The Pitt Season 1 Episode 4 “10:00 A.M.” sees hospital staff betting on the fate of the stolen ambulance, Dr. Santos making a major mistake, some new patients whose stories have the potential to make some important social commentary, Mr. Spencer’s last breaths, and much more. It’s another hour that both makes it easy to get swept along for the ride…and kinda difficult to fully invest in more than a single plot point or character because there are just so many. One can’t help but wonder if having all 15 hours available at once to binge might have been helpful. Then again, if we stick with Dr. Robby and see just how difficult it is for him to navigate the seemingly-endless list of patients, maybe we can actually appreciate the week off between each of his shift’s hours.
It would certainly be great if our main character could get, like, a full five minutes to himself. But that’s clearly not on the menu. Even when he does get alone time, we’re pretty sure it doesn’t last quite that long. Not to mention, Robby’s “me” time is more like “OMG KILL ME NOW” time. So…yeah…
MORE: Having trouble keeping up with everything? (Same.) You can use our The Pitt Season 1 Episode 1 review, our The Pitt Season 1 Episode 2 review, and our The Pitt Season 1 Episode 3 review for some assistance!
“It’s not fair.”

In The Pitt Season 1 Episode 4, the Spencers finally let Dr. Robby extubate their dad, and even though his death could have dragged out for much longer, he takes his last breaths by the end of the 10:00 A.M. hour. That doesn’t mean the waiting isn’t still difficult, though. Without knowing how much time their dad has left, Jereme and Helen have to find a way to say goodbye. And Dr. Robby gives them some very simple-sounding advice: “I love you. Thank you. I forgive you. Please forgive me.” But it’s how the family expresses those things that winds up not being very simple at all.
When Jereme admits he’s “been doing all the talking” and encourages Helen to take her turn — while she still has a chance — she wants to know “what’s there to say” other than that she’s sad and angry. But once the words start, they don’t seem to want to stop. She admits that, not only is her dad’s death not fair, but also…nothing about her life with him was. Helen says she loves her dad, and she thanks him for everything he did to provide for the family. But…she admits she wanted what her dad and Jereme had. She wanted baseball, and models, and fishing; yet, she forgives him for not being the dad she wanted. In the moment, we might even think her dad snubbed her somehow, but that turns out not to be the case at all.
In fact, Helen’s “I forgive you” is really the start of her “please forgive me” because she admits to being embarrassed of him because he didn’t have a “grownup” enough job like all her friends’ parents did. Instead, Mr. Spencer helped build all the sets at Mr. Rogers’ Neighborhood. It’s why, according to Jereme, it’s “kinda perfect” for their dad to die “in a room with cartoon forest animals all over it” (as Helen had described the room during her last-minute bargaining before the extubation). By the end of her outpouring of emotion, Helen admits that the world being such a dark place means the work her dad did was “an incredible gift.”
But now, well, it’s too late. She doesn’t get to have that relationship with him like Jereme did. Because she simply can’t go back, just like nobody can in these situations. So, while Helen laments that they “could’ve gone fishing,” that’s not happening now. Because that’s…that’s life. And, more to the point, that’s death. It’s the end.
The whole journey from “I love you” to “Daddy, I am…so sorry. Please, please forgive me” is beautifully written. When it comes to expressing our emotions, our thoughts rarely follow a linear pattern. And, when it comes to trying to figure out how to say goodbye to a loved one in their final moments, what we have to say is going to be even less logical. Especially when we have so many regrets like Helen obviously does — which, realistically, most of us do in most situations.
Case in point: Focusing on fishing, specifically, isn’t necessarily Helen’s point. That single activity isn’t the end all, be all. And, yet, she mentions it more than once. She’s not upset about this one thing but all the missed opportunities she’s had because of staying away. And, yeah, maybe this one thing that her brother had so much fun doing with their dad could’ve been fun for her, too. But now, she’ll never know now. There’s so much she’ll never know.
Rebecca Tilney’s performance in The Pitt Season 1 Episode 4 is especially moving as she portrays a grown woman, losing the father she never quite let herself even have. Even earlier in the episode, when Helen appears as if she might actually change her mind and put the breaks on the extubation, that desperate, frantic bargaining against the very concept of death is brilliant. Then, as the character says her goodbyes, as Tilney starts and stops, trails off and starts again, and simply breaks at the end when she tearfully asks for forgiveness, the pain she portrays is so raw and real. So incredibly relatable.
Interestingly enough, even as Tilney helps us to feel Helen’s grief right along with her, the series’ perspective also stays firmly with Dr. Robby. So, we feel his empathy for her as if it is our own…we ache with both him and the patient’s family. But when Helen is in that bargaining stage of grief, we even might feel his frustration as he has to explain (yet again) why leaving his patient — her father — intubated is needlessly cruel.
