How The Pitt’s Realism Impacts The Actors and The Audience: Shawn Hatosy, Emmy-Winning Actor and Director

Lindsey Smith

Hi, I'm Lindsey Smith, welcoming you to Raise the Line from Elsevier, an ongoing exploration about how to improve health and healthcare. HBO Max's hit show, The Pitt, has struck a chord with audiences across the country, including many clinicians, by presenting a realistic look at the challenges of providing emergency medicine.

As we learned in an interview earlier this year on the podcast with Dr. Mel Herbert—one of the show's and advisors—a lot of care is taken to get the medicine right, but also to capture the psychological burdens this work can create.

We move today from the writers' room to the set of The Pitt by welcoming actor and director Shawn Hatosy, who plays Dr. Jack Abbot on the show. Dr. Abbot is a physician with an edge. He brings calm in the face of chaos and can handle seemingly anything thrown at him. But he's struggling underneath it all, and that tension has made him one of the show's most compelling figures.

Shawn Hatosy has been a constant presence on the screen for nearly thirty years, with TV credits that include standout roles in Southland, Chicago P.D., and Animal Kingdom. On film, he's perhaps best known for his work in Anywhere but Here, In & Out, and Outside Providence, to name a few.

His portrayal of Dr. Abbot earned him the 2025 Primetime Emmy for Outstanding Guest Actor in a Drama Series, and this year he earned a second Emmy nomination for his role, moving up to the Outstanding Supporting Actor category as his part on the show expanded.

He's also stepped behind the camera this season, directing an episode of The Pitt in addition to his expanded role on screen.

Shawn, welcome to the podcast today.

Shawn Hatosy

Thank you. Thanks for having me.

Lindsey Smith

So let's just jump right in, and let's start with learning more about your background and what first got you into acting.

Shawn Hatosy

Wow. I grew up in fr— in a small town called Ijamsville in, in Maryland, just near Frederick. I was kind of an athletic kid, and it was pretty a s— pretty suburban, kind of a small-town feel outside of, like, forty-five minutes outside of Washington, D.C., forty-five minutes away from Baltimore, and I, around the sixth grade, I started to show an interest in performing arts.

There wasn't a lot of opportunities, really. I found my way in, in through the chorus, and my, my mom— that was one of our, you know, electives. So it was either, like, chorus or study hall, and I got thrown into the chorus. I was one of three guys, and I found out very quickly that they needed guys. There weren't a lot of options, right? So that was, that was my way in.

I— I, I wanted to be in the, the— there was a— our first performance was Santa's Frosted Follies. I wanted to be Santa Claus. I didn't get the part. I got the role of the clown, and that was it for me. I just kind of leaned into it. There was also community theater around town. You know, the, the, the sort of local community playhouse would do musical theater. I wasn't a really good singer, I wasn't a really good dancer, but it was just my way in.

And sometime around that, my— there was a kid in our neighborhood who was doing, like, local auditions for commercials. He actually got a commercial, which was such a big deal, and my mom knew his mom. I got introduced to their manager, and I started auditioning for things locally. So that was kind of my start.

Lindsey Smith

That's interesting. It all started from choir, and today you are on The Pitt. So let's talk about Dr. Abbot, because he's quickly become one of The Pitt's most beloved characters. So for any of our listeners, maybe, who aren't familiar with the show, Dr. Abbot is a former combat medic, widower, and amputee, who is clearly carrying a lot kind of beneath that surface. Can you tell us what it's been like building a character with that much internal complexity?

Shawn Hatosy

Yes. Well, what I love most about Abbot is that, that his complexity is underneath the surface. He doesn't s— you know, he doesn't outwardly tell you about his trauma. He's, he's a combat vet, an amputee, a single-leg amputee. He's, he also lost his wife. He has struggled with his mental health, but he's also incredibly functional and very good at his job.

