Sublime Screenplay – ER

Our TV company has just put up 10 of the best episodes of ER ever, which gave us the opportunity to see a double episode I hadn’t seen since it aired here in 2001. I was at my mum’s at the time whilst lovely husband was at home and I remember ringing him at the halfway point so we could rave about it. At the end we were both almost speechless with emotion, much to my mother’s amusement. It was great to see the episodes again and that they had lost none of their punch over the years. Of course the reason I remembered these two above the 200 or so episodes I’ve ever watched is because of the quality of the writing, which brought the best out of the fine ER actors and directors. So having recovered from the emotional rollercoaster, here is my tribute to another example of sublime screenplay.

Part 1 – Be Still My Heart by Lydia Woodward

Interlocking stories.
One of the great strength of ER is it’s multi-story format, which allows us to see the central characters grappling with similar issues but in different ways. Be Still My Heart is a great example of this, where the central title is replayed in every story, from the dramatic, to the comic. The episode opens on Valentine’s Day (of course) and a recurring motif throughout is the number of hearts around, paper hearts, heart shaped cards etc, as the staff plan to end the shift with a party.

The major storyline is Carter & Lucy. Carter is one of ER’s heroes. A young idealistic student in Season 1, he has matured through changing direction from surgery to ER doctor, suffered any number of traumatic incidents, to be a resident at this point (Season 6). One of his duties as a resident is to mentor young students like himself, and Lucy has been his student for a while. Carter’s relationship with Lucy is a mirror of his relationship with his mentor Benton. Benton was a tough supervisor, arrogant, clever, who nevertheless respected Carter’s integrity and humanity. Carter is a tough supervisor to Lucy, who he recognises is much cleverer than him, but he mistrusts her value base. By this episode they have reached a truce, but Carter has never quite supported her in the way Benton supported him. When she comes to him at the beginning with a request to help with a patient, he is busy, and dismisses her, setting in motion events that will lead to tragedy.

Storyline 2 involves Carter and a new student Abby. Abby is a former ante-natal nurse who has switched to a career in medicine. She is confronted with a typical ER scenario of the elderly patient who doesn’t want too much intervention. Carter and Abby are more natural allies, she is empathetic, warm and caring. Consequently, Carter is a kinder and more supportive supervisor  & this story acts as a counterpoint to Storyline 1.

Storyline 3 starts about a third of the way in, and centres on Carol Hathaway, the head nurse and one of the emotional centres of the show, and Luka Kovac, the new Doctor from Serbia, who is still finding his way around. Each of them is involved in treating parents injured in a car crash which in turn becomes a bonding moment for them.

Storyline 4 provides the comedy. Dr Romano the Chief of Staff and most unpleasant character in the show, pages his Head Surgeon, Elizabeth Corday for an urgent operation, which turns out to be for his dog.

Storyline 5 centres round Elizabeth and her boyfriend Mark Greene one of  the ER’s attending physicians (consultant)  and another person at the heart of the progamme, and their relationships with their parents, Mark’s widowed father and Elizabeth’s divorced mother.

Story 1 is the most dramatic and leads directly into the events of Episode 2. Lucy’s patient is presenting in an odd way. She tries to ask Carter for help and her rebuffs her, because he is dealing with Abby’s patient. Then Lucy’s patient becomes a bit aggressive. Lucy is looking for Carter to assist but the patient leaves the room, causes a scene and Dr Greene notices. He lambasts Carter for not supporting Lucy, who then shouts at Lucy for not calling him. As the programme unfolds, Lucy’s patient becomes increasingly problematic and likely to need psychiatric care.When he is given a spinal tap to check for meningitis, he fights Lucy and Carter and we realise he is potentially dangerous. We can see that Lucy is trying her best, but this is over her head. He leaves the treatment room again and is found in the staff room where there food is out ready for the party. Lucy gets him back, but Carter is cross that she hasn’t managed to get the psychiatric consultation so she can get on with medical cases. He tells her to sort it out.