That brings us to Noah Wyle. He’s as fantastic as ever throughout this hour. But his biggest moment in The Pitt Season 1 Episode 4 is, of course, the way he plays Dr. Robby’s reaction after giving Mr. Spencer some medication to help with his secretions. Robby absolutely cannot stay in that room as he tries to fight back against a flashback and quickly loses. So, he rushes out and loses it — but only for the briefest period of time. And it’s the little details that really make the moment make the most impact. The hands swiping across his eye on the way into the restroom, bracing himself against the wall as he curls in on himself, the heavy breathing…his expression and the way he shakes his head as he looks in the mirror. And those noises. A laugh with less than zero humor, followed by that…groan, we’ll call it?
In other news, if we thought about Dr. Carter seeing Sobricki again…no we didn’t. Because if we did, we’d have to say this was even better. Can’t have that.
More on The Pitt Season 1 Episode 4

- Again going to ask what the deal with Collins and Robby is. The whole “good! You shouldn’t have intubated” exchange turning into an offer of help, a refusal, and then…that concerned look when Dr. Robby leaves…interesting.
- “This is happening? Like now? Like — like today? We just decided that Dad is gonna die in this room? In a room with cartoon forest animals all over it?”
- Ok but the “gold star for you” is the one time I’ll go ahead and cheer on Dr. Santos’ total lack of social skills. Get her.
- “How thin is your skin?” “Rhino.” And then, the way Dr. Santos’ face…falls as Dr. Mohan tells her how her approach was all wrong and doesn’t even give her a chance to explain her perspective. Sooooo, thinking that “rhino” was a little bit, um, off.
- Also: What are the experiences??
- Good that he at least stopped to use the bathroom while he was in there. Finally.
- “Um. I need more coffee.” Same.
- Put the way Tasha reacts to Javadi fixing the errors in her chart together with the misgendering and incorrect name when they call her to give back her insurance card…so much better than how TV would’ve introduced a trans character back in the day. And really, correcting a name — not to mention, treating people like people — should be just that easy and just that much of a non-issue. But, well. Current horror show of a nation says otherwise.
- I wonder whether Javadi really gets it or is just naive enough to think there was really just a filing mistake in the system, though. The reaction to Dr. McKay calling it “cool” that she made the change…could go either way?
- “She likes you.” “I met her two hours ago.” “Must’ve made a strong first impression.”
- “Laughing our way to being a third world country…Remind you of home?” Shoutout to Mateo for not decking this guy, actually. What a racist piece of trash. And spoiler alert: It’s guys that look like that patient that are currently ruining the country. Oops.
- “Reflexes. I have regretted a few of my own.” Actually begging for McKay’s full backstory at this point.
- “Wow, beautiful moment. Lotta love in the room.” I laughed.
- Is Garcia actually being overly fair on Santos here just to upset Langdon? Did Santos really make a great first impression? Different teaching styles? What’s going on here?
- Kraken dude peeing on little Whitaker after he already had to change scrubs once…hilarious. At one point, he even looked like the little shrug dude, too. (¯\_(ツ)_/¯)
- But we feel bad anyway.
- “I know something about life changing.” Indeed.
- Trans women are women. By the way.
- Very interested to know what anti-choice, forced-birth nightmare of a state this Christy kid traveled from because that comment about leaving behind her alarm clock and the look she exchanged with Lynette…yeah…
- Also: very uncomfortable with Dr. Collins’ reaction to that ultrasound. Too many weeks in for the meds? Just struggling because of her own personal situation??? This is going to get bad, isn’t it?
- Everything is bad, is what I’m saying.
- “It’s not Shakespeare. Luke, the disciple. He probably heard it from Paul the apostle. But what do I know? I’m Jewish. It’s not my book. Shakespeare had nothing to do with it, though.” My people.
- The scene with Jenna and Nick’s parents is a lot. So much emotion from both Jenna and the parents. And his poor mom not even knowing who this girl is or what’s going on here.
- It’s like so much happens in this episode that also, aside from Mr. Spencer’s death…not a lot happens?
- “Do you know what a hymen is?” “…not really.” They taught us in, like, 5th grade.
- Oh, Mel. I that, to a doctor, that diagnosis counts as “good news” because it’s something that’s a relatively “easy” fix, but OMG. Sounds horrible, actually.
- “i hate to break it to you, but I run a tight ship with or without you.” “More fun with me, though, right? Jokes are better?” “Always. But your tell is? The hairier it gets, the funnier you get, and you are on fire today.” Ok first of all, I continue to love these easy, light walk and talk scenes with Dr. Robby and Dana. Second, that last part makes total sense after him saying he’s Jewish. We love us our dark humor! Should’ve known!
- The way his walking slows, and that fond smile disappears, and he hands over the coffee…Oof.
- The noise Helen makes because she knows.
- And we end with…the nice guy from the waiting area having a seizure? Seems bad!