How realistic is 'The Pitt'?

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Good morning! It’s Tony. I’m old enough to remember when the big medical drama with Noah Wyle was called “ER” and was part of NBC’s “must-see-TV” Thursday night lineup. Now, though, I’m told that the hot Wyle-led medical show is “The Pitt,” and today, writer Michelle Crouch looks at whether it’s Hollywood fiction or an accurate reflection of life in North Carolina ERs. Whether you know him as Dr. Robby or Dr. Carter, Michelle’s article is a revealing look at realities of ER life. Plus CLT growth forecasts, a Lawrence Toppman review, the city seeking employers and a proposal to stop offering financial incentives to data centers. Get reading, stat!

Today’s Charlotte Ledger is sponsored by Ginkgo Residential. A focused strategy in workforce rental housing across North and South Carolina. Ginkgo REIT provides tax-efficient income, portfolio diversification, and long-term capital appreciation.

by Michelle Crouch
Co-published with N.C. Health News

When Dr. Jennifer Casaletto’s kids started watching “The Pitt” last year, her 14-year-old son had a question: Which one are you?

“I’m Doctor Robby,” she told him, referencing the attending physician played by Noah Wyle who oversees the chaotic emergency room in the hit HBO TV drama.

She said his jaw dropped: “That’s what you do??”

Casaletto, who has worked as an emergency medicine physician in Charlotte for 15 years, said it was the first time her kids really understood what she does. They are now more mindful when she’s sleeping after a night shift and less likely to complain when she’s at work, she said.

“It has made a huge difference in our house,” she said. “I’ve been doing this for 25 years, and I’ve never really been able to explain to people what I do. This show has made us feel seen and made us feel heard.”

Matt Trifan, an emergency medicine physician at Cone Health, said the show is helping humanize the profession at a time when trust in medicine has eroded in the wake of the pandemic that upended health care workers’ lives.

“I’ve had more than a few patients say, ‘I watch ‘The Pitt.’ I know how busy you guys are,’” Trifan said. “Hopefully, it will help build back a little trust.”

Now in its second season, “The Pitt” unfolds in real time, with each episode following a single hour of a shift in a hectic Pittsburgh emergency room. The show’s creators consulted closely with real emergency department workers. Doctors and nurses from across North Carolina told The Charlotte Ledger/NC Health News the result is unnervingly accurate.

“It gives me flashbacks,” said one Charlotte doctor who asked not to be named. She added that some of her colleagues stopped watching the show because it was too much like being back on shift.

What makes “The Pitt” stand out isn’t just its medical accuracy, doctors and nurses said. It’s how well it captures the challenges they face: overcrowded waiting rooms, violence against staff, staffing shortages and more, along with the emotional whiplash of the job. But “The Pitt” also highlights the teamwork and connections that keep them going.

“One thing that really hits home for me is how well the show communicates that we work really hard not just with our brains, but with our hearts,” said Casaletto, a member of the American College of Emergency Physicians’ board of directors. “Our hearts are tied to each and every patient. It’s a job, but it’s so much more than that.”

Here are several aspects of emergency room work that North Carolina ER workers say “The Pitt” gets right:

On “The Pitt,” the packed, noisy waiting room is a constant backdrop, with frustrated patients waiting for hours, and a long line just to check in. In North Carolina, which has the eighth-worst emergency department wait times nationwide, ER staff said their waiting rooms often look similar, especially in winter when respiratory viruses peak.

Trifan said the waiting room scenes made him “squirm a little bit” because they’re so accurate. “It’s like a pressure cooker in there, with sick people, frustrated people,” he said.  

A Charlotte doctor said she covers her badge when walking past the waiting room, because if patients see it, they ask for help. Like the physicians on the show, she feels guilty telling them they have to wait their turn.

On “The Pitt,” Dr. Robby tells the medical trainees the emergency department is “clogged up with boarders” — patients who have been admitted to the hospital but are waiting for a room, sometimes for days.

North Carolina staffers said boarding here can be worse than the show depicts, with beds lining hallways and filling every corner. At times, as many as a third or half of ER beds are filled by people waiting to be transferred to another facility or to a bed in another part of the hospital, doctors and nurses said.

Boarders include not just admitted patients, but psychiatric patients, older adults waiting to move to a rehab facility and children in state custody with nowhere to go, said Tim Lietz, an emergency medicine physician who recently switched roles after 30 years in Charlotte area hospitals.

“There was one kid who lived in the emergency department for three months — through Thanksgiving, Christmas and New Year’s,” Lietz said. “This poor kid, they couldn’t get him placed. He had nobody to talk to because we were all busy doing our work. He was just eating junk food. I think he gained 50 pounds.”  

While they wait, those patients still need medications, meals and basic care — work that falls to already stretched staff.  