Carter is also being called on to help Abby deal with the events of Story 2. Her patient has breathing difficulties and limited options. Abby begins to bond with her when she shows her a Valentine’s card she is carrying from the year before, from her husband, who has since died. The card says, “Be still my heart” as in, always be my heart. But the alternative meaning is literally, let my heart be still ie let me die. When her patient suffers cardiac arrest, Abby tries everything to revive her till Carter intervenes and tells her that this is not what she wants. Reluctantly, Abby lets the patient die, but afterwards she is devastated. Later, Carter finds Abby on the roof, where she acknowledges how different this is from the maternity ward. Carter is everything a boss should be, sympathetic, supportive, a marked contrast to his behaviour with Lucy and Abby is reassured.

Story 3 is much shorter, and in typical ER fashion rushes through at breakneck speed. A couple and their young children are brought in after a road traffic accident. Luka is treating one, Carol the other. Their children are stunned but OK and are taken to the paedatric unit down the corridor. The little girl breaks away and wanders up to the treatment rooms, but is pulled away before she can see what’s going on. The action switches between the treatment rooms as the doctors and nurses work furiously trying to save the patients. But within seconds,  both parents die, and it is left to Luka and Carol to go and tell the children, a moment that is both painful for them (how do you give children such terrible news) but also brings Luka and Carol closer. We know that Luka has some mystery about him, and that Carol has lost the love of her life, Doug Ross, so we are left wondering if these two will now become lovers.

Story 4 is simpler still. Dr Romano abuses his surgery privileges to operate on his dog, Gretel. This being ER we have all the usual complications and difficulties, and the pet nearly dies. But thanks to Elizabeth’s fine skills, she survives. The point of the story is both to reflect the main action in a humorous way, but also to highlight Romano’s humanity. He is usual cold &calculating – to discover he cares about any living creature, even if it is just a dog, is a revelation, and we can see that behind her laughter, Elizabeth is deeply moved.

Story 5 is classic ER example of personal lives intruding on work. Mark’s mother has recently died, his dad has emphysema. The men love each other, but until now have found it difficult to relate, but Mark has invited his dad  home to care for him. Elizabeth’s mother is a scientist, clever, cool, critical. She’s passing through Chicago for a night and wants to see Elizabeth at work. Elizabeth, normally very confident, is defensive with her mother, and embarrassed when her first sight of Elizabeth in the hospital is with Romano’s dog. But later, her mother sees her operating and is impressed, and we can see this has an impact. By the end of the episode, Elizabeth’s mother has arranged for Mark, Elizabeth and Mark’s father to all go out for the evening. And although the pair are dreading it, it starts off well, with their parents vying to boast of their offspring’s medical exploits, and Mark’s father singing at the open mic.

As all the story lines pull together, the Valentine’s party is in full swing, though noone can find the cake knife. Mark and Elizabeth leave for their evening with their parents. Carol goes  home to her twin girls, so postponing any possible romance with Luka. Carter & Abby wander in. Things have quietened down workwise, though the party music is deafening, and Carter remembers to go and find Lucy. In a normal episode, this would be the moment for him to apologise for his bad behaviour, and for them to move forward in their always rather delicate relationship. But this is not a normal episode, and he can’t find her. He opens the door to a treatment room, and notices a card on the floor, the very same one that Abby’s patient had. He stoops to pick it up, and we see Lucy’s patient behind the door. Before he has time to turn round, Lucy’s patient stabs him, and  he collapses on the floor. The last shot shows him looking under a trolley to see Lucy, who has also been stabbed. He calls her name and the credits roll.

The real skill of this episode is making these disparate stories connect without us feeling anything is forced. The whole thing is beautifully paced so that we weave between the highs and lows of each tale, giving us time to catch our breath as the tension builds in the Lucy/Carter story. Which allows for 2 minutes of the most nail-biting television that literally left me reeling first time round and still caused me to catch my breath when I saw it this week. It really is a piece of fine writing and hats off to Lydia Woodward for pulling it off so well.

Dialogue.

