ER wasn’t the only medical drama to premiere in the fall of 1994. It wasn’t even the only medical drama set in Chicago to premiere that year. But it’s easily one of the best television series ever produced, and its pilot should be taught to anyone who wants to tell stories for a living, regardless of the format. The show gave us a world you could truly sink into every week.
All 331 episodes of ER are finally streaming on Hulu, and the difference between it and its descendants is striking if you happen to segue directly into another show. Perhaps the most jarring experience is going from the ER pilot to Fox’s recently premiered The Resident, an endpoint to the genre’s evolution that began with ER.
“Evolution” doesn’t come with a positive connotation, here. The journey from ER to The Resident is indicative of a larger problem facing television — namely, that the people currently making TV seem to have been incepted with the idea of making their show look and feel as “cinematic” as possible, at the expense of building a textured world from episode to episode.
Take the opening of both pilots. In The Resident, the first thing we see is a surgery gone awry because the surgeon’s hands are shot and the anesthesiologist hasn’t done his job properly. Our first impression of this world is that its inhabitants are vain and reckless and have no regard for their patients’ wellbeing. The doctors are immaculately groomed, wearing crisp, tailored clothes. They speak in what can only be described as dialogue. The writing, sets, and characters themselves feel artificial, too sleek by half. The world of Atlanta’s Chastain Hospital exists only in fantasy, and the viewer is acutely aware of that throughout the entire episode.
In ER, we enter the episode at the same time as our protagonist, Mark Greene (Anthony Edwards). A nurse, who we’ll see again and again and is a character in her own right, wakes him to take care of an inebriated colleague. We follow him through the halls of County General, getting to know the place. His stride indicates a confidence tinged with wear; he passes by people doing repairs, mopping, mundane jobs viewers don’t think about much. The music of our journey is played over the radio. Within a few minutes, we’re thrown into a large-scale trauma that organically introduces us to everyone we need to know and gets our blood pumping, setting a kinetic tone that carries through the episode.
With the exception of perhaps Eriq La Salle and George Clooney (who’s a few years away from full Movie Star Handsome at this point), the characters in the ER pilot look like normal people. Clothes look like they’ve been worn before, and appear to have come from a department or chain store, rather than off a designer’s rack. Colors are present, but not oversaturated. This is a world that has existed before we entered it, and will exist long after we’ve stopped watching.
Now take the ending for each pilot: The Resident sees its ostensible protagonist about to switch off the life support for a brain-dead patient. ER comes full circle, with an exhausted Dr. Greene being woken by the same nurse.
What stands out most about the ER pilot is the confidence John Wells and Michael Crichton had in their characters and world, trusting their actors to deliver performances that would inspire attachment, rather than stocking the episode with character-defining monologues or overly witty banter or inorganic conflict.
When nurse Carol Hathaway (Julianna Margulies), whom we’ve only known for a few scenes, is rushed into the ER after a suicide attempt, it’s shocking and anxiety-inducing. Viewers genuinely want Carol to pull through — not just for Carol’s sake, but for her friends. These characters have flaws — sometimes deep and damaging — but at the end of the day, these are people who are doing their best to help other people. You can feel the warmth and humanity radiating off every character.
To put it bluntly, there’s a texture to ER that is absent not just from current medical dramas on the air, but nearly every other show.
Technological advances account for some of that criticism — formats like Ultra HD and 4K heighten the glossy, slick look of most current shows. Part of the “grit” we see when we watch early ER comes from it being shot on film. New broadcast shows also get the short end of the stick when it comes to runtime these days: “hourlong” episodes on broadcast come in around 42 or 43 minutes; ER had around 46 or 47 minutes in its early seasons.
But so many current shows are cast, costumed, and shot like blockbusters. In early ER, we see the lines on actors’ faces and their errant hairs. Shots linger to allow everyone to breathe.
These are cosmetic problems that can easily be addressed. The real reason we don’t see broadcast shows like ER anymore is that creative teams think the word “gritty” applies to “edgy” characters and plotlines, rather than describing the depth of the world they’ve built. And that’s why half your Twitter feed is currently full of people discovering and rediscovering ER — it’s one of the best examples of how good television can be when it allows itself to be television.