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'ER' and 'County General'

Tuesday, March 31, 2009
Chicago Tribune
by Chicago Tribune editorial staff

In 1994, the new television drama "ER" so infuriated the head of emergency medicine at the old Cook County Hospital that he wanted to sue for slander. Can't do, hospital lawyers informed Dr. Robert Simon: The show's depiction of the fictional "Cook County General Hospital" might be outlandish—in his letters to NBC and the show's producers, Simon fumed about "gross inaccuracies"—but the real Chicago hospital had no legal recourse.

Simon, fiercely proud of his nationally respected ER and its companion, Cook County's fabled trauma unit, couldn't abide such scripted absurdities as a junior resident operating on an aortic aneurysm, or a pediatrician crassly ordering a mother to buy medicine she couldn't afford. "These things can happen," Simon told one reporter at the time. "My problem is, they can't happen here."

Fifteen years later, as NBC prepares to air the show's concluding episode Thursday night, Simon is a changed observer, with an appreciative opinion. He may even watch the final program from start to finish—something he's never done.

• • •

The squawks from Cook County Hospital eventually cowed the creators of "ER" to shorten their TV hospital's name to what it remains today: "County General." But by keeping their distance from the real hospital on Chicago's Near West Side, "ER's" writers missed its stranger-than-fiction moments.

In the months before the show first aired, surgeons in the real Trauma Unit had ditched running shoes for bright, clopping clogs made of rubber—the better to wash off dried blood.

The show also didn't pick up on the real-life tensions when rival gangbangers shared a waiting room after a gun battle. And a companion problem: Cook County Hospital security guards had kept gang members out of stairwells to keep them from retrieving the bodies of their murder victims for the ultimate dis: dismemberment.

The early "ER" also missed half of the reasons why Cook County Hospital staffers stripped the clothes of seriously wounded patients. "Officially, we undress people to look at their wounds," charge nurse Lola Whalen confided at the time. "Unofficially, we do it to unload their weapons." And who, without hearing the true tale from someone at Cook County, could know about the futility doctors experienced over the man who was fatally shot in the head by his brother in a fight over . . . a channel changer?

Early on, many doctors at Cook County and other busy hospitals complained about the show's cavalier approach to medicine—particularly the lack of supervision in the emergency room. And characters were so careless handling blood that infection control instructors at the University of Chicago Hospitals taped episodes of "ER" to show medical staffers what they shouldn't do.

But that was then. As the show ends, we don't need to stretch too far to say that "ER" the medical soap opera may well have saved some lives. Someday, just maybe yours.

• • •

Emergency medicine developed as something of a mongrel field; physicians from many specialties typically rotated through emergency rooms or responded to individual cases as they came crashing through the doors. Not until 1979 was emergency medicine formally recognized as a specialty by the American Board of Medical Specialties.

"ER" glamorized emergency medicine like no show before it—not even "St. Elsewhere," the program many docs still praise for its realistic portrayal of urban medicine. Some of the effects of that glamour are undeniable: No medical specialty gets to claim George Clooney as its own, even in a TV drama, without seeing its stature rise and the quality of its residency applicants improve. That will be one lasting legacy of "ER": The program enhanced public respect for emergency medicine and the people who practice it.

Even Dr. Robert Simon volunteers that verdict. Holding TV audiences hostage for 15 years in a make-believe emergency room, he says, "has created a positive impression of our profession. It's shown people the compassion for patients in real emergencies."

None of us aspires to be one of those patients. Will we someday find ourselves at the mercy of an especially skilled ER doc who got interested in that specialty by watching "ER"? Could be.

The show, with its attentive emphasis on real Chicago scenes and real-enough Chicagoans, has been good for the city. If it has also been good for some of the patients who'll arrive in U.S. emergency rooms next week or next year—if only because the surroundings will look familiar—then so much the better.

As for the eye candy, the exaggeration and the irreverence—even Dr. Simon managed to get past that. Doc, you bring the popcorn Thursday night.


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