The following story contains spoilers for The Pitt season 2, episode 5, "11:00 A.M."
WE CAN OFTEN classify certain things that men are doing for a rush—without much or any thought—with two different phrases: "Dudes Rock" and "Dudes Being Dudes." Now, let's dive a little bit deeper into that. If the men in question are doing something unabashedly dumb, but that action doesn't hurt anyone or anything, and is actually maybe kind of cool, then, sure, that's where we like to say "Dudes Rock." Everything that happens in the 2001 movie Ocean's Eleven is a Dudes Rock moment. Anything Matt Damon and Ben Affleck do together on screen is a Dudes Rock moment. Leonardo DiCaprio and Benicio del Toro chugging beers in One Battle After Another? Dudes rock moment.
You get the point—there has to be some kind of positive feeling or good outcome for something somewhat reckless but still cool to be classified as "Dudes Rock." "Dudes Being Dudes," on the other hand, can be more open to interpretation. If something bad happens and cannot be rationalized, "Dudes Being Dudes" can be something of an explanation. "We thought this was a good idea, but..." and, lo and behold, it was not a good idea.
In The Pitt's season 2, episode 5 episode, titled "11:00 A.M.," the show made its first foray into an injury that we unfortunately can only rationalize as a "Dudes Being Dude" incident. As Dr. Langdon (Patrick Ball) approaches his latest ER patient—a chill bro, all things considered—he quickly gets the story of what's happened. Alex Bednar (Jett Burton) was hanging out with his brother, Aaron, and they decided it would be a good idea to... brand Alex in his chest with dry ice. Spoiler: It was not a good idea.
As Dr. Langdon treats Alex's deep burn, Aaron (Lukas Jann) shows up, and they further explain what happened. Aaron and Alex wanted Alex to get the same brand that Alex already has on his back, which they refer to as their "family crest": the Pittsburgh Pirates logo. Aaron's got a video too, which Dr. Langdon and Nurse Donnie (Brandon Mendez Homer) cannot help but take a look at.
The brothers suggest that they wanted the branding to help bond them for life, which Dr. Langdon quickly refutes: They're already bonded for life in their DNA. A claim to which they have no rebuttal. Dr. Langdon lets them know throughout the course of the treatment that Alex is going to have a scar, and that he's going to be OK. Aaron even suggests that they try the branding again in a couple months... an idea that Dr. Langon and Nurse Donnie immediately and loudly shoot down.
Look, no one ever said that "Dudes Being Dudes" were smart.
An ER Doctor Reacts to The Pitt season 2 episode 5's Dry Ice Branding Injury—and How Dr. Langdon Treated It
For a deeper dive on the dry ice burn/branding that we see treated by Dr. Langdon in The Pitt season 2, episode 5, we once again got in touch with Dr. Robert Glatter, the Assistant Professor of Emergency Medicine at Lenox Hill Hospital, an experienced ER doctor, and a member of the MH Advisory Board. Dr. Glatter reviewed the scenes from The Pitt, and shared his thoughts with us on the injury.
First and foremost, this practice—often referred to as “freeze branding” or “cryobranding”—is extremely dangerous, as is any time dry ice is applied to bare skin.
“Dry ice is composed of carbon dioxide that is exceedingly cold—minus 110°F for reference,” Dr. Glatter says. “Direct contact with dry ice on skin results in a "full-thickness" burn (all layers of skin down to muscle) freezing skin cells and the water inside them instantly, which leads to rupture of skin cells and death of surrounding tissue. The long term result is a white appearing patterned keloid or hypertrophic scar or “brand” on the skin.”
This isn’t like giving someone a tattoo. Dr. Glatter says the process was originally made to mark cattle who have much thicker skin than humans, which is thinner and more fragile. When you brand human skin, the third-degree burns do give the intended visual effect—which we see in the episode, when Aaron shows his own Penguins branding on his shoulder. But health risks lie underneath. Dr. Glatter explains you’re also at increased risk for sepsis—a life-threatening condition where the body is fighting an infection and starts to damage nearby organs and tissue. “The combination of tissue with poor blood supply and potential bacterial contamination creates conditions for systemic infection,” he explains.
Then there’s cancer. Since people lose pigment (melanin) in the branded area of skin, Dr. Glatter says people who are branded also have a higher chance of developing skin cancer.
The bigger the branding, the bigger the problem. Dr. Glatter says large burns on the chest from freeze branding can lead to dehydration, since the body loses fluids through the damaged skin. In extreme cases, those kinds of situations have been linked to septic shock and even death.
“Such extreme cold can act as a temporary local anesthetic, akin to numbing skin sensory nerves so the person may not feel the full extent of the damage as it occurs,” Dr. Glatter says. “However, as the tissue thaws, patients often experience debilitating pain; some may suffer long-term nerve pain.”
Healing is quite unpredictable, he notes. Typical healing times for cold burns can take up to 17 days. Depending on the depth of the burn, however, it may take months for the branded area to show signs of viable skin again. Even then, Dr. Glatter warns the skin won’t look the same.
The remaining tissue will continue to show progressive damage over time, Dr. Glatter explains, with altered biomechanical properties and decreased elasticity. And while the permanently raised white scar may have been the intention (in the case of The Pitt), it's absolutely not a smart choice to make in any way.
In short? Please stay away from the dry ice, and, if you feel so inclined, instead just get a tattoo!
