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[The following story contains spoilers from the season two finale of HBO Max’s The Pitt, “9:00 p.m.”]

In the final hours of season two of The Pitt, viewers have gotten more and more of a glimpse of Dr. Robby’s (Noah Wyle) suicidal thoughts.

What began with offhand comments and jokes led to him admitting first to his friend Duke (Jeff Kober) that he doesn’t know if he wants “to be here anymore,” and then to Dr. Abbot (Shawn Hatosy) that while the most important things he’s done in his life have happened in this hospital, “It is killing me.”

“I’ve seen so many people die that I feel like it’s leaching something from my soul,” Robby says.

Though this mental health storyline might seem extreme, as showrunner R. Scott Gemmill explains, “It’s a real thing,” with the American College of Emergency Physicians reporting that roughly 300 to 400 physicians a year die by suicide and the American Medical Association noting that “physicians are at a higher risk of suicide and suicidal ideation than the general population.”

And, as Gemmill argues, after a season of Robby rejecting conventional therapy for the issues he identified at the end of season one, the attending physician’s season two storyline “shows what can happen if you don’t take the time to resolve mental health issues.”

“Robby is someone who is very good at giving advice and very poor at taking it, and he hasn’t been dealing with his own mental health issues,” Gemmill says. “As a result, they have exacerbated and got to a point where he’s really in a bad head space, and he needs to take steps to get better, or things are going to get worse, and he could end up like a statistic.”

Though Robby has tense exchanges with a number of his colleagues in the final hours of his July 4 shift, it’s Abbot who’s finally able to engage him in a conversation about his mental health.

“Abbot is similar to Robby. He has been experiencing some of the same suicidal ideations,” Hatosy says of the night shift attending who Robby found on the roof in The Pitt‘s pilot episode. “He’s also a character on the show that has has had to manage the stress in the same way that Robby’s has. They are understaffed. There’s not enough funding to take care of everything coming through the door, and that wears on these attending positions. They are very similar, but very different at the same time [in regard to] how they handle things. And Robby respects Abbot.”

Though Abbot shares why he’s held on despite losing his leg and his wife and advises that Robby find a way to “dance through the darkness,” Hatosy argues it’s all of the interactions Robby has at the end of his shift — chatting with Dr. Mohan (Supriya Ganesh) about her future, talking to Dana (Katherine LaNasa), Langdon (Patrick Ball) insisting he needs help and saying he saw a lot of guys like Robby in rehab — as well as the pair’s experience performing an emergency C-section and Robby spending a quiet moment with baby Jane Doe that hopefully keep him from a dangerous, final motorcycle ride.

Hatosy reveals that he and Wyle talked extensively about their last scene together in season two.

“Coming into that last scene, we spent a lot of time with [The Pitt executive producer] John [Wells], who was directing, and Scott just sort of figuring out exactly where the dynamic came to,” Hatosy says. “And I thought it was really important to say that even though Abbot is under the impression that he is also doing the work, his hobby that his therapist recommended was golf, but he’s off working as a SWAT medic and getting shot at. So again, very similar paths. It’s a death wish and it’s something that Abbot believes he’s in the process of working through. Maybe instead of once a week, he needs to go twice a week until he figures that out. But at least he’s talking about it.”

Going into The Pitt‘s already ordered season three, Gemmill hopes that Robby finally gets some of the treatment he needs.

“Hopefully, season three is all about that mental health journey and seeing him finally admitting to needing help and seeking it out and setting himself as an example of what should be done when one is struggling,” Gemmill says. “As opposed to what we’ve seen in the last two seasons, which is what you shouldn’t do and just shutting it down.”

Prior to his heart-to-heart with Abbot, Langdon shares his perspective as someone who’s been to rehab and is trying to deal with his own issues.

“He’s come to terms over the last 14 hours, 15 hours, with the fact that he that the role model that he looked up to and modeled his life after for so long might not be the sterling, pristine example to follow that he might have assumed previously,” Ball tells The Hollywood Reporter of what prompts his angry exchange with his former mentor. “I think this is why it’s so it was so injurious in in season one, when this rift opened between Langdon and Robby, there is an assumption of like, ‘Look, man, I see you hurting. I see what you are carrying. I see that you are in pain, and I see that you carry that pain for the benefit of everyone around you, and I see the responsibility that you hold, and I feel like I can see you and understand you and support you in a way that you need.’

