'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 a hundred hours. Every week, spend a lot of time in operating rooms, spend a lotta time in emergency rooms. And I gotta tell ya, there's nowhere else quite like it. You never know what's gonna 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 gonna be saved and sometimes lives will be lost. 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 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 Gray's Anatomy, especially with my teenage daughters. And then I heard about this show, The Pitt. I didn't know what to make of it. I didn' even know what that meant. Did that mean The Pitt, 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 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's 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 Pitt 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 healthcare policy discussions overall. The Pitt 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 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 Macs, 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 statements. 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 hear 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 Pitt. 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 to a shift, what we actually asked 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 was 30 years, has been a 30-year emergency room attending, you know, at UCLA and at 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 is in the writers' room with Dr. Jo. And then, we have nine working ER nurses who are in the show as all of our regular When you see 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 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 the sort of coming out of COVID and, you know, I was very immersed in COVID and I, 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.

Really want. There are scenes in the in the piece that show Dr. Robbie's played by Noel Wiley in full, you know, 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. And, you know, so all of that kind of attention to detail, everyone was very supportive of. I mean, you know, I like to talk about, and I may sound a little overblown in this, but, you know, if there were... I think the Kaiser Health News and Foundation found out that we lost 3600 US health care 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 docu-series, 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 healthcare workers, and yet you wanna 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 you know, prosthetics, and 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 documentaries, 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 feel it, and people at the beginning had always told me they were closing, you know, 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 are 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 writers' 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 are lines like that that you thought about, and if so, can you share any of those?

Well, there's always been, 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. That you didn't also see successes. You didn't 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 nobody ever told us not to do it, but we knew not to. You know, a child at an episode for 15 episodes.

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 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 also the 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 Gemmell, 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 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 seen things online that it spurred people to talk to their parents and 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, of the parent who's dying or should be taken I support, you know, a way in which to deal with that. Which was beautiful, I'd never heard it before a Hawaiian saying. And you know those kinds of things when we can, that gets us into this human experience. You know, 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 is 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've been part of it, yeah. No, look, I- No, it takes a while, you know, you don't, you really don't. We're sort of the last to know a lot of times because we're in the writer's room or we're on stage, we're working and you start to hear people sending texts saying, really loved your show or I'm really into it or, you now, but it's all still settling in on us that there's an audience that's responded 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. 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, you know, and some silly things like on the max site, you can see the top 10 of who's watching. So every morning I'd get up and check and see where we were in the top 10 and what people are watching. But mostly, yeah, it's word of mouth. And we get word of 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 are 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 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 wanna 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 restraints.

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 know, you can look up right now, you could 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, you know, 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, I don't know. It's all photographed on set. It's prosthetics and done in camera. So it's that real.

Okay, we're gonna 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 Pitt. 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, and yet I think there's these messages that you're trying to impart. Certainly with The Pitt, 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 the show, Bill Broyles, insisted upon us actually talking to real vets and getting their real stories. 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 the thing, whether they'd be on the West Wing with all of the various. Political advisors that we had that worked on the shows who were out or on ER or The Pitt or China Beach, they tell you the stories and you don't have to reach for advocacy. You don't to try and find a theme in the room that we're then gonna try and do because in the case of The Pitt, the medicine itself and what the experiences are that people tell you turn towards that advocacy. One of the examples on The Pitt is that One of the things we started here 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 right 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 emergency room are the people that have the unenviable job of actually trying to save people who've been. And so you don't have to be, we're not, we've never said gun control. We never talked about, we were 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. What are you talking about?

Right, right.

So yeah, so you got to get if you start to have the conversations with the people really do it you you get all these different points of view and you don't have to try and You just present what the ramifications are some of the decisions we make and what 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.

All of them and 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 and

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 counter argument? 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? 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 anticipate.

Dissipating it, and I assume at some point we will.

'Anti-vaxxers or Second Amendment folks, anything.

Happened 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 gonna be on max now for years. And so people are gonna start to catch up to it more. And, you know, when we were doing West Wing, almost every Friday morning, I get a letter from Senator Ted Stevens of Alaska's office, who never missed an episode and then would argue with me about whatever, whatever we had on the show, but in a... His position was, I'm gonna tell you what my position is on this. I'm not telling you wrong. I'm just saying there is another point of view and I wanna tell you what that other point of you 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 healthcare 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 throw up. He's great at suturing. 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 actor's ribs that you're trying to do CPR with. That's the biggest criticism we always get is, you know, we're not risking heartbreak, right, or whatever, but we're also not hurting any of 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 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 dialog and we don't, we try really hard not to dumb down that medical dialog. So it's doctors talking to doctors or nurses talking to nurses and doctors. But you're doing that and you're also, you know, trying to do some very specific medical procedures. So, you now, which involves a lot of you know 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 dialog 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 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 a 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 schedule on every hour of when their meal's gonna come, when their x-rays are coming back, when they'll get it. 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 relationship between the physician's 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 healthcare 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. 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 Fourth of July.

I imagine we'll see some fireworks quite literally and injuries. What any other scoop you can give us and what you got planned?

You know, I'm not trying to be coy. We just really are back in the writer's room and Scott Gemmell, 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 fall shift, which is what we had last time. And so we'll have that 10 months or so in between so people will change, things will happen in their lives, we'll learn a little bit more about them. But again, we're gonna be clocking in at 7 a.m.

Is it airing in July? Is that when you're gonna release it?

No, it'll the intent is to be on the same time which is in mid to early January. Okay, 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 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 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, maybe 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. It worked for you guys. Chasing Life is a production of CNN Audio. Our podcast is produced by Aaron Mathewson, Jennifer Lai, Grace Walker, Laurie Galereta, Jesse Remedios, Sofia Sanchez, and Kyra Dahring. Andrea Kane is our medical writer. Our senior producer is Dan Bloom. Amanda Sealy is our showrunner. Dan DeZula is our technical director, and the executive producer of CNN audio is Steve Lichtai. With support from Jameis Andrest, John Dianora, Haley Thomas. Alex Manassari, Robert Mathers, Lainey Steinhardt, Nicole Pesaru, and Lisa Namara. Special thanks to Ben Tinker and Nadia Kounang of CNN Health and Wendy Brundige.