“It pulls us away from patients who are acute and sick,” Casaletto said.

On “The Pitt,” patients lash out at doctors and nurses. In one episode, a nurse was punched by a disgruntled patient. In another, a nurse was choked.  

ER workers said those episodes hit close to home, mirroring a real-world increase in violence. Verbal abuse and threats happen every day, they said, and they’ve seen colleagues punched, kicked, spit on and threatened with knives and guns.

“Patients swing at us, people get hit all the time,” said Gia Bonis, a registered nurse at Cone Health. “It has just become something that we have to — I hate to say accept, because it's not OK — but unfortunately, we do accept it.”

Lietz said he once saw a patient head-butt an attending physician, knocking out several teeth. He also saw a nurse “grabbed by the hair and held down.”

Even routine interactions can turn ugly, especially when patients are in pain or frustrated by long waits, said Alycia Beverly-McCown, a registered nurse at Cone Health.

“Patients will cuss you out in a heartbeat,” she said. “It can be over a turkey sandwich, over some water, a blanket.”

The staffers said hospitals now provide training to help them spot warning signs and de-escalate tense situations, and some have issued panic buttons staff can press if they feel unsafe. In 2023, North Carolina also passed a law championed by Rep. Tim Reeder (R-Ayden), an ER physician, requiring emergency departments to have a law enforcement officer on site.  

Those changes have helped, workers said, but the risk hasn’t gone away. 

“Violence is still a very real reality” in the ER, Trifan said.

➡️ Keep reading: The dark humor, the emotional whiplash, the moments that make it all worth it — read on for six more things that N.C. doctors and nurses say "The Pitt" gets right.

Today’s supporting sponsor is Landon A. Dunn, attorney-at-law in Matthews:

Charlotte’s airport is forecasting that the number of passengers flying into and out of Charlotte will remain flat into next year, at a level about 8% lower than its 2024 peak.

The airport, which has grown steadily over the past few decades and is widely regarded as a major economic engine for the Charlotte region, has taken a breather from passenger growth, which airport officials say stems from a variety of factors.

In a presentation to a Charlotte City Council committee last week, airport chief financial officer Mike Hill said having fewer passengers is both “good and bad.” He said that “from the financial side of the house, we want to get those passenger numbers up, because they buy more hot dogs [and] they park the cars more often.”

But he also said that having fewer passengers will avoid a repeat of 2024, when the airport had record-low customer-service survey scores that resulted from “cramming nearly 60 million customers into a building that quite frankly is not big enough to handle it.”

The airport handled 57.4 million passengers in fiscal year 2024, but since then, those numbers have fallen. It’s forecasting 52.8 million this fiscal year, which ends in June, and 52.9 million for the following 12 months.

Hill cited several factors in the passenger decline and stabilization, including “impacts of geopolitical concerns” such as the Iranian conflict, rising oil prices and federal budget effects related to the pay of airport security screeners. Most of those have developed only since February 2026, though, while the number of Charlotte airport passengers peaked in 2024. As Charlotte's numbers dropped, demand for air travel rose nationally by 2.4% in 2025.

A bigger factor would seem to be the decision by American Airlines, Charlotte’s biggest carrier, to reduce flights here.

“It really is a repositioning to some extent,” Hill said. “American in particular realized that in 2024 and 2025, when they drove down our passenger experience scores to where our folks couldn’t really even traverse the terminal building the way they needed to — and then our bag system limitations, the limitations of the building — they have repositioned maybe somewhere around 7-8% of those flights as they also are trying to compete with United in Chicago.”

Hill cited industry figures from 2024 that showed that CLT was the seventh-largest airport in the country by passengers. More recent data, though, shows that CLT slipped to No. 11 in 2025, surpassed by Orlando, Miami, Las Vegas and San Francisco.

In the update to the City Council committee, Hill also touted the airport’s efforts to enhance the customer experience, develop the airport’s workforce, partner with community groups, assist children with developmental disabilities and support small and disadvantaged businesses.

He did not mention and was not asked by council members about the airport’s ongoing demolitions of historic structures, last month’s parking price increases or Charlotte’s higher-than-average airfares.

He also did not directly address the status of lease negotiations with airlines, with a new lease expected this summer that could help determine the future of construction at Charlotte’s airport for the next decade. 

He said net airline payments to the airport are expected to rise 11% next year, to $168M, and that the cost per enplaned passenger would rise 32% next year compared with this year’s budget, to $5.06 — still among the lowest of major airports.

The airport is finishing renovations on Concourses D and E, as well as continuing construction on a fourth runway.