“And whenever that sympathy was not reciprocated back to Langdon, whenever his wound became exposed, I think that felt like a real abandonment. Now Langdon has had the the privilege of sitting with himself for the last 10 months and getting help and getting clean and getting someone to talk to and the space to acknowledge what he is feeling that Robby has not because he has had to show up at work every day and be responsible for everybody else. And I think Langdon is now able to come back in the door and say, ‘Whoa, man, you need to pause, because you are not doing well.’ And this whole ‘Suck it up and don’t talk about it and don’t acknowledge anything that’s going on with you,’ which I’ve emulated for so long, that led me down an errant path, and I think it’s leading you down an errant path. I’ve talked with people that have gone through what you’re going through, that have dealt with these feelings, they’re not that uncommon, and they can be overcome. They can be acknowledged, but it requires a willingness to pause and admit that they’re there, rather than just running and continuing to run.”

At the end of the last hour, viewers got the answer to another mystery from this season as Robby learned that new attending Dr. Al-Hashimi (Sepideh Moafi) suffers from a seizure disorder, which Moafi said she knew was a part of her character since the end of the audition process, with Gemmill confirming it when she appears to zone out while looking at baby Jane Doe at the end of the first episode of season two, and that she did extensive research to try to understand.

“I spoke to as many doctors as I could. I spoke to epileptologists. I spoke to doctors with varying disabilities and medical conditions and about how they manage it,” Moafi says. “I read a lot of testimonials of people who are living with this condition, or people who are parents with children with this condition.”

She also watched footage of people with seizures that “manifest in a very similar way” and insisted that the show’s medical advisers let her know if anything in her performance wasn’t accurate. At the end of the episode, after Robby insists Dr. Al-Hashimi disclose her condition to the administration or he will, viewers see her crying in her car, a moment Moafi says reflects “the world crumbling around her and the rugs having been pulled from underneath her.” The moment also originally featured another dimension to her character, she reveals.

“The car scene initially had a bit of dialogue where she gets in the car, she’s about to drive, and she doesn’t,” Moafi recalls. “She calls her her ex husband to watch their child overnight. Instead of going to pick up her kid after work, she asks if he can watch her another night because she’s having car trouble, and her ex says, ‘Yeah, of course. Are you OK? You need me to come get you?’ And that’s when she chokes back tears, and she tries to hide it and get off the phone with him as quickly as possible and then completely unravels, because I think at that moment she is used to hiding. She’s used to isolating. What she wants more than anything else is for someone to hold her and tell her, ‘Everything’s going to be OK. You got this. You’re not going to lose everything.’ She’s just grasping at some kind of control in that moment and she can’t.”

When she tells Robby about her condition, after he’s already spotted some curious behavior, she truly is seeking his medical expertise as someone she respects, Moafi says. But the way he reacts destroys the level of trust that she has in him, Moafi says, and that’s something that will continue to affect their dynamic in the future.

“She sees that there’s like a very generous, loving, wounded child in him, and there is a generous wounded child in her, and so she takes that part of her and reveals it to him, in hopes of getting closer and finding connection through their shared, respective traumas, and it backfires,” Moafi explains. “So I think she expected to find more of a colleague and friend in him, in revealing herself, and it’s that he threatens her, and it obviously flares up her trust issues.

“She can’t be restricted or excluded just for having epilepsy, but she can be prevented from practicing if she poses a direct threat to patients or to herself, and usually this is at the discretion of the physician themselves. They’re the ones who decide if it’s safe, and so for Robby to come in and threaten her, that’s the biggest betrayal. Because it is not his call, and she has proven throughout her life and her career that she prioritizes patient care, and it’s not about her ego. And so she will go about this responsibly but for him to try to report her — she doesn’t need to report herself. She got confirmation from her neurologist saying you’re fine, you just need double coverage, which is standard for [the] ER. It’s unusual to have single coverage. So the way that he’s viewing this is he’s taking everything kind of personally and making it about himself and his sense of control and not treating her like a colleague, like a pro, and so it’s really unjust, and it’s shitty, and I think that’s obviously going to affect her trust issues moving forward and affect how she relates to him moving forward.”

As for Langdon, though he’s gotten a bit of his confidence back, particularly through the closed reduction of the spinal injury in the penultimate episode of the season, he’s still on a longer journey of recovery that Ball says “is an act of daily maintenance.”

After his first day back, he’s “doing OK,” Ball says, noting that his character “didn’t relapse,” but “that possibility is always there.”