The other stunning feature of this episode is the brilliant use of dialogue. A lot of the scenes described could be really clunky. But the strongest emotional moments – Abby speaking to her patient about her husband, Luka telling the children about their parents, Abby and Carter talking about death – are pitched just right, so it never sinks to melodrama. When Elizabeth’s mother sees her actually work on an operation, she is stunned, and all she says is “I never knew”, but we know that for her, this is high praise indeed. Such poignancy is nicely contrasted with the comedy of Elizabeth preparing for surgery  whilst Romano describes the symptoms of her patient. He rushes her to the table where she’s shocked by what she sees –  “Robert this is a dog” / “Correction Lizzie, this is my dog” – you can see the whole story condensed here.

There are many references to hearts, the “Be Still My Heart”, heart attacks, hearts stopping beating, Robert’s dog is a hearty dog. And there are other lines that link stories for example after the parents die in the car crash, another character says that two squabbling medical students, are like children arguing in the back of the car, an image that now has a huge jolt for the audience. Visual images are used to link scenes as well, thus one scene ends with a character giving an injection, as we move to the operating theatre where someone is injecting Romano’s dog. And of course, there is the vital moment when someone mentions a missing knife…

Complex characterisation.

Another thing that I love about this episode is that none of the characters are black and white. We have seen Lucy be an irritant to Carter, but here she is simply trying to do the best for her patient. He really is intolerant of her, and all our sympathies are with her, particularly when he is so nice to Abby. Seeing Carter at his worst like this is quite shocking, because we’ve invested so many episodes in rooting for him.

Equally, Robert Romano is a consistently vile character. He’s a brilliant surgeon but dismissive of patients and staff alike. He is sexist, racist, homophobic, says the most outrageous things to people and frequently belittles them. So to see him have such strong feelings for his dog, is a complete eye-opener and helps us all see another side of him.

Part 2 – All in the Family – by Jack Orman.

It would be hard to top that, you’d think,  but Jack Orman’s concluding episode at least equals the power of the first. If the theme of the first episode is  love, life and death in the ER, the theme of the second is work as family, as we switch from the complexity of stories in the first, to the aftermath of the stabbings in the second. This is all about Lucy and Carter now, will they survive, and how does this affect their colleagues?

Single Story.

Now the story is a single one, how the ER treats two of their own. As Dr Carrie Weaver, Head of ER arrives and winds down the party, she notices some blood and discovers what happens. Everyone is into over-drive and we are into a typical 20 minutes of ER’s high adrenaline. The two of them are rushed into  the treatment rooms as their colleagues run around to help. Luka, Carrie, Abby, and two other doctors Chen and Malucci are on the scene. Elizabeth and Mark are simultaneously paged from the bar where they have enthusiastically joined in the open mic and are singing badly. Peter Benton, Carter’s old mentor rushes down from surgery and is visibly shocked to see Carter on the trolley. As Mark arrives, Carrie is unable to continue with the procedure she is attempting on Lucy and Mark takes over, but not before she has berated everyone for being in a party.

Here the story-telling does something quite common in ER, shifting between patients, as things go wrong, heart rates rise, breathing is awkward, there are problems with kidneys. We’ve often seen it before, and regular viewers know that it is likely that one of the two will die, and possibly the one with whom we have most sympathy. This has much more of an impact than in a normal episode, because we know and love both characters and therefore the audience’s sympathies are much more engaged than normal. Meanwhile the assailant has disappeared, and the police have arrived. As a shaken Abby rushes out to get some equipment, she discovers the bloodstained knife. She has no time do anymore than give it to the police before she hurries back. The assailant’s wife arrives at the ER, confused and unable to believe her husband has done that. Both Lucy and Carter suffer blood loss and life threatening situations. The team have to crack Lucy’s chest open but she comes round enough to speak briefly to the police, and it is the injury to Carter’s kidney that seems more serious.As this section ends with them they are both taken off to surgery.

Again this is a typical ER scenario, the doctors treat as far as they can, then the surgeons take over. It allows the pace to slow a bit, but whereas usually, other patients arrive, in this situation, the ER doctors and nurses are left wondering what’s happened. Carrie rages at Mark for not supervising Carter and Lucy adequately, he rages back, possibly from guilt. Staff gradually drift off duty and gather at Doc Magoo’s the cafe across the way, as the surgeons begin to operate. The assailant is brought in after being hit by a car, and the ER staff have to treat him and get him the psychiatric evaluation. His wife is devastated.

