‘ER’ celebrates 200th episode
Creators reflect on hit show that almost never made it to TV

What is quality television? Do you know it when you see it? A lot of shows are popular, but how many really meet your highest standard or set a new one? On every network, there are the few, the proud, the memorable. This week, NBC celebrates one of its own. On Thursday, “ER” reaches a new milestone, marking its 200th episode, a rare event in television. “Dateline” has a behind-the-scenes look at the cast and creators, sharing their fondest memories, their funniest outtakes, and a few secrets about how this program got on the air. And that’s where we begin, with the birth of “ER,” and how NBC executives didn’t seem to know quality when they first saw it in this case.

Maura Tierney as Abby Lockhart and Noah Wyle as Dr. John Carter. © Warner Bros.

IT’S A KALEIDOSCOPE of critical care, fast turns, shifting scenes, straight away drama, gritty, raw, and most of all, very real. For 200 episodes now, 200 Thursday night, “ER” has brought the pulse and panic of a big-city emergency room, right into millions of living rooms. It’s changed the pace and look of TV, set a new standard for realism, and helped push all hour-long dramas into more closely reflecting every day life.

So the biggest surprise about this unpredictable show may be that it took 20 years to get made. ER might as well have stood for “eerie reminder” that in the formula-driven world of television, a new and challenging idea can get stuck in the waiting room.

For the first time ever, the three creators of “ER” sat down together, to tell the story of the hit that almost wasn’t: writers Michael Crichton and John Wells, and director Steven Spielberg.

Stone Phillips: “Three big names. How a network couldn’t say, ‘green light, bless it, hands off. Do your thing. We trust you.’”
Michael Crichton: “Amazing isn’t it?”
John Wells: “That’s always how it goes.”
Steven Spielberg: “On television, all the networks think they’re the 1,000 pound gorillas and they only treat us like these 700 pound gorillas.

Think of the original “ER” script as their patient, one that had to take a long trip through a big city hospital. It all started in the newborn unit, with a Harvard medical student in the late 1960s named Michael Crichton. He was doing his student rotation at a Boston emergency room.
Phillips: “What was it about the reality of the emergency room that drew you to it?”
Crichton: “The complexity and the sort of overlapping quality, you know, one minute it’s very funny, the next minute it’s very sad.”
Crichton wrote a book about his ER experience, entitled “Five Patients.” Soon, he was writing other books, novels, to help pay for school. Several became bestsellers, then hit movies.
So, instead of a career in medicine, Crichton stuck with writing. But he never forgot the ER. In 1974, Crichton was already one of the top pop fiction writers of his generation, when he sat down and wrote a movie screenplay, “EW,” for “emergency ward,” the common name for ERs back then.
Phillips: “When you first started shopping around the script, what was the reaction?”
Crichton: “At first, there was a lot of interest and then people began to get scared because it was very technical, because it seemed to go awfully fast.”
The script had 85 scenes, and more than 100 speaking parts, all jammed with medical talk and the frantic feel of a real ER. Despite Crichton’s incredible track record as a writer, this screenplay was too much for Hollywood.
“EW” slipped into long-term care. Crichton shopped it around for years, with no luck. Then, in the late 80s, he gave the script to Hollywood’s reigning king of blockbuster movies, director Steven Spielberg.
Spielberg: “It was like an action film with character, not with guns or car chases, or anything else, but it was all action oriented.”
Phillips: “And you bought the screenplay?”
Spielberg: “I bought the screenplay.”
After 15 years, Crichton’s movie script, now re-titled “ER,” was finally going to get made. Or was it?
Phillips: “Michael told you about another little project he was working on.”
Spielberg: “Yeah, it was a great mistake that he made. (Laughter) I’m grateful to Michael to this day for the the mistake he made.”
It seems Spielberg one day happened to ask Crichton what else he was working on. After some arm-twisting, he got an answer.
Spielberg: “He says, look, I can’t tell you in detail what I’m doing. I can only tell you, as a friend, that I’m writing a novel about DNA and dinosaurs. And all of a sudden ‘ER’ became a thing of the immediate past.”
Phillips: “Enough of these dying people, give me dinosaurs, DNA —”
Spielberg: “And these overworked physicians and interns.”

