“The Pitt” Name-Checked Them in a Crisis Storyline. In Real Life, They Do This Every Day.

Dr. Dallas Malzi learned from colleagues on Friday morning that the community health center where he worked had been mentioned by name on The Pitt, HBO Max’s widely admired show about hospital workers in Pittsburgh.

One of the show’s ongoing storylines involves a construction worker with no health insurance who arrives at the ER with an injured shoulder, only to be quickly diagnosed with diabetic ketoacidosis, a life-threatening diabetes complication. The tests and treatment he receives save his life, but rack up many thousands of dollars in medical bills he can’t afford. In an effort to find an affordable solution, one of the show’s doctors offers up “we’ll get together everything you need at home – and a referral to North Side Christian Health Center.”

The particulars of the patient’s story were fiction.

But for Dr. Malzi, a pediatrician and North Side Christian Health Center’s real-life chief medical officer, the outlines of the story – potentially deadly health crisis, emergency room, astronomical bill, and an uninsured patient who needs high-quality care to manage a long-term condition – were completely familiar.

“It’s really validating to hear that coming from a major TV show,” he told Direct Relief. Many times, “patients truly are in crisis…it’s a lot more people out there than I think people really know about.”

Real-Life Crisis

Dr. Malzi described an uninsured patient with high blood pressure and diabetes who was rushed to an ER with chest pain. It turned out to be a myocardial infarction – a heart attack. “His arteries were severely blocked, requiring that he have a triple bypass in the hospital,” Dr. Malzi recalled.

The patient was discharged with an expensive list of medications for recovery. (He already needed medications for diabetes and hypertension.) At North Side Christian, providers worked with him to develop a treatment plan, and arranged for him to receive low-cost prescriptions from a charitable pharmacy.

Now, “his diabetes is under better control, and he is actively involved in improving his diet and exercising more,” Dr. Malzi said. “He has not been back to the emergency room since his initial heart attack.”

Another patient was admitted to a local ER with deep vein thrombosis, and given a prescription for long-term anticoagulation therapy he couldn’t afford. Once he was referred to North Side Christian, providers were able to source low-cost medications for him, including a prescription for the anticoagulant dabigatran, provided by partner Direct Relief.

One of North Side Christian’s recent patients could have substituted neatly in for The Pitt’s: Despite being employed as a chef at a local restaurant, he didn’t receive health insurance through his job. Although he knew he had diabetes, he couldn’t afford the medications he needed to successfully manage the disease.

He was rushed to an ER in diabetic ketoacidosis.

Behind the ‘The Pitt’ storyline

Again, the emergency room staff referred him to North Side Christian, where providers worked with a charitable pharmacy to source his medication at low cost, and he began walking his dog and lifting weights. His diabetes is now under control, Dr. Malzi said.

“It’s fictional, but this is really what happens in real life,” said Robert McGrogan, the health center’s development director. “The Pitt has done a great job of highlighting all things Pittsburgh, but to hear North Side Christian specifically called out, it was really validating.”

CEO Bethany Blackburn wasn’t entirely surprised when she saw the episode. About a year ago, she said, the show’s writers – and lead actor and executive producer Noah Wyle – asked to meet with her. Throughout their conversation, she said, they were focused on what would happen to someone in the area who didn’t have health insurance.

“I told them you can get preventive care, but as soon as you start needing specialty care or something more complex, you’re getting into needing to make some more difficult choices,” she recalled. “We see patients who are pretty nervous entering the healthcare space because they don’t know what it’s going to cost them.”

North Side Christian Health Center was founded in the 1990s by three physicians who were concerned about the poor health they saw among Pittsburgh’s lower-income residents. Today, the health center cares for about 3,800 patients each year.

Seventy percent of their patients belong to racial and ethnic groups, 18% are in public housing, and virtually all are within 200% of the federal poverty line. Like other community health centers, they care for a high percentage of uninsured patients, and never turn people away when they can’t pay.

Saying Yes

Many of Dr. Malzi’s patients have been struggling for years to avoid a health crisis by the time he sees them.

“You’re worried and you’re hoping to God that something doesn’t happen to you,” he said of many patients’ experiences. By the time they come to North Side Christian, “there’s a heaviness when they initially meet [a provider]. They don’t know where to turn. They don’t know if they can trust you.”

Being able to offer patients high-quality care over the long term – helping them source free or low-cost prescriptions, developing a long-term plan to manage diseases like diabetes or hypertension, and providing consistent and stable clinical care – is one of the highlights of Dr. Malzi’s job.

“I can be the person who says yes to our patients when so many people can’t say yes,” he said.
That often means helping patients access healthy food – via food boxes that the health center provides or food vouchers from a local partner – or legal services in addition to healthcare and medicine.

It’s the ability to provide this kind of service to the most vulnerable patients – to change desperation to health and stability – that drew Dr. Malzi to this work.

“We’re not exactly a big, flashy place to work,” he said of working at a community health center. “Not a lot of people know who we are. We’re used to working in a low-resource setting.”

But Dr. Malzi takes continuing motivation from the impact his work has. Talent, he said, is best used where it’s most urgently needed.

“And that’s a federally qualified health center,” he told Direct Relief. “I don’t think there’s any place you can do quite as much good with the talent you have.”