‘The Pitt’ Production Designer Unveils Historic Designs In Season 2

From creator R. Scott Gemmill, The Pitt highlights the challenges U.S. frontline healthcare professionals face through the lens of the fictional Pittsburgh Trauma Medical Center’s emergency department. In a real-time, hour-by-hour format, audiences see the medical cases and the personal turmoil (and occasional life-saving joys) that physicians and nurses must navigate as they reckon with an overabundance of patients and a lack of resources.

For production designer Nina Ruscio, creating that world meant building an emergency department capable of sustaining the series’ relentless pace without ever feeling repetitive. The Season 2 expansion completes more of the 360-degree set, giving the camera and performers even more room to move through the hospital’s maze-like environment. But much of Ruscio’s most meticulous work is designed to go unnoticed, from embedding lighting into the set itself to camera-testing every material and paint color. Even seemingly small details, like an owl carved into the hospital’s columns, carry deeper meaning. Here, Ruscio takes Deadline inside the design of The Pitt, from its pediatric and waiting rooms to the painstaking details that make the emergency department feel lived-in and real.

DEADLINE: What has changed between The Pitt Season 1 and Season 2? How do you make the environment more dynamic when an emergency room is just an emergency room?

NINA RUSCIO: We actually made a big addition to the second stage. Essentially, the set is on two different stages. On the first stage, we went fire lane to fire lane and completed every single inch of that thing. There’s not a single spot on that stage that’s not well used for full-on immersive scenery.

But on the second stage, we drew a line in the sand in the first season because we wanted to preserve a big batch of that stage for other purposes. But at the beginning of Season 2, we gave that up. We wanted to make the set on the second stage—the triage and the waiting room—as immersive and 360-degree photographic as possible.

DEADLINE: Are there any areas of the hospital that you’d love to explore onscreen that viewers haven’t seen yet?

RUSCIO: Well, there are. That’s a twofold answer that I’m going to give you. What’s very impressive to me is that we are now working towards 45 episodes of this show. As someone was saying to me the other day, it’s 45 hours of television in an environment that was essentially designed as a pilot. And that it has sustained this much storytelling is very satisfying for everybody because it was a daunting task to be asked to do something without written words, and for it to have had all the life that it’s had. And people are not at the doldrums level of it yet. I’m very proud of how the set has sustained people’s interest. And it was intentionally designed to confuse you at the beginning, so you couldn’t take it all in and fully understand the geography as a viewer.

If you look at all the curves in the floor and ceiling, keep your eye going as if you can continue around, so you never really know where the beginning and the end of something is. So if you’re wondering what parts of the hospital we’d want to explore, we’re so dominantly the emergency department that the need in the story would have to be born out of a need in the story to tell of another department in the hospital, which would be a little counterintuitive for this show because there’s so many stories to tell about the emergency department.

DEADLINE: Any Easter eggs you’d like to point out for the fans that they might not notice?

RUSCIO: There’s an owl carved into the columns. They are as if they’re painted terracotta tile, essentially. And I love this owl detail. Owls are a symbol of the transition between life and death and wisdom and knowledge. They are also fierce and scary. For me, it represents metaphorically what happens here every day. The stakes are very high. You’re dealing with this intersection of where life might meet death and death might meet life. And all of that is the subtextual intensity of working in this environment because the stakes are really high. And that it’s a symbol of knowledge. I love that. And that maybe no one’s ever seen it. Maybe people have been watching this show for a while, and they’ve never seen it. But for me, these little gestures that point to what this place is all about, I love.

And the other thing that I love, that people have embraced, is this idea that these columns are in this physical space that are part of the original history of the 100-year-old hospital and that they haven’t plastered over them because this is the idea that the show is in a pit, that you’re in the basement of this hospital, and that this hospital emergency department is the foundational support for all the rest of the hospital that we don’t get to see.

DEADLINE: Was there a set piece that looks deceptively simple but is actually incredibly difficult to put together?

RUSCIO: Because the environment is 360 degrees, everything has to be capable of being looked at in detail, whether it’s the foreground, the mid-ground or the background, and all of it has to be accurate. But because we’ve made this very brave choice, and it’s borne itself out as satisfying, to light the environment primarily and exclusively with the practicals that are in the set – we don’t use traditional lighting. We don’t use ground-based lighting, and there’s not a lot of grip equipment. But we do not light from the ground because, as a director or as an actor, you can walk from one end of this set without any equipment in your way, as if it is a real emergency department. After all, all of the lighting is embedded there.

But the functions of what happens on a normal set, where there have to be bounce boards to light back up people’s faces, and all that stuff, that’s all designed into the set as well. So all of these flooring materials and all of these counter materials are calibrated and specifically chosen to function as grip equipment for uplighting. All of the top lighting is being reflected up, and that’s why the lighting is so full, because all of this stuff has factored in as functional elements of the craft that we normally would see as equipment that is not supposed to be seen. We needed to include all of that into the design because we couldn’t have that physical stuff in the space.

So it looks deceptively simple. But every single one of these materials was camera-tested. Every single paint color was camera-tested. The levels of sheen and saturation in a beautiful dark-ish palette of the wardrobe make people pop out because they’re the most important part of the story.

DEADLINE: I love the pediatric room. What conversations were had about the creation of that?

RUSCIO: Peds was born out of my very first meeting because I met with John [Wells] and Noah [Wyle] and Scott [Gemmill] and Michael Hissrich when they talked to me about doing the project. They approached me to design an emergency department before they wrote anything. And that’s an extremely flattering and unique position to be in because I needed to cover any possibility that they might come up with. In speaking with them, we tossed around a lot of ideas, and whether it was an institutional design, it still has the essence of what should be an emotional reflection of the people that are in it.

And so my conversation with Noah centered on the idea of a space where there would be a discordance between what the physical space looked like and what was happening emotionally in that room. He had this idea of a single animal, and I suggested it could be a menagerie of animals. And this space, this ironic room of cartoon animals and colors, would be the place of such extreme trauma. And that juxtaposition holds true to a lot of life. A lot of really bad things happen in a lot of really powerful, beautiful places. And then these places hold emotional psychotraumatic weight, ultimately, always, no matter when you step into them. So that was born out of that.

DEADLINE: The waiting room next to Peds also has color, not as much color, of course, but it matches that elaborate staircase in the back where we sometimes see characters taking a moment of respite.

RUSCIO: This waiting room is the idea that the emergency department has a completely historical space that hasn’t been renovated in a hundred years; that was a big important part of the story to tell. And then there’s all kinds of layers of time in these furnishings. Maybe they got these chairs when they first got there, and then they got all jacked up, so they covered them with plastic. Then they tried to get more chairs from the same manufacturer, but they didn’t make them. All of these are brand-new, custom-made, and aged to tell these stories. But all of these subtle internal details help make the space look real and invisible because that’s what it would be if you had a hundred people in here every hour of every day. It would be a really pretty, physically traumatized space and beat to shit.

DEADLINE: Does anyone still get lost on set?

RUSCIO: People do still get lost, but really part of that is solved by our OSHA compliance. So all the emergency signs and exit signs are real. If you go to them, they will take you out, and you will be safe. But also, if you keep walking and walking in a circle, you’re going to get back to where you came from. It’s both practical and real.