The Pitt's Fiona Dourif Reflects On Cassie's Relationships With Robby, Langdon, And Roxie, Teases Season 3 Theme That's 'Quite Personal To Me'

By the time Roxie Hamler died in "The Pitt" Season 2, she and Dr. Cassie McKay had known each other for less than a day. But that didn't make losing her any easier.

Over the course of several episodes, McKay developed a profound bond with the terminal cancer patient, culminating in a moving conversation about faith, mortality, and whether there might be something beyond either. For Fiona Dourif, those scenes opposite Brittany Allen "felt a little bit like I imagine church does."

"I didn't want to over-prepare," Dourif tells me of that revealing discussion in Episode 9. "I didn't need to. Brittany is such a beautiful actress, and I think part of what they were doing there was showing Cassie's own mortality, because it's a person who's my age, and has a kid my kid's age. There is no justifiable reason why her body is breaking down and mine is not."

Cassie hasn't yet reached the end of the proverbial road called life like Roxie has, but she's traveled some difficult stretches of it herself. As a recovering addict, she's able to relate to Patrick Ball's Dr. Langdon on his first day back at work following a 10-month stint in rehab. And because she knew so many people in a previous life who danced with death, she recognizes the danger Robby is in as her attending prepares to embark on a three-month motorcycle odyssey from which he may not return.

In the video Q&A above — a transcript is provided below — Dourif reflects on Cassie's relationships with Roxie, Langdon, and Robby, discusses the emotional realities of emergency medicine, and teases a Season 3 theme that is "quite personal" to her.

TVLINE | The last time you and I spoke, we were talking about Cassie agreeing to go on a date with Brian.
Isn't that nice?

TVLINE | But I got to the end of the season, and it left me with a question I figured we should start with today.
And I think it's an important question, yeah...

TVLINE | Do you think Cassie ever got in touch with Brian and let him know that she wouldn't be able to make it?
Oh, I think Cassie made it.

TVLINE | Do you...?
Oh, yeah! I think Cassie put her big-girl pants on and went to the art gallery. [After watching the fireworks], I asked Samira if she wants to be my wingman.

I think that Season 2 was a lot of things, but partially a lighter journey for McKay. I think she's trying to take some risks in a way that will pay off, but that is quite uncomfortable in the moment.

TVLINE | So much of this show is about the doctors putting their patients first, sometimes to the detriment of their mental health. By the end of Season 2, we see just how much that has cost Robby — this idea that every patient he's lost has leeched something from his soul. Do you think that's true of all doctors, including Cassie?
I think that happens in the medical field, yeah. I mean, I think part of what "The Pitt" is really trying to do is tell the actual story of what it's like to be in this position.

In order to make it exciting television, it's like an entire career in one shift. A real day in the ER can include much more downtime. But the coolest and most unexpected turn of this job is just getting to know so many actual doctors. Walking around in my life, doctors talk to me all the time now. It's wild how many actual medical professionals watch the show, and then they feel like they want to approach me and say something, and it's been lovely, and I hope they continue to do it.

But that is something that has been reported. I was just shadowing a shift at Massachusetts General Hospital in Boston, and one of the attendings, who had only been an attending for a year, was talking about a kid that came in from a car accident that he just couldn't save. There wasn't the specialty doctor at that particular hospital at the time, and he just watched this kid bleed out, and it stays with them. It's just there. There wasn't this emotional running into a closet and crying thing that you would see on television, but it will never leave him.

It's just a bare-bones reality of being in that position. It's crazy we get to tell it. It's very cool.

TVLINE | You have so many wonderful scenes this year opposite Brittany Allen, but the one that has really stuck with me is that conversation in Episode 9, when Roxie asks Cassie whether she believes in God. There's so much goodness in the writing, and in Shawn Hatosy's directing, but what I keep coming back to is the way you look at each other. These are two people who didn't know each other before that morning, yet Roxie is going to carry that conversation with her for the rest of her life. How did that scene affect you?
You know, I don't mean to be too self-serious, but the experience of showing up that day to shoot it felt a little bit like I imagine church does. Like, there's something that's special and delicate.

I try to approach almost every scene on this show as not really being about me. It's about the person I'm talking to, and who is going through this pivotal moment in their life. That's how I approached it, and then just let the whole thing hit me as truthfully and in the moment as I could. 

The writing is so good that you can do that. I didn't want to over-prepare. I didn't need to. Brittany is such a beautiful actress, and I think part of what they were doing there was showing Cassie's own mortality, because it's a person who's my age, and has a kid my kid's age. There is no justifiable reason why her body is breaking down and mine is not. 

The whole thing was existential and really interesting. I think it affected both me and Brittney in the same way. We didn't want to do it too many times. I felt very protective of her, and the set is really good at protecting the actual work and the actors. It feels like a very special thing to do with your life, like church.

TVLINE | You pointed out those parallels. How much were you thinking about them as you shot this storyline? Or did they crystalize for you in that moment, while shooting that specific scene in Episode 9?
I think I was very aware of them from the jump. So many details of her life felt really loud to me. She was there with a loving husband and container that I think neither Cassie nor Fiona has.

