Beyond Blood and Yucks : NBC’s fast-paced new medical drama ‘ER’ owes more to ‘Cops’ and ‘Rescue 911’ than to ‘Dr. Kildare’ and ‘Marcus Welby, M.D.’--which is just fine with ‘90s viewers

<i> Rick Du Brow is The Times' television writer</i>

It’s an eye-catching set for a TV show, a large and compelling maze of hospital rooms that takes up most of Stage 11 at Warner Bros. studios in Burbank. There, at the moment, a sprawling, surprising major new hit--the medical series “ER”--is being crafted. The initials stand for emergency room , and the NBC drama’s trademark is a frenetic pace as blurry swarms of people and stories crisscross in a program that took off like a shot in the ratings.

Outside, during a break on a recent sunny morning, most of the heretofore low-profile principals in the cast--who play the medical staff--are sitting on brand-new bicycles with Christmas decorations, a gift from one of their colleagues, actor George Clooney, who portrays a cool, loose, womanizing pediatrician. Examining their bikes, they name him Santa Clooney.

Clooney, son of former KNBC-TV Channel 4 anchor Nick Clooney, sums up the tone of the Angst -ridden, emotion-churning yet often funny one-hour series as well as anybody: “In a line, it’s Rome burns.” He adds: “When you have so many things flying around, it’s not like a standard TV show where you sit down and there’s two people talking at a table for four pages.”


In fact, says NBC Entertainment President Warren Littlefield, “our viewers, in network research groups, consistently describe this as an action show”--certainly a new twist on that old staple of television drama, the medical series.

The furious pace of the “ER” format has already taken its toll, clobbering another new medical series that took a more traditional approach in its style, CBS’ “Chicago Hope,” when they went head to head at season’s start. CBS moved “Chicago Hope” to another time slot.

“ER,” which ranked among TV’s top four shows in its first month on the air, also clobbered ABC’s high-profile newsmagazine “PrimeTime Live” and its $7-million anchor star, Diane Sawyer. ABC is moving “PrimeTime Live” to a new time slot in January.

“I haven’t been this jazzed about anything I’ve been involved with on television since ‘Columbo,’ ” says Steven Spielberg, whose company co-produces “ER” with the author and creator of the series, Michael Crichton, and Warner Bros.

When “Columbo,” starring Peter Falk, became a regular series in 1971, Spielberg directed the first episode and Steven Bochco wrote the script.

“I have a stake in television,” Spielberg says. “ ‘ER’ is the first time we’ve had a hit, in the early stages.”

It’s a big event for NBC too, and viewers must have been stunned when the network preempted “ER” on Oct. 27 to showcase another new drama, “Sweet Justice,” risking the growing word of mouth the medical series had generated. Right or wrong, NBC already is convinced that it has a long-term smash.



Thus far, at least, “ER” has been turning TV upside down on several important levels, despite criticism from some quarters that it does not accurately depict the practice of emergency medicine physicians in the 1990s. The series is based on Crichton’s experiences as a medical student at Massachusetts General Hospital.

“ ‘ER’ illustrates the practice of emergency medicine from 20 years ago, not the unique medical specialty that it is today,” Dr. John B. McCabe, president of the American College of Emergency Physicians, said in response to the pilot of the series, which is set in a Chicago teaching hospital.

Nonetheless, to the surprise even of NBC, which initially was skeptical of the show’s chances, “ER” has clearly touched a nerve with audiences. The most obvious connection may be the national concern and debate over health care.

“We are in an era where people are concerned about being taken care of,” says Leslie Moonves, president of Warner Bros. Television.

“ER,” in short, may well be an idea that was simply ripe, because, as Crichton acknowledges, the project was rejected through the years in various quarters--partly, he says, because of its “larger dose of reality.”

Perhaps just as important to the appeal of “ER”--the show is guided daily by former “China Beach” producer John Wells--is the sheer power of the fast-paced style, which, building on Crichton’s memories, was refined in the slam-bang premiere by director Rod Holcomb.


