The Nocturnists Present: Inside 'The Pit': Medicine's Most Authentic TV Drama
Send us a textThe Nocturnists Podcast with Emily Silverman, MDThe HBO Max series "The Pit" has struck a chord with healthcare professionals unlike any medical drama before it. What makes this show so different? Why are doctors and nurses messaging each other saying, "You have to watch this—they finally got it right"?In this special bonus episode, I sit down with the brilliant creative team behind the show that's capturing the true essence of emergency medicine: R. Scott Gemmel (creator and showrunner), Joe Sachs (emergency physician and writer), and Mel Herbert (renowned ER educator and consultant).Our conversation reveals how "The Pit" breaks new ground through its revolutionary real-time storytelling format—each episode covers just one hour of a 15-hour shift, immersing viewers in the relentless pace experienced by healthcare workers. We explore how the team meticulously crafts authentic medical scenarios, using actual cases as jumping-off points for character development while ensuring perfect technical accuracy.The show's commitment to authenticity extends beyond medicine to address systemic healthcare challenges—the boarding crisis, corporate pressure over satisfaction scores, staff shortages, and the alarming rise in violence against healthcare workers. As Joe reveals, "56% of nurses reported experiencing physical assault in the last month." By tackling these realities head-on, "The Pit" serves as both entertainment and powerful advocacy.We also get fascinating behind-the-scenes insights into the production process, from the incredibly detailed set design (complete with sometimes-too-convincing fake toilets) to the custom-built anatomical models created for intubation scenes. The team's dedication to getting every detail right explains why healthcare workers are feeling so seen by this groundbreaking show.The conversation concludes on a hopeful note as the creators share their ultimate mission—to celebrate the extraordinary dedication of emergency medicine professionals while inspiring a new generation to enter healthcare despite today's challenges. As Scott beautifully puts it, the show is fundamentally "a love letter to a profession that is sometimes just taken for granted."Listen now to discover how storytelling can bridge the gap between healthcare realities and public understanding in ways that might just change how we all see the emergency department and those who work there.Support the show
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Burnout and Coaching with Scott Weingart
Send us a textLink to scott course: https://guidewirecoaching.com/unburnable/Scott Weingart shares his experiences developing physician executive coaching to help emergency physicians find meaning and purpose despite a broken healthcare system.• Burnout often stems from negative inner voice rather than external circumstances• Cognitive distancing helps physicians separate themselves from unhelpful thoughts• Stoic acceptance allows doctors to focus energy on what they can control• Nonviolent communication techniques transform interactions with difficult consultants• Maintaining fundamentals during shifts (eating, drinking, bathroom breaks) is essential• Optimal performance pace prioritizes patient safety and career longevity• Sleep optimization receives special focus, with warnings about alcohol and caffeine• Lifelong learning reignites the curiosity and satisfaction many found in residency• Executive coaching costs approximately $3,000 for twelve sessions over 24 weeks• Regular meditation practice can be transformative for emergency physicians• Every emergency physician should consider therapy from the beginning of their careerCall us or visit our website to learn more about physician executive coaching and register for upcoming sessions.Support the show
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The Dangers and Delights of AI search and "The Pitt"
Send us a textWe're exploring the integration of AI search within Corpendium and discussing the delicate balance between powerful search capabilities and maintaining medical accuracy. Our team dives deep into the technical challenges and ethical considerations of implementing AI in a trusted medical reference platform.• AI search struggles with staying confined to just Corpendium's content despite explicit instructions• RAG (Retrieval Augmented Generation) allows AI to search internal databases while maintaining natural language understanding• The tension between sensitivity and specificity mirrors clinical decision-making in emergency medicine• Vector space embeddings help AI understand semantic relationships between medical terms beyond simple keyword matching• Citations and references are crucial for verifying AI-generated information against human-authored content• Traditional search still has value, especially in offline modes where large language models aren't available• Expert human judgment remains essential as AI can make dangerous mistakes despite sounding authoritative• Editorial teams benefit from AI by automating formatting tasks while focusing human expertise on clinical content• The system will launch in beta with user feedback mechanisms to continuously improve accuracy• AI is most valuable as a tool for experts rather than a replacement for medical education and trainingAI doesn't replace the learning that medical professionals go through. It's exceptionally helpful in the hands of experts, but always scrutinize what it tells you.Support the show
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Travel Pause
Send us a textMel will be on a trip to Kenya doing some teaching. Show will reboot in mid March. Lts of great interviews coming up!Support the show
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AI vs. Doctors: Navigating Medicine's Future with ChatGPT and Human Expertise
Send us a textMel interviews Graham Walk of "MD Calc" fame. This episode explores the evolving role of AI in healthcare, focusing on a study that compares ChatGPT's performance to that of human doctors in managing complex medical cases. We discuss the implications of these findings, the potential for misinformation, and the future of AI integration in clinical practice.• Examination of the BMJ study on AI vs. doctors • Real-world application of AI in patient care • Concerns around AI misdiagnosis and misinformation • Future prospects of AI in healthcare settings • Impacts of AI integration on workforce and private equity • Human-AI collaboration as a path forwardSupport the show
Mel Herbert, MD, and the creators of EM:RAP, UCMAX, CorePendium, and the collaborators on "The Pitt" and many of the most influential medical education series present a new free podcast: “Dirty White Coat.” Join us twice a month as we dive into all things medicine—from AI to venture capital, long COVID to ketamine, RFK Jr. to Ozempic, and so much more. Created by doctors for clinicians of all levels and anyone interested in medicine, this show delivers expert insights, engaging discussions, and the humor we all desperately need more of!
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