In The Pitt

In search of existentialism

One of the features of our time is how feelings have trumped facts. As Fredrich Nietzsche put it a hundred years ago, “There are no facts, only interpretations”. So this trend is not new so much as newly adopted. This has resulted in an accompanying change in the meaning of words, of which you will all be familiar, so I won’t bore you with a long list of examples.

But one other feature of the times is how we have latched onto some words and given them newly discovered meaning. One such word is ‘existential’.

(As an aside, I must tell you about my recent discovery of a new species of freshwater shrimp that can change its sex from male to female at will. How modern is that? No, it’s not called a Transhrimp, it’s called a Paratya Curvirostis and I discovered it while reading an extremely dry book on botany.)

Back to my word of the week, ‘existential’. I have previously tried to demonstrate that the removal of this word from any sentence does not in any way change the sentence’s meaning. On the other hand, I acknowledge that its inclusion does undeniably add gravitas to the sentence. For this reason I have been using the word often recently, hoping it will reveal some recognisable meaning that demands its inclusion. Imagine my pleasure therefore when I came across a copy of Jean Paul Sartre’s L’existentialisme est un humanisme (1946) in my library while browsing for some bedtime reading to clear my path to ‘a good night’s sleep’.

Now, I’m not going to pretend that I read Sartre in French, for that would make his work essentially unintelligible to me. No, I read it in translation, which makes it only mildly less unintelligible, and I openly admit that I have An Introduction to Existentialism (1948) published by the University of Chicago Press to tell me what the hell he meant.

For context, let me describe the circumstances at the time. I had finished reading Lenin in his Own Words and Quotations of the Anarchists and needed an escape from binge watching Yellowstone and Industry on television when I came across the award-winning series The Pitt, set in the emergency department of the Pittsburgh Hospital. A review described it as ‘an existential drama’, so I was compelled to watch.

A tendency to be fatalistic about life and death, and medical matters generally, may make me sound flippant. I recall an occasion during the Covid pandemic when a woman friend expressed awe and sympathy for Jacinda Arden and the weight she was carrying on her shoulders saving the lives of all New Zealanders. In response I opined that the best way to take the weight off her shoulders would be to remove her head. (I haven’t heard from my friend since, and it’s been 5 years.)

Nevertheless, as a frequent visitor to emergency departments in recent years I have a proprietorial attitude towards them. Part of the attraction is recognising many of the symptoms patients are manifesting, and part of it is accurately predicting the treatment they will be offered. There are many other highlights of this show that I could mention. For instance the skilful casting that has managed to find a space for every single race and nationality in the world, and the portrayal of the lead doctor as a man who, in any other environment with similar stress levels would be a candidate for emergency treatment himself.

Needless to say, the fact that the majority of Americans are unable to afford Medicare or insurance is front and centre in this ‘existential’ drama and we are left in no doubt that ‘upstairs’ hospital management, cold-hearted insurance companies, and the ‘they/them’ of the country’s elite are squarely to blame. But if you want to know where the world’s saints are hiding, they’re up to their armpits in blood and guts, exhaustion and insulting levels of underpayment in the ED ward of The Pitt.

No time for sleep, no time for sex; that’s the right show for me I thought. I’ll binge watch it until an hour before bedtime. Well, it’s like watching a hamster on a treadmill with no way of slowing down or getting off. Not only is the pace relentless, each trauma being swept aside by a new and greater one arriving every two or three minutes, but the camera close-ups of fingers and scalpels penetrating open wounds quickly inure one to horror or pity. Bodies cease to be people and become merely soft-tissue objects.

Jean Paul Sartre’s philosophy of existentialism, as far as I was able to understand it at 2:00 a.m. in the morning, is that existence precedes essence. This means that humans first exist — we are thrown into the world without any pre-defined purpose, nature, or blueprint (as ‘soft tissue objects’) — and only afterwards do we define ourselves through our choices, actions, and projects.

In short, Sartre’s existentialism emphasizes one’s responsibility for one’s life, and the absence of any given meaning — or essence — until we create it through our choices (for which we bear complete responsibility, with no excuses).

So how did the adjective ‘existential’ suddenly become the most over-used word in media, such that The Washington Post, The Atlantic, The Guardian, the NYT and BBC cannot express themselves without including it? In their worlds now there is no threat that isn’t an existential threat; no crisis that isn’t existential; and no anxiety that isn’t existential dread. As a buzzword it has become an intensifier, serving as a stylistic flair, while adding no substantive meaning.

Perhaps it’s being used as a synonym for ‘very bad’. However, most threats, crises and dreads are already understood to be very bad, in which case it’s redundant.

The Pitt is a very good hospital drama. Surprisingly few people die, only a minority are there by dint of their own actions and choices, and it is a remorseless and chilling example of how vulnerable the fleshy body that contains our essence really is.

As TV shows go, it’s very good. But it ain’t ‘existential’. So could we please stop trying to impress by using the word.

A.I. Fabler

March 28, 2026