George Clooney’s March 12 return to “ER” drove viewers to a recent episode, but for doctors, the high point in that episode was Dr. Benton reading the safe surgery checklist before Dr Carter’s transplant surgery — and saving Carter’s life as a result.
“What I love about ‘ER’ is that they address very complex ethical issues with all the nuances we face in our daily lives,” says Sandra de Castro Buffington, director of Hollywood, Health & Society at the USC Annenberg Norman Lear Center. “The next day after that episode aired, 150 surgeons were gathered in New York to talk about safe surgery protocols and the organizers made them watch the entire episode.”
The impact made by “ER” expands far beyond its entertainment value, although that has been considerable. At its peak, the series reached 47.8 million viewers, and it remains NBC’s second-most watched drama (behind only "Law & Order: SVU"). Through years of cast changes leading to the departure of every major character, “ER” still soldiered on, providing solid ratings and keeping the quality standard high.
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As “ER” ends its remarkable 15-year run on April 2, it’s difficult to believe the pilot was rejected by almost every network before its 1994 launch. It was finally reluctantly brought to NBC due to the power of two names. Steven Spielberg and the late Michael Crichton, who penned the original script in 1974, were coming off the blockbuster film “Jurassic Park” when they pressed their case for “ER.” The network begrudgingly put it on the schedule after test audiences gave the pilot an enthusiastic response.
Despite that, TV critics overwhelmingly preferred another freshman medical series set in the same city. Prolific TV hit maker David E. Kelley’s polished “Chicago Hope” was expected to send the frenetic “ER” to a ratings ICU.
“Nobody was more surprised than I was when our show took off,” says executive producer John Wells, who has run the show for 15 years. “For those of us on the show, it took a couple of years to realize just how culturally pervasive ‘ER’ had become. I hesitate to say that ‘ER’ changed how dramas were done, but people did build other shows with this greater idea of reality. What we were doing was something much closer to what really happens in a hospital than other shows that came before it.”
Video: 'ER' cast celebrates with goodbye bash Under the guidance of Wells, ‘ER” embarked on a phenomenal journey as a top-rated drama that not only entertained, but educated the public on medical and social issues.
“I don’t think I’m ever going to tap into that sort of zeitgeist again. It was such a huge and unexpected hit that impacted the way dramas were done,” Wells says. “It fired on all cylinders. The popularity of the show ensured the fact that we could do stories we were proud of. It was liberating as a producer and a writer to have a show with that many viewers, so you could have the power at the network to do what you wanted.”
Social legacy endures through finale
While ”ER” will always be known as the show that turned dapper Clooney from show killer to box office master, the real legacy of “ER” will be a series that broke traditional TV drama storytelling rules and made a significant social impact in the process.
The series employed fast-action cuts reminiscent of an MTV music video, with scenes filled with extras milling around. The stories strayed from the typical main plot plus one or two subplots to a more fluid story flow that seldom adhered to a strict linear style. And it inserted topical issues in a way that seemed organic to the stories unfolding on the screen.
Video: 'ER's' TV legacy That social legacy continues with the final episode on April 2 which includes a storyline inspired by Wells’ own 17-year-old niece Shelby Lyn Allen, who died last December after a night of binge drinking with her friends in Redding, Calif.
In the course of its long run, “ER” presented stories on issues ranging from racism in medicine to the crisis in the Congo and Darfur.
“We turned some attention on the Congo and on Darfur when nobody else was. We had a bigger audience than a nightly newscast will ever see, making 25 to 30 million people aware of what was going on in Africa,” Wells said. “The show is not about telling people to eat their vegetables, but if we can do that in an entertaining context, then there’s nothing better.”
Wells also was responsible for casting Parminder Nagra, who plays Dr. Neela Kaur Rasgotra. Nagra had caught Wells’ attention after she starred in the popular British film “Bend It Like Beckham.” Unlike hospitals in the real world which employ a large number of doctors of Indian descent, the fictional “ER” had none, and Wells wanted to rectify that.
In addition to numerous storylines on racial issues, “ER” has tackled an array of social issues: AIDS, HIV organ transplants, the rights of gay parents and human trafficking. Buffington says an episode about the correlation between the inherited BRCA1 gene and breast cancer caused a significant uptick in women seeking more information on the subject.
Original cast member Anthony Edwards played Dr. Mark Greene, a beloved character who died of a brain tumor. Greene's diagnosis allowed the series to thrust a physician into the often-nightmarish world of a patient trying to cope with the bureaucracy of the medical system.
Edwards returned to the series last fall in a flashback episode, just one of numerous cameos as old stars returned to bid farewell to County General.
“ER” is all about change,” Edwards says. “From the start, the series reflected the reality of the emergency room with a visual, writing and acting style that pays respect to that. You felt like you were watching a real world, with people coming and going, and the audience rewarded that with longevity.”
Edwards says the series constantly challenged the actors, and he’s proud of his work.
“I can point to a lot of those big episodes with pride,” Edwards says. “But what I’m most proud of is the consistent quality of the show.”
Wells says a show like “ER” may be a once-in-a-lifetime experience for him.
“To have done something that has had the kind of cultural imprint of ‘ER’ says you weren’t wrong about what you could accomplish in your life,” Wells says. “You had something to offer.”
Susan C. Young is a writer in Oakland, Calif.
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