St. Elsewhere

TV In a rundown hospital corridor, a young, tired looking junior Doctor steps into view. He's been doing the rounds and as the detail of his work are revealed he slowly realises that that his relief won't be turning in for work and that there will still more hours before he sees his wife. Although this sounds like the opening of some independent film rooted within social realism, it's actually the opening moments of the first episode of St. Elsewhere, the pioneering medical drama with has recently been released on Region One dvd.

That the opening episode of this first season does not begin with some giant melodramatic moment to introduce all of the characters and the geography of the hospital demonstrates that this is television from another era, but still shockingly innovative and amazing viewing twenty years later. You're watching the birth of a new kind of television (part of a movement which also included Steven Bochco's Hill Street Blues), in which creators Joshua Brand and John Falsey willingly taking risks with story and character.

As the episode proceeds the rest of the cast is introduced, but again none really have anything that could be described as a fulsome storyline. Instead, Brand and Falsey take a leaf from Robert Altman's play book, and have the characters appearing in and out of shot, the plots building up from random moments within a scene rather than individually. This model continues generally throughout the series, with stories that stretch over many episodes and others that last mere moments or an hour, an approached that would copied and developed in ensuing years and its easy now to see the DNA of e.r. and its peers evolving all those years ago. Some episodes are more 'traditional' than others though -- and as the season continues, there are more two handers allowing the regulars and their relationships to develop.

One surprise is that the show gives the stories of the patients equal weight to the Doctors and hospital staff; early on in the season, in the Emmy award winning episode 'Cora and Arnie', the relationship of these two homeless people and Cora's life decision -- treatment or looking after Arnie and certain death -- is considered to be as important as the others. Similarly, the plight of a potential widower drags on for whole episodes as the cycle of his grief is shown in all of its tragedy.

That's possible, because, like Lost and most soap operas, many of these episodes run directly after one another, the whole season probably playing out in a couple of months, unlike most other dramas in which whole weeks have apparently passed. This gives the show an immediacy and watching more than one episode can be quite an intense proposition, particularly since most of humour and themes are quite dark. And most of the episodes have quite a rigid structure stretching over twenty four hours, a clock in the corner signaling lunch time and shift changes, regimenting the viewer to the lives of the doctors.

Cleverly this is not a show about a successful hospital. Like the UK's Casualty, this is about a health service in dire straights, under funded and seen as a poor substitute to private care. This is a committed medical team though and they still have the capacity to do the job well -- it's the perception that knocks them down. Again, early in the season, a young girl being treated and having bonded with Morrison is taken out of St. Eligius and placed in the nice big clean new hospital down the road, even though it is Eligius that treated her initial complaint and have largely nursed her back to health.

Like all of the best ensemble medical series though, the bureaucracy is revealed through the horror of the medicine. When a Legionnaires outbreak occurs in the hospital, there are none of the screams of fear you'd expect, dramatic pauses or melodramatic drumbeats. Instead, the meticulous coping method is described, with the economic effects on the hospital's budget getting as much screen time as the potential medical knock-on effects. The point being made is that the administrators and doctors are both coming at the same job, making people well, from different angles.

The blurb on the box points to the number of stars that would be made on the series and obviously the other fun is seeing regulars like Denzel Washington or bit player Tim Robbins in small roles within a greater ensemble, and trying to spot their star quality -- I'd say that Washington is as good here as he's ever been, which is a compliment, and Robbins had yet to fulfill his potential. Of course too there's Howie Mandel and dear David Morse, the humanitarian who would later be stuck playing endless psychopaths. In this opening season there are the early rumblings of the double act of the Victor Ehrlich/Mark Craig double act, the latter's loveable tirant being a clear template for e.r.'s Rocket Romano.

Craig is the source of much of the humour in the show, his boarish arrogance and secret loserism being apparent from the start. It's interesting to note that the show isn't afraid to show him as something of a racist too. In one particularly difficult scene he berates Kochar who has the audacity to but an advert on a notice board asking for help with his English with: "Yeah, well you shoulda saw to that before you came over here you know, I wouldn't go to India to live if I couldn't talk to the natives. Shows a lack of respect." Uncomfortable to watch, but it makes his comeuppance all the sweeter to watch.

In this opening season, the absurdities that would become more prominent later have yet to develop. There is some surrealism - such as the explanation for why hospital supplies have gone missing and the lady flasher but on the whole the genre busting tendencies, fantasy elements and crossovers that happen later have yet to flourish. Instead this often goes for the heart and for now, this is an entertaining frequently touching and innovative medical drama that's worth rediscovering.