ER: Discussion Thread

[Y&RWorldTurner]

Great to see ER end the way it premiered - at #1.

How easily we forget that at its peak, ER was brininging in higher ratings that both Seinfeld and Friends.

[DaytimeFan]

I'm thrilled ER left at Number 1 for the night...fantastic. I just loved that finale. Satisfying!

[detroitpiston]

If your gonna end a long running show, you better do it right and ER definitely did. I hadn't watched the show since season 9 but tuned back in for the last 7 episodes and all I have to say is thank you NBC and the producers of the show for bringing back all my faves and giving them all a nice ending. And another big thank you for bringing back the opening credits for the finale. When I heard that "dunn dunn dunn dunn dunn" I literally stood up and yelled YEAH!

[UCLAN]

Great Show. Great Finale. Way to go full circle ER!

[Toups]

As I was watching the restropective special, I thought, "Why didn't I get hooked on this show? It's awesome!" I never really watched ER - only watched a few episodes here and there. I forget what I was watching back then instead of ER, but I think I might start watching it from the beginning if I ever have the chance. I've always loved the steady cam shots - I just thought they were so cool and brought you right into the action. Of course I gotta mention Marty Davich's background music!

I thought the ending was great with everyone out there waiting for the ambulances and then the slow out with the ER theme playing.

Loved the scene with the woman giving birth to the twins. I was at all that blood gushing out and her uterus falling out and Alexis Bledel has to push it back in! Then the shot of all the bloody footprints as the husband just stood there. Great writing and directing right there!

[YRBB]

I haven't seen the episode yet--have another 14 seasons before I get to it--but I am SO happy that it ended on a high note, and that the ratings were great. What a great, amazing show, and it will be dearly missed.

[Y&RWorldTurner]

I have to hand it to ER, they didn't have the go the extra mile in their 15th and final season, but they did anyway - for the fans. This entire last season felt like a tribute to the fans who loved and admired the show though the years. If you're going to end a long-running show, you need to do it right and in a respectful way, and ER more than delivered this season.

[DaytimeFan]

What I really appreciated about ER is how 'by the book' it was when it came to medicine. What happened with that woman's uterus happens all the time and the show got the details 'just right'...a show like Grey's Anatomy does SO MUCH NONSENSE, I can't watch it anymore.

Mark my words, if Izzy doesn't die from the melanoma (the deadliest skin cancer, please get yourselves screened people!) she has I think the medical consultants, if there are any, should be fired.

ER never f--ked with medicine. It was very respectful towards the institution. I felt that Haleh's last line "Oh it was just like any other day" summed it up perfectly.

[Sylph]

A Made-Up Hospital That Offered Real Medicine


By Pam Belluck


Two years after "ER" hit the airwaves in 1994, a study in The New England Journal of Medicine reported that it and other medical shows were giving an unrealistically rosy picture of cardiopulmonary resuscitation. Television doctors, the study found, used CPR much more often on young people than real doctors do, and so much more successfully, that the authors feared people might expect near-miraculous recoveries. If it was striking to see the upper-echelon medical establishment weigh in on pop culture, it was equally noteworthy to see how pop culture responded. An "ER" co-producer, Neal A. Baer, argued in the journal that the show aimed for accuracy — it was created by a doctor, Michael Crichton, and its writers included an emergency room physician and Dr. Baer, trained as a pediatrician. And the next year, Dr. Baer had Dr. John Carter, the character played by Noah Wyle, break an elderly man's rib as he gave him CPR.

"I was justly chastised," Dr. Baer said recently. "Like it or not, people think it's real."

"ER" broadcast the final episode of its 15-year run on Thursday, but the show leaves a powerful legacy: a give-and-take between the world of entertainment and the world of medicine that has become stronger and more deeply intertwined with each year that "ER" has been on the air, carrying over to other medical shows.

One of the first hospital dramas to take its medicine seriously — as the engine rather than the backdrop for its scripts — "ER" caught the attention of the medical establishment as a source of health information for millions of Americans. A 2002 study by the Kaiser Family Foundation found that viewers' knowledge of emergency contraception and the human papilloma virus increased after watching episodes that mentioned those subjects; a third of them said the show helped them make health care choices. One in five doctors in a 2001 survey said patients asked about diseases or treatments they saw on shows like "ER."

Today, a small industry has grown up to influence writers and producers. A program called Hollywood, Health and Society gets money from health organizations and federal agencies like the Centers for Disease Control and Prevention to arrange meetings where doctors urge medical-show writers to highlight certain diseases or issues.

"We coach our experts in telling writers real stories of real people," said Sandra de Castro Buffington, director of the program, part of the Norman Lear Center at the University of Southern California's Annenberg School of Communication.

So when Dr. Atul Gawande, a surgeon and New Yorker writer, met with "ER" writers to stress the importance of a pre-surgery checklist, he recounted the dramatic case of a girl who fell into a frozen lake, Ms. Buffington said. The writers worked a checklist into an episode last month.