“There are things that you can see over the course of the season where you can understand that Langdon is not perfectly reformed,” he adds. “There’s still clearly some fear and resentment like that conversation with Santos [Isa Briones], that conversation with Robby, there’s still this sense of having been wronged and anger around that that is not fully processed, that I think will take time. There are little breadcrumbs throughout season two that suggest that Langdon is coming in and really trying to put his best foot forward. But the sort of perfectly reformed act is a bit of a shield, and there maybe is still a lot of pain and embitterment going on behind that that I think there’s still plenty of story to tell there.”

Meanwhile, looking at the superficial elements of season three, Gemmill confirmed that the show is planning a roughly four-month time lapse to November, in part so that the hospital will have to deal with colder-weather injuries.

“We wanted a shorter jump; less story has transpired in between seasons,” Gemmill says. “We wanted to do cold weather because we hadn’t. We’ve done summer, and we did September [in season one], and we figured it’d be nice to do colder weather and what that brings into the ER and what sort of emergency situations change seasonally.”

One person who won’t be returning, it was recently announced, is Ganesh’s Dr. Mohan, who won’t be back for story reasons, as was the case with Tracy Ifeachor’s Dr. Heather Collins, who left after season one, as the series aims to reflect the staff turnover reality at teaching hospitals.

While fans have been upset by both departures, Gemmill continues to defend the show’s approach to cast changes.

“I’m sure people are going to be disappointed because people are going to come and go, and that’s just the reality of the medical world that we’ve created,” Gemmill says. “I think one of the things it does is it eliminates the false jeopardy that a lot of shows might have. If I show someone who might not come back, some shows you know they’re coming back and so you don’t really believe it, whereas I think here, people don’t come back sometimes, and that adds an authenticity to it and real-life jeopardy that I think the show benefits from. And I think the show also does something very well, in that it launches actors’ careers as well. So I think that’s one of the good things too, people come on the show and even if they don’t stay I think the show is a good launch pad for whatever comes next.”

Dr. Mohan will also be missed by Dr. Abbot, who Hatosy confirms “definitely has feelings” for his co-worker, with whom he’s had a number of memorable friendly interactions. But Hatosy suspects they’ll find a way to stay in touch.

“She could go to Jupiter, and he’ll find her,” he says. “They’ll have a laugh about some medical case study from who knows where. Maybe they’ll send a GIF to each other and an appreciation for how fantastic the doctors are who worked on it. It’s sad, but I guess that’s part of the job and people move on. And it’s part of television. Abbot will miss her.”

Abbot and Mohan aren’t the only Pitt duo that fans have hoped would have a romantic relationship. For this series, though, with each season taking place over one day, Gemmill indicates it might be tough to show characters’ personal lives.

“Our show really doesn’t leave the ER, so we’re not going to go home with people,” he says. “We break the POV sometimes, but those are sort of quick little clips of life at the end of the shift. But anything that we want to do really has to be, I think, told within the confines of our sets, because that’s where the show lives and breathes.”

Fans are also enjoying the bond between Langdon and Taylor Dearden’s Mel, which Ball argues more resembles a brother-sister dynamic.

“I think there is a sense of sameness,” he says. “There is a sense of identification that Langdon finds in Mel. Mel is a primary caretaker for her sister, and there is an element of needing to be needed, and the disappointment that comes when Mel realizes that Becca [Tal Anderson] is an individuated person who might actually not need her as much as previously assumed, and that Mel was drawing identification of being a provider. And I think that is something that feels true to Langdon as well as a husband and a young father. I think that shared experience of needing to be needed is something that he sees in Mel. And I also think Mel is also an outsider and and doesn’t quite fit in with the other kids. And I think that is something that I think any addict knows. There is a sense of chronic uniqueness or apartness that any addict understands. And there is just a recognition there that I think is really special.”

While Mel may be struggling to fit in, she has a bonding moment with Santos at the end of the July 4 shift as the two let their hair down and perform a karaoke version of Alanis Morrisette’s “You Oughta Know” over the closing credits of the season two finale.

“It just seemed like it would be fun to have a little Easter egg in the credits for the fans who put in all the time for the whole season and the whole episode,” Gemmill says. “And Mel and Santos had such a rough shift that it felt like they needed to blow off a little steam.”

Gemmill wrote the moment knowing Briones could sing and with Dearden on board, and selected Morrissette (“something they both could wail to”) while giving them the option to swap it for another song, but they kept it.

“They went with for it with gusto. And that was one of my funnest little things I’ve done in a long time,” Gemmill says. “It was a nice, propulsive moment to launch us into season three with hope that these guys are going to survive, and they’re going to do well, and they’re going to thrive, and we’ll be back.”

The first two seasons of The Pitt are now streaming on HBO Max.