You know, I think his, his calm comes through having seen so much. There isn't a lot he hasn't seen, in terms of just his, his combat history and also what he's seen come through the door as a, as a, an attending physician in an ER. I think he's learned how to operate under chaos because it's, it's almost a norm to him, and I always knew when I was crafting the character, just in my experience as a, as a human in the world, just seeing how, like, paramedics come into a scene and, and handle it with such, such ease and calm, and how everybody else around them is, you know, in panic mode.

I, I felt like that was Abbot's core, you know, that's his DNA. That's, that's how he moves through this world, and I really wanted to make that an important attribute.

Lindsey Smith

Love in the show how little pieces of his character kind of continue to slowly get kind of revealed throughout the show, and that brings me to something that I think the show is really kind of known for, with Dr. Abbot being so real, the show being so authentic. We talked earlier this year with Dr. Mel Herbert, who I know you know, and he shared just how intentional that sh— the show has been about getting the medicine right, with so many practicing ER physicians involved throughout production. But what does the show's commitment to realism look like from your side?

Shawn Hatosy

Yeah, we're, we're so lucky to have great technical advisors, real-life attendings. All, all of our three technical advisors do this. You know, that's what they do. So whenever we have questions about not only the procedure but just the, sometimes where they are emotionally or how they would handle it, they're right there with, with the answers.

I think the, the most important part of the preparation for Abbot is the re— repetition of, because these answers have to be on the tongue, you know, on the tip of the tongue. So it's, it's— it doesn't work if you're searching or, or looking for the words, because they're there. It's like they know, you know, this is the medicine that I'm gonna prescribe. It's right there. So that's, you know, I think the more preparation, the more, you know, it seems real.

Also with, within, in the, in the procedure, thank God. I mean, Abbot has to sort of be able to direct everybody and know what they're doing, and oftentimes he's just observing and teaching, which is great, because I can just pretend like I know what's going on, and then sometimes he does get very hands-on. But we, we spend a, a good amount of time going through each procedure as it would happen. Our technical advisors, our, our medical advisor shows us what we would be doing. Here's the, here's the probe, here's the phased array probe. You're gonna stick it here, you're gonna be looking at the, you know, at the monitor, and, and, and so thank— thankful to have these experts around me, because I, you know, I'd be lost without—

Lindsey Smith

You can really see that preparation, I think, come through with all of the medical details, and I think that's why clinicians have responded the way they have to The Pitt. So playing a physician is one thing, but sounding like one is a entirely different thing. Since so many of our listeners work in healthcare, I'm curious, how challenging has the medical terminology been, and were there any terms that tripped you up?

Shawn Hatosy

It's very challenging for me. I— you know, Dr. Fred, one of our technical advisors, said that your— once you go through medical school, your, your vocabulary, you know, you might have, like, access to four thousand words, but by the time you're done it doubles, you know, which is a lot, really, and so they're not y— it's not easy for, for, for people like me who are stepping into it, and I ca— I look at the words and— and we have to— I have to have it, like, written out phonetically, because particularly, like, the medicine, it just doesn't look like it's— it sounds.

It's almost like Shakespeare. You know, you have to sort of rehearse it and prepare it in that way and then bring your own meaning to it, and, and no, they come in and, like, I pr— I use them, and then once I move on to the next, they're gone. But, you know, it, it's interesting how, how some of the terminology, you know, we use it again and again, and I start to— then I read something like a diverticular abscess and I'm like, I, I know what that is. Like, that's really weird, and I, I just have so much respect for how much these information is, is, is in, in the head and how quickly they have to move from one case to the next.

And, you know, a person, you know, at— attending physician like Abbot or Robby, there is a certain amount of command presence that is required, and it's, it, it has to be so innate, and just because Abbot also has a military background, obviously that sort of, you know, leads it. But y— it's, it's just such a remarkable, you know, thing to be doing, and I have the utmost respect for, for these individuals, and I'm— you know, when I'm working on The Pitt, there's not a moment that I'm not thinking about what these people are experiencing day to day.

