DARK SECRETS: It s made me very grateful for the nhs gerran howell is the brit of the pitt - The Real Truth

But British viewers have had to wait until HBO Max’s long-awaited UK launch in March, with a single episode of the first season dropping over 15 weeks. So while Howell’s American castmates are getting “a little bit mobbed” when they’re out in public, he’s been able to fly under the radar.

“It blew up and became very popular, and at the very peak of that, I came back home across the pond,” says Howell. “I don't have to worry about being recognised. It was nice to escape it, to be honest.” Still, he’s very much aware of the show’s impact and the passionate response it engenders. “I can usually tell when people have binged it,” he says, “They've got a look in their eyes.”

It’s an intense show. Set in the fictional Pittsburgh Trauma Medical Center, it follows an ensemble cast of medical professionals and patients over the course of a single day shift in a busy emergency department. Everybody is having an extraordinarily bad day – not least Whitiker, a fourth-year med student on his first shift in The Pitt, as its denizens mock affectionately nicknamed their overcrowded and understaffed workplace.

No spoilers for the UK audience, but the former farm boy from Nebraska receives a baptism of fire – and of all kinds of bodily fluids. He goes through five sets of scrubs over the course of one blood-and-urine-soaked shift. “It is almost farcical the bad day he's having,” says Howell. “But I loved to have the opportunity to go into something and embrace being a little bit out of your depth as an actor, let those instincts kind of run a little bit wild.”

Fans have been quick to develop a soft spot for Whitaker’s haplessness in contrast to some of the hyper-competent senior doctors rattling off quickfire dialogue that’s impenetrable to anyone without a medical degree. “I hope it’s a touchstone for audiences to kind of grab onto, for them to connect with a character that doesn't know necessarily what's going on,” says Howell. “Inside the chaos of all the medical jargon and all the competency, to have a character that isn't that way.”

Howell is also unique in that, of the current cast, he is the only Brit. Tracy Ifeachor played Dr Heather Collins in the first season, but was subsequently – and somewhat controversially – written out (with the loss of Dr Samira Mohan, played by Supriya Ganesh, some fans are getting testy about the loss of two major characters portrayed by women of colour). Not that you’d guess from his nailed-on Midwestern accent. Luckily, he already had one in his repertoire when the invitation to audition came “A lot of the Brits, we've grown up with American TV, right? And as an actor, you’ve always got a general American accent in your back pocket.”

But when he got the invitation to send in a self-tape for a new medical procedural, he assumed the job would go to an actor already based near the Warner Bros Burbank Studios. “I was a bit dubious whether it would go any further,” Howell says. “Ninety per cent of the time, in my experience, when you look up who's got the job, it's someone who's from LA.”

At first, he assumed the part was for a stereotypical American medical procedural. That changed when the scripts came through. “Then it was very obvious that they were doing something very different,” Howell recalls. “It became very apparent they were doing something very, very special when we got a brief from Noah [Wyle, The Pitt’s star and co-executive producer] along with the tape request, which was kind of a mission statement.” The show was going to be intense, said the brief, with a focus on making it something more akin to theatre. This was an invitation to “be a part of something big”, says Howell. “It was a call to arms.”

Several of the cast members come from theatrical backgrounds. Isa Briones, who plays Dr Trinity Santos (the spikey fellow intern who bestows the nickname ‘Huckleberry’ on Witaker), is starring in Just in Time on Broadway between seasons, while Patrick Ball, who plays Dr Frank Langdon, is making his Broadway debut in Becky Shaw. Howell, by his own admission, hasn’t done much theatre (yet), but one suspects the casting directors’ interest was piqued by his role as Private Parry in Sam Mendes’s film 1917, which was shot in just a few extraordinarily long takes.

The Pitt is, likewise, a highly choreographed affair, Howell explains, and not just for the trauma scenes that require a lot of people and moving parts. The action often follows characters as they move through the department’s many wards and bays. “It feels like the filming of a play, with the real-time aspect of it,” he explains. “We're all on set all the time, also. Even when the camera isn't necessarily on us, we're still expected to be continuing scenes off camera.”

While they can’t freestyle any of the medical jargon, otherwise the cast is actively encouraged to “get loose and willing to play and improvise” says Howell. When they’re not doing these background scenes, the cast uses the ER’s ‘family room’ as their green room. “We're always hanging out,” he says. “We’ve become a nice little close-knit family.

Medical accuracy is another key ingredient in The Pitt’s secret sauce. Beyond watching Casulty growing up, Howell hadn’t had much prior exposure to hospitals. The cast were put through medical boot camp before filming started, and there are medical consultants on set at all times. While urban legend has it that Wyle, who rose to fame playing Dr John Carter on ER back in the Nineties, has stitched up an injured crew member on set before, Howell has no desire to put his Pitt training to the test. “At the end of the day, I've just got to let it trickle out of one ear,” he says. “Otherwise I'll go a bit insane.”

The real pressure, he says, comes when working with some very valuable props to simulate some particularly graphic medical procedures (The Pitt, famously, loves an intubation scene).

“A lot of the time, we're presented with very expensive prosthetics,” says Howell. If they’re cutting into it, they only have two, maybe three takes to get it right. “That sounds like a lot, but when you are cutting with a scalpel, there's also two men underneath the bed with a pneumatic contraption that's full of fake blood, and someone else pumping a fake heart, and it all has to work together,” he says. Sometimes, Howell explains, it’s best not to ask how much that fake heart costs – especially when the director is encouraging you to compress it harder.

Filming three seasons in as many years requires an intense production schedule. Back in September, when The Pitt swept five Emmys, the cast and crew went straight back to the studio after a night of celebration. Scripts for each episode are only a week or two before they start filming the episode. “Sometimes we would have barely any time, they were almost cold reads of the scripts,” says Howell. “We'd all be gasping and exclaiming and swearing.” They’d try to guess which patients would make it, “We were not far off from setting our own betting pool on which characters were going to get killed off,” Howell jokes.

Life and death in the emergency room is heavy stuff. Like switching in and out of his accent between scenes, Howell is careful to draw boundaries between himself and the fictional trauma surrounding his character.

“It puts into perspective what the real medical professionals go through, losing patients on a day-to-day basis, no matter how hard they try. Whitaker really struggles in that aspect. You meet someone, you potentially connect with them, make them feel safe, and then you can lose them. How much of yourself do you give to those patients as the character? But I have the luxury of being able to let it go, because it's not real.” The exhaustion the medics experience as the shift drags on is real for the actors, though. “It can be intense,” he says. “Sometimes you just have to go home and sleep.”

For Howell, there’s an extra bit of perspective given The Pitt is set in America, where everyone is at the mercy of health insurance. Many of the show’s plotlines revolve around patients who can’t afford the treatment that would save their lives. The actor still can’t wrap his head around it. “It's made me very grateful for the NHS,” he says. “The most surprising thing was that money can be such an obstacle in life and death. That’s still very crazy for me”

But the actor hopes that British doctors and nurses will see their own experience reflected back at them, something to watch with friends and family who might not understand the highs and lows they go through on a daily basis. The pandemic left just as many healthcare professionals burned out here as it did in the US. “I think it will be very eye-opening,” says Howell. “There's some catharsis there for people here, an appreciation of what we have, and maybe a warning of what we could lose.”

It’ll be worth it, he reckons, even if the price is privacy. “There may be less places for me to hide,” he says, “but I can’t wait for the UK reaction.”

All episodes of THE PITT Season 1 are available to stream exclusively on HBO Max in the UK and Ireland, with episodes from Season 2 airing on a weekly basis