The Pitt, HBO Max’s hospital-set drama, back for a second season, is a throwback in every sense of the word: formulaic, propulsive, topical. Each episode represents a single hour of one shift in a Pittsburgh emergency department presided over by Dr. Michael “Robby” Robinavitch (played by Noah Wyle) and the charge nurse Dana Evans (Katherine LaNasa), immersing viewers in the relentless stress of crisis medicine. Season 1 detailed how Robby—a crinkle-eyed stalwart whose stethoscope seems made of thorns—was still suffering from PTSD from his experiences working during the coronavirus pandemic, while a violent attack from a patient made the otherwise flinty Dana reconsider whether her job was still bearable. None of this was unfamiliar to viewers of ER, the groundbreaking NBC hospital drama that ran for 15 seasons, introducing Wyle as the haplessly green medical student John Carter, and that tackled an array of social issues including HIV, sexual violence, and drug addiction. “The popularity of the show ensured we could do stories we were proud of,” John Wells, one of the show’s executive producers, told Today as the series was ending. TV was still in its virtuous Very Special Episode era when ER debuted in 1994, but 30 years later, when Wells, Wyle, and the writer R. Scott Gemmill reunited for The Pitt, antihero narratives and dissociative sadcoms had inured TV viewers to anything earnest or didactic. (A lawsuit is still pending from the estate of Michael Crichton, the creator of ER, over whether The Pitt is an unauthorized reboot of the earlier show or simply a medical drama in the same mold.) Even so, The Pitt was a smash. Plotlines tackled the fentanyl crisis, vaccine hesitancy, and a mass shooting at a music festival, unloading catastrophe after disaster on Dr. Robby until he physically broke down, having a panic attack alone in a pediatric treatment room. The series later won five Emmys, upending presumptions about the kinds of shows people still really want to watch. [Read: The Pitt has revolutionized the medical drama] Some might call The Pitt preachy. (A recent Vulture review argued that the show’s righteousness has become “distractingly pedantic, even patronizing,” as though considering real-world flash points through a humanizing lens was wholly new for television rather than embedded in its history: Remember Maude’s abortion? Rose’s Golden Girls HIV test?) I’d argue, rather, that The Pitt has an emphatic moral clarity that feels awkward only because we haven’t seen it for so long. It refuses to both-sides issues that it considers straightforward. Should you vaccinate your children against measles? Yes, The Pitt says, offering up a child with not just spots all over his body but also acute inflammation in his brain and spinal cord. The show is set in the emergency room, where society’s problems become inescapable, where people who have fallen through the cracks land. In an era of relentlessly absurd and wealth-washed TV, The Pitt’s realism, its defiant lack of glamour, is bracing. The second season is even more insistent than the first that we wake up. Set on the Fourth of July, a day devoted to blowing things up and gauzy narratives of American exceptionalism, it opens with Dr. Robby riding to work triumphantly on a motorcycle, wearing no helmet, impossibly contented as he heads to his last shift before a three-month sabbatical. I mention the helmet because it feels relevant, just as important as the fact that Dana smokes—being confronted daily with the consequences of risky behaviors doesn’t make The Pitt’s staffers any less human. Case in point: Frank Langdon (Patrick Ball) is back from rehab, after being caught last season stealing prescription drugs from patients, and his return seems personally offensive to Robby, who can’t quite bear to look at him. The resident coming to take Robby’s place, Dr. Baran Al-Hashimi (Sepideh Moafi), similarly needles him, with her cautious approach and bureaucratic lean (she’s a big fan of generative AI). Over the course of the first nine episodes made available for review, the doctors do their best to patch up the gaps in people’s lives where a social safety net should be. They tend to surly patients who accuse them of profiteering, an unhoused man with a festering wound on his arm, a new baby abandoned in a bathroom. A patient of Dr. Samira Mohan (Supriya Ganesh) absconds because he’s so terrified of the medical bills he’ll amass if the hospital treats him. We see the direct impact of ICE deportations on families. The show is even more graphic this time around, given its emphasis on the bodily indignities both doctors and patients can be subjected to (I do not recommend watching while eating). Blithe stupidity is a constant: Multiple patients try to film their doctors to post on TikTok. And risk is everywhere. Dana tells a new nurse that the ER has a safe word, Hula-Hoop, should health providers feel threatened, and one of the floor’s residents, Mel King (Taylor Dearden), is preoccupied by a deposition she has to give for a malpractice lawsuit. All of this makes for very good television. The show’s ability to flip back and forth between patients is both narratively forceful—we don’t have time to get bored—and realistic. Wyle and LaNasa, both of whom won Emmys last year for their roles on The Pitt, manage to show us exactly how much their character’s job costs them without leaning all the way into martyrdom. Wyle especially underscores Robby’s innate humanity while also letting us see his god complex, his unwillingness to be challenged. Over the course of the shift, his body seems to calcify with tension, as though every successive hour in the hospital adds weight. And a scene in which Dana treats a rape victim—documenting the care she takes, the processes she meticulously goes through, and the rage she experiences when she discovers a rape kit from two weeks ago ignored by local police—is indelible. There’s simply no way to watch The Pitt and feel good about the way society is currently functioning. Which is the point. The show can be funny, the camaraderie among the characters is gratifying, and the doctors are extraordinarily good-looking in the way only TV doctors can be. But in a moment when most series seem intent on keeping us mindlessly half-engaged and monetizing the minutes we watch, there’s something inherently satisfying about a series that actually wants us to think. And, even more crucially, to care.