You can't get around thinking and wondering about how your body is going to break down in hospitals, both when I shadowed in an actual ER recently and also on "The Pitt," because that's what you're there to treat, and it's going to happen to all of us.

Part of what resonates with the show is there's no getting around losing a parent, or having your own body break down, or being in those rooms at some point in your life. We're trying to show it in this realistic way. 

TVLINE | I was thinking about how doctors can only steer outcomes. They can't save everyone. In Season 1, there was potential trafficking victim Piper. Cassie couldn't save her, she could only treat her. And with Roxie, she can't save her either, but at least there's a known outcome. She can help make her comfortable. Do you think that brings Cassie any semblance of peace?
There's a utility in helping in some way in these situations that are unavoidable. I think a lot of doctors talk about that. I wouldn't say that peace or satisfaction would really come in when death — especially with somebody so young — is the outcome. 

I think there's a lot of turmoil in this work, actually. And as you get older and more experienced, you get more used to it. It's just their everyday job, which is a wild thing to think about.

TVLINE | Cassie is one of the first people—well, she's among a small group of people who recognize that Robby may not come back from this sabbatical the same person, if it all. What she says to him is so revealing — this idea that she used to know people who liked to see how close they could get to the edge, and that they all eventually found it. To me, this suggests that Cassie understands exactly how much danger Robby is in, but she also knows she can't make his problems her own. Do you think that's something she learned through her sobriety journey, or is that something she learned later as a physician?
Oh no, I think that comes from Cassie's life. Cassie took a lot of twists and turns before she hit rock bottom in her late 20s/early 30s, and then got her life together and made the decision to get into medical school much later. I mean, she's 10-15 years older than the other residents, right? That thing that she sees — that recklessness and potential for self-destruction — I think she understands it, or she thinks she understands it, more than he does. Like, "Are you aware of what you're doing? Are you conscious of what you're feeling?" It's just a road she's been down. It's a road I've been down, actually. I understood it completely.

In those situations, you can make decisions you don't come back from, which is something that I have seen in people very close to me. I have also experimented with those periods of time in my life and luckily made decisions that I could come back from. I think it's part of the reason I was hired for Cassie. There have been these life experiences that feel very close to what they were looking for for the character, so it was just this kismet thing. But yeah, I understood it perfectly.

TVLINE | We also see how much compassion Cassie has for Langdon, who is still at the beginning of his sobriety journey. What do you think it means to her to have a peer who is walking a path she knows so well, and who may one day look to her for guidance?
I think this is a common characteristic in sobriety circles. Part of what will keep you grounded and sober is helping others. It's the community aspect of it. I think she wants to participate in that, both for herself and for Langdon. It's also boundaried, right? You don't want to push somebody to talk about something that they don't want to talk about, so I think she's testing the waters there. I think it would be helpful to have that type of intimacy and help and friendship with somebody that she works with. And also, it doesn't have to be there. I think she's just testing the waters.

TVLINE | There's a moment after Roxie dies where Cassie tells Langdon she can't remember the last time she cried. She talks about shutting down her emotions for so long that she doesn't know if she can turn them back on. Do you see that as a positive for someone like Cassie? A negative? Or is it more complicated than that?
I have talked to actual doctors about this, and it's a real thing that happens because they get very good at compartmentalizing what they went through in order to be effective — especially if they're in a very busy shift and something very upsetting has happened. They need to move on to the next thing and make rational decisions calmly, so they compartmentalize. But you compartmentalize something for so long that there are physical effects over time.

I once had the wisest person I ever met tell me that there is no avoiding grief. You can prolong it and put it off, but you'll have to face it eventually. I believe that's true. I think Cassie is telling that story at that point, and I think it's real.

TVLINE | As we're talking, it's June 10. I know you guys start production on Season 3 soon. When's your first day back on set?
We start shooting a week from today [on Wednesday, June 17]. 

TVLINE | Oh, that's very soon.
I'm not going to tell you my particular first day back is because I've been media trained, but... [Laughs]

TVLINE | We know Season 3 takes place in November, and there have been hints that it may take place around Thanksgiving. The holidays tend to bring their own kind of stress, especially when it comes to family — something Cassie knows all too well. Have you been given any sense of what themes, if not actual plot details, about what Cassie might be dealing with this season?
Yes. [Silence, followed by awkward laughter]

TVLINE | What might those be?
I think that it would be harmful to reveal it. But there is one particular theme that's going to be explored with Season 3 that is quite personal to me, and is exciting and scary and cool. 

TVLINE | As you look back on everything Cassie went through this year, is there something you learned about her that you didn't know at the outset of Season 2 — something you'll now have in your arsenal going into Season 3?
Though this wasn't obvious or written in, but by the time I wrapped Season 2, I was aware that there is a yearning — this unspecified yearning that colors her life and that, again, I relate to. I think it's pretty common, but it wasn't something that I had initially read into her. I think it's a yearning for meaning and intimacy and relationships, and very human things.