know why you have belly pain, but I know it’s not something really bad, because I’ve ruled the really bad things out.’ But I do understand that doesn’t make for very good television.”

The highly rated drama has even made its way into the Memorial Central lexicon, Leatham said.

“When things get really hectic in the ER, someone will say, ‘We’re having a Pitt day,’” she said.

Season two of “The Pitt” sees its central character, veteran ER doctor Michael “Robby” Robinavitch, teetering on the edge of a mental health crisis. Burnout is real and pervasive among emergency department personnel; according to the American College of Emergency Physicians, more than 60% of emergency doctors and residents say they’ve experienced burnout at some point in their careers.

“Much of what we see — not just doctors, but nurses and techs as well — can be really tragic,” Leatham said. “It’s hard to take all that on. Our wellness committee is run by an ER physician, and we have all kinds of resources including a peer-to-peer support group so we can help protect each other.”

Working in the ER can be stressful, and even traumatic, but it can also be incredibly gratifying, Leatham said.

“Truly, this is the best job ever,” she said. “I’ve met incredible people and helped them in very difficult situations. We all have. I like that ‘The Pitt’ shows that part of the job.”