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The Independent Culture
On 18 September 1994, CBS broadcast a two-hour pilot for its new flagship drama; the following evening, NBC did likewise. Both were set in Chicago, both were hospital dramas and, in a huge gamble by the US networks, Chicago Hope and ER were to run head-to-head in the Thursday 10pm slot, once filled by Hill Street Blues and LA Law. There could only be one winner: ER shaded it with the critics, and got the larger audience. A year later, it matched Hill Street Blues's record of eight Emmys.

Created by Michael Crichton, the author of Jurassic Park and a Harvard medical graduate, ER followed the staff of Cook County Hospital as they dealt with casualties from the mundane to the gruesome: there were 45 cases in the pilot alone. The principled Dr Greene (Anthony Edwards) was backed up by a team that was a model of "demographic correctness": "The brilliant black doctor (Eriq LaSalle), the female doctor (Sherry Stringfield), the young starter (Noah Wyle) and the troubled friend (George Clooney, right)" (New York Times). Their dedication was admirable, their private lives were a mess. Nurse Hathaway attempted suicide. (Julianna Margulies went on to win an Emmy.)

Chicago Hope's consultants performed hi-tech miracles before playing golf. In the pilot, they separated Siamese twins; "What'll they do when November arrives?" asked the San Francisco Chronicle. "Head transplants?" "From Hope's idealistic and lovelorn, high-level surgeons you get more science; from ER more blood" (Variety). Chicago Hope was "old-fashioned medical theatrics with endoscopes. ER is gritty (Hollywood gritty, at least), ramshackle and rapid-fire. If there were an endoscope here it would be broken" (New York Times). The Chicago Tribune felt ER's doctors were "far more human, far easier to relate to".

ER was also distinguished by "pulsating and fluid camerawork" which meant "you rarely lose interest" (LA Times). All the critics were impressed by the cast's handling of scientific jargon and medical instruments: "This is, like many graphic medical dramas, NPTV, which means No Pizza Television. Get all your living-room noshing out of the way well before [it] begins" (Washington Post).

ER started on Britain's Channel 4 in 1995 and is now seen in 130 countries. Alexei de Keyser, series producer on BBC1's Casualty, says: "It's a myth that people want heartwarming, feelgood shows. If you look at the ratings, it's obvious that people want to see someone suffering - they want them to get better, so you need to watch the death toll - but there's an absolute fascination in whether they're going to live or whether they'll die." Although de Keyser finds things about ER "inspiring" - "its budget, for a start: one episode of ER costs about the same as a series of Casualty" - he believes its influence has been limited. "The fast- cutting style was developed for a US audience, which has an attention span of 30 seconds. The episodes are cut to the beat of a pop video: it's fantastic and ingenious, but a British audience doesn't need it." Casualty - which is now in its 13th year - has 12m viewers, whereas ER's British audience is about three million.