“ER” went back into long-term care and “Jurassic Park” was born. Three hundred million box office dollars later, Spielberg, in 1993, finally turned his attention back to “ER,” this time thinking it could be a TV series.
John Wells: “It was very different than what anybody else was doing on television, or suggesting doing on television.”
Writer-producer John Wells, who’d worked on the series “China Beach,” set in a military hospital in Vietnam, was brought on board. He loved the script, but wasn’t sure any network would.
Phillips: “Were you concerned commercially that you’d be able to get it done; be able to get support, get a network behind it?”
Wells: “I think we sort of assumed we weren’t, you know, honestly. It’s so difficult to actually get anything made, particularly something that’s unusual.”
Remember, over the years, most medical dramas followed a well-worn TV formula. Shows like “Ben Casey” in the early 60s, and “Marcus Welby, M.D.” in the ’70s, presented doctors as gods in white coats. In the 1980s, “St. Elsewhere” began to move away from that, with an off-beat, irreverent look at medicine.
But Crichton wanted “ER’s” doctors to break the mold completely.
Phillips: “Overworked, stressed out, struggling to somehow get through these 12-14 hour shifts.”
Crichton: “Yes and I always saw them as genuine modern day heroes. They are.”
But even these three big names, teamed up with Warner Brothers studio, still had to push and prod. They finally got NBC to at least approve shooting Crichton’s script as a TV pilot, a sample of what a series might be.

In early 1994, 20 years after “EW” was first written, casting for the pilot began. Crichton’s patient, his script, was now under intensive care. The first hire for this risky project was a risk himself, a struggling actor with a streak of bad luck, named George Clooney.
Spielberg: “I was told it was almost a guarantee, that if you put George in a pilot, it won’t sell. And George had been attached to six or seven pilots that didn’t sell.”
That includes a sitcom that was called ER.
George Clooney: “You do a lot of shows, and truly in general the best pilots you do, don’t get picked up.”
Would this “ER” suffer the same Clooney fate? As the pilot’s cast came together, no one was very confident.
Noah Wyle got the role of medical student John Carter.
Noah Wyle: “I really thought the show would go six or seven episodes and be cancelled. I figured I would take the money and run and do something else.”
Anthony Edwards was cast as Dr. Mark Greene.
Sherry Stringfield became Dr. Susan Lewis.
Sherry Stringfield: “There was certainly this kind of attitude like, what are they doing? And they’re taking this huge risk with saying the real medical jargon in real time or faster.”
Shooting on “ER” had begun. But, even after two decades of roadblocks, the biggest problems were yet to come.

‘ER’ GETS ITS SHOT
There was no money for a set, so the pilot was filmed at a shutdown hospital in east Los Angeles. Right from the start, the frantic pace of Crichton’s script was proving hard to capture. For one thing, all that medical dialogue was driving the actors crazy.
Crichton: “They actually thought we were doing it on purpose, just to torture them. I know a lot of accusations that went back and forth about it, and a lot of takes.”
Wiley: “It was a lot of mumbo jumbo. You really couldn’t understand a lot of what the guys were talking about.”
Clooney: “We say dialogue we do not understand and have to understand by the time we shoot, and have to say it as if we said it 1,000 times and it is second nature to us.”

The real medicine behind 'ER'