Lindsey Smith

I can absolutely relate on the medical terminology piece, and I think there's something really humanizing about hearing how much work goes into getting it right. I wanna switch gears a little bit and talk about the night shift crew, often referred to as the Nightcrawlers.

Shawn Hatosy

Yes. Right, the crawlers, the Nightcrawlers, as we call—

Lindsey Smith

Yes. So what kind of people are drawn to working those overnight hours, and what sets them apart from the daytime staff?

Shawn Hatosy

Well, you look at Abbot, you know, he's somebody who, as we said, there's a lot of uncovered hidden trauma that he's dealing with, and he's somebody that speaks openly about his, his comfort in the darkness, that his therapist recommends that he gets a hobby, that, you know, like golf, and so you can see that he's somebody who is in constant need of this pop of adrenaline.

I also, I don't think he likes to spend too much time by himself. He's, he's, he's moonlighting as a SWAT medic during the day when, when he should probably be playing golf or sleeping, you know. So as you can see, it's, it— it takes a certain type of personality to choose to work night, which I really like. I, I love that we explore that.

It's also totally such a different type of shift, which we don't get to see a lot of it. We get to see the end of, or, or the beginning of a shift at the end of season two. So you, you know, you, y— you see Dr. Cruz, Dr. Nazalie, Dr. Shen together as they begin their shift. They sort of have this hokey approach, you know, he's leading them through a chant, which is, you know, typical Abbot, sort of like— like a dad, you know, in the most uncomfortable way, but fun, and so, yeah, you, you, you see these different personalities, how they work. Also what's coming through the door is a little bit different than what, what we see during the day, and look, I mean, I'm, I'm hopeful that as this— the success of The Pitt continues, that we, we get to explore deeply more into this world.

Lindsey Smith

I love that answer, and I've heard that there's been some requests for a Nightcrawler spinoff. Is there any truth to that?

Shawn Hatosy

There's definitely been a lot of requests, I'm seeing it all the time, but I don't— you know, I've just— I've heard from— not, not like face-to-face, but I've heard in the press just how HBO Max and even Noah are not really feeling the night shift spinoff right now, but who's to say that that won't be something we explore down the road?

Lindsey Smith

Awesome. So staying on the Nightcrawler theme here, if Dr. Abbot had a Spotify playlist for a night shift, what's on it?

Shawn Hatosy

It's pretty funny. I, I would— I get that request a lot, so I, I made a playlist and I put it on back when I was involved in Twitter. I imagine Abbot, you know, as, as somebody who grew up in the nineties myself, and music was such a, a big part of the nineties, you know, with what, what is now known as grunge, but back then was sort of thought of as alternative, you know, the, the kind of, like, that, that, that would be my, my, my view of what Abbot's Spotify playlist would be.

Now, that's not to say that's what, that's what Scott Gemmill's view of Abbot's playlist would be, and he has a different idea of, of that, and we might, we might get a little sense of that going forward.

Lindsey Smith

Okay, we'll stay tuned for that, but I can definitely see that it feels very on brand. So let's talk about this past season. Some of the most memorable moments were between Dr. Abbot and Dr. Robby, with scenes that involve trust and tension and vulnerability all happening at once. What was it like bringing those scenes to life?

Shawn Hatosy

Yeah. Yeah, those are my favorite scenes w— when, when working on the show. You got two guys who can handle anything, any kind of medical crisis, but they're not necessarily equipped to deal with what's happening inside themselves, and, you know, and I, I— as we get to the end of season two, Robby is— he's in survival mode, very clearly, and he's— Abbot recognizes something in Robby because he's, he's been very close to that edge himself, right? And he's, he's not trying to fix him. He's, he's really just saying that, I know, I know where you are, I've been there, you're not alone, and, you know, Noah and I have developed a, a, a great trust with each other, so that, you know, we, we can, we can really— we're in a place where we can let those scenes just breathe and not push them, let them happen, experience the emotion as we, as we're going through it.