With help from a Steadicam--a body-mounted camera that allows lengthy, gliding shots--and consistent lighting aided by low fluorescent ceilings that simulate hospital rooms, the action often moves in a steady, seemingly nonstop flow. And the human flow frequently rings true, with bits and pieces of stories interlocking, as real life does in close quarters where hectic events overlap.

“I think what’s great about this show is that it’s like watching a bad freeway design,” Spielberg says. “All of the roads intersect at the critical point in the epicenter, and you sit back and watch the pileup, and then you wonder: Is there going to be any continuity to this chaos? It does all have meaning, and it does sort itself out. And by the end of the episodes, you see that the characters are having relationships with each other, they have lives away from the ER, and the series is going in a slow but positive direction.”

The pace, by accident or design, also serves another purpose for NBC: At a time when networks are concerned about channel surfing by impatient viewers--which has resulted in the elimination of some theme songs and commercials so that one series can go directly into another--”ER” is a formidable weapon in holding viewer attention.

“It’s always moving,” says the show’s director of photography, Richard Thorpe. “I think that this is a new kind of show. The pace is what makes this show run. Before a viewer can get bored and surf to another channel, we’re changing--going to the next drama or the next little moment. In the ‘90s, people’s attention spans are so short, but this show’s grabbing you all the time. We’re never dwelling on any one thing. We’re off on something else.”

And then there’s the ultimate irony: TV’s reality and newsmagazine shows, which have displaced many drama series and now are feeling the lash-back of “ER,” may well have contributed to the style that is making the medical show a success.

“We owe a real debt to the reality shows of the ‘80s,” says co-executive producer Wells, “because the dramatic artifice, the theatricality of cop and medical shows in the past, gave way to great expectations of realism on the audience’s part. When ‘Rescue 911’ and ‘Cops’ are on, I don’t think you can go back and do the cop and medical shows you did 15 years ago. . . .


“But the difficulty that all the reality shows have is that you can’t artificially manipulate the dramatic tension. You have to follow the incident as it happens, and sometimes things don’t happen and you can’t do anything. But in ‘90s dramas, you get the sense of pace, and writers can manipulate and make it more rewarding and give you more.”

Dr. Lance Gentile, technical adviser and writer for “ER,” says that because of reality shows, “You can’t do ‘Marcus Welby’ anymore.”

Says Warner Bros.’ Moonves: “What ‘NYPD Blue’ and ‘ER’ have done is re-establish drama as a great place for the networks to go. Dramas are beating the hell out of the newsmagazines. I think a year from now we’ll see fewer newsmagazines on the air.”

Crichton, who is working with Spielberg on their sequel to “Jurassic Park,” thinks that with or without reality shows, network television painted itself into a corner through the years: “It slipped further and further into its own sense of a kind of established television reality that appears on all of the networks. They drifted too far away from any reality that I recognize.”

Spielberg says that “ER” has “a style that has been very successful in verite television. In ‘Cops’ and even in some of the often awkwardly constructed (shows) of re-creations of actual emergencies, there have been a couple of years of what I like to just call emergency television.”

He adds: “It’s a Catch-22 in a very good way. What laid the groundwork for ‘ER’ stylistically was actuality television, and now perhaps ‘ER’ will cancel out not all the actuality television but some of the actuality television where the re-creations aren’t as realistic as they could be.”


Wells just plain admits that he’s “absolutely” surprised at the way “ER” took off: “I expected that ‘PrimeTime Live’ would win the hour and that ‘ER’ and ‘Chicago Hope’ would be duking it out for second place. Everyone predicted that. The network was, I believe, guaranteeing (advertisers) a 23 share.”

That’s 23% of the audience. But in its first month, “ER” averaged a whopping 31%, right up there with “Home Improvement,” “Grace Under Fire” and “Seinfeld.”

“Nobody expected it,” Wells says.

O n this particular day on Stage 11, they’re shooting an epi sode scheduled to air Dec. 8 in the 10 p.m. Thursday time slot “ER” has inherited from two other breakthrough dramas also launched by NBC--”Hill Street Blues” and “L.A. Law.”

