Nothing Sounds as Good as The Pitt

“It was harder for a lot of our partners to really embrace it,” says Wells. “Just because, historically, [a score] has been very useful to tell the audience what they’re supposed to feel. And we felt strongly that we wanted to depend upon the audience’s intelligence to understand what it is. We kept talking about this as a documentary ride-along where you’re coming into the emergency room and you’re just following these doctors, and that anything that got in between that experience was going to be detrimental to what it was we were trying to achieve.”

That barely mediated exchange between you and the myriad traumas happening on The Pitt really jerks all the tears. Every episode mercilessly redeploys you back into the middle of an overworked, understaffed emergency room dealing with fentanyl overdoses, mass shooting events, miscarriages, seizures, childbirth, and child death.

You can feel the proximity of the hospital with the camera’s kinetic, handheld, vérité style. And because there are no conventional establishing shots or scene transitions, there really is no need for a music cue to move the viewer along. Instead of a score, we hear the whirring of an ECMO machine, gurneys wheeling around corners, joints being popped back into place, eye sockets being drained of blood, EKG machines bleep-blooping, ankle monitor alarms going off, or the distant keening wails of a grieving mother. This is the real score of The Pitt.

“One of the advantages to using a [traditional] score is you can use it to cover up a thinner sound design,” admits Wells. “So we knew from the beginning that if we were going to have no music or very, very minimal sound, that the sound design itself was going to have to be much more extensive. When you’re in these chaotic environments, your brain is making choices about what you hear. And so that meant we had a much more extensive sound palette to work with.”

Wells and Gemmill created several extra layers to the show’s sound design with the help of writer and producer Joe Sachs, who is also a medical professional in real life. Sachs sat down with real nurses, who incidentally also populate the background of the show, and recorded what they would talk about in the ER. Then they gave that to the background actors who would record it.

“So there’s all these specific conversations in the background. It’s not just phones ringing, or carts going past, or people ‘blah blah blah’-ing. It’s layered in the space with the score and the foreground dialog. There’s a tremendous amount of time and energy put into making it sound absolutely natural.”