Perhaps because of its longevity or because its inventions became conventions or because anything with such broad appeal is likely to invite disdain from some quarters, "ER," which of course concludes tonight after 15 seasons, never seemed to be as highly regarded as, to mention a few, "The Sopranos," "Six Feet Under," "Hill Street Blues" or "St. Elsewhere." Most people I know viewed it as a formulaic medical soap opera with the requisite life-affirming uplift -- a verdict that became even more pronounced as the seasons passed and diseases, situations and character types were recycled.
Yet for those of us who kept watching it, and I have seen every episode, "ER," far from declining, actually gained a cumulative power and, more, began to purvey a vision that would surprise those who gave up the show for dead. With its interlarding of medical triumph and personal angst, "ER" may have begun as a show about salvation, in the operating room and in the doctors' own lives, but it became a show about the near impossibility of salvation -- a show less about healing than about damage. Those holiday episodes notwithstanding ("a very special 'ER' "), the show may now be the darkest, bleakest program on broadcast television and the one with the most sophisticated take on life.
The seeds for this vision were planted early. The nurses and doctors performed heroically (surprisingly few patients have been lost over the years), but from the outset they all bore their own stigmata. Many of these were physical. There was AIDS, Alzheimer's, a rape, a double amputation, death in a helicopter crash, an emergency hysterectomy, a deadly aneurysm, a knife attack that seriously hurt one doctor and killed another, and Dr. Greene's (Anthony Edwards) fatal brain tumor. In short, the patients had nothing on the people who attended them.
But it was the emotional wounds that bit deep. Virtually every doctor bore some psychological scar, whether it was Dr. Kovac's (Goran Visnjic) memory of his family killed in Croatia, or Dr. Greene's paranoia after he was beaten by an unknown assailant, or Abby Lockhart's (Maura Tierney) alcoholism, or Dr. Benton's (Eriq La Salle) emotional frigidity, or Dr. Ross' (George Clooney) self-destructive womanizing, or Dr. Rasgotra's (Parminder Nagra) paralyzing indecisiveness. Patients survived. The doctors barely did.
The effect of these personal torments in any single episode or even over any single season might be negligible -- just more soap opera bathos. In the course of 15 seasons, however, the unrelenting bombardment cohered into something in which the miasmic whole is much larger than the sum of its parts. Many of these doctors may have had preexisting conditions: traumatic childhoods, strained family relations, internal demons, etc. Still, it is the emergency room that exacerbates them, as one might expect. They work in a place where every single person who busts through the doors is diseased, hurt or hurting. It is a hell of constant suffering, which is why their own suffering is heightened. In "ER," the entire world is reduced to people's pain.
Indeed, as its stars kept departing the show and replacements took their slots, it became more and more apparent that the real star of "ER" was the ER itself and that the room had been transfigured from a literal emergency room into a metaphor of crisis where every triumph is temporary because it is inevitably followed by another disaster -- actually dozens of disasters. It also became apparent that those who stayed in the ER and kept facing the carnage there were condemned. The only way to survive was to move on -- a case in which the program cleverly used its departing cast members (and their characters) to make a point. To heal the damage to yourself, you have to remove yourself from the hell. Or put another way, in a world of sorrow, you must rediscover hope.
The character who may have most embodied the damage inflicted by the ER is Dr. John Carter (Noah Wyle), who early on was the audience's primary point of identification and whose tenure on the program neatly traces the thematic trajectory of "ER" from its early nobility to its later futility. When the show began, Carter was a wealthy, fresh-faced intern, an idealist who cared so much about each and every patient that he could barely cope with tragedy. As seasons passed, Carter not only honed his medical skills, eventually becoming a great technical doctor, but he also learned how necessary it was to inure himself to much of what he sees. He is a great doctor because he feels. But he can function as a doctor only when he ceases to feel so much.
