Dr. Michael Robby Rabinavitch has to pee. The senior attending at Pittsburgh Trauma Medical Hospital played by Noah Wyle makes this announcement midway through the third episode of the Max medical drama The Pitt. Before he can get to the bathroom, however, he first has to oversee two simultaneous open-heart surgeries. Then must speak with a mother and father about their sons fentanyl overdose. Amid all that chaos he resolves to keep an eye on a fourth-year medical student at the learning hospital who just lost his first patient.By the time Robby finally unzips in front of a urinal hes interrupted yet again by Dr. Frank Langdon (Patrick Ball) who needs a cardiovert unstable AFib in North 1. The addendum that the systolics 90 is enough for Robby to abandon his urination mission altogether and rush out of the bathroom to more chaos. Things move pretty quickly in the emergency department at Pittsburgh Trauma Medical Hospital, which Robby calls The Pitt. And that goes not only for the shows characters, but its audience as well. Because like the great Fox espionage thriller 24 before it, The Pitt operates in real time or close to it.There is no ticking clock at the bottom of the screen on The Pitt but each of the shows 15 episodes is designed to roughly correspond to an hour spent during a 15-hour shift in the titular Pitt. The series follows a weekly release model and the three episodes released thus far are titled 7:00 A.M., 8:00 A.M., and 9:00 A.M. None of these episodes are precisely 60 minutes long but they come close enough in the 51-53-minute range. The real-time format is far from The Pitts only selling point. Starring ERs Wyle and created by former ER writer R. Scott Gemmill, the series is essentially a heightened version of the long-running NBC medical classic with an added prestige streaming sheen. In fact, The Pitt studio Warner Bros. Television was hit with a lawsuit from the Michael Crichton estate, which alleged that the show was a reworking of an ER spinoff. The Pitt is also one of the first post-Covid hospital dramas to use the pandemic as a thematic grounding rod. Dr. Robby still clearly bears the mental and physical scars of being an healthcare worker during that traumatic time.Still, its the real-time aspect that gives The Pitt its greatest competitive advantage over comparable TV properties. The pace of the show is quite simply relentless. Very rarely do Robby and his fellow doctors exit one scene to enter into a calmer one. Its early in the day in Western Pennsylvania and the emergencies continue to mount up. At one point the socially awkward former veteran affairs doctor Melissa Mel King (Taylor Dearden) steps outside for a breather only to be immediately met by a van tearing into the parking lot to dump off a gunshot wound victim.How realistic this confluence of emergencies is for one hospital is up for debate, though for whats its worth, many real-life healthcare professionals have commended the show for its accurate depiction of the doctor-patient dynamic and the deployment of proper medical jargon (see: cardiovert unstable AFib). But whats not debatable about The Pitts breakneck approach is that it works. In fact, through its first few episodes its already working better than the pioneer of the real-time TV season format.24 was not the first TV series or movie to utilize a running clock as a plot device. It was, however, the first to make the connection that there are 24 hours in a day and TV seasons of hour-long dramas tend to run in the 20-25-episode range, creating the opportunity for the mythical day-long televised experience (with commercials, of course). The idea for 24s format was so strong that it preceded the plot of the show itself. Creators Joel Surnow and Robert Cochran originally intended for their series to document the dramatic 24-hour period in advance of a wedding before shifting to an action concept featuring the head of the Counter Terrorist Unit racing against the clock to save his daughter.The thing about 24 though is that 24 hours is truly So. Many. Hours. The writers and producers of the series would invariably run into this realization time and time again. Of the shows eight proper seasons (outside of the TV movie 24: Redemption and spinoff 24: Live Another Day), only season 4 really attempted to follow one concurrent terrorist plot over the span of a full day to narratively messy results. The other seven seasons took the far more sensible approach of breaking their 24 hours into two distinct storytelling blocks: one in which Jack Bauer (Kiefer Sutherland) saved the day, and another in which he uncovered the real big bad behind the terrorist conspiracy.At only 15 hours, The Pitt appears to have learned the right lessons from its real-time progenitor just as its learned the right lessons from its medical drama forefathers. Viewers dont need to see a running clock to feel the tension, nor do they need a full 24-hour period to get the bit. Viewers need only consistent escalation and movement. Thus far, The Pitt has found a way to work with its gimmick rather than become beholden to it. By the time episode 4 opens at 10:00 A.M. Eastern Time, Dr. Michael Robby Rabinavitch will still have to pee. The tension of whether he makes it to the bathroom before the next emergency will have the same dramatic weight of Jack Bauer defusing a bomb.The first three episodes of The Pitt are available to stream on Max now. New episodes premiere Thursdays at 9 p.m. ET on Max.Join our mailing listGet the best of Den of Geek delivered right to your inbox!