As far as future construction, Hill said the airport is working with consultants on a master plan, which could address the growing difficulty getting around a larger airport by calling for “some sort of underground people-moving system to a remote concourse.” —Tony Mecia

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The Mayor’s Youth Employment Program, the city of Charlotte’s summer internship program for 16- to 18-year-olds, has received a record number of applications for 2026 and is looking for additional employers to match those teens with jobs.

This year, the city received 1,200 applications, up from 700 the previous year and the most the city has ever seen, according to Raquishela Stewart, deputy director of the city’s Housing & Neighborhood Services department.

Stewart attributed the uptick in applications to the city doing greater and earlier outreach, including at Title I schools, the applicants from which more than doubled year over year, according to the city.

“Research shows that 63% of youth who are not in school or not working are in some kind of trouble,” she said. “Our programming does not only consist of career experience. We're also looking at career development. We're looking at how to brand yourself, how to show up, transferable skills … The jobs of yesterday are not necessarily the jobs of today.”

The city hires about 50 interns each year for the program.

The program has traditionally required six-week internships, but this year, after a successful pilot last summer, two- and four-week internships are being offered as well. The program includes hands-on internships as well as “virtual pathways.”

Stewart said the city began matching applicants with companies last week. The deadline for employers to apply to the program was April 10, but, Stewart said, applications will be accepted into this week.

Internships are fully funded by employers, and participating companies are required to pay interns at least $13/hour, matching what the city pays its interns. 

Stewart said the city tries to match students with industries they rank highly on their applications, but emphasis is also placed on what transferable skills can be learned, even if a teen is working in an industry that might not be their top choice. Working at CharMeck 311, the city’s call center, may not necessarily be a 16-year-old’s dream job, but it can teach skills like relationship building, customer service and technical skills that even doctors and lawyers need to have proficiency in, Stewart said.

The program starts June 22 and runs through July 31. Stewart said the city is open to receiving applications from employers in any industry. —Ashley Fahey

Want to apply? You can do so here.

Gov. Josh Stein, tapping into the public skepticism toward data centers, says he wants to eliminate long-standing state subsidies for them so that taxpayers aren’t putting money toward energy-guzzling buildings that drive up utility costs.

“AI will be part of our future, and we want to keep innovation central to this state's economic development strategy,” Stein said, according to Raleigh TV station WRAL. “But we cannot be blind to the impact these data centers are having on our state. They need to pay their way, so that our residential consumers don't have to bear the cost.”

Figures from the N.C. Department of Commerce show that the state is probably forgoing about $50M a year because of data center exemptions, and that figure seems likely to rise as the number of data centers balloons. Stein said the tax breaks were created 20 years ago.

It is unclear whether the state legislature would be receptive to such a proposal. Stein is a Democrat, and the General Assembly is led by Republicans. Leaders from both major political parties generally support the state’s economic development incentives to attract new businesses.

Companies are increasingly proposing data centers, which provide computer servers and other infrastructure for artificial intelligence and other technologies.

There are 43 data centers in the 14-county Charlotte region, with more planned, The Ledger reported in October. Several City Council members have said they would like guidelines in place before approving rezonings for data centers, like one planned near Reedy Creek Nature Preserve in east Charlotte. —Tony Mecia

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Events submitted by readers to The Ledger’s events board:

THURSDAY: “State of the Economy Update,” 8-9:30 a.m., AC Hotel Charlotte Ballantyne, 14819 Ballantyne Village Way. Join South Charlotte Partners for a talk by Carrie Cook, vice president and community affairs officer at the Federal Reserve Bank of Richmond, for a timely “State of the Economy” update. This engaging breakfast program will explore national and regional economic trends, key indicators shaping business decisions and what to watch in the months ahead. $25.

FRIDAY: “Weekly Meeting of Senior Scholars,” 10-11 a.m., at Providence United Methodist Church, 2810 Providence Road. Join the members of Senior Scholars as Steven Spencer, Director of Community Relations for NeoGenix Stem Cell and Regenerative Therapies, traces the evolution of stem cell research, highlights key scientific milestones, explores current clinical applications and looks ahead to promising new developments. $5 for guests. $25 annual membership.

SATURDAY: “Kids Night Out: Music and Art,” 5:30-8:30 p.m., at Arts+ Community Campus, 2304 The Plaza. Come bring your kids for a fun night in while you take a break with a night off! Children will enjoy an evening of play and creation as they sing, dance and make beautiful artworks. $50.

SATURDAY: “Mardi Gras Casino Night for Sight,” 7-11 p.m., at Griffith Hall, 3000 S. Tryon St. Join Metrolina Association for the Blind (MAB) and the Charlotte Area Delta Gamma Alumnae for a high-spirited and fun-filled evening benefiting MAB! There will be live music, New Orleans-style food, beads and masks. Black tie optional. There will be casino-style games, but no cash prizes will be issued. $78/ticket.

➡️ List your event on the Ledger events board.