While 1:00 P.M. is lunchtime at Pittsburgh Trauma Medical Hospital, its emergency department is too busy for anyone to actually eat lunch. And besides, a simple attack of the hangrys does not fully encompass what’s going on in Episode 7 of The Pitt, which presents a staff verging on fray mode. “We risk our lives coming to work here every day,” Dr. Robby snaps at Gloria in round two of their argument from last hour. He’s got a near-assault on one of his senior residents by a mom angry about her daughter’s potential abortion, 50 unseen cases waiting in chairs, and an existing patient traffic jam between trauma and open beds in the ICU and psych wards. “One of ‘em” – The Kraken; remember when he pissed on Whitaker? – “has been here for a fucking week.” Glaring at Gloria, Robby folds his hands in mocking penitence. “Please, for the love of God, hire more nurses.”

That the attending and his staff are overworked is not in doubt. But Robby’s attitude is driving wedges as his stress grows and he continues trying to manage his PTSD flashbacks to Adamson’s COVID fate. When Mohan treats new patient Nandi (Sasha Bhasin), she pauses the differential diagnosis that would indicate schizophrenia, and the Slo-Mo stuff rises back up. Thing is, though, Samira might have correctly perceived her patient’s condition as not psychological but a byproduct of Nandi’s life as a beauty product influencer. Robby ordered Mohan to move on, Collins said she’d back her up, and in turn, attending attacks resident for undermining his authority. Glimmers of a past-present romance dashed?

Tracy Ifeachor plays all the sides of Dr. Collins’ personality so well. In one minute she eases Kristi’s desperation and fear over the medical abortion, in the next minute she convinces Kristi’s mom to respect her daughter’s choice, and in the next she whirls on Robby and his double standard. Collins calls out his working a PTMH shift he knows will be emotionally trying. It’s imperative that his staff leaves their baggage at the door, but he’s allowed to carry his around in trauma, take it out on everybody working there, and threaten the professional growth of a promising R3 like Mohan? Come on, son. The air is charged with bad vibes as Collins and Robby are each called away from the argument. 

But the staff fraying doesn’t stop, because Dr. Santos is incensed with Robby, too. What she thought were alcoholism-related symptoms in Silas Dunn (Tyler Poelle) are actually the result of his wife Susan (Jessica Morris) dosing his coffee with the hormone steroid progesterone. To kill her husband’s libido. So he stops molesting their teenage daughter. But Santos’s shock over this revelation turns to anger when Robby refuses to report Silas directly to the authorities, and adds they’d have to report Susan for attempted poisoning. 

Robby’s just gonna let the girl continue to be a target for incest? Her attending surgeon’s attitude and hospital regs be damned. Santos, with more than a suggestion about her personal history with such abuse, addresses Silas while he’s conscious but still intubated. Don’t fuck with his daughter, and don’t fuck with her. “Blink twice if you agree to this. Once if you want me to let you die. I’ve already lost two patients today, one more’s not gonna make a difference.”

In the midst of this heavy shit, this week’s Pitt does find some time for bonding instead of fraying. Langdon’s getting nowhere with his new case, a man with a sprained ankle. That is until Mel recognizes that Terrance is autistic; her sister is also on the spectrum. (Terrence is played by autistic actor Coby Bird.) She dims the lights, calms his apprehension, and takes interest in his table tennis dreams. Langdon compliments Dr. King for her overall work in the emergency department, but he’s also visibly impressed with her ability to connect with Terrence. “How’d you do that? Talk to him?” And a hotshot senior resident learns a lesson in humility from a second-year. “I listened.”

And remember Minu (Arun Storrs) from way back in Episode 1, and how the Nepalese woman’s leg was ruined when she was pushed onto the tracks of Pittsburgh’s T line? Well, Sam (Lovensky Jean-Baptiste), whose name matches his Good Samaritan status, has woken from sedation. Collins and McKay fogo the translation machine as Minu and Sam greet each other from their respective hospital beds. He saw who pushed her, Sam tells her. He’ll work with the cops to find a little bit of justice for what happened to her. A thankful Minu clasps something into Sam’s palm – it’s a pendant representing Vishnu, protector and guardian of the universe. There is no language barrier here, just the assurance that there is still good in the world.

But there is also another facet of The Pitt’s earliest moments that has returned, and not in a good way. While Dr. Collins has continued to feel minor twinges of discomfort stemming from the pregnancy that she acknowledged only to Dana Evans, here in episode 7, after Collins solved the mother-daughter abortion altercation and gave Dr. Robby’s snippy attitude what for, she’s thinking about a weekend to herself and a Great British Bake Off marathon when something suddenly feels very wrong inside. Sadly, there is another facet to how great Tracy Ifeachor is in The Pitt, because once inside the restroom, where she discovers blood in her underwear, a weeping Collins slams her fist into the stall’s walls in despair.

Johnny Loftus (@glennganges) is an independent writer and editor living at large in Chicagoland. His work has appeared in The Village Voice, All Music Guide, Pitchfork Media, and Nicki Swift.