What few traces of music we do hear are composed by Gavin Brivik. In addition to the closing credits song—the one reliable exhale the show allows you to have—Brivik also delicately provided the show with subtle drones and recurring motifs. When a new patient is wheeled into the ER from the trauma bay or someone suddenly falls unconscious, a low, fast-paced thumping always fades into the mix of the show. This is essentially the only music you hear in the show. For Gemmill, it was an unusual thing to ask a composer: to score a scene without wanting anyone to know it’s there.
“It was much more about tonalities,” Gemmill says, “and so that was the compromise, to find a bed essentially that Gavin gave us that would support the scene and could move somewhat with it if we felt it was necessary. But I think it’s something more that you are feeling than actually hearing.”
“We were actually trying to talk about it as a tension,” Wells adds. “Like a tone or a thing that would increase the tension without you ever being aware that it’s really there.”
I tell them that I think it’s less a piece of music and more of a frequency that subtly changes the energy in the room. Gemmill agrees and adds that it was also meant to blur the line between diegetic and non-diegetic sound. “At times, you can’t tell if that’s coming off one of the machines or if it’s there. So it’s sort of playing a little cat and mouse with you.”
“We even try to make it feel occasionally like it’s Robby’s tinnitus,” says Wells.
But far and away the most powerful moment in all of The Pitt’s first season takes place in near-total silence. At the end of Episode 8, the parents of a young college student who accidentally overdosed on fentanyl finally accept that their son is brain-dead and will donate his organs. (The episode is historically relentless: This happens immediately after we learn that a young girl cannot be revived after she tried to save her younger sister from drowning.) As is customary in many hospitals, the donor receives an “honor walk”—an ad hoc ceremony where staff, family, and friends line the halls of the ER as the donor is transported from the hospital room out to the ambulance. For almost a minute, all we hear is the steady beep of a life-support machine and the sniffles of those taking a moment of silence.
The way The Pitt employs silence reminds me of the work of avant-garde composer and philosopher John Cage, a famous practitioner and theorizer of the power of silence. In the late 1950s, through the influence of Zen Buddhism, Cage began to understand silence not as the absence of sound but simply as a duration of time where sound can occur by chance. Silence is not nothing; it is the possibility of anything. When you accept the pretext of silence, you become more attuned to the leaves rustling or a robin chirping, the sound of your heartbeat in your ear or the whoosh of the HVAC. Cage’s most famous composition—a piece where any performer exists in any space for four minutes and 33 seconds—is performed in nominal silence. But, in that silence, there is a heightened state of awareness and vulnerability created in the audience.
So much of the verisimilitude and the nervy emotion of The Pitt is owed to the sound of silence. The biggest phenomenon in the wake of this season has been the overwhelming response from real-world healthcare professionals, who feel, finally, as if a television show reflects the actual environment of a hospital, especially post-COVID. It’s rare in art that “accuracy” becomes a main driver of emotion and a measure of greatness, but such is the case with The Pitt. It’s a show that understands that a hospital is not a magical liminal space, but just a big room with no music where my dear friends usher people in and out of limbo as best they can. It’s enough to make you weep.
