SPOILER ALERT: This interview contains spoilers from “6:00 PM,” the 12th episode of the first season of Max’s “The Pitt.”
It’s the 12th hour of “The Pitt” and an active shooter incident at the musical festival Pittfest unfolds on this week’s episode of the Max series.
With an unknown number of casualties expected, the team at Pittsburgh Trauma Medical Hospital is told to expect the worst. With the emergency room turned upside down, production designer Nina Ruscio, who had immersed herself into the world of hospital design to build the show’s set, found herself with a new challenge. She had to understand what happens to the emergency room when a situation like this occurs and had to “reinvent the space.”
Related Stories
Speaking with Variety, Ruscio says she listened to doctors who had been involved in the Pulse Nightclub shooting. “In those moments when they were open to trauma, they shed all of the patients in the emergency room to other floors within the hospital so the full space would be completely available.” She continues, “They put all the patients in the public spaces and centralized themselves so they could be in the middle of multiple gurneys, and so we redefined the hospital into zones.”
Popular on Variety
Here Ruscio breaks down how she revamped her set for the episode and found the right balance of blood.
Things in ‘The Pitt’ take a turn with this week’s episode with a mass casualty. What did you have to do for this episode?
We had to reinvent the space. We did a lot of research, and we redefined the hospital into red, pink and yellow zones: red meant you needed to be treated within five minutes, or you would die, pink meant you had a little longer, and yellow meant you had maybe half an hour. Before all of that, you needed to be assessed and treated. We also had a green zone for patients who weren’t brought into the emergency department at all.
The actual architecture of the space was inversed like a black and white image, and we changed the physical dynamic of the space to be able to handle multiple victims at once – imagine it like the center of a wheel, and there would be patients in gurneys all around the doctors. I speak about it in a very detached way, but the level of horror of it all is very much like a war. Through our research we learned there is a whole system of protocols that fall into place. There are different jackets that people wear, and there’s different equipment that they’re using because they need to make sure it’s all in one contained space. There’s a lot of blood, and I obsessed with how to make the blood real looking and sustainable.
How did you find that balance in making the blood look real?
These events are taking place within the course of 50 minutes, and there’s a lot of blood happening. Blood is coming out of people, off of people, and it’s on the floor. So coming up with a strategy to help manage the blood was a very important part of my job.
The blood needed to be sustainable for 300 people running around the space and blood continuity needed to be correct. These are all banal aspects of a mass casualty, but they were important to the storytelling and visual space to keep it real looking.
How did you achieve that?
I’m only responsible for the blood on the set itself and on the floor – I can’t be responsible for the clothing. A rule for myself was how blood is tracked from space to space: on the gurneys, or off the gurneys onto the floor. It had to be ergonomically connected to where the wound was.
The only thing I could do was to make sure that it was realistically placed and motivated specifically by wounds or specific patients. There was a lot more blood in the red zone because people have extreme wounds, while there was going to be less in the pink zone.
For a medical facility in a mass casualty, the range of what is real and what is common goes way up so managing gore to make sure it doesn’t look like horror comes from accurately portraying where the blood is coming from. It’s coming off a wound, or where the gurney was when it rolls away.
You designed this without having looked at a script — where did you begin?
I immersed myself quite intensely in hospital design. I read up on so many things, and I looked at so many places. I went inside and I would drive 45 minutes to a different emergency room to take care of a bee sting or whatever it might have been. I really wanted to have enough cross sections of different types of emergency rooms. We were going to set that emergency department on the East Coast and in a design style that was maybe 15 years old – and the emergency department itself would be renovated 15 years ago.
What were the first conversations about how ‘The Pitt’ set would be?
I’ve worked with John Wells in the past, and the intention of the project was to at that moment in time they had thought that they would do this contiguous time concept, and because of that, the choreography of the movement of everybody was essentially needed to be locked in space and time. I met with showrunners John, Noah Wyle and Scott Gemmill, and I had a delightful meeting with them about understanding what it was that they wanted to accomplish. I set about doing an emergency department and waiting room that would service multiple varieties of storytelling because I had no idea what the storytelling was. I did know that the hope was to have it be completely handheld. I did know that my personal intention was to make it stand out, visually unique and on its own, but very much unique in that, it was accurate and real. I also needed to maximize stage space so extremely that you would never feel claustrophobic, or I didn’t want to provide a dead end because of the continuous action, but also because of the idea that we would be in this same space for the entire season. So, I just so wanted to create a space with enough variety and possibility that any story could be told.
It’s a pretty sterile world, how did you create texture?
The intentionality of this was to create a level of realism that would make you make it almost more documentary than narrative. It’s an extremely blanched palette. And knowing that we wanted to create a setting that was both universal and realistic and not visually off-putting. Creating this very blanched palette is realism. It’s really what the experience is. When you go to an emergency, you don’t feel happy and you feel anxious.
I met with the cinematographer, and we I jokingly called it 50 shades of white.
We made five choices that I think anchored the show. They were the floor, the ceiling, the palette and the geometry of the space. The textures were added in not to compete with the blanched effect, but to put in these architectural historical kisses that gave the building gravitas. You’ll see brick and marble that are cued off of the esthetic of the exterior of the Allegheny General Hospital in Pittsburgh. If you spend any time in Pittsburgh, it is soaked in architecturally odd heritage spaces, and I wanted to give the hospital some gravitas.
The floors are three different shades. There’s cream, gray and blue. And there’s some wood tone in the walls. That ceiling is designed into the set. Each of those physical geometries leads you from one space to the next, and there are lines in the ceiling so that the camera movement feels seamless and never feels blockaded.
You’ve called the set an immersive experience, what did you mean by that?
The people that are in there, the actors, the background players, the set create this feeling of work for everyone. Everyone flips on all the switches, and then you’re in an emergency department all day long. So the experience itself is something that’s kind of fun.
This interview has been edited and condensed for clarity.
