By Robert J. Thompson
Special to The Washington Post
Sunday, December 17, 2006; Y05
A hospital is a perfect setting for a TV show. Smart people work long hours under heavy pressure, patients provide a never-ending supply of life-or-death situations, and the overnight on-call rooms turn the place into a hotel of sorts, an ideal microcosm for a roiling cauldron of serialized melodrama. Is it any wonder the doctor show is one of the most enduring genres on American television?
"Grey's Anatomy," one of TV's top-rated programs, combines the format and pacing of "ER" with the stylized urban romance and hyper-analytical narration of "Sex and the City." But doctor shows didn't always look and sound so bold. Something happened between "Marcus Welby, M.D.," whose title character was a model of paternal perfection, and Dr. Miranda Bailey of "Grey's," whom colleagues call "the Nazi."
What happened was "St. Elsewhere," an NBC hospital drama that debuted in 1982 and radically redefined the TV doctor. Its first season was released recently on DVD.
"St. Elsewhere" did to medical dramas what "Hill Street Blues" did to police shows: It crowded the screen with a large ensemble cast, padded the script with a bewildering number of ongoing stories and introduced human flaws to a breed of professionals that television previously had presented as super-human.
The personal lives of the doctors were as important as the jobs they were doing. They were flawed, they made mistakes and their patients didn't always get better.
The title character in "House" (Hugh Laurie) owes his existence to "St. Elsewhere's" acerbic but brilliant Mark Craig (William Daniels). Others on the staff of St. Eligius Hospital -- from the righteously serious Dr. Phillip Chandler (Denzel Washington) to the comic Dr. Wayne Fiscus (Howie Mandel, with a full head of hair) -- continue to be echoed in characters on current hospital shows.
"St. Elsewhere" was a literary achievement, filled with sophisticated dialogue, complex stories and an attention to narrative detail never before seen in a TV series. Although critics loved the show, it never achieved real ratings success over its six-year run.
But "ER," which premiered in 1994, juiced up the formula, quickly achieving the star status that eluded its predecessor. While "St. Elsewhere" at its best had become postmodernist theater of the absurd, "ER" was about doctors.
Joe Sachs, an executive producer and writer on "ER" who's a former emergency room doctor himself, said the show delivers the illusion that viewers are seeing the inner workings of an urban emergency room.
"There are physicians on the writing staff," he said, "and not just as consultants. They are there every day."
More importantly, perhaps, is the fact that "ER" moves faster than a speeding bullet. This is made possible, Sachs said, by sets, cameras and digital editing systems that accommodate intensely frenetic shots and editing.
"Grey's Anatomy" follows in the footsteps of "St. Elsewhere" and "ER," though creator Shonda Rhimes has never seen "St. Elsewhere," said co-executive producer Betsy Beers.
In "Grey's" there's a core of young interns under the guidance of more experienced medical tyrants; within these characters, ego and libido battle with Hippocratic commitments in highly satisfying ways.
One thing that differentiates "Grey's Anatomy" from its predecessors, Beers said, is that it's about surgical interns. "In the emergency room there is no down time," Beers said. "Surgery has downtime, space for breathing."
Heavy breathing, sometimes. Now in its third season and thriving on Thursday, TV's most competitive night, simmering stories have begun to boil. The show has become the thinking person's soap opera, "The O.C." for big kids.
It's hard to imagine the doctor shows of yesterday attempting to pull off what "Grey's" can. The first medical TV shows appeared in the early 1950s, but it was in the 1960s that the form was really established. This was the decade that introduced a bright and shining trio of the most perfect, caring, compassionate healers you could ever hope to meet, even in a time before the HMO.
"Dr. Kildare," starring Richard Chamberlain, debuted on NBC in 1961. Four days later, Vince Edwards brought "Ben Casey" to ABC. "Marcus Welby, M.D.," also on ABC, rounded out the team in 1969, with Robert Young bringing to the title role the same gentle authority he wielded on "Father Knows Best."
This was an era of the doctor as demigod. Dedicated visionaries with impeccable bedside manners, these three gave intimate personal attention to their patients and were willing to make house calls.
In the 1970s, shows such as "M*A*S*H" brought a more modern sensibility to the genre, and by the 1980s the doctor-as-hero was on the verge of extinction.
Emmy laureate Mark Tinker, who has directed episodes of "St. Elsewhere," "ER," "Chicago Hope," and "Grey's Anatomy," classified "Kildare" and its earlier counterparts as "Mom and Dad's doctor show."
"'St. Elsewhere' broke that mold, featuring a hospital that was no place you wanted to go when you were sick," Tinker said. "'ER' was 'St. Elsewhere' on methamphetamines, then 'Grey's Anatomy' combined them both and added the romanticized style of 'Sex and the City' and the music video."
Club MedSome of broadcast TV's most popular medical shows since 1960:
1960s:
Dr. Kildare (1961-66): Richard Chamberlain, below, starred as the dashing doctor on NBC.
Ben Casey (1961-66): Four days after "Kildare" premiered, ABC launched a doc drama of its own.
1970s:
Marcus Welby, M.D. (1969-76): Robert Young starred as Welby, the model of paternal perfection, on ABC. Elena Verdugo co-starred.
Medical Center (1969-76): CBS drama focused on patients as well as doctors.
Emergency! (1972-77): The NBC show was based on real-life L.A. paramedics.
M*A*S*H (1972-83): The first true ensemble medical series, on CBS, also was the longest-running till "ER."
1980s:
Trapper John, M.D. (1979-86): The "M*A*S*H" spinoff on CBS starred Pernell Roberts as a Korean War veteran turned hospital chief of surgery.
House Calls (1979-82): The CBS comedy based on a movie of the same name paired a rule-bending surgeon and a fussy administrative assistant.
St. Elsewhere (1982-88): The standard-bearer for med dramas earned 63 Emmy nods and 13 wins during its run on NBC.
1990s:
Doogie Howser, M.D. (1989-93): ABC's story of a medical prodigy.
Dr. Quinn, Medicine Woman (1993-98): Jane Seymour starred in the CBS tale of a female doctor in the 1860s in Colorado.
ER (1994-): Anthony Edwards and George Clooney were in the original cast of the NBC drama, which is seeing a ratings revival in Season 13.
Chicago Hope (1994-2000): CBS's ans-wer to "ER" built a solid fan base of its own.
2000s:
Scrubs (2001-): The quirky NBC med comedy with Zach Braff just started Season 6.
House (2004-): The title doctor of this Fox drama is good, but he's also a grump -- so don't get on his bad side.
Grey's Anatomy (2005-): Sandra Oh stars in ABC's hospital "dramedy," where interns and surgeons share cozy bonds inside and outside the hospital.
Doctors On DVDAmong the fictional docs always on call:
<< Doogie Howser, M.D.: Seasons 1-4, $29.98-$39.98 each.
<< Dr. Quinn, Medicine Woman: Seasons 1-6, $79.95-$119.95 each.
Emergency!: Seasons 1 and 2, $39.98 each.
ER: Seasons 1-5, $27.98-$49.98 each. Season 6 (available Tuesday), $49.98. All six seasons (available Tuesday), $279.98.
Grey's Anatomy: Season 1, $29.99; Season 2, $59.99.
<< House: Seasons 1-2, $59.98 each.
M*A*S*H: Seasons 1-11, $39.98 each.
Scrubs: Seasons 1-4, $39.99-$49.99 each.
St. Elsewhere: Season 1, $39.98.