Physicians and researchers frequently monitor medical shows. Last month, Dr. Peter G. Brindley, associate professor of critical care medicine at the University of Alberta, and a colleague wrote in the journal Resuscitation that many medical students were improperly positioning patients' heads to insert breathing tubes. Many students said they had learned the skill from watching medical shows, especially "ER" — which, Dr. Brindley said, "did it wrong every single time."

The shows don't object to the attention. "We love to be able to work in some of the public health messages," said David Foster, a former internist who writes for "House," which included the disease chlamydia in a 2007 episode after urging from Hollywood, Health and Society. After similar overtures, "Grey's Anatomy" and "ER" featured patients with the BRCA gene mutation, which predisposes some women to breast cancer.

"People, for lack of a better word, lobby me about their health causes, and I sit down and talk to them and try to figure out if there's a way we can incorporate their disease in the show," said Elizabeth Klaviter, director of medical research for "Grey's Anatomy" and "Private Practice."

As long as it makes good television, of course.

"They were trying to get us to include the consumption of five fruits and vegetables a day in a story line," Ms. Klaviter said. Alas, the writers haven't yet figured out how to have McDreamy extol the benefits of broccoli (though in the "ER" finale, Dr. Archie Morris was chided that he would need angioplasty if he kept eating meat pizza).

It's not that the doctor shows of earlier eras were untouched by medical scrutiny. The American Medical Association sometimes vetted and gave its seal of approval to shows like "Ben Casey" and "Marcus Welby, M.D." But the concern was that physicians be shown as admirable healers.

"These were sort of adoring doctor dramas," said John D. Lantos, a bioethicist at the University of Chicago. "My sense is that the medicine was irrelevant and unsophisticated — someone's lying in a room that looks like your living room and there's an IV running, the universal symbol that something medical is going on."

That began to change with "St. Elsewhere" in the 1980s, and "ER" took it further, with doctors as nuanced, imperfect people who tackled challenging cases involving cutting-edge medical realities like AIDS and envelope-pushing technology.

"We talked about how can we reveal characters through the medicine," said Dr. Baer, now executive producer of "Law & Order: SVU." Writers went to observe emergency rooms. Actors were shown by doctors how to perform thoracotomies.

Other shows borrow from "ER" but add their own twists. For "House," writers pore through medical journals and surf the Internet for "the one-in-a-million case" for the cantankerous title character and his staff to solve, Dr. Foster said. Medical accuracy is crucial, he said, in part because "anybody can fact-check anything" on the Web.

But some real cases are too fantastical, like the swallowed toothpick that poked through a woman's intestine and punctured her lung. In an episode inspired by that case, "House" writers toned down the injuries a toothpick inflicted because "an audience wouldn't find them believable," Dr. Foster said.

What doesn't have to be accurate is the way the "House" characters break into patients' homes to investigate their medicine cabinets. ("I can't say that in my medical training I ever did that," Dr. Foster said.) Or the ethics of Dr. House, a Vicodin addict who runs roughshod over patients' wishes.

"Grey's Anatomy," too, sometimes throws ethics to the wind. Doctors sleep with residents, and interns perform procedures they would never be entrusted to do. While the writers want to get the medicine right, characters and relationships are primary, said Ms. Klaviter, who does not have a medical background, but was a longtime researcher for the show's creator, Shonda Rhimes.

Last year, Ms. Rhimes "felt like our characters were having trouble moving forward" and wanted to reflect that with a patient completely encased in concrete, Ms. Klaviter said. The first idea was "somebody being under a concrete truck while the truck was unloading," but "when we realized no one could survive that," it was changed to a teenager who jumps into wet cement on a dare.

The writers are not expected to include medical details in scripts — not since one writer invented a medication, unbeknownst to a "Grey's Anatomy" medical consultant who "spent an hour looking it up and was sort of embarrassed that he didn't know what it was," Ms. Klaviter said. Now, she said, writers leave a placeholder for researchers to fill in. "They might write, 'Izzie goes to the bedside and performs a medical medical.' "



http://www.nytimes.com/2009/04/05/weekinreview/05belluck.html?_r=1&ref=television&pagewanted=print

[DaytimeFan]

Sylph, that article is correct of course. ER, in fact all medical shows, have always made CPR look effective when the fact is, it really isn't that effective unless you've got the paddles in play.

That said, I think ER was head and shoulders above the rest of the medical pack. Grey's Anatomy really bothers me, every f--king case is a medical miracle.

Certainly, creative license is involved, but I think ER did a lot more good than bad.

[Sylph]

All from Hollywood Reporter, this article in particular:

[Sylph]

For all of you: how did this show progress from season to season for you? Which ones did you find the strongest and which were weak? Any weak spots or moments when it started to 'go down'? Any seasons where it regained momentum which you especially like?