Meanwhile Benton is helping Dr Anspaugh (former Chief of Staff) operate on Carter. Benton has promised Carter he’ll take care of him, and like Abby is visibly upset. As the surgery develops there is a lot of blood, Benton panics and wants to whisk out Carter’s kidney, but Anspaugh persuades him to wait. Anspaugh proves to be right and Carter’s kidney is saved. But next door, a new surgical case requires Benton’s skills. Benton is reluctant to leave Carter till Anspaugh sends him out. He visits the other person judges it can wait, and leaves his junior, Cleo, to hold on to the situation till Carter’s surgery is complete. Complications ensue, Cleo is forced to take drastic measures, and when Benton returns he berates her.

Next door, Lucy has come round  but she needs surgery as she has a clot in her blood system that is potentially dangerous (a pulmonary embolism). Elizabeth and Romano are going to operate and are able to speak and joke to her. Lucy whispers her thanks to Elizabeth. Just as Elizabeth is reassuring her all is well, she begins to shake, and they discover multiple clots. We see the terror on Lucy’s face as she realises what is happening, and watch as Elizabeth and Romano are  unable to save her.

After the dramatic beginning, the episode becomes a slow lament, as one by one, characters discover Lucy’s fate. First, Elizabeth and Romano, then Benton, as he apologises to Cleo for his behaviour, then the collected staff sitting in Dr Magoo’s as they have been telling stories about Carter and Lucy. Till finally, Carter, as he wakes up from surgery. Elizabeth staggers home where she can’t speak to her mother. Mark stays on duty as Carol returns to work, shocked by what she’s heard.

The episode ends with with Romano and Carrie tidying Lucy’s body, a tender moment from two of the hardest characters and a nice echo of  Romano’s love for his dog. It seems that in the end, he really does care, something we’ve never seen from him before.

Dramatic irony.

The episode starts with the party which is soaked in dramatic irony for the viewers. We know Carter and Lucy are bleeding to death, while their friends have the music up loud and are having fun. It is inevitable they will be found, but every time someone mentions their names we wince.Carrie Weaver, the strict Head of ER arrives, and everyone is quick to say it is quiet and they’ll finish soon. She tells them to wind down in 5 minutes & asks where Dr Carter is. The party begins to wind down and people start getting on with their jobs. Carrie picks up a chart and gets to work, and then she sees the blood trail and the victims are discovered.

The other key moment of dramatic irony is Lucy waking up only to recognise the peril she is in. The moment she whispers “PE?” to Elizabeth, and Elizabeth nods, is one of the most charged of the episode. Lucy is an intelligent medical student, she has been around long enough to know exactly what this means. It is rapidly followed by the realisation by both of them that she has multiple clots and her chances are pretty slim.

Dialogue and visuals.

As with the first part, the dialogue is very understated. As Lucy and Carter are rushed into the ER, a doctor barks an order that doesn’t need finishing, the nurse understands completely. Carrie’s accusation to her staff, this happened while you were partying, bites. The moment Carrie can’t cope with what’s going on, she nods to Mark who takes over. When Lucy dies, the look between Mark and Carrie is unbearable. Elizabeth arrives home and her mother asks “Do you want to talk about it?” and Elizabeth simply says “No”.
Everyone is laughing at a hilarious story about Lucy at Doc Magoo’s when Chuny walks in says “Lucy” and they all fall silent. Carter asks Benton about Lucy and realises what has happened by Benton’s silence. As Carol arrives for work she asks Mark how he is doing. He says “later” and we watch him swallow, gather himself together and go off to treat the next patient.

The final scene is beautifully paced. Carrie enters as Romano is finishing stitching Lucy’s body, and cuts the thread. As she pulls the cover up, he tells her it is a nurse’s job.All she says is “I know” .What she really knows is that, as the Chief of ER, this job is hers.

That’s a bit of a gallop through two amazing episodes. All credit to the actors and Laura Innes’ direction (she also plays Carrie Weaver) for making the most of the material. But without Lydia Woodward and Jack Orman, they’d have nothing. So thanks to both, for 2 hours brilliant, brilliant drama that stayed with me for 9 years and was well worth seeing again. I can’t recommend this enough.

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