Like those shows, “ER” has an ensemble cast, and the six principal stars are all there for the shoot--faces that are swiftly becoming more recognizable as they emerge from the swarm of extras, who average about 35 a day, says second assistant director Michael Pendell.

(“I use some real nurses with the actors,” says adviser-writer Gentile, who has practiced emergency medicine for 18 years, “and that raises the level of reality because they know how to work the equipment and how to move and push their way in between the doctor-actors and do their stuff.”)

“Prior to ‘ER,’ you wouldn’t call it a superstar cast,” says NBC’s Littlefield. “However, today they all are.”


Well, not quite yet, but they’re on their way. Besides Clooney, 33, the medical staff includes Anthony Edwards as the soft-spoken chief resident who is clearly the anchor of the on-screen proceedings; Sherry Stringfield as a no-nonsense physician; Eriq LaSalle as a confident surgical resident; Noah Wyle as a wide-eyed, good-hearted medical student who is sometimes in over his head, and Julianna Margulies as the head nurse coming back after a suicide attempt.

Wearing his green medical scrubs, Edwards, 32, is a very real-looking, unglamorous yet confident presence.

“There’s no reason for your chief resident to be as good-looking as George Hamilton,” he cracks. “The whole point is to get people to relate to the characters.”

Stringfield, 27, has quickly moved from one of television’s top shows to another. Last season, she played an assistant district attorney and ex-wife of David Caruso on another breakout drama, ABC’s “NYPD Blue.” Why would she leave?

“I wasn’t working hard,” she says. “I was a regular, and I wasn’t very regular on the show. They (“ER”) called my agent and sent the script. I knew the show would take off. The writing from the beginning was great.”

LaSalle is convinced that “the style of the show makes it very accessible.”

“It’s not long and drawn out,” the 32-year-old actor says. “The most important thing is that I think the audience feels they go on the journey with us. So it’s more interactive. We take the audience on a ride.”


Or, as Gentile puts it: “If you don’t like the story or actor now, there’ll be another one in a minute. It’s more like life. Things happen. You don’t always have an ending. You come in the middle of people’s lives.”

“It’s a puzzle that’s very orchestrated,” says the director of the episode, Mimi Leder, another “China Beach” veteran, who is also a supervising producer of the series. With the essentially “pre-lit” sets and the Steadicam, “we’re on a continuous motion,” she adds. “I often weave scenes. If I can have one person take me to another scene, I do.”

Adding to the tone, says Margulies, 26, is that she has no idea where her character is going in the series: “I think it’s great because it keeps it spontaneous.”

Meanwhile, Wyle, at 23, is a reminder of the teaching aspect of the hospital: “I’ve got a lot of letters from medical students who say their experience is like the one I’m having on the show, or comparable.”

Then there’s Gentile, a droll veteran whose behind-the-scenes role is one of those only-in-Hollywood stories. As a practitioner of emergency medicine, with current part-time duties at Lakewood Regional Medical Center and Century City Hospital, he is a link for “ER” with doctors who criticize the show.

At the same time, the 45-year-old Gentile, as a scriptwriter, technical adviser and graduate of the USC School of Cinema and Television, is involved with the series’ creative side, including the cast. For instance, he says, he gives audiotapes of medical terms to the performers along with their scripts so they can become more proficient at rattling off the hospital language.


“They’re getting better at it,” he says.

T he making of the “ER” televi sion series is yet another prof itable product involving the longtime acquaintance of Spielberg and Crichton.

“When I first signed my seven-year contract with Universal, when I was 20 years old,” Spielberg says, “my first assignment was to escort this tall young man (Crichton) and give him a tour of Universal Studios because he’d just sold the novel ‘The Andromeda Strain’ to (director) Robert Wise and Universal.”

The book was published in 1969, the film came out in 1971, and “we have stayed in touch all these years,” Spielberg says.

In the 1980s, he says, “Michael brought me the script . . . called ‘ER.’ I loved what I thought the script could be as a feature film. I bought it from Michael directly, and I began to develop it with Michael for me as a director. We had worked on it a number of days. . . . We were discussing revisions, and in the middle of one of the meetings, I just sort of casually asked Michael what else he was doing.”

