It’s July Fourth on HBO’s ‘The Pitt.’ Why is it one of the deadliest days in the U.S.?
One of HBO Max’s biggest hits returns for a second season, this time set during a specific day: July Fourth. An expert explains why Independence Day is one of the deadliest and most hectic days for hospitals in the U.S.
“The Pitt,” HBO Max’s medical drama juggernaut, is back for its second season, and, this time, fireworks are in the sky and fireworks victims are in the ER.
The entirety of the hit medical procedural’s sophomore season is set during a single hectic shift for the show’s fictional Pittsburgh hospital on the Fourth of July. “The Pitt,” which has been praised for its realistic depiction of health care work, could have taken place on any day, so why Independence Day?
As it turns out, the Fourth of July is one of the single-most dangerous and hectic days for Americans and American hospitals, said Leah Prasse, who has 26 years of experience as a nurse and works as a visiting assistant clinical professor at Northeastern University’s Charlotte campus, which focuses on health care.
“Anything that mixes alcohol and explosives turns into a recipe for disaster,” Prasse said.
Most holidays tend to be particularly busy times for emergency rooms in the U.S., with staffing already at much lower levels than other parts of the year, Prasse explained. But the Fourth of July is particularly deadly. An average of more than 45,000 people visit emergency rooms in the U.S. on July 4 and 5, accounting for the highest daily numbers in the entire year, according to the Pew Research Center. The average daily numbers for the summer months are around 40,700.
The biggest culprit behind those ER visits is obvious: fireworks.
On average, more than half of all fireworks-related injuries every year take place during the first eight days of July, according to data from the Consumer Product Safety Commission.
“It doesn’t just affect a certain demographic,” Prasse said. “Little kids, older folks, everyone is out there participating.”
While most of those injuries are minor and involve heat burns, bruises or cuts, there is plenty of factual backing for “The Pitt” to tackle more serious, and horrifying, Fourth of July injuries.
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A little less than 4% of fireworks-related Fourth of July injuries involve a body part being amputated. The cliche warning “You could put your eye out” is also supported by the Pew Research Center’s analysis. In the first eight days of July, eyeballs were injured in 1 in 6 of all fireworks-related injuries.
Beyond the boom of fireworks on July Fourth, the heavy drinking that takes place also plays a massive role in why Independence Day can turn so deadly.
“When you think about any time that alcohol is part of a celebration, car accidents are definitely on the rise,” Prasse said.
Between 2019 and 2023, 2,653 people were killed in motor vehicle crashes over the Fourth of July weekend in the U.S., according to the National Highway Safety Traffic Administration. In 2023 alone, 617 people died during the holiday period. Around 40% of those fatalities involved drunken driving.
“Then you also think about you’re adding in heat-related issues,” Prasse said. “If you work anywhere near a body of water: drinking, boating, water accidents. It just leads a lot of … emergency rooms in particular to have to deal with more traumatic and very specific type injuries that aren’t the norm.”
On top of all the fireworks and alcohol, July Fourth is considered one of the most violent days of the year, according to the Mass Killing Database organized by the Associated Press, USA Today and Northeastern University. Since 2013, there have been 66 mass shootings on July 4 resulting in four or more people injured or killed.
Northeastern criminologist James Alan Fox attributed the uptick in violence to both the hot summer weather — violent crime generally increases during the summer months — and large parties where alcohol is being consumed.
While the hospital in “The Pitt” is a large urban facility that is largely equipped to handle emergencies, for smaller hospitals that are already underresourced, the Fourth of July can pose a massive challenge, Prasse added.
“Two people in a boat accident becomes a mass situation for them due to the size of their blood banks, the number of [operating rooms] they have,” Prasse said.
“The Pitt” has been a massive success for Warner Bros. Discovery and HBO Max, where each episode of the first season has racked up more than 18 million viewers, according to Warner Bros. Discovery. Those numbers put it in line with “Game of Thrones” in its mid-season run.
However, Prasse said, it’s also been a huge success for health care workers who can finally see a show that accurately reflects the challenges of their work. She hopes the second season continues to do right by the people it portrays but also educates people, in an entertaining way, about the very real dangers around the Fourth of July.
“Especially with festivals or large gatherings, [it’s] just reinforcing some of the teaching in a more vivid way than having a public service announcement or your doctor remind you or a nurse at the ER saying, ‘Hey, maybe next time let’s not light the firework up and hold it between our knees and run around while we’re drinking,’” Prasse said.
