The Pitt's Hawaiian Goodbye Ritual: Ho'oponopono Explained

The Ho'oponopono scene in The Pitt moved a lot of viewers. What Dr. Robby says, where those four statements come from, and how to use them yourself.

If you searched for this after watching The Pitt, you're not alone. The scene where Dr. Robby talks a family through saying goodbye has become one of the most talked-about moments of the show, and many people went looking for the words afterward.

This page explains what the scene says, why it's called Ho'oponopono, and the part most write-ups miss: the four statements in the episode and the four phrases of Ho'oponopono are close, but they are not the same.

Which episode is it?

The scene is in Season 1, Episode 4, titled "10:00 A.M." It first aired on January 23, 2025, on Max (now HBO Max). The episode was written by Noah Wyle, who plays Dr. Michael "Robby" Robinavitch.

In the scene, Dr. Robby is with the family of a dying patient. He tells them about a Hawaiian ritual called Ho'oponopono, which he describes as "the four things that matter most," and gives them four simple things to say while they say goodbye.

What are the four things Dr. Robby says?

The four statements in the scene are:

• I love you.
• Thank you.
• I forgive you.
• Please forgive me.

They are meant to be said to the person who is dying, out loud, while there is still time.

Where those four statements come from

The words in the scene most closely match the work of Dr. Ira Byock, an American palliative-care physician. His book The Four Things That Matter Most (2004) is built around four statements for completing a relationship before death: please forgive me, I forgive you, thank you, I love you. Byock's work is widely used in hospice and end-of-life care, and it is a fitting source for a scene set in a hospital.

The episode connects those four statements with Ho'oponopono, and the connection makes sense. Both are about the same thing: setting a relationship right, through forgiveness and love, before it's too late.

How that differs from Ho'oponopono's four phrases

Ho'oponopono is a Hawaiian practice of making things right. Its traditional form was a family reconciliation process. Its modern form, Self-Identity Through Ho'oponopono, was developed by the Hawaiian healer Morrnah Simeona, and its four short phrases were popularized by Dr. Ihaleakala Hew Len and the book Zero Limits.

Those four phrases are:

• I'm sorry.
• Please forgive me.
• Thank you.
• I love you.

Two differences are worth knowing.

"I forgive you" versus "I'm sorry." The Pitt's version includes forgiving the other person. The Ho'oponopono phrases don't. They start from taking responsibility, I'm sorry, rather than granting forgiveness.

Said to the person versus said within. Byock's four statements are spoken to the person in front of you. In Ho'oponopono as Dr. Hew Len taught it, the phrases are said inwardly, to the Divine, about the memory or pain you carry. You don't need the other person present, or even alive, to say them.

Neither version is "wrong." They do different jobs. One helps you finish a conversation with someone while you can. The other helps you clean what remains in you, whenever you're ready. For more on the phrases themselves, see the four phrases of Ho'oponopono.

How to use the four things at a bedside

If you are with someone near the end of life, the scene's approach is simple and kind. You don't need to say all four at once, in order, or perfectly.

• Say what's true for you. If "I forgive you" isn't true yet, don't force it. "Thank you" and "I love you" are enough.
• Keep it short. Long speeches are hard to give and hard to hear. Four short sentences can carry a lifetime.
• Assume they can hear you. Hospice staff often encourage families to keep talking to someone who seems unresponsive.
• Ask the care team. Nurses, chaplains and hospice workers help families through these moments every day. They can tell you what to expect and when.

If you didn't get to say goodbye

Many people who search for this scene are not standing at a bedside. They are remembering one they missed, or a goodbye that never happened.

This is where Ho'oponopono's inward form can help. Because the phrases are said within, you can still say I'm sorry, please forgive me, thank you, I love you about someone who has already died. Some people find it brings a measure of peace to what was left unsaid. We wrote a full guide to this: Ho'oponopono for someone who has died.

If grief feels overwhelming or isn't easing with time, please talk to a grief counselor, a hospice bereavement program or your doctor. Ho'oponopono can support that help. It doesn't replace it.

Is Ho'oponopono a real Hawaiian practice?

Yes. Ho'oponopono is a genuine Hawaiian practice, centuries older than the show. The modern, individual form most people encounter today dates from the 1970s, when Morrnah Simeona adapted it into a practice one person can do alone. If you'd like to understand where it comes from and what the word means, start with what Ho'oponopono is.

A simple way to start

If the scene stayed with you, you don't need to wait for a hospital room to practice. Many people say the four Ho'oponopono phrases quietly each day, about whoever or whatever is weighing on them.

Our free guide walks you through the phrases, how to pronounce them, a short morning routine, and the common mistakes beginners make.