The last few episodes of The Pitt have been a whirlwind of activity. Though not covered here, the show ran the gamut from staff assault to the appearance of ICE. The latter was a prescient addition to the storyline with the current climate within America, and something that the show portrayed correctly. They present ICE as, rightfully, thugs, uncaring about the physical condition of the woman they have clearly roughed up on their own. And poor Emma, still in her first day on the job, gets put into a headlock by a confused and irate patient, prompting a code Hula Hoop (which Dana helpfully mentioned earlier on in the season).

Now, as the day shift changes into the night shift, PTMC slows down, if only a little. Our continuation of the assault begins with Dana rushing in to assist, closely followed by Dr. Robby. It is a deliberate choice to splice these POVs, giving us only a glimpse at Dana injecting the patient with what turns out to be Versed, but not showing how, exactly, he became the owner of a bloody nose.

It’s definitely a different structure than the last season. Like most of us, I assumed that there would be a catalyst like the PittFest shooting to cause turmoil in the ER. We were even teased a few times throughout the season. But the reality is that this is just another shift on just another holiday for those in the Pitt. The conflict, instead, lies within our characters.

The slow breakdown of Dana and Robby

Robby has been slowly breaking down over the course of the season. Though he keeps pushing his sabbatical as time off, it is becoming increasingly clear that time off is not what he is searching for, and people are beginning to notice. Dana, especially, has sniffed it out. In this hour at PTMC, we’re squarely in the middle of what is going on with the doctors. The patients are there to prop them up, but this hour doesn’t focus on their stories.

It is also the most focus we have had on Dana. We see closer-up just how fiercely protective she is over her nurses, and how she isn’t afraid to go toe-to-toe with Robby to defend herself. She made her decision and she’ll be damned before she’s made to feel bad about it. But, like most other staff at this point, Dana is also barely holding it together. Add in the lasting trauma from her own assault last season and you understand why she went into the bathroom to yell.

This slow breakdown of what can essentially be seen as the parents of the ER dovetails with the breakdown back to analog for the department. Dana is too proud to admit that she needs help dealing with her own assault; Robby is, quite literally, one foot in the grave at this point. However, they both refuse to get help or actually talk about their problems. Rather, they butt heads, each seeking their own sense of validation for their actions.

“6:00 PM” heralds a jump straight back into action

“It’s always ‘do as I say, not as I do’ with you, isn’t it?” Dana says to Robby at one point, and looking back on their past arguments, she is not wrong. We get the sense that this is something that has cycled through them before, and they always end up at the same impasse. And with the suggestion that two attendings at all times would be better than one for the whole department’s sake, Robby’s ego is feeling extra bruised, making him extra hostile.

The breakdown encompasses more than just Dana and Robby. Santos is seen taking a scalpel from a tray. Orlando Diaz is right back in the ER, but in presumably much worse shape than when he left it the first time. Langdon and Santos’s conflict is still escalating. The ER is functional, but there are many fuses still waiting to be lit for the remaining episodes: Now, it’s a matter of when.

Additionally, The Pitt always has spot-on social commentary, and this week’s appearance of a son who drove his father over an hour to PTMC because their nearest hospital was closed is a great example of it. They didn’t even know it was closed until he drove there, and the results could have easily been much worse.