Coming Out About Epilepsy

The rest of Dr. Baran Al-Hashimi’s story came out in the opening scene of the final episode of The Pitt on Thursday, April 16, 2026. With her voice shaking and tears in her eyes, she began to reveal her story:

“It began after a bad case of viral meningitis when I was five. They tried every anti-seizure medication, but I still had episodes every few months or so. No one’s ever noticed before. They just think I am thoughtful.”

The Pitt - Final Episode 2026

Those last two sentences are definitive of how people with drug resistant epilepsy try to hide seizures from everyone. We quickly learn that people are going to continue to judge us with everything we do if our seizures are not controlled.

For many of us, every move or sound we make sparks the question from loved ones, “Are you Ok?” But, the medication(s) we are taking, as prescribed by our primary care physician, neurologist, or epileptologist, is not stopping the seizures, and we have no control over that. People in the general public believe that once we begin taking our medication, “we are fine.”

Anti-Seizure Medications do not cure epilepsy, they help control seizures. And, different drugs work differently for different people. Seizures are successfully controlled for only 50% of people with epilepsy. Another 20% will have a reduction in seizures. The final 30% of people with epilepsy live with drug resistant epilepsy.

Robby asks, “Are you driving?”

“I couldn’t until laser ablation to my left temporal lobe 12 years ago. Between that and the Keppra, I have been seizure free - cleared by neurology to drive and to work as an attending.”

https://www.youtube.com/watch?v=puuSzMSlvBI

This is her proof that the seizures are focal - meaning they start in one area of her brain - her left temporal lobe. Laser ablation is a surgery that is minimally invasive and is used to destroy the tissue or lesions causing the seizures arising from that specific area of the brain. And Robby asking that question illustrated the beginning of the “watching over” period that is going to hang over her character for the rest of the time she is there, if they choose to continue the story line. It distinctly illustrates just how different people with epilepsy are perceived once they state that they have epilepsy, and their seizures are not controlled.

Robby asks next, “How long between the seizure you had today and the last one?”

Responding with tears in her eyes, she reveals the insecurity of that traumatic “coming out” moment that people with epilepsy experience, but rarely discuss. She explains that her drug resistant epilepsy is back, and she doesn’t have an answer as to why.  But, she lists a few suspicions that people with epilepsy always have to define right away to others as to why the seizures are back. The issue is, we don’t always know why and when the seizures will come back. She lists the usual reasons we provide.

“It’s been well over a year since the last seizure, but I had 2 today. I don’t know why. It could be sleep deprivation, new job stress. I haven’t had to deal with peds cases since Afghanistan.”

“What are your options now?” was Robby’s final question.

“Um, up my keppra or maybe try one of the newer ASM’s, but if that doesn’t work work, I am left with two choices - a temporal lobectomy which could impair my speech or get a neuromodulation device, which can sense or stop the seizures immediately.”

Next comes the hardest part for people with epilepsy. Robby insists, “You need to disclose this.” The hurdles we have to overcome are now up. She quickly responds, “I know. I have a plan.”

People with epilepsy always have to have a plan to prove that we are good enough or OK enough to do whatever we are expected to do. And now, with the interrogation over, Dr. Al-Hashimi has become a liability to Dr. Robby, and soon to the rest of the hospital. Proof of that was in the next scene when he asked Dana, the charge nurse, if her staff could keep an eye on her until she leaves at the end of her shift. Notice, it wasn’t just asking Dana, it was asking the whole staff to watch over her. Dr. Al-Hashimi will now have to explain and defend every move she makes at work. And she knows that. This increase in stress may also increase her seizures.

Explaining that we have epilepsy to others immediately puts guards up with people, including family, friends, and co-workers, in every part of our lives. The lack of epilepsy education in the general public is huge, and many people assume that if we have seizures, we are going to have Generalized Tonic Clonic Seizures. That scares them because very few people have been taught what to do. And, there are well over 40 different types of seizures and syndromes, so not every seizure causes a person to fall on the floor, requiring people around us to turn us on our side. Emergency Room treatment for epilepsy and seizures in is an entirely different topic for a different day.

They then provide another ER case of refractory seizures with a pregnant woman. But, we won’t see Dr. Al Hashimi for the next 30 minutes of the show, illustrating that her character is hiding and trying to figure everything out. People with epilepsy have to have answers and plans immediately in every situation. Her not being in most of the rest of the episode speaks volumes in illustrating the immediate isolation of people with epilepsy.

As Robby walks back into the ER toward the end of the episode, he finds her and says, “I didn’t think you were still here.”

She responds, “I was just talking to the neurologist on call. We had a nice chat. She agrees I can work with double coverage.”

“That’s not her call to make. You can’t do anything critical with a 5 second lapse of consciousness that could potentially kill a patient.” Robby calls out her lack of control with uncontrolled seizures, which is one of the biggest fears people with epilepsy have.

“I agree,” she responds. “But, 90% of our patients don’t require critical procedures.”

Robby replies: “And the ones that do?”

“Will be handled by whomever’s working with me……” and the argument ensues. They now continue to go back and forth about why she is no longer 100% able to do her job efficiently, as she will be a liability.

“Unless they are also tied up with a critical patient. What if it’s a double or triple trauma,” he responds.

“Robby, I can handle it.”

“No you can’t, and I can’t let you.”

“I am fully capable of handling the cases.”

“No, you are not fully capable, and you know it.”

“What do you want from me?”

“I want what is best for this department, patients and staff. Best case scenario, you get a handle on this, you are seizure free for six months, you get a drivers license back. You are cleared to work.”

“I am cleared for my driver’s license. Robby I can handle it.”

“You shouldn’t be driving at all like this. If you were a patient, we would have to report you.”

This illustrates how once people have a seizure, physicians would have to report people living with epilepsy to the Bureau of Motor Vehicles. This is one of the biggest causes of isolation for people with epilepsy. Pittsburgh, like many midwestern cities, does not provide easy access to public transportation. As a result, people with epilepsy have a difficult time getting to work or school, and have to rely on everyone else to do daily tasks.

“I cannot let you work in my emergency department until you are fully capable of doing so.”

“That is not your call. I am trying to protect you and my patients.”

And the argument continues focusing on how he handled other characters issues. “I kicked him out until he got the appropriate help that he needs. You have got until Monday to let the administration know or I will.”

She walks out, listening to music, and trying to remain in control as she gets in car to drive home. She pauses, shakes her head, and begins to drive out of the parking lot. Realizing she is again doing something wrong while living with epilepsy, she stops and begins to cry.

Hopefully this episode better illustrated why people with epilepsy have to make very careful choices about disclosing the diagnosis of epilepsy to others.

For more information about epilepsy and seizures, or to learn more about our free Empowering Epilepsy Patient Education Program, which teaches people with epilepsy and their loved ones more about their specific diagnosis and treatment plan, please visit our website at https://empoweringepilepsy.org.

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