After 15 years, the plug is being pulled on the series that brought frenetic pacing, authentic medical jargon and of course George Clooney into our living-rooms
WHEN
ER
first careened on to our screens back in 1994, it was a shot of visual amphetamine – and an instant “must-see” hit. Viewers around the globe were thrilled by the camerawork, the weird medical jargon and, of course, the posse of implausibly good-looking doctors who charged around County General’s emergency ward ministering to the bloody and the battered. At the time
, ER
’s heart-thumping, breakneck pace and multi-stranded plotlines – ideas transposed from successful cop shows such as
NYPD Blue and Homicide
– made previous medical dramas look stodgy and tame. An hour of ER contained between 700 and 800 edits, twice as many as a standard hour of television. It was an addictive, exhilarating ride – for a while, at least – but now the crash cart has finally skidded to a halt. After 15 seasons on NBC and 122 Emmy nominations (more than any other TV drama in history, 22 of which resulted in wins), the most successful hospital drama in television history ended on Thursday night, when fans in the US watched the very last episode of ER. Viewers here have a few more weeks of high-octane emergency procedures to enjoy before the lights go out.
Created by the late novelist Michael Crichton (the author of science-based thrillers such as
Jurassic Park
and
The Andromeda Strain
), in collaboration with Steven Spielberg, ER was based on Crichton’s experiences as a medical student. In true telly mythology fashion, the show almost didn’t make it out of the script-pile: network executives were at first perplexed by the ever-shifting cast of characters and rapid-fire dialogue. Yet, at its peak, ER was watched across the globe, and subtitled in 22 languages. It propelled the hitherto little-known George Clooney (aka paediatrician Dr Doug Ross – warm brown eyes; wicked, womanising heart) into superstardom. In fact, in Clooney’s final season as Ross, in 1998-99, NBC reportedly lavished $13 million on each episode. Inevitably, however, the initial excitement, and the flow of dollars, abated. The clever camerawork and snappy edits – credited with bringing the production values of the cinema into TV drama – started to look familiar, cliched even. Other shows rushed to replicate the giddy Steadicam effect that made you, the viewer, feel as though you were in the thick of it, dashing along a corridor yelling something unintelligible about drug dosages.
Yet, even in recent years, ERhas managed to draw a fairly credible audience of nine million per episode. So, how did it manage to last so long? The messy, painful lives of the medical staff themselves – rather than the unfortunate patients – probably exerted the most enduring fascination for audiences. With the advent of ER, medics were no longer remote authoritarians in white coats: they were flawed, world-weary heroes whose ruinous personal lives kept spilling over into their professional careers and getting hopelessly tangled up there. Juicy stuff. As longtime ERenthusiast Stefan Schumacher explained to Slate magazine, "The doctors on ERsave lives and they kill people by mistake. Then they learn to live with it. They drink too much and they sleep with the wrong people. They get hooked on painkillers and they get off painkillers, and they stop drinking, and they find a way to move on with their lives. They work tirelessly in a system that doesn't work. But they keep fighting."
TO THE FRUSTRATION of diehard ERfans, who would prefer to concentrate on the considerable talents of latterday stars such as Parminder Nagra and Mekhi Pfifer, the lingering Clooney effect can still be felt among viewers mourning the loss of the show – especially since he resurfaced as Dr Ross in the final series. He's not the only familiar face: Dr John Carter (Noah Wyle), stroppy surgeon Dr Peter Benton (Eriq La Salle) and Dr Elizabeth Corday (played by British actor Alex Kingston) have all popped up again for a last hurrah. Against pretty grim odds, even Dr Mark Greene (Anthony Edwards), last seen expiring on a Hawaii beach, managed to make it.
Recalling their favourite moments, ERaficionados fondly reminisce about Clooney's tortured relationship with head nurse Carol Hathaway (Julianna Margulies); his "trademarked lip-bite and eyes looking up below lowered forehead" expression, as well as "all the scenes in which Doug Ross, in despair at the system again, walked away down a corridor rubbing the back of his head".