Crichton, says Spielberg, told him that he was working up a story about dinosaurs: “I got him to open up and tell me the whole bloody story. And by the end of the couple of hours, we hadn’t discussed ‘ER’ at all--we had only discussed ‘Jurassic Park.’ I was just so in love with this story of his that we agreed on a handshake that if I would physically direct the movie, he would give me the rights to the book.

“And so I immediately became completely tuned in to ‘Jurassic Park,’ and ‘ER’ went on the shelf. ‘ER’ sat around my company for a number of years because I owned it. Then one day, Tony Thomopoulos (president of Spielberg’s Amblin Television division) called me and he said, ‘I’ve just read this script--which is in the inactive file--called “ER,” by Michael Crichton. I think it would make a great pilot.’ And I said, ‘Really?’ He said, ‘Yeah. Can I run with it?’ And I said, ‘Absolutely.’ ”


While Crichton and Spielberg have full plates, they keep a careful eye on “ER.” Says Crichton: “With each succeeding episode, I have found that I have less to say. I subscribe to the medical belief that there is nothing better than no symptoms.”

Spielberg says he looks at the dailies “on videotape every day” and sends notes on the story outlines, treatments and scripts: “I’m focused on my new company (with partners Jeffrey Katzenberg and David Geffen) and on my life, but I so enjoy ‘ER,’ I got in the habit of just getting involved.” He emphasizes, however, that “John Wells is responsible to the series and is doing a brilliant job.”

Says Wells: “We’ve hit some kind of chord that people are responding to.”

Response also continues from real-life emergency medicine physicians.

On Oct. 3, Dr. Gerald Whelan, an associate professor at the USC School of Medicine and secretary-treasurer of the American Board of Emergency Medicine, charged in a Counterpunch article in The Times that the premiere of “ER” presented an outdated, “dangerous, erroneous” picture of emergency medical care that offered “neither hide nor hair of a single attending physician.”

Asked recently if he thought that “ER” had changed since the premiere, Whelan said: “I think it’s improved a little bit in that the actual medical treatments are technically reasonable for a dramatic series. But what’s still missing is the presence of any attending physicians. I’ve been in contact with Dr. Gentile, and they indicated that they intended to bring in more attending physicians but wanted to develop the characters first.”

Dr. Marshall T. Morgan, director of emergency medicine at the UCLA Medical Center, thinks that “ER” is “a pretty good show” despite some unrealistic situations that result from compression of dramatic material. But he believes that Whelan’s criticism was “accurate,” especially in regard to “unsupervised resident physicians--you’d never guess there is a bona fide specialty of emergency medicine.”

Says Dr. Toni Mitchell, who practices at an urban hospital in Tampa, Fla., and is a spokeswoman for the American College of Emergency Physicians: “They have made a tremendous number of improvements from a technical standpoint. They’re very reflective of the kinds of patients I have in terms of story lines.


“But I’d like (the show) to say a little more strongly that these are specialists in emergency medicine and that they won’t be something else when they grow up, and this is something we do every day, by choice.”

Responds Wells: “Every emergency room is not alike. We haven’t done a single thing that hasn’t come out of research. The biggest criticism that I think is justified is that there aren’t enough attending physicians. But as the show continues, you will see more attending doctors.”

Gentile says the criticism comes from concern that, without attending physicians, “people will be afraid to go to emergency rooms, thinking they’re going to get doctors in training.” He believes, however, that there is a positive message in the presentation of doctors as heroic and caring.

Contacted before the most recent episode, Dr. Robert Karns, president of the Los Angeles County Medical Assn., said: “I haven’t seen the show, but the patients say it’s great.”

O n the set of “ER,” director Leder is coolly moving through one scene after another. Two takes. Three takes. Two takes. “Cut. Print. Excellent.”

During a break, Clooney casually strolls through the set singing, paraphrasing the lyrics to a pop song: “I want to wake up in a city that never sleeps.”


He’s found the right place.*