LA Daily News
April 23, 2001

First, do no wrong.
The producers of 'ER' wanted drama, but they also insisted on making it real

By Evan Henerson
Staff Writer

In 1993, writers and producers from a television show in development asked to visit the emergency room of Northridge Hospital Medical Center to observe and learn how day-to-day operations take place in a busy ER setting.

Dr. Paul Karis, the hospital's director of emergency services, took the phone call, which he says came from Steven Spielberg's office.

"They told me it was going to be on in the fall, that it would replace 'L.A. Law,' which was the hit show at the time," recalled Karis. "They said it would be written by Michael Crichton," said Karis. "I said, 'Who's that?'"

Karis OK'd that request and subsequent ones for follow-up visits. By most accounts, the writers, producers and medical consultants did their research well. They even hired a Northridge Hospital emergency room doctor to become the show's chief medical technical advisor.

For seven years now, it has been TV viewers who have watched the hit show "ER" and learned.

And they're still learning budding medical professionals and laypersons alike a little at a time, week after week. Cast names, producers, even medical advisors may change, but the accuracy and attention to medical detail is as steady as a closely monitored IV drip. Medical professionals and members of advocacy groups say "ER" is as close to a textbook case of popular entertainment being a vehicle for conveying valuable health information as the come.

Of course, having doctors serving both as writers and advisers and getting guest stars like Sally Field who returns to the show for three more episodes beginning Thursday to sit down with the Surgeon General to talk about the depiction of mental health in the media figures to increase your credibility.

"They're very careful in their research, and they tend to get it right," says Larry Deutchman, senior vice president of marketing and industry relations with the Entertainment Industries Council.

The EIC issues the annual Prism Awards, which focus on the accurate portrayal of addiction. "ER" has won three.

"They get as much information as possible and in most cases, because they've turned to a leading authority, they tend to get it right," added Deutchman.

People in the medical field share Deutchman's opinion. "Even when you go to an emergency national meeting where everything is very academic and people are talking about science, 'ER' usually comes up," says Karis. "Everybody comments about how the show is very accurate, and on how much the show has done to show the public who we are and what we do."

Forget high ratings and water-cooler buzz. You'd be hard-pressed to find another program that is as closely monitored for medical discussion and education. Numerous universities and medical professionals use "ER" as a teaching tool.

Show producers, however, are quick to point out they are not in the medical education business. If the hourlong program on Thursdays is a "medical drama" producers say the emphasis should always be on that second word.

Dr. Joe Sachs, whose medical and film school expertise made him an ideal candidate to be hired from Northridge as one of "ER's" first medical advisors, calls all the educational tie-ins "the side effects of 'ER'."

"We always start with a dramatic situation, story and character development," says Sachs, a writer and producer of "ER." "If the appeal was just to see the medicine, 30 million people a week would be watching the Learning Channel instead of 'ER.' Medicine is just the wallpaper."

After nearly seven seasons and more than 150 episodes, it would be nearly impossible to calculate the number and breadth of medical diseases, conditions and dilemmas faced by "ER's" fictional patients, and, quite often, by their doctors, as well.

The regular cast members have certainly seen their share. After his son is born deaf, Dr. Peter Benton (Eriq LaSalle) struggled with the decision to pursue a cochlear implant procedure. Dr. John Carter (Noah Wyle) battled an addiction to pain pills. This season, Dr. mark Greene (Anthony Edwards) was diagnosed with a malignant brain tumor that required a new procedure in which the patient was conscious during the operation.

In each case, Sachs said, the story not the medicine came first.

"We said, 'Let's give Greene a disease that will make him reflect on his life, and make him have to be the patient,'" said Sachs, who still works one shift a week at Northridge Hospital. "We chose the brain tumor for several reasons, on of which is the fact that there is all of this new stuff being done for the treatment of brain tumors."

The series' writers routinely consult with medical experts in and around the L.A. area. For the brain-mapping procedure, they went to Dr. Keith Black, chief of nuerosurgery at Cedars-Sinai Medical Center, who gave the segment "an A+."

"What impressed me was the intense interest from patients with brain tumors and their families," said Black. "They were very much interested in the outcome. They very much wanted it to be an optimistic and hopeful portrayal."

The show also rounds up recognizable guest stars, several of whom play characters suffering from a particular disease or condition. Their very presence can help spur educational efforts, say "ER" watchers and media critics.

In 1999 a doctor played by Alan Alda suffered the early symptoms of Alzheimer's disease. This season, James Cromwell ("Babe") had a four-episode stint as a bishop who was dying of lupus.

"I remember when we did the pres junket, the people from 'ER' were concerned. Because of plot reasons, they didn't want to give away the disease," said Cromwell. "I thought, 'That's unfortunate. Here's a nice opportunity for people to understand the nature of this disease, get it out in the open and give it some publicity.'"

Cromwell also understood the story-first reasoning.

"Diseases are fascinating and, of course, heart-rending for the people who go through them, but they're not necessarily dramatic," he said. "If you lose the drama, people turn it off for one reason or another."

Over a widely praised three-episode arc that aired in November, two-time Oscar-winning actress Sally Field played a woman named Maggie who suffers from bipolar disorder. The character, who returns this week, is the mother of Abby Lockheart (played by Maura Tierney, one of the series regulars).

"We had some really good luck working with a neurologist when Alan Alda did the Alzheimer's story," said Dr. Neal Baer, "ER's" former executive producer, who now holds a similar position with the TV series "Law & Order: Special Victims Unit." "Bipolar disorder seemed like an interesting area, one that hadn't been treated realistically, accurately and honestly."

In conducting her research, Field met and worked with a UCLA expert on psychiatric disorders and met several patients who suffered from the condition.

Appearing with Baer and former U.S. Surgeon General David Satcher at an entertainment symposium sponsored by the EIC, Field said her character showed "all the sides of this very crippling disorder."

Those sides weren't necessarily always flattering. But even as mental illness sufferers and advocates discussed Field's portrayal both within support groups and on the Web the response has been overwhelmingly positive, says Sue Bergeson, deputy executive director of the national Depression and Mood Disorders Association.

"People who live with mood disorders are very sensitive to what's going on in the media. We track it fairly carefully," said Bergeson, who added that the NDMDA wasn't especially pleased with the comic depiction of schizophrenia in last summer's Jim Carrey comedy "Me, Myself & Irene."

"I think the writers and Ms. Field did a wonderful job of portraying the complexities and seriousness of the illness."