However, it’s generally agreed that the show’s nadir came in episode 209, when writers summarily dispatched Dr Robert Romano – who had already lost an arm to a helicopter blade – by dropping a helicopter on him. That was the moment when many fans departed and never came back.
It’s true that the unashamed use of real-life medical terminology and slang – as well as the careful reproduction of surgical procedures – added to the frisson for many. In a bid for maximum authenticity, the show’s producers hired physicians as technical advisors. They even went so far as to set up stalls at the annual American College of Emergency Physicians’ convention, where real ER doctors could spill the beans on their most lurid stories or “facinomas” as they are flippantly known in the trade.
Audiences quickly deciphered the stream of medical lingo. Soon any committed ERviewer could knowingly toss around terms such as "tox screen" (a blood test for drugs), "perfed appy" (a perforated appendix), "PID shuffle" (the awkward gait of a prostitute with pelvic inflammatory disease) or "pulse ox" (a painless way of measuring blood oxygen). One ERwatcher recalls, "My proudest moment was watching an episode and thinking 'well, he clearly needs a pericardiocentisis', and being proven correct a few seconds later."
EVEN GENUINE MEDICS were impressed. Emergency department director Mark Hoornstra said, “ER has done more to educate Americans on emergency medical care and treatment than any other television show . . . The show also refused to dumb down how doctors actually speak, as the writers wove medical jargon and terminology into their scripts and storylines. Whether it was demonstrating hypothermia after cardiac arrest, the management of multiple trauma cases, or using clot-busting drugs in a stroke patient, the show got it right.”
Some went further, claiming that ER had actually saved lives. Joe Sachs, an emergency-room doctor and executive producer, said, “When Mark Greene’s brain tumour came back, I had to come up with a way to dramatise it . . . He bit his tongue because he couldn’t control [it] . . . So about a year after that episode was written, I got a letter from a young woman in Texas who was having terrible headaches, and none of the doctors were taking her seriously. They said, ‘It’s stress. You’ve got two little kids,’ and her tongue was protruding to the side. So when she saw that, she went to the ER and demanded a Cat scan. She had a huge tumour that was growing behind her nose that was a millimetre away from her spinal cord. Two weeks later she would have been dead. She had surgery. She’s still alive.”
So far, so uplifting. But not everyone shares the benign view of ERas an exciting drama that doubles as a handy diagnostic aid. "It's not exactly social realism," said Anne Karpf, author of Doctoring the Media. "You wouldn't use it as a primer of what's going on in medical care, but you can't have it be warts-and-all and still work as a drama. When you think that . . . most of the US population is either crippled by their [insurance] premiums or living in dread of falling ill – well, how many episodes can you get out of that?"
Others found ER’s definitive qualities – the frenetic pace, colour and noise – off-putting from the start. “Couldn’t get past the overacting, the perpetual urgency,” said one critic, “the sense that shock and awe interventions with tubes and fluids and bunker-busting shouting would be preferred even if an application of antibiotic ointment was all that was really called for.” Even its dogged longevity failed to win over critic Frazier Moore, who accused it of “operating less from inspiration than from muscle memory”. Author Neal Gabler described the show as “a series of ongoing crises that bleed into one another with little relief” – and he claimed to be a fan.
Whatever the final verdict on ER, it seems that we will not see its like again. According to television critic David Zurawik, "There's just no way in the business model of network television for a producer out in Hollywood to say 'Here's the concept, and I've got this star, this star and this star'. By the time they got two sentences out, the production studio head they are pitching would say 'Who's going to be paying for that?' The economics for that are just not there, and neither is the audience."
After 15 years of frontline services, ER has finally flatlined. As the medics themselves would say, DNR (do not resuscitate).
CV:ER
What is it?Long-running hospital drama, the most Emmy-nominated series in television history
Why is it in the news?The final episode was screened in the US on Thursday
Most appealing characteristic: Refusing to dumb down medical terminology for the masses
Least appealing characteristic: Killing off poor old Dr Romano by dropping a flaming helicopter on his head
Most likely to say: "Get me a cross-table C-spine x-ray and make it snappy with the endotracheal tube"
Least likely to say: "Things are pretty quiet in the emergency room today, aren't they? Think I'll just slip off for a cappuccino"