Rx for Success

It seemed like a natural for an evening out--two lovers going to a nightclub to hear some cool jazz. But the situation was anything but simple for Dr. Peter Benton, County General Memorial Hospital’s intense, high-profile black surgeon played by Eriq La Salle and one of the central figures in “ER.”

The show’s writers have woven Benton’s struggle to adjust to his relationship with white surgeon Elizabeth Corday (Alex Kingston) through most of this season and last. In this particular episode, Benton faces his anxiety about being seen with Corday at the club, which has a largely black clientele.

While Benton fights his own internal battles, the emergency room corridor is lined with unfolding stories of class, race, cultural diversity, AIDS, disabilities and prejudice in all its forms--themes that course through the show season after season. And while “ER” moves at a breathless pace with its trademark rapid-fire medical terminology, quick camera moves, surreal happenings and romantic entanglements, it takes its time dealing with significant social issues.

It’s a format that’s working. The landmark medical drama is television’s most popular series--and at $850 million over the next three years, its most expensive. On Thursday, “ER” celebrates its 100th episode still at the top of the ratings pack.

Amid all of the care and healing taking place at the emergency room of the Chicago facility, tempers flare, romantic tensions unravel and the personal lives of the physicians require almost as much mending as the medical problems of the patients they’re treating.

Lydia Woodward, an executive producer on the series, said the story lines explored on “ER” flow naturally out of the characters, and not because of any agenda put forth by the writers or producers.

“All of our storytelling starts with the character, not with the issue,” said Woodward. “The only message that we ever want to put forth is that these are really hard jobs that these people are doing--emotionally demanding. These people see a lot of things that most of us don’t see, and they have certain ways of handling it.”

Nevertheless the series gets high marks from outsiders for its diligence in tackling often-controversial issues with a dimension and intensity seldom seen on network television.

“What they have done on ‘ER’ is nothing short of revolutionary in dealing with real-life issues among physicians that have rarely come to light,” said Dr. Gary Cohen, a board member of the Pacific Oaks Medical Group, which he called the largest HIV treatment facility in the country. “It’s shown physicians as human beings, not as magicians.”

By slowly advancing the plot on the Benton-Corday relationship, the show’s producers have been able to touch on a number of complex aspects surrounding interracial dating, cultural identity and the difficulty of romance in the workplace. And they have made it as much Corday’s story as Benton’s.

“The race issue played a small part of that interaction in the beginning, but then we let that fall away,” Woodward said. “Now it’s basically about two hard-working individuals who have trouble seeing each other. We approach it as ‘How would two people juggle all of this?’ ”

“It’s good for TV to show that interracial relationships do happen,” said Karen Grigsby Bates, a commentator on National Public Radio. “People on television dramas have diversity, while sitcoms are still largely segregated.”

As they have with La Salle’s character, the writers have spent several years following Jeanie Boulet (Gloria Reuben), a physician’s assistant who is HIV-positive. The series shows her dealing with her own health crisis while being determined to help others. She contracted the virus from her estranged husband, who had been having extramarital affairs. Reuben’s character moved from anger to forgiveness in a series of poignant episodes.

In previous seasons, the writers used Reuben’s character to get at the public’s reaction to those who are living with HIV, exploring fear, discrimination and, ultimately, acceptance.

“There are an awful lot of quality people and health-care workers infected with HIV, and this was a story that needed to be told,” said Cohen. “Jeanie is shown as being a competent person dealing with a real-life issue.”

The themes the writing staff chooses are rarely easy ones. The drama has also dealt with the inward struggle of Dr. John Carter (Noah Wyle) as he tries to reconcile his lifestyle and choice of profession with his silver-spoon, upper-class upbringing. And the abrasiveness of attending physician Kerry Weaver (Laura Innes), who walks with a crutch and has run-ins with almost everyone around her.

“When you have these familiar characters and audiences form a kind of personal relationship with them, it’s a fertile way to show how they would deal with certain societal or quality-of-life issues,” said Innes, who joined the series in its second season. “The value of my character is that Kerry has a disability, but she functions extremely well in a high-pressure environment, and she has an expertise that makes her colleagues respect her.”

Had Kerry Weaver been written as a victim, the role would not have interested Innes: “Usually disabled people are portrayed as victims, on the outside looking in. They are pitied. Kerry is not any of those things. I don’t want to sound highfalutin, but TV is the perfect format to change that image.”

That sensibility also applies to the way “ER” writers deal with Jeanie Boulet’s HIV status.

“Our idea from the very beginning was to show someone living with HIV on a day-to-day basis,” Woodward said. “Luckily, when we started that story line, there were drugs that allowed people to live with it, and now people are surviving. So we’re able to show that.”

Despite the series’ avoidance of getting on platforms, scholars and others suggest that by taking on difficult topics, what ultimately results is simply good television.

“What they’ve done, particularly with Jeanie Boulet, is terrific,” said Stuart Fischoff, professor of media psychology at Cal State L.A. “It’s provided some of the most moving hours of television. When she reacts to things in the hospital, all the audience needs to see is a close-up of her face, and that speaks volumes. They don’t have to keep announcing what her affliction is.”

Innes agreed: “I think we’ve made some inroads into people having an idea that HIV just doesn’t hit junkies and gay men. Gloria did a beautiful job, and it’s nice to see a different face on that kind of problem.”

At first even the studio that produces the series didn’t have a sense of the show’s potential. And then executives began seeing the footage.

“The first 10 episodes of this show exceeded everyone’s expectations, and during the last five years it’s just been running hot and steady,” said Tony Jonas, president of Warner Bros. Television, which produces the series along with Constant c Productions and Amblin Television.

The writers slipped in a subtle nod to the show’s survival with a story line that runs throughout “ER’s” 100th episode. In this week’s show, the hospital’s oldest patient, Ruth Johnson (Anne Pitoniak), who was born at the facility 100 years ago, is honored during the hospital’s 100th anniversary.

Said Innes of hitting 100: “It’s a bit of a surreal event. I don’t think it registered too much with everyone until the day of the cake-cutting. But other than that, there’s still the work to do. And we’re here every day.”

* “ER” airs Thursdays at 10 p.m. on NBC.