Shakedown Street

Trying to shake the persisting art block with a brand new AU (for me at least) - Restaurant AU. 

Head/Exec Chef Robby and his Sous Chef Jack like to get in a bit early to get the ball rolling on service prep. It gives them a little bit of time to just decompress and spend some time together before the controlled chaos of the night gets well and truly underway.

Won't You Stay With Me

A series of fanart pieces by @qedart

anyways this was one of my favorite scenes of the season and hit like a gut punch.

Throughout season one, Samira's repeatedly shown to be an excellent physician. She's thoughtful, clinically skilled, observant, deeply empathetic, and willing to spend the time necessary to understand the person sitting in front of her rather than simply the presenting complaint. None of those qualities are ever portrayed as weaknesses - rather, they're among her greatest strengths as a doctor. To many, she may even be the ideal type of doctor - her patient satisfaction scores are presented as an indication of that. And when Gloria gets on Robby's case about improving patient satisfaction scores and turnover rates, leading him to begrudgingly instruct other characters to prioritise those same goals, there's a sense of validation because Samira's style of practising medicine is what the system is asking for. But there's almost a catch-22 element to this as well - Gloria is asking Robby to improve patient satisfaction and patient throughput, and, efficiency and waiting times. In an ideal world, those goals can absolutely coexist - if a department is adequately staffed, well-funded, and functioning smoothly. But The Pitt isn't depicting an ideal world. It's depicting the reality of the American healthcare system through an overcrowded ED, where staff are already stretched thin and the department is already underfunded. Once resources become constrained, every extra minute spent on one patient is a minute that can't be spent on another - even when those extra minutes with a single patient (like the mercury poison case) are needed. To me, Samira is almost exposing the contradiction built into the system. She's almost functioning as a stress test - if one physician attempts to provide the level of attention patients consistently say they want, the system immediately begins pushing back because it can't absorb that level of care across every patient.

Because the reality of an emergency department is that it's not simply a collection of individual doctor-patient interactions. It's a complex system that has to balance competing priorities simultaneously: quality of care, patient safety, waiting times, staffing shortages, patient turnover, resource allocation, overcrowding, and countless unpredictable emergencies. So the irony lies in the disconnect between what the metrics celebrate and what the ED (in its current state) may actually need in a high-volume, high-risk environment: therefore, Samira's excellence at the individual level may not naturally translate into efficiency or benefit at the system level. My takeaway from season one - though I can accept this may not have been the intention - was that the show was utilising Samira to illustrate that even exceptional care can create trade-offs when viewed in the context of complex systems like EM. The show is asking questions like: should deep individualised care be prioritised over maintaining access for many? How do we find the balance between the methods of care preferred by patients with what may be ideal for the department as a whole? It almost becomes a 'few versus the many' concept.

And I think when you look at Samira's season one storyline through this lens, the argument for sustainability and burnout and disillusionment, and whether EM is the right fit for her, becomes easier to connect. Because Samira does adapt throughout the season; she works to the required standards during traumas and, during the MCI, we see her rise to the occasion, practising medicine at pace and excelling. But the vast majority of emergency medicine aren't various MCIs. It's shift after shift of managing a constant stream of patients with more ordinary emergency care needs - and these are the cases where she's said to fall behind. Samira's also the only character (I think) that we see turn a little manic after the event, and then experience a, likely mental, emotional, and physical, post-adrenaline crash. We don't see anyone else react in such a way - the other characters are mostly shown to be tired and drained and a bit traumatised, but Samira going from manic and energised to crying from the release of all the adrenaline (not just from working through an MCI, but also spending a shift actively working against her natural inclination of being slower and more methodical), I think, is intentional. So then the question becomes (again, I think) to what extent should a physician have to adapt themselves and their preferred style of providing care to better accommodate the system? Because yes, Samira can adapt: she can get faster, she can see more patients, she can compromise on her thoroughness, she can tone back the extent of empathy she imparts on her patients, she can rewire entire aspects of her values and her own self - she can absolutely do that. But should she have to? What are the costs of the adaptation? In the long term, would that level of adaptation become detrimental to her wellbeing? Would it be sustainable? Would she continue to find the same sense of purpose in medicine?

Samira's shown to be naturally more inclined to practice medicine in a slower, more deliberate, more emotionally engaged way, but is being asked to function in a system that rewards speed, rapid turnover, and emotional compartmentalisation. So to meet these requirements, she likely has to work against her natural pace, potentially truncate the kind of care she values, or push herself into high-speed mode more often than she's comfortable with. We know that this change was something Samira was resisting for most of her residency up until we meet her in season one, where she's decided that she'll 'speed up'. But this kind of values-based change (especially when that 'value' was internalised as a result of a deeply personal loss) can take a toll on someone's mental and emotional wellbeing, turning into a type of burnout - burnout not just through working to excessive demands, but through a sustained mismatch between your values / working style and what your environment demands. This is something that, I think (and if the show was intending to take her in this direction), Samira could have been vulnerable to if she continued on the adaptation path. The breakdown scene could have been a really interesting early indication of this path, because it suggests that she can operate in the way the system demands, but it's not her baseline, and doing it repeatedly may not be sustainable.

sometimes they're covered in blood but don't worry it usually doesn't belong to themselves 😊

enforcer Jack & mob doc Robby has a stranglehold on me ok

Vid under cut / get one for urself

The overall parallelism between the two of them is enough to make me want to scream, and if we were talking about any sort of ancient tragedy, they would 100% be coded as character mirrors. Now, obviously The Pitt is a modern medical drama and not something written for a bunch of Greeks to perform in front of an audience. HOWEVER, Robby and Jack are 100% exactly that.

Robby is the cool, chilly, dying days of Autumn. Fiery and brilliant like the abundance of color collected on trees and bushes even as the flowerbeds decay at your feet. The leaves fall–softly at first–and then all at once like the sobbing tears of a child clinging to the skirts of their mother as she walks out the front door for the last time. Still, the evergreens light up the world with a spattering of green even as everything else turns red and gold and orange…then brown and grey and dead. Like nights of bonfires with friends filled with laughter and joy, and then brushfires of dry leaves—wild and untamed and destructive. The first cold day where the sweaters feel warm and cozy and welcome, and then the first frost where even the sunflowers wilt and droop and die. Grey mornings of gloomy drizzle and freezing air warmed by black coffee and thick oatmeal. Family holidays with no one else seated at the table but there's a friend willing to drink hot cider that upcoming weekend. Frayed scarves and holey gloves that can no longer keep you warm but contain memories of kind hands and apple strudel and prayers in languages you barely remember. 

Two dicotomies. Two men. And depending on how you view it, one is always chasing the other.

But there is no way you can have one without having the other. There is no life without death, as there is no death without life.