From its series premiere on HBO Max, one thing became evident about The Pitt: This is the best show of 2025, with Emmy-worthy work both in front of and behind the camera. Not only does it excel in showcasing the doctors and patients at the Pittsburgh Trauma Medical Center, but it also does so in a way that’s fresh and unique: in real-time, with each Season 1 episode covering one hour of a 15-hour shift.

Leading the charge is Robby (Noah Wyle), the attending on shift grappling with it being the anniversary of his mentor’s death (a day he usually takes off), the usual pressures of the ER, the added ones of specific traumas, and a mass casualty shooting at which his stepson was present. All season is building up to a breakdown, which comes in Episode 13, one of the best of the season. Each episode tracks the weight being added to his shoulders, but none more so than this one, beautifully directed by Damian Marcano (who also was behind the camera for Episodes 3, 6, and 10, and will return for Season 2).

“I always was concerned about the human thread. The medicine that we do on the show is brilliant. I can’t even take full credit for that because we have actual physicians that come and give us a medical rehearsal right before we shoot a scene if we’re in the heats of a trauma or something like that,” Marcano tells TV Insider. “When I’m directing all of those scenes, I try to remind our performers, ‘Hey, you have this going on with this person.’”

He notes that the real-time aspect also allows the continuity to remain “so fresh,” such as in Season 1 Episode 6, when Santos (Isa Briones) drops the scalpel into Garcia’s (Alexandra Metz) foot, then we see her stitching it up.

Below, director Damian Marcano takes us inside some key moments from his Season 1 episodes.

The Pitt, Season 2, TBA, HBO Max