Dr. Jack Abbot quotes from The Pitt

Abbot

Okay, nipples to navel is no man's land. If he got shot while exhaling, the bullet possibly passed below the diaphragm.

Abbot

Sir! We are gonna get you more pain meds, but you need to shut your fuckin' mouth.

Robinavitch

This is how it's going to work. Our ambulance bay is now our Triage. EMS will be overwhelmed. Most will probably arrive by car, several victims per vehicle. For all you newbies that don't know, Dr. Shen is our night shift attending. John, I'm gonna put you on Point Triage.

Cool.

Robinavitch

Triage will decide who goes where depending on their injury.

Abbot

Every department will have a designated primary who will oversee their staff. If you need someone, look for the vest. We're all gonna have walkies. We can get you whatever you need.

Robinavitch

No patient goes into a room unless it's a trauma bay, and they will have four patients each. We need to keep everybody out in the open so we can keep an eye on everything, OK? Triage is gonna assess and assign every patient to a specific zone with a colored slap band. Patient who comes in with a red slap band goes to the Red Zone, which is the trauma rooms, with overflow out here. These are the most critical patients who will die without immediate attention. Samira, where are you? You are here with Dr. Abbot and me. Jack's gonna run traffic.

Abbot

We have five minutes to try and stabilize the reds. After that, it's OR, ICU, or morgue.

Robinavitch

The south and central common area over there will be the Pink Zone. That is for patients who will die in under an hour without treatment. McKay and Javadi, you are over there, with help from incoming night shift and surgical staff. Yellow Zone is the North Corridor. Those are gonna be mostly extremity wounds good vitals, talking. Mel, you're gonna run point there with Santos and Whitaker.

King

Uh, what if what if there's a-a pulseless extremity?

Abbot

Oh, if you if you can't feel a pulse, check for Doppler flow with this. It's a mini-ultrasound. Follow the screen prompts.

Robinavitch

But a yellow can change to a red if they go south. You got to stay on top of them, even if they seem stable.

King

OK, yeah.

Robinavitch

You got this, Dr. King. Green minor lacs and sprains. They go to Family Medicine. Black and white bands are DOA, imminent death. Pedes is now our morgue. Let's hope we don't get too many of these.

Abbot

We're a MASH unit now. There's no charting, no electronic medical records, no board.

McKay

How do we document treatment?

Abbot

Oh, you'll all get Sharpies, and every patient has a wrist chart to document treatment and procedures. You run out of room, write on the patient's forehead.

McKay

Really?

Abbot

Yeah, really.

Robinavitch

Each wrist chart has a unique mass-casualty-incident barcode and patient number. That's how the patients are gonna get identified.

Abbot

This is no-frills combat-zone medicine. No ultrasound, no X-rays, no CT, no labs. Assess based on mental status and pulse strength. Every critical patient gets an IO, intubation, a unit of blood and chest tube if needed. Everything you need blood, drugs, bandages everything will be in the Behavioral Health rooms. That's our supply depot. Um oh, keep a couple of 11 blades in your pocket. Goal is to resuscitate ASAP so they'll make it upstairs for definitive care.

Robinavitch

Trauma surgery and neurosurgery will decide who goes up to the OR immediately and who goes to the ICU for further treatment and evaluation. Communicate. Ask for help if you need it. Trust your attendings. We will get through this together.

Abbot

Damn right we will.

Abbot

Deaver retractor.

Named for John Blair Deaver, Philadelphia surgeon who revolutionized abdominal surgery in the early 1900s.

Abbot

I'm surrounded by med nerds.

I went to med school at Penn. I walked by his portrait every day. Dude did, like, 100,000 surgeries.

SWAT? Really?

Abbot

I suck at golf.

You spend time in the Middle East?

Abbot

More than I would have liked.

I worked in Kabul with Médecins Sans Frontières, and in 2020 at the maternity hospital. I met the most incredible, bravest doctors there.

Abbot

Dashte Barchi. Tragedy. [sighs] We should grab a beer sometime. Share war stories.

I'd like that. [walks out, leaving Abbot and Robby]

Abbot

[to Robby] She seems cool.

Abbot

We are the Night Crawlers! We deal with the weirdest and the wildest because…

We are the weirdest and the wildest of them all!

Abbot

That is right, and tonight they are really gonna be crawling. Now go get some!

HOOAH!

Abbot

You want to know why I never killed myself? After what I saw, lived through? Losing my leg, losing...my wife? Because it comes for all of us, man. You and I know it more than most. We see it every shift, but we can't let ourselves succumb to it. Yes, life can suck. It can be unbearable and-and-and brutal and ugly and heartbreaking; but it's also beautiful, and hilarious, and that woman today, her baby? They'd both be in the morgue if you hadn't been here. That's us. That's you and me. That's what we're here for.

Robby

The most important things I've ever done in my life have been in this hospital. Nothing will ever matter more than what I've done in this hospital, but it is killing me. You know how they say that a part of you dies when you lose someone you love? I'm not convinced that a part of you doesn't die every time you see a fellow human pass. And I've seen so many people die that I feel like it's leaching something from my soul.

Abbot

Go on a cruise, man. Knock off this helmet-less motorcycle shit. Yeah, people talk. That's death wish behavior.

Robby

I'm tired of being a role model. Tired of feeling like you can't get ahead. Tired of feeling like I'm drowning every day. Tired of all of it.

Abbot

You need to get away for a while. You need to get some help. You need this place as much as it needs you.

Robby

Am I fucked up?

Abbot

100 percent. But nobody works here as long as you and me and doesn't get screwed up. You've gotta find somebody to help you dance through the darkness.

Robby

[pause] Did you just make that up?

Abbot

Maybe it's a song lyric. I don't know. Maybe my therapist said it.