If someone wanted to write a book called “How to Create a Hit Show,” “Grey’s Anatomy” would be an excellent case study.
It’s a medical drama that’s hitting its stride as perennial ratings winner “ER” continues its long, slow descent into irrelevance. Because the medical drama is a tried-and-true archetype for successful television, there’s no need to reinvent the wheel. Take a good-looking group of doctors, add an attractive group of guest stars as patients, sprinkle with a liberal amount of sexual tension and a dash of rare and compelling medical mysteries, and voila — compelling television.
To go with that tested format, the producers came up with a top-notch ensemble cast, featuring talented actors and actresses without the genuine “stars” that can distract viewers from everything else that’s going on.
There was That Girl from “Old School” (Ellen Pompeo), The Cool One from “Sideways” and “Arli$$” (Sandra Oh), and of course “The 80s Heartthrob Who Everyone Sort of Forgot About” (Patrick Dempsey), all of whom were recognizable, but none of whom are big enough to throw focus on the actor as opposed to the character Add additional cast members such as T.R. Knight, Isaiah Washington, Chandra Wilson, Katherine Heigl, Justin Chambers and James Pickens Jr, and the result is a group where any combination can carry the show for any given week.
In that group are a number of different character types geared towards establishing a rapport with the audience. Pompeo as Meredith Grey is the central figure, but Knight’s George O’Malley is the conscience, designed to be the audience favorite even as he sometimes makes choices that makes viewers want to throw things. Wilson’s Dr. Bailey is the no-nonsense supervisor, and so on. It takes an effort not to find someone on the show with whom to identify.
The same is true for the show's relationships, which in true TV tradition are fraught with complications and the whiff of inappropriateness. There’s the one between Dr. Christina Yang (Oh) and Dr. Preston Burke (Washington), which is above reproach except that Burke is one of Yang’s supervisors. There’s the obligatory love triangle between Grey, Dempsey’s Dr. Derek Shepherd, and Shepherd’s on-again, off-again wife, also a doctor at the hospital. And there’s the who-knows-what-the-heck-is-going-on relationship between Dr. Izzie Stevens (Heigl), Dr. Alex Karev (Chambers), and a patient who may or may not be dying of organ failure. There’s literally something for everyone; those searching for stable relationships, and those more into trainwrecks.
Once the cast was set, the show started off with the best lead-in ABC had to offer, the megahit That meant it didn’t need to count on clever promos or critical reviews to gain an audience; all it needed was for the viewers to be too lazy or tired to change the channel.
But the show soon took off on its own, and now "Grey's" looks as if it could carry a night even if it was preceded by the one-episode-only “Emily’s Reasons Why Not.” Episodes are well-written and expertly filmed, and the pacing is usually languid enough that it’s comforting to follow.
There’s medical drama — this season already has featured a man with an unexploded bomb in his abdomen, and a pair of commuters impaled on the same beam after a train accident — but very rarely does the show adopt the rapid-fire high-intensity pacing of a traditional hospital drama. Because "Grey's" is character-driven, the medical cases usually don’t need to take up most of the action.
Does the hospital seem to get more than its fair share of tragic figures, random illnesses, and injuries unlikely to occur in real life? Sure, because it’s hard to get viewers interested in things like sprained ankles and the stomach flu. But "Grey's" is also reminiscent of shows like “ China Beach ,” or maybe “ER” before the days when every Thursday was a “Very Special Episode You Can’t Miss Because This Show Costs Too Much And We Really Need the Nielsens.”
Since the show is character-focused, it’s succeeded at getting viewers to pick their favorites and root for them to achieve bigger and better storylines. Sure, the ensemble cast limits screen time, but a surprising number of characters are well-rounded. Even those that aren’t are unpredictable. Alex is the closest thing the show has to a villain, but he seems to have a good heart. Trailer-park raised Izzie sometimes seems as if her backstory is made up on the fly, but she also acts consistently with the motivations of her character. And so on.
And the show's writers, plus creator Shonda Rhimes, are great at interacting with fans. There’s a and a podcast on iTunes, catering to the hardcore viewers and nurturing them into a stronger bond with the show. Everyone associated with the program seems to acknowledge the role those little extras like that can mean in the gaining and wooing of a dedicated audience, and they’re taking advantage of it as few other shows have been able to do.
But it's going to be tricky for this show to sustain its momentum, for a number of reasons. First of all, it’s just as close to “ Melrose Place” as it is to other medical dramas. The relationship fluidity, the romantic interplay between the leading characters, and the other complicating factors that make for good television also mean that the writers have to develop ideas as fast as they can to keep walking the line between compelling and ridiculous.
The show's numerous strong characters also mean that it’s tough to keep everyone happy, both on the set and on the viewers’ couches. There are episodes when the focus is on Patrick Dempsey’s character, and then he’s barely seen at all for the next three weeks. The inevitable result is that some actors likely will grow unhappy with their roles and leave. That’s a natural part of the evolution of most shows, and one or two characters could leave without much of an effect. (Though the loss of Pompeo would be tough, since the show’s named after her character. Would they have to change the name to “Yang’s Anatomy?”).
So far, however, "Grey's" writers have excelled at nurturing storylines right to the point where they’re poised to become annoying, then backing off and restoring the equilibrium. Meredith seemingly hit rock bottom, dug herself into an even deeper emotional hole, and now is slowly crawling back out. George spent a season and a half moping after Meredith, played the martyr card until it became too much already, and has gotten his feet back under him again. Earlier in the show’s history, it was Christina who got pregnant, broke up with Burke, lost the baby, broke down in the hospital, and subsequently got back together with Burke and now has the most stable relationship on the show, at least for today.
Ultimately, the show’s big talent is making its fans happy. As long as it can keep doing that, that "Desperate Housewives" lead-in is nice, but not really necessary.
Craig Berman is a writer in Washington, D.C.