>> By Neal Flomenbaum, MD EDITORIAL EDITOR-IN-CHIEF

Another ER Closes

ata from the CDC lish emergency medicine as a very >> There is no question indicate that about appealing specialty in the minds of 10% of the emer- the public while attracting some that “ER” helped establish gency departments of the best and brightest gradu- emergency medicine as a very inD this country have closed since ating medical students to careers appealing specialty.<< 1995. On April 2, 2009, an ER in emergency medicine. Instead closed after a highly successful of the typical questions I used to 15-year run of treating patients hear—”are you going to open up than other “reality-based” se- Thursday evenings for only one your own practice after you fin- ries such as “Hill Street Blues” hour. But in that hour it managed ish in the emergency room?”—I and “L.A. Law.” Prior to “ER,” to treat more critically ill patients began hearing “is what you do few medical dramas came close and influence more people inter- really like “ER” on television?” to capturing the realism that ested in emergency medicine than Move over Marcus Welby, MD, the late Michael Crichton, MD, any ED except ABEM General— make room for Dr. Greene! Steven Spielberg, and a crew of and this one was a lot more en- Mark Greene, MD, the ED chief emergency physician writers and tertaining. The ER I am referring ably portrayed by actor Anthony advisors instilled in each episode. to, of course, is the fictional tele- Edwards, was, in fact, the charac- One earlier series that did was vision “ER” of Chicago’s County ter I most closely identified with the 1980s’ “St. Elsewhere,” which General Hospital that became when the series began—possibly included the smart, wisecracking one of the longest-running and because of the glasses and hair, or ED doc Wayne Fiscus, portrayed most successful medical series of the roles Edwards played before by Howie Mandel (currently all time. According to the New “ER” (Gilbert Lowell in “Revenge the host of “Deal or No Deal”). York Times, “ER” was the most- of the Nerds,” Lt. “Goose” Another very positive character in watched television show for three Bradshaw in “Top Gun”). Then at the early years of “ER” was Dr. seasons and, at the height of its the end of the eighth season, they Doug Ross, the pediatric emer- popularity in 1998, attracted al- killed him. Couldn’t they have gency physician with an extremely most 48 million viewers. stopped with “burnout”? After strong conscience—sorry, that’s “ER” has also been the subject that I was never really able to redundant—portrayed by George of numerous editorials and com- maintain my interest in the series, Clooney. mentaries almost since the first but I suspect that I would have All in all, “ER” managed to episode aired in September 1994. lost interest anyway as “ER,” like bring to public attention dozens of Journals such as JAMA and the all long-running series, began to important health issues and prob- New England Journal of Medicine focus more on its characters’ per- lems faced by the nation’s EDs expressed concern that the re- sonal lives. Most colleagues also and emergency physicians in our markably high resuscitation rates seem to have stopped watching attempts to provide the best emer- achieved might lead to unrealistic regularly in recent years—some gency care. By doing so, the pro- public expectations and that the out of fear of missing the increas- ducers of “ER” did well by emer- excitement of the series might at- ingly esoteric diagnoses. gency medicine and the show, in tract impressionable medical stu- Perhaps as an indication of the turn, served up a very positive im- dents to our specialty. There is no substance and depth of our spe- age of our profession. Now, what question that “ER” helped estab- cialty, “ER” ran for more years to do on Thursday nights? Q www.emedmag.com MAY 2009 | EMERGENCY MEDICINE 5