Good Drama, Not Idealized Medicine, Keeps ‘ER’ Alive

Let’s be honest. While many television writers look to personal experience for inspiration, they ultimately write to what dramatically serves their series and its characters. According to The Times, “NYPD Blue” executive producer David Milch hoped to disillusion drama TV audiences from the idealized view of medicine propagated by shows like “ER.” (“For ‘NYPD’ Producer, Script Gets to the Heart of the Matter,” Calendar, Nov. 23.) Unlike “ER,” the Jimmy Smits’ exit arc would accurately depict an imperfect medical system and those who work in it as something less than heroes.

Either Milch was misrepresented or he doesn’t watch “ER”--a series in which the most memorable episode saw its main character essentially kill a woman through a sequence of medical mistakes, leaving a newborn baby motherless. Throughout the last 4 1/2 seasons, “ER” has told scores of stories in which patients have suffered through medicine--everything from horrific clinical errors to dehumanizing procedures to a deficient, often biased system. Of course, “ER” also celebrates many medical victories, even miracles. Arguably, triumph and tragedy are the real health care experience. But more important for “ER,” it’s good drama.

In any event, Milch’s true motive behind any depiction of a medical crisis lies in something far more practical than enlightening a public deluded by hospital shows. It’s a motive he shares with all dramatists--storytelling. When Dr. Mark Greene was brutally assaulted on “ER,” its writers chose to make the police unable (and not particularly driven) to find his assailant. Why? To service Greene’s story line--not to attack the common cop show premise that all good detectives eventually find their perp. Likewise, Milch’s job is to make viewers empathize with his characters. If that means portraying a frustrating medical experience, so be it. People don’t watch “NYPD Blue” to relate to the hospital staff.

On the subject of doctors as heroes, “ER’s” are guilty as charged--flawed, human and complicated--but heroes nonetheless. The same is true of Milch’s Andy Sipowicz and Bobby Simone. Otherwise, why would anyone tune in?