The Pitt: Sickle Cell Disease Explained

Sickle cell disease plays a major role in The Pitt season 1, episode 2, but Max’s new medical drama doesn’t explain everything about the chronic disease. The Pitt, led by a very talented cast of characters, takes a very realistic and stark look at the state of the healthcare industry and the challenges healthcare providers face. The show has already touched on topics like the nursing shortage in The Pitt and the lingering effects of the COVID-19 pandemic, so it clearly doesn’t balk at tackling the difficult realities of the medical field. That makes it the perfect show to talk about misunderstood conditions like sickle cell disease.

In The Pitt episode 2, a Black woman is admitted to the emergency room while screaming and writhing in pain. Though the paramedics assume she is a drug addict looking for opioids, Dr. Samira Mohan (Supriya Ganesh) speaks to the woman and learns her name is Joyce St. Claire (Ashley Romans) and that she is suffering from sickle cell crisis. While the inclusion of extremely realistic diseases and medical emergencies likely helped The Pitt land a solid Rotten Tomatoes score, the show doesn’t explain the intricacies of sickle cell disease and how it affects real people.

Sickle Cell Disease Is A Genetic Blood Disorder That Primarily Affects Black & African Americans

Sickle Cell Disease Causes Misshapen Blood Cells That Can Create Clots & Other Medical Complications

Broadly speaking, sickle cell disease is a genetic disorder that causes a person’s red blood cells to become misshapen (via Mayo Clinic). Normally, red blood cells are shaped like discs with a dip in the middle, but a person with SCD has some or all of their blood cells shaped like a crescent, or sickle. Those sickle-shaped blood cells are less flexible and more “sticky” than normal blood cells, so people with SCD very easily experience symptoms like blood clots, anemia, swelling of the hands and feet, infections, vision problems, and more. On top of that, people with SCD have a life expectancy of 20 years shorter than normal (via CDC).

As a genetic disorder, sickle cell disease is spread through reproduction. When two people carrying the recessive sickle cell trait reproduce, their children are at an increased risk of developing sickle cell disease. According to the American Society of Hematology, between 8% and 10% of Black Americans carry the sickle cell trait, so sickle cell disease primarily affects Black people in the United States. The American Red Cross explains that sickle cell disease likely originated in Africa thousands of years ago as a defense against malaria.

Sickle Cell Crisis Is A Horrifically Painful Condition Of The Disease

Sickle Cell Crisis Cuts Off A Person’s Blood Flow & Can Cause Intense, Unbearable Pain

One of the many serious symptoms of sickle cell disease is known as sickle cell crisis. Sickle cell crisis occurs when the blood cells in a person with SCD create clots throughout the small blood vessels in the body, blocking oxygen from reaching the body’s cells and muscles (via Cleveland Clinic). These clots typically occur in the lower back, chest, and extremities, and they often cause intense pain, fatigue, and other symptoms. The pain associated with sickle cell crisis can range from mild discomfort that can be treated at home with over-the-counter painkillers like aspirin, to intense stabbing pain that requires hospitalization.

Dr. Mohan’s summary of sickle cell crisis in The Pitt is actually a fairly good overview of the most severe cases of the condition. As Dr. Mohan states, “Blood cells get caught and plug up your capillaries and deprive all your cells of oxygen. It’s been described as an electrical stabbing pain that feels like it’s breaking your bones and flushing glass through your body.” A bout of sickle cell crisis can be more painful than most people who haven’t experienced it firsthand can even imagine.

How Sickle Cell Crisis Is Treated (& How Racial Bias Factors In)

Severe Sickle Cell Crisis Is Treated With High-Strength Painkillers

Despite the intense pain associated with sickle cell crisis, many patients who seek treatment aren’t given adequate pain management medication. For more severe sickle cell crises that require hospital stays, patients may require narcotics, opioids, and other prescription-strength painkillers like oxycodone, morphine, and tramadol. There is, however, an ongoing opioid epidemic in America (via CDC), so there’s also quite a bit of stigma surrounding high-strength painkillers. Doctors are generally less inclined to administer narcotics and opioids to manage pain, and they’re even less likely to administer them to people of color as opposed to white patients (via National Library of Medicine).

Related

How Many Episodes Of Max’s The Pitt There Are & When The Finale Is

Max’s new medical drama The Pitt is already off to a strong start, and some viewers may want to know how much more is left before the season ends.

Many doctors and healthcare providers in the United States have some level of implicit racial bias that negatively affects the healthcare people of color receive (via National Library of Medicine). Per the NLM, “The National Healthcare Disparities Report showed that White patients received better quality of care than Black American, Hispanic, American Indian, and Asian patients.” That implicit bias can manifest in a number of ways. In The Pitt, both the paramedics who bring Joyce to the hospital and Dr. Whitaker (Gerran Howell) display implicit bias by assuming Joyce is a drug addict looking for painkillers.

While The Pitt displays a very overt example of racial bias in healthcare, it can often be more subtle than that. As Dr. Mohan notes in the episode, many white doctors don’t have experience treating sickle cell disease, and therefore underestimate how intense the pain of sickle cell crisis can be. As a result, many patients experiencing sickle cell crisis receive fewer painkillers or lower doses than they need to adequately manage their intense pain. One study found that “The language used by providers to describe patients with SCD has included ‘over-reporting of pain,’ ‘drug-seeking behavior,’ or ‘caring for patients with SCD is frustrating,'” (Anderson et al. via National Library of Medicine).

Related

The Real-Life Legal Controversy Behind Max’s The Pitt Explained

Noah Wyle’s new show The Pitt is on the way, but the new Max medical drama has faced challenges in the form of a lawsuit before its debut.

The stigma surrounding sickle cell disease and its treatment is a very real problem in American healthcare, which makes it the perfect subject for The Pitt to examine. The characters of The Pitt are constantly trying to find the balance between efficiency metrics and the need to move patients in and out of the emergency room quickly with the care and compassion required to effectively treat sick and injured people. Sickle cell disease is the perfect condition to highlight The Pitt‘s balancing act: it requires care and consideration that hospital metrics don’t take into account.

Your changes have been saved

My List

My Favorite TV Shows
My Watchlist

The Pitt is a medical drama developed by veterans of the television series ER. The series will follow healthcare workers set in Pittsburgh, showing he challenges faced in the modern-day United States by nurses, doctors, and other medical professionals.

Network

Max

Cast

Noah Wyle

Character(s)

Dr. Michael ‘Robby’ Robinavitch
, Uncredited

Creator(s)

R. Scott Gemmill
, John Wells
, Noah Wyle

Producers

John Wells
, Noah Wyle
, R. Scott Gemmill
, Simran Baidwan
, Erin Jontow

Seasons

1

Writers

R. Scott Gemmill
, John Wells
, Noah Wyle

Showrunner

R. Scott Gemmill

Expand