That's one of the things I found with Abbot. It's, you know, in season one he was sort of a, a pragmatic approach to getting Robby off the edge. He was saying, look, I didn't know what my purpose was when this day started, but through the mass casualty incident, it crystallizes his purpose, because not everybody can do this work. We're the only ones equipped to do it, and there's great comfort in knowing what your purpose is. There's also this feeling of— you have a guy like Abbot who, who, who does the, you know, the— they have a, a protocol for a mass casualty incident, and it's like there's binders and there's, there's all of this— these tools that they're ready in case it happens, and when it does, it's like, my God, look, I have all of the answers right here.

But when it comes to the end of season two and he sees, he sees Robby in survival mode and he tries that approach of this pragmatic, this is what we're here for, this is what— it doesn't work. He sees that the guy's in survival mode, and so he has to sort of lay out his, a little bit more of his emotional hidden trauma to, to, to get him to snap it back into reality, which only Abbot can do. And I really enjoyed how that scene played out.

Lindsey Smith

You two definitely have a special connection that you can see coming through on screen, and I, I think it resonated with a lot of people. You've mentioned previously that you get messages from attending physicians saying Dr. Abbot made them feel seen. What were they pointing to specifically, and did that tell you anything about what the show got right?

Shawn Hatosy

Yeah, I mean, there's, there's one particular guy I ran into in an airport, and he, he was from— he was actually with his kid, who was also a fan. We did a picture, and he said to me that he had a colleague recently who, who lost his life, commit suicide, and that the show really, you know, helped him sort of get through a, a brutal time, and not only that, but just the staff that— and I actually— Robby— I mean, Noah s— speaks to this exact case, 'cause I— it, it happened to be the same guy that Noah that knew, and we, we sent a video to them, to their, to their ER, because they were, they were struggling.

You know, it, it, it's a— a job that is very stressful, and it is hard to— when you're in a leadership position, to show that you're— that there are cracks, that you need— that you might need to, to ask for help. It's hard to ask for help, especially, you know, when you're in that position of, of leadership. So, you know, I— hearing from people and, and knowing that the— that we are getting that part of it right and, and talking about something that's not that easy to talk about, you know, that really is the core of the show. It's this man who is, who is struggling, and it's hard to say, look, I need professional help, you know? It really is.

Lindsey Smith

Absolutely, and that has to mean a lot. I think mental health is, is something that's not talked about enough, but such an important piece for healthcare workers and just the general public. So just to our listeners out there, if Dr. Abbot's story connects with anything that you're carrying yourself, know that you can ask for help and that support is available. We'll be sure to include, include some mental health resources in the show notes for everyone to check out as well.

Wanna switch gears a little bit and talk about this past season when you stepped behind the camera to direct an episode. Can you tell us what that experience was like?

Shawn Hatosy

Yeah, as you said early on, we're, we're— the immersive quality, the, the feeling that we are— you know, we as the audience are experiencing it, you know, in real time, that's kind of the, the, you know, what this show set out to do. It's, it's a little bit of a risk, I think, in terms of narrative, to try to, to capture something minute by minute, fifteen hours, in, in one shift, but I think that we have proved that, that, that this kind of concept works, and as we moved into season two, it's like not only does it work, but we're building on it, and, and it makes sense to try to tell this story and what medical professionals are dealing with day to day, or minute to minute, really.

Now, obviously we've had to pack a lot of medical cases into one day, and that would be, you know, it, it's probably twenty years' worth of medical cases into one, one shift. So in terms of realism, obviously we have to push it to make it make sense for, for this narrative, but as a director, the r— i— the, the job is to kind of make it seem like it's happening in a spontaneous way, however we've choreogra— choreographed it. So it, it starts to feel like, this, this, this is a, a ballet that we're seeing occur in front of us, but you really want to make it seem like it's— mistakes are happening and it's not perfect, and even with the camera movements, it's like it starts to become very choreographed, but then you're messing it up to make it seem real.

