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Image: "ER"
Chris Haston  /  NBC
Parminder Nagra (left, with Leland Orser) was initially treated dismissively by "ER" clerk Frank Martin because of her ethnicity. Racism was just one of the many social issues tackled by the NBC show, which airs its series finale April 2.
msnbc.com contributor
updated 3/24/2009 7:22:06 PM ET 2009-03-24T23:22:06

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.

(Msnbc.com is a joint venture between Microsoft and NBC Universal.)

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.

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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.

© 2013 msnbc.com.  Reprints

Photos: The doctors of 'ER'

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  1. Dr. Doug Ross

    He's now a movie superstar, but George Clooney was still somewhat unknown (if you don't count his handyman role on "Facts of Life") when he was cast on "ER" when it began in 1994. His character, pediatrician Doug Ross, became a fan favorite. A womanizer for some time, his most lasting relationship was with Nurse Carol Hathaway (Julianna Margulies). She became pregnant with their twin girls and the family eventually left Chicago and resides in Seattle. Clooney made a cameo appearance on an episode as "ER" neared its end. (NBC) Back to slideshow navigation
  2. Dr. Susan Lewis

    Sherry Stringfield received three Emmy nominations for playing Dr. Susan Lewis, an original character who left in season three, returned in season eight, and left again in the 12th season. One of her most memorable storylines concerned her troubled sister Chloe, who delivers "Little Susie" and then abandons her daughter to Susan. Chloe eventually takes her daughter back. A relationship with Dr. Mark Greene turns into a friendship, and Susan also has a fling with Dr. John Carter, but it's with flight nurse Chuck Martin (Donal Logue) that she has a son, Cosmo. (NBC) Back to slideshow navigation
  3. Dr. Peter Benton

    Who could forget Eriq LaSalle's slow-mo martial-arts move in the show's credits? LaSalle played Dr. Peter Benton, a surgeon who lasted eight seasons on the show. Memorable plotlines included his relationship with his mother and with the boy he thinks is his son, Reese, who is deaf. Benton eventually learns that he is not the biological father of Reese, but still is granted custody of the boy. His interracial relationship with Dr. Elizabeth Corday also made headlines. (NBC) Back to slideshow navigation
  4. Dr. Mark Greene

    Another fan favorite, Anthony Edwards played the doomed Dr. Mark Greene, who began the series as chief resident in the ER. He began the series married to Jenn with a daughter, Rachel, but their marriage hit the rocks. In a memorable episode, a pregnant woman dies in childbirth when Greene makes mistakes in her delivery, scarring him for a long time. Things don't get much better for Greene, who was randomly beaten in the ER men's room and later diagnosed with a brain tumor, which eventually took his life. His daughter, Rachel, is scheduled to return to the show in the series finale. (NBC) Back to slideshow navigation
  5. Dr. Anna Del Amico

    Dr. Anna Del Amico (Maria Bello) came to the show as a pediatrics intern in the third season. She has a relationship with Dr. John Carter, although his family wealth becomes an issue for them. She eventually reunites with her ex-boyfriend, Dr. Max Rocher, a reformed drug addict, and leaves the show for Philadelphia. (NBC) Back to slideshow navigation
  6. Dr. John Carter

    Poor little rich boy Dr. John Carter (Noah Wyle) was raised in an enormously wealthy family, and his parents weren't too thrilled about his working among the great unwashed of County General. His many soap-operatic plots included being stabbed by a patient, becoming addicted to painkillers, almost dying at the hands of guerillas in the Congo, and having a son stillborn. Wyle was the only main character who stayed from the series' pilot through 11 seasons, before leaving and then returning for a number of episodes. (NBC) Back to slideshow navigation
  7. Dr. Abby Lockhart

    "NewsRadio" veteran Maura Tierney joined "ER" in season six as Abby Lockhart, working as Carol Hathaway's labor and delivery nurse. Lockhart then pursues her medical degree, but often struggles to pay her tuition. Her memorable mother, Maggie (played by Sally Field), visits and it's revealed that Abby has long had to struggle with Maggie's bipolar disorder. She had a relationship with Dr. John Carter, but it's Dr. Luka Kovac who she marries and with whom she has a son, Joe. Abby also struggled with alcoholism. (NBC) Back to slideshow navigation
  8. Dr. Luka Kovac