Crichton says he also had to teach the cast to behave like real ER doctors:
Crichton: “They would be looking at the patients faces and talking to them... and I kept saying to John, you know, they’ve got to look at the wound.”
Wells: “They don’t care about faces.”
Phillips: “Actors look at faces. Doctors look at wounds.”
Crichton: “Exactly.”
Shoots for many scenes dragged on and on. In one early scene, Eriq Lasalle takes Noah Wyle on a fast-talking tour of the ER, for five pages of interrupted monologue.
Phillips: “The scene of Eric LaSalle and Noah Wyle, that first introduction to the ER — 24 takes? Is that right?
Wells: “Twenty-two. Until we got it right and then two more to make sure we had it.”
Then, to top it off, George Clooney actually had trouble with his opening scene.
Phillips: “I heard he had no idea how to play a drunk.”
Wells: “No, he claimed he had no idea how to play a drunk.”
Sure enough, Clooney started to get the idea, and after a few takes, he hit the right note.
But all these problems begged the question: Had the Hollywood suits, the industry doubters, been right these last 20 years? Was Crichton’s script, with all those scenes and characters, just too tough to actually make? Was the chaos just part of the creative process, or cause for concern?
Stringfeld: “There had never been anything like that on television. The whole time you’re going, ‘What’s going on? What’s going on?’”
Spielberg: “For me, that’s just standard op. When you’re making a movie or a TV Show, you just get used to seeing all the mistakes, and you keep hoping they’ll get funnier and funnier, so you’ve got an outtake reel to go to at the wrap party.”
Then bit by bit, he says, it all began to click.
Spielberg: “When the director said, ‘action,’ you really felt you were in the middle of a war zone. When it came together, you’d always know what take it was coming together on. It was chilling.”
By the time the pilot was done, everyone felt this just might work as a series. But when NBC network executives looked at “ER,” they weren’t exactly in a hurry to talk about it.
Wells: “They kept us waiting for about an hour and a half and finally came out, you know, eyes downcast, very sad and said guys we’re not even going to give you any notes. We really don’t like the show. It’s not going to make the schedule.”
Spielberg was out of town when he got a call from one of his executives.
Spielberg: “I said what do you mean it didn’t go well? He said they thought it was too frenetic and fast-paced and they didn’t understand half the dialogue. They want you to slow down and make eye contact — stop looking at the wounds, so to speak.”
Phillips: “How frustrating was that for you, Michael?”
Crichton: “I didn’t expect it would be as bad as it was. I was also out of town. I mean, we let John go with it.”
Phillips: “You were the guy huh? With friends like these, you know?”
“ER” was headed for the trauma unit, showing few signs of life. But Warner Brothers, the studio that financed the show, did a “test screening of “ER” for an audience of regular viewers. It got the highest test numbers the studio had ever seen. Happy ending, right? Wrong. NBC didn’t believe it.
Wells: “Then they tested it the next day at NBC themselves, and it tested better the next day.”
Phillips: “What’s up with these NBC television executives?”
Spielberg: “Everybody who didn’t want ER on the air is no longer affiliated with NBC. I don’t think any of them are at the network anymore. (Laughter) Not because of this, because they just happened not to be here.”
With those big audience test scores, “ER” was headed for full recovery. NBC finally climbed on board, and gave the show a green-light for the fall season. The pilot debuted as a two-hour special on September 19, 1994. By mid-season, “ER” would be the number one show on television.
Two hundred episodes later, “ER” is still alive and kicking. While “Dateline” was there visiting, Wells showed everyone a new set, a hospital in Africa, built for the season finale later this month.
Phillips: “How many episodes will this cover?”
Wells: “It’ll cover two right now and possibly a third next season.”
They met up with Noah Wiley, the only cast member to be part of all 200 episodes.
Wells: “It’s been a long time.”
Phillips: “Yeah, it’s a little disconcerting for me.”
Wyle: “Heck, it’s the longest relationship of my life!”
Even on this new set, the feel was pure “ER,” frenetic, crowded, and very real — all the same elements, remember, that kept the show on the shelf for 20 years and almost kept it off the air.
Phillips: “Is there a moral here for television executives?”
Spielberg: “Well, I think it’s a moral for all of us, that none of us know anything. Everybody thinks we have a crystal ball. There’s no such thing, you just have to always fly by the seat of your pants and do the best work you can do. Everything is a mystery.”
Phillips: “As some other writer said, all’s well that ends well, Michael.”
Crichton: “That’s true.”
Spielberg: “Well, let’s hope this never ends.”

Two hundred episodes, and now, maybe, at long last, “ER, the Movie.” Would Steven Spielberg still be interested in making the film version of “ER” that he started working on in the late 80s, before it was turned into a television series? He said, lately, he has been thinking of “dusting off” his copy of the original script, and seeing if he might want to take a crack at directing it — almost 30 years after medical student Michael Crichton first wrote the book that “ER” is based on.