It's such a joy. It really is. It's so fun to, to do— you know, many of our actors have, have a, a theater background, and there's something about this show that feels like theater, because we run scenes together, sometimes, you know, three and four scenes, to, to s— to set this— set it up for the camera, and everything's working in, in sync, and it really is a lot of fun. I, I enjoy it. Thankfully, I have great medical tech advisors that are, are showing me what, what the— what these procedures look like, and I don't have to know all the answers, because I'd be lost, and, yeah, it's, it's been a lot of fun.

Lindsey Smith

You're telling such an important story, and it sounds like directing is something that you enjoy. So hopefully we'll get to see more of that in season three. I wanna ask you if you have a favorite— a favorite character beyond Dr. Abbot.

Shawn Hatosy

They're all so great. Yeah, I like, I like what Taylor has brought to Dr. Mel King. I really enjoy Santos and her, her dry personality and how she's copi— how her coping skills can be a little bit abrasive to everybody around her. I think Langdon's story is fantastic and one that needs to be told, you know, dealing with addiction and, and how, how that has affected his, you know, his medical journey, and, and it's also something that is very real and, you know, hard to discuss, you know, it's, it— and I think his performance is beautiful. I mean, I've, I've given you three answers and you asked for one, but I can't just pick one. It's like, you know, it— they're like my kids.

Lindsey Smith

That's okay. Yeah, you're so right. There's so many good characters. It is really hard to pick. I'm also a big fan of Dr. Mel King, and I also love Nurse Dana. There's something we hear about all the time from physicians is that they've worked with their own Nurse Dana, which I think is really cool. So in our audience, we have many students and early-career health professionals. If Dr. Abbot could say one thing to a medical student about to start their first clinical rotation, what would it be?

Shawn Hatosy

Yeah. Yeah. I would say wear comfortable shoes. I know. I— it's amazing that he has become this— he's been a— become an inspiring character. I, I've always played characters that have been shot at and ended up in the hospital or were— you know, so it's, it's— and I'm not the most— I wasn't the most academic student and barely got through school, so it's, it's, it's always such a, a, a fresh— a breath of fresh air when I hear people asking me advice about things like this, because I'm the one that needs the advice.

But, you know, I just think that it's important to— sort of what we were talking about before— is to take care of yourself mentally, and the, the stress that, that can come, come into this can have such a, a profound impact, and so it's, it's important to, to take those moments to take care, take care of yourself and not be afraid, if something is, is building up, to, to talk to somebody, and p— th— those tools are there, and, and we should all utilize them.

Lindsey Smith

Just play that back a little bit: it's important to take care of yourself and talk to someone if you need help. That's such a great piece of advice. Before we wrap up today's show, is there anything I didn't ask that you're hoping we'd have a chance to talk about?

Shawn Hatosy

Man. No, but I got my coffee mug, as you can see, and I wanna thank you for it. It's been— it's, it's, it's gonna be up there in our cabin, and I'm gonna use it all the time.

Lindsey Smith

I love it. I— it has been such a pleasure to have you on the show today. Thank you so much for spending time with us and inspiring the next generation of healthcare professionals. We are all looking forward to seeing what's next for Dr. Abbot in season three.

Shawn Hatosy

Thanks so much, Lindsey.

Lindsey Smith

And that does it for today's episode of Raise the Line. This has been a wonderful conversation, and I think everyone in healthcare listening will feel it too. Dr. Abbot isn't a hero in the traditional sense. He's someone doing an extraordinary job while quietly caring more than anyone can see, and the fact that real clinicians feel so seen by him says everything about what The Pitt is getting right.

It's also a powerful reminder that people caring for all of us need to be cared for too. In honor of Men's Health Month, we've included some mental health and wellness resources in the show notes. Please do take a moment to check them out. For those of you who haven't watched The Pitt yet, you can catch it on HBO Max, and we're counting down the days until season three begins. I'm Lindsey Smith. Thanks for listening to today's episode. Remember to do your part to raise the line and strengthen the healthcare system. We're all in this together.