    Dr. Luka Kovac (Goran Visnjic) helped make the word "Croatian" equivalent with "heartthrob." He joined the show after George Clooney's season-five departure, and even kissed Clooney's girl, Nurse Carol Hathaway. Kovac's tragic past – a wife and two children died in a Croatian mortar attack – seemed to haunt him, and his many relationships were often troubled. He eventually marries and has a son with Dr. Abby Lockhart. (NBC) Back to slideshow navigation
  9. Dr. Elizabeth Corday

    British actress Alex Kingston played Dr. Elizabeth Corday, and her addition to the show in 1997 reportedly helped "ER" find more viewers in the United Kingdom. She marries Dr. Mark Greene and has a daughter, Ella, but loses Greene to a brain tumor. She eventually returns to England after performing illegal organ donation surgery. She makes a return visit to County General in the show's final season. (NBC) Back to slideshow navigation
  10. Dr. Cleo Finch

    Michael Michele played Dr. Cleo Finch, introduced as a pediatric resident in the sixth season of "ER." Her relationship with Dr. Peter Benton had its ups and downs, but they stuck together, and eventually both left the show in the eighth season, finding happiness away from County General. (NBC) Back to slideshow navigation
  11. Dr. Gregory Pratt

    Dr. Gregory Pratt (Mekhi Phifer) didn't join the show until its eighth season, but his six-year tenure was memorable. His life was fraught with struggles, including a mentally handicapped stepbrother, estranged father, and difficult relationship with a half-brother. Before he could propose to girlfriend Dr. Bettina DeJesus, Pratt was killed when the Turkish mob blew up an ambulance he was riding in (aiming not for Pratt, but for his patient). (NBC) Back to slideshow navigation
  12. Dr. Deb Chen

    Ming Na plays Dr. Jing-Mei Chen, also known as Deb, who joined the show in its first season as a med student. She left the show, returned in season six, and left again in season eleven. She has a baby boy by nurse Frank Bacon, but gives the child up for adoption. A relationship with Dr. Greg Pratt eventually ends. When her ill father wants her to euthanize him, she does so and leaves the hospital. (NBC) Back to slideshow navigation
  13. Dr. Cate Banfield

    Legendary Golden Globe-winning actress Angela Bassett plays Dr. Cate Banfield, who joined "ER" for its final season. Her character replaced Dr. Skye Wexler as chief of the ER. Via flashbacks involving the late Dr. Mark Greene, viewers learned that Benfield's 5-year-old son died of leukemia six years earlier, and she blames herself for not realizing his illness sooner. She and her husband decide they want to have another child, but the chances don't look good. (NBC) Back to slideshow navigation
  14. Dr. Ray Barnett

    Shane West joined "ER" in 2004, playing Dr. Ray Barnett, a doctor and a rock musician. When drunk, he was hit by a truck, losing both of his legs. He then left the show for two seasons, returning briefly to show off new prosthetic legs and discussing his work in disability medicine. His relationship with Dr. Neela Rasgotra weaves in and out of his time on the show. (NBC) Back to slideshow navigation
  15. Dr. Neela Rasgotra

    Parminder Nagra plays Dr. Neela Rasgotra, the first character of Indian descent on "ER." Nagra came to fame playing the starring role in "Bend It Like Beckham." She became the show's leading female character. She married Dr. Michael Gallant but became a widow when he was killed in Iraq. She has had numerous other romantic relationships, including with Dr. Simon Brenner, but eventually leaves County General to be with Dr. Ray Barnett. (NBC) Back to slideshow navigation
  16. Dr. Tony Gates

    Yes, that's John Stamos, from "Full House" and "General Hospital." Stamos played Dr. Tony Gates, a paramedic who went on to become a doctor. His relationship with Dr. Neela Rasgotra dates back to his paramedic days, but he also had another relationship with a woman and her daughter, who turned out not to be biologically his. His medical career has been as troubled as his emotional life, and he often clashed with Dr. John Carter. (NBC) Back to slideshow navigation
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