Emergency measures

The current cast of ER: from left, Linda Cardellini, Scott Grimes, John Stamos, Maura Tierney, Goran Visnjic, Mekhi Phifer and Parminder Nagra. (CTV/NBC)

As we reach the halfway point of what was supposed to be ER’s endgame, word has it that executive producer John Wells has decided to revoke the show’s do-not-resuscitate order and drag it, wheezing and limping, through another television season.

Now in its fourteenth year, the once-valiant medical marvel is a shell of what it once was. Largely gone are the core characters that carried the series; with the advent of season 14 came the announcement that the two remaining “stars” — swarthy sex symbol Luka Kovac (Goran Visjnic) and long-suffering nurse-turned-doctor Abby Lockhart (Maura Tierney) — were jumping ship. Without them, ER is a sprawling mass of also-rans, none of whom have well-enough developed identities or plotlines.

Indeed, in the last several years, ER has subjected viewers to an onslaught of newbies, who have swooped into Chicago’s County General hospital and marched out the door just as quickly. Sara Gilbert kept showing up as a freakishly clever med student turned doctor, but don’t ask me what her demons were — she was gone before I could figure them out. Meanwhile, the introduction of the studly doctor Tony Gates (’80s icon John Stamos) and his quirky serial crushes smacks of Grey’s Anatomy envy (paging Dr. McDreamy). Without the allure of personal struggle, fallibility and gradually unfolding narrative arcs, it’s virtually impossible to convince people to keep tuning in.

Where it once stood at the top of the heap, averaging an astounding 30 million viewers per episode, ER’s ratings have been steadily declining since its ninth season. In recent years, viewership has plummeted to a paltry 9.3 million fans every Thursday night. Most laypeople don’t even realize the drama that helped make NBC king in the ’90s is still on the air. But I am enough of an ER lifer to stand by my program and hold its hand as it fades gently into that good night. ER deserves to die with dignity.

ER aired its groundbreaking first episode in 1994. Technically, rival Chicago Hope beat it by a day, but the head start never paid off. Despite having more big names in its cast, Chicago Hope lacked the frank writing and verité quality ER brought to the table. Both shows debuted in a primetime wasteland. The only real-life grit you’d find on a weekday night came in the form of tough coppers ’n’ criminals capers: Steven Bochco’s NYPD Blue, Dick Wolf’s devoutly procedural Law & Order and the Baltimore thriller Homicide: Life on the Street. Nearly six years after St. Elsewhere ended its run, explorations of medical institutions were all but absent from the network landscape. Hospitals were merely a background for the corny cracks on the Golden Girls spin-off Empty Nest (jovial pediatrician jokes with desk clerk) and Nurses (weary women in scrubs joke with desk clerks).

The cast of ER, circa 1996: from left, Noah Wyle, Sherry Stringfield, Anthony Edwards, Julianna Margulies, George Clooney, Gloria Reuben and Eriq La Salle. (Hulton Archive/Getty)

ER changed this. In contrast to the boys in blue hot-footing after nefarious thugs, ER depicted the immediate aftermath of violence: bodies, and lives, that demanded repair. From the urgent first synth chord and heartbeat thu-thunk of James Newton Howard’s opening theme — which sounded like a Code Blue call echoing through hospital corridors — you were in. The tone of that inimitable tune was clear: “Human Lives Hang In the Balance. But We Will Do Everything Necessary To Save Them.”

It was easy to identify with the staff at County General because they were so human and fallible. Take the pilot episode, in which the trauma doctors and nurses were forced to treat one of their own: nurse Carol Hathaway (Julianna Margulies), who after struggling with depression had tried to off herself with pills. As set-ups go, this was a superb way of mapping out the complex web of characters necessary to make viewers invest themselves in the show. The nurses whispered as their catatonic colleague was whisked by on a gurney. I watched Doug Ross (George Clooney) blanch while his buddy and fellow resident Mark Greene (Anthony Edwards) frowned disapproval. And I thought, “Like, OMG! That bastard Ross was dating Hathaway and totally screwed her over. And now he could get stuck with her blood on his hands? That’s so messed up!” Margulies was originally written off after that brief-but-crucial appearance, but due to massive public response to that first episode, Hathaway became a core character.

I was hooked.

Main characters, and their Major Life Dramas, have always carried ER. We weathered Mark Greene’s marital strife, then familial bliss and eventual death from a brain tumour. We prayed with tough-as-nails physician-assistant Jeanie Boulet (Canada’s Gloria Reuben) when she became one of the first HIV-positive characters on a primetime drama. We cheered through ER chief Kerry Weaver’s (Laura Innes) coming-out process and her struggles as a queer parent. We witnessed various addictions and rehab stints, pregnancies and miscarriages and romance after romance after romance.

ER’s message — one that network TV had never previously considered — was that the people who save lives have complicated lives of their own. And yet ER’s writers refused to get sentimental about it, handling these personal crises with the same candor they did the medical emergencies. Obviously, ER was the precursor to the bantering, bed-hopping interns/neurotics on Grey’s Anatomy. Grey’s has borrowed the soapy drama of its older sibling and added self-consciously wacky humour, but its whiny navel-gazing usually misses the mark.

A scene from the thirteenth season of ER (CTV/NBC)

Grey’s is also missing a key element of the ER formula: scientific authority. Whether or not I could comprehend the dense jargon with which exec producer Wells and original writer Michael Crichton front-loaded their scripts, I bought it. Thanks to them, I could rattle off finicky prescriptions involving “an amp of epi,” puzzle over complex diagnostics and fret about whether a given doc was correct in releasing a troubling patient. Most cast members delivered their terse assessments with enough urgency and determination to convince an Everygirl viewer she was getting a privileged glimpse into a real-life emergency room.

ER’s gloriously gory, cinematic style also helped. (From the outset, the series was shot in 16:9 widescreen, though it didn’t start airing in a proper letterbox format till the season 7.) While ER has become increasingly stylized, the original vibe was cold and clinical, capturing a bare-bones, budget-conscious inner-city hospital. Of course, that’s all just a backdrop for the real guts of ER’s aesthetic. Namely, the guts — the bloody, slimy, pulsing viscera of bodies sliced open, organs laid bare and vulnerable. When I think of ER, I think of a latex-clad fist clenching a pulsing heart, or of Dr. Elizabeth Corday (Alex Kingston) purring in her clipped British accent, “I’m sorry, but we’re going to have to remove your spleen.”

The intelligent writing and big-screen ambition have contributed to ER’s staying power, and allowed the show to pull off some nifty gimmicks: major stunt casting (Sally Field! Red Buttons! Mickey Rooney!) and countless episodes directed by cast members. One of my favourite episodes remains the Breakfast Club homage “Secrets & Lies” (2002), in which four staffers were forced to attend sexual harassment training after stumbling on a dominatrix’s bag of tricks at work.

Alas, the ER team has grown so desperate for material that now, the show has resorted to the gravest of all primetime drama sins: recycling its own plotlines. This season, poor, fallen-off-the-wagon Abby Lockhart returns from rehab to toil under the judgmental eyes of her colleagues. I loved Abby-the-drunk the first time around (like, eight years ago). Tierney knows how to croak through a downward spiral like nobody else on the show, but enough is enough. Recycling the ER of yore will only hurt the patient. The show should remember the Hippocratic Oath: “First, do no harm.” I hate to say it, but I think it may be time to pull the plug.

Sarah Liss writes about the arts for CBCNews.ca.

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