by Michael Crichton
First Draft - 1994
Dramatic Pilot - 131 pages
"If there's one thing you learn in my job, it's that nothing is certain. Nothing that seems very bad, and nothing that seems very good. Nothing is certain. Nothing." - Lewis
ER ran for 331 episodes over the course of fifteen seasons. According to Wikipedia, it was nominated for 375 industry awards and won 116 of them, including 22 Emmys. As it was a long-running drama that garnered lots of critical acclaim, I wanted to look at the pilot episode to see how it all started.
The pilot is a double episode, running seven acts over the course of two hours. In between the cover page and the actual start of the script are several pages of additional information: a statement, on its own page, that this is "an account of 24 hours in a Boston hospital emergency ward on March 17th, St. Patrick's Day."; a cast list; a breakdown of the patients, by act, including their ailments; the time of day that each act covers; and, finally, the set list. While many of these are standard production elements, I found the time of day and the fact that the nurses and aides were split into day/night shifts particularly enlightening, especially as the episode had a cyclic feel with Dr. Greene being asked to be woken at 6:30am in both the beginning and the end of the the episode.
Although it happens to be St. Patrick's Day, this is just another day for the hospital staff. While there is clear evidence of a life before we joined these characters, the trope of bringing a new character into the environment is utilized to explain the world to us. Here, it is mostly done through Carter, a medical student on the first day of his rotation. As the world is explained to him, we learn about the doctors' long shifts, the different departments in the ER, and how everything works. As always, it is a great exposition hider, and, here, Carter is given a nuanced emotional arc that further conceals the exposition. What he sees affects him, and he serves as a stand in for us.
This is especially important as the world of ER is gritty. Here, injuries are ghastly, people die, and there's plenty of pain and blood. As a whole, the world is messy, not sexy. The moment that truly brought this to light for me was right in the first act when a female patient vomits blood all over Dr. Ross, yet he barely misses a beat - and he continues working in his blood-soaked clothes.
Thankfully humor is interspersed throughout the script. This is necessary to give us a breath in between meeting so many characters experiencing one of the worst days of their lives. Two moments stood out. One, an exchange between Dr. Lewis and one of her patients:
Barr is grinning at her, half in relief, and half in a sexual come-on.
Barr: You're beautiful.
Lewis: Thank you.
Barr: You married?
Lewis: No. I'm a doctor.
Barr: Well then, listen --
Lewis (patting arm, smiling): Take care of yourself. You don't want to fall on your face twice in one day.
The other that particularly tickled me was after hospital security was called when, pages later, a "frail, elderly man who looks like a cough would knock him to his knees" came around the corner. So much for security. There are moments such as these throughout all seven acts.
Contributing to both the humor in and the realness of the world, the hospital personnel themselves aren't perfect. Their foibles are clearly shown, which is perhaps most evident with the character of Dr. Ross. In the first scene of the pilot, Dr. Green is woken for a patient, who turns out to be the drunken Dr. Ross. Dr. Greene gets the IV set and deals with the situation - this happens every time the pediatrician has a night off.
The character that I felt had the biggest impact in the pilot was head nurse Carol Hathaway. We meet her on page 6, but she's barely given an introduction - "Timmy turns to HATHAWAY, the attractive day head nurse" - but she seems smart, funny, and good at her job. She's not afraid of the doctors, telling Dr. Benton to make some more coffee when he complains that the doctors' lounge is all out thanks to the nurses who come in and drink it. We don't get to spend a lot of time with her, but I liked her. It's a surprise (that's wisely built up to with a call that a special patient is coming in) when she's rolled in on page 83 - a suicide attempt via a drug overdose.
As this plot line develops, we learn that Hathaway knew what she was doing and that the rest of the ER staff likely won't get the miracle they're hoping for. There isn't must progress in getting the drugs out of her system and on page 124, the last time Hathaway is discussed, Lewis states she's "not going to make it." I'm quite curious whether this was changed prior to the filming of the pilot to leave a ray of hope, as I know Hathaway survives in the series - an important main character. However, as written, it gives the sense that no one in the hospital is safe, and that anyone can die at any moment - including the nurses and doctors.
I could talk about the intertwined storylines of ER for much longer, but I feel that one thing about how the script appears on the page is worth mentioning. As we are in the hospital throughout and all the action takes place in one day, only the location is mentioned in the slug lines, things like "Treatment Room," "Corridor," or "The Waiting Room." Often the slug bleeds into the description, like:
THE ADMITTING OFFICE
where a number of hopital personnel are beginning to cluster, waiting and talking quietly.
But sometimes the slugs are a person instead of a place:
Peering at the dilated eyes of Hathaway.
While it might take a moment for production personnel to figure out the precise set location (Is Lewis in a room? If so, what room? A hall?), perhaps having to flip back to earlier pages in the script, I found that, as a reader, it did not at all interfere with my experience of the story and often told me what, precisely, was the most important thing in the scene. While the technique wouldn't always be appropriate, it makes a big impact. I'd certainly consider using it in the future.