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Topical Anesthesia

When the call went out for someone to review ER for PopMatters, I initially ignored it. Sure, I watch the show, but then so do eight gazillion other people. It's a ratings juggernaut and the most expensive show on television and George Clooney used to be on it and now he's not -- after seven years on the air there's really not much else to say about it, except that it's in letterbox format this season and looks really good that way. I changed my mind about the assignment in November, when Oscar-winning actress Sally Field made the first of six appearances as Maggie, the estranged mother of nurse Abby Lockhart (Maura Tierney), not because she's Movie Star Lady but because Field's story arc was about bipolar disorder and its effects on both the patient and the patient's family. Bipolar disorder has traditionally received short shrift in real life -- ask a depressive how he or she feels about the phrase "cheer up" -- and on television, where "bipolar" has become shorthand for "homicidal" even on shows as astute as Law & Order.

As someone who has lived with a bipolar for fifteen years, I was intensely interested in seeing how the subject would be covered at length in the hands of ER's (mostly) excellent writers and cast, especially with an actress of Field's caliber as the patient in question. The initial episode of the arc, written by John Wells, did not disappoint. Wells and Field accurately captured the intense highs of the manic phase, the desperation and dependency and rage of the depressive phase, and the violence of the often abrupt transitions between the phases. Tierney held her own as well, ably conveying the helpless frustration of the patient's loved one who must constantly play a second-guessing game with her mother's illness. Are the things the patient says, the promises made and the invective hurled, to be believed or dismissed as "just the depression talking"? Is giving in to the depressive's demands a kindness or counterproductive enabling? Does refusing to help someone who seemingly won't help herself -- like many bipolar patients, Maggie is on medication but refuses to take it because the manic phase produces a euphoric state, and anti-depressants often produce a numbing effect that feels worse than the depression itself -- constitute self-assertion or abandonment? Because these issues affect a great many people and yet the disease, like most mental disorders, is grossly underrated in dominant American culture, here was an opportunity for ER to do some real good with its market-share clout.

Unfortunately, while the show's treatment of Maggie's condition has touched on some key points, there's no way it can possibly deal with the situation with the appropriate depth, because after three episodes, during November sweeps, the Maggie storyline has been shelved, presumably to be picked up during February sweeps, when it will be advantageous to have Sally Field on the show again. There's just too much else going on, too many other, more important tragedies to deal with. In the same sweeps episode where Maggie first appeared, British-born surgeon Elizabeth Corday (Alex Kingston) discovered that she was pregnant and being sued for malpractice, while at the same time her fiance Mark Greene (Anthony Edwards) was being diagnosed with a fatal brain tumor. Adding to the catastrophes of that month: young resident John Carter (Noah Wyle) continued to struggle with an addiction to painkillers, which began last season after a maniac stabbed him and killed off another cast member; the nephew of arrogant surgeon Peter Benton (Eriq La Salle) was killed in a drive-by shooting and now he must protect the nephew's gang-banger girlfriend; hunky, brooding Croatian pediatrician Luka Kovac (Goran Visnjic, who apparently is there to fill the hospital's state-mandated "hunky, brooding pediatrician" quota now that Clooney is off the show) killed a mugger in self-defense and must live with the guilt. Compared to all that death, what's a little mental illness in an ancillary character?

As initially conceived by physician/author/producer/director/cosmic overlord Michael Crichton, ER was meant to be an uncompromising look at the relentless stresses attending the lives of overworked residents in an urban emergency room. That in itself is enough tension for three shows, and a quantum leap beyond the sedate theatrics of most medical dramas -- only *M*A*S*H* ever came as close to depicting this kind of nerve-wracking chaos. The cast was relatively small and the show's emphasis lay in probing character studies. For example, Clooney's character, Doug Ross, was an fascinating portrait of contradictions -- a maverick pediatrician fiercely committed to helping children, yet also a womanizing, alcoholic louse -- and La Salle's Benton maintained an always interesting balancing act between his black, inner-city roots and the nascent God complex that frequently afflicts brilliant surgeons.

Seven years later the cast of ER is bloated and unwieldy. To be sure, the actors are almost entirely top-notch (particularly Kingston, Laura Innes, and Paul McCrane); there's just too damn many of them. Erik Palladino has played a goofy, overeager resident named "Dr. Dave" for two seasons now, and his name's in the main credits, but the writers have yet to invent any compelling stories for him. Another med student, Jing-Mei Chen (Ming-Na Wen), had a baby out of wedlock but that's about it. And former chief resident Kerry Weaver (Innes) has suddenly entered a lesbian relationship so contrived you can actually hear the writers scratching their heads, looking for something for Weaver to do. Meanwhile, other characters are overburdened with traumas, tragedies, and sheer woe until they can hardly move. Perhaps there should be a redistribution of sorrow here, a socialism of tragedy. Spread the misery around so everyone can have some. Let Elizabeth be pregnant and let "Dr. Dave" get sued for malpractice and pass the brain tumor on to someone else who can use it.