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Emergency 24/7 doctor gives their verdict on accuracy of HBO's The Pitt: "Emotion runs high"
Cameras reveal the expertise and workload of an emergency department in Bristol, but how do its dedicated staff deal with the stress?
Warrick Page/HBO Max
- Kate Battersby
Published: Tuesday, 11 August 2026 at 12:01 am
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This article first appeared in Radio Times magazine.
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Dr Natalia Ermalai can’t remember a time when her heart wasn’t set on joining the medical profession. “I knew it at age five,” says the neurosurgical registrar. “I wanted to be a doctor so I could help people. Now I’ve been practising neurosurgery for 14 years, and I still haven’t lost that feeling.”
Emergency medicine registrar Dr Tom Roberts – who with Dr Ermalai features in a new documentary series filmed inside the emergency department at Southmead Hospital, Bristol – found his passion in his teens.
“I realised at 17 that I wanted to use my education for something really positive,” he says. “For those of us in emergency medicine, you meet so many people on some of the worst days of their lives, and your skills help them get better. It’s a real privilege.”
In Emergency 24/7, viewers witness the everyday pressures and complex teamwork among the multi-departmental trauma team, consultants, surgeons and nursing staff who care for patients from diagnosis to subsequent treatment, encountering everything from amputations to serious burns.
A colleague, Dr Reston Smith has the challenging job of treating a man who stepped in front of a train. He’s also seen carefully explaining all that’s happening with the patient to his relatives in a private room. Meanwhile, Dr Roberts treats a man with an apparent stab wound.
Dr Natalia Ermalai (left) and Dr Neil Upadhyay in Emergency 24/7. BBC/Expectation TV
The programme makers undertook a lengthy consultation process with the hospital, run by Bristol NHS Foundation Trust, and dozens of its staff before filming began. Despite the presence of cameras, all three doctors manage to retain their professional focus as normal.
“When I explain what my job is to friends who aren’t medical, they perceive it as extraordinary and very stressful,” says Dr Smith. “Parts of my job are indeed extremely stressful, and there are times where I feel under enormous pressure. But I’ve trained for a long time to do this work. My experience and expertise allow me to do it.”
Dr Roberts elaborates: “You aren’t exposed to the most critically unwell patients on day one of your training. Years and years are spent getting accustomed to the pace of work and, ultimately, you just do it.”
Sometimes a patient has to be told very soon after admission that their condition requires urgent surgery, the outcome of which may be uncertain. Viewers see Dr Ermalai explaining to a 26-year-old motorcyclist that his road accident means he now faces possible paralysis.
“Giving news, including bad news, is part of our training,” she says. “I try to understand a little about the individual patient as a person, because everyone receives this type of news differently. Then my aim is always to be honest, to show compassion and tell the patient the truth – to tell them what I can do and what I cannot do.”
Inevitably, there are times where the most skilful treatment and care don’t achieve what is hoped for. “We have to accept we aren’t omnipotent,” says Smith who, like Roberts, is married with a young family. “We do everything we can, yet there are times where that just isn’t enough and that’s really hard. It can take a toll on your personal life.
Katherine LaNasa, Noah Wyle, Patrick Ball and Sepideh Moafi in The Pitt. Warrick Page/HBO Max
“There’s an emotional burden that comes with looking after people, when what you do doesn’t work. Part of what makes a good healthcare professional is being human, so of course you are affected. I know there are times where I can’t be at my best at home because of what I’ve experienced at work.”
Colleagues lean on one another at these times, and further support is available when wanted.
“Certain cases you’ll always reflect on and never forget,” says Dr Roberts. “We all have to accept that at some point we’re going to need time and maybe professional help to get through the most traumatic of cases. There’s lots of psychological support for months afterwards, if needed. The distress and trauma associated with working in emergency care can have significant effects on individuals.”
It makes downtime especially important. For Dr Roberts, that can even mean watching the garlanded US medical television drama, The Pitt.
“It’s such a powerful representation of the challenges we face that you can use The Pitt almost as an educational tool,” he says. “The unrealistic part is that it’s all of the cases you’d expect to see in a career, combined into one shift. But people in medicine really like the challenges the characters face, and the way they interact as a team.”
The Pitt, like the documentary series itself, features an increasingly familiar facet of emergency departments – the abuse of staff. Yet when asked about it, all three Southmead Hospital clinicians respond with generous empathy for the possible reasons behind it.
“I do see aggression and violence towards staff,” says Dr Smith. “We see a lot of people whose injuries mean they’re extremely frustrated. Emotion runs high. It makes me sad that people feel they have no other option than to display violence.”
Dr Reston Smith in in Emergency 24/7. BBC/BBC/Expectation TV/Drew Forsyth
It seems a marked contrast to Covid times, when the public applauded the life-saving work of the NHS from their doorsteps each week.
“Honestly, I still feel that respect for the NHS from the public,” says Dr Ermalai. “The only difference is that people aren’t clapping us any more. People are still very grateful for what we do.
“I’m from Romania, and I have worked in many places. There is no better organisation in the world than the NHS. I cannot see a future without it. Nothing can replace it.”
Her implicit reference to the future of the NHS is made without prompting. Roberts does the same. “I love that everyone gets treated by priority, according to your need,” he says. “That’s a huge testament to what the NHS means for the nation. If it were ever to go, it would be to the detriment of people in the UK.”
Smith concurs: “I would hope the silent majority would find their voice if the NHS were under threat. Despite its limitations, we should be proud of it.”
Emergency 24/7 airs Tuesday 18 August at 9pm on BBC Two and BBC iPlayer.
You can watch the first two series of The Pitt on HBO Max.
The latest issue of Radio Times is out on Tuesday – subscribe here.
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Authors
Kate Battersby
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