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1* ActingInTheDark: The production could only afford to occasionally shoot on location in Chicago so the actors and crew would be given briefs and snippets of scenes for multiple episodes that they would have to rush to complete without knowing the context of what they were doing. Sometimes the writers didn't even know what was going on, often being told to take scenes pre-shot in Chicago and to build episodes around them.
2* ActorInspiredElement:
3** The basketball hoop found outside of the ambulance bay of the ER, was actually Creator/GeorgeClooney's idea. Apparently, he liked to unwind in-between takes, by shooting some hoops. Because of this, it was placed in an area of the Warner Brothers (Burbank, California) studio lot, where it could be picked up by the camera. It quickly became a part of the series.
4** Creator/GoranVisnjic named his own character after the writers were unable to develop an appropriately Croatian name. The character is named for Visnjic's nephew (Luka) and his best friend (Kovac).
5* ActorLeavesCharacterDies: Lucy Knight was murdered by a schizophrenic patient in Season 6 when Creator/KellieMartin wanted to leave the show. In [[https://web.archive.org/web/20170906204755/https://www.vox.com/2017/9/6/16257986/er-lucy-death-kellie-martin this 2017 Vox interview]], Martin explained that she felt working on a medical drama only one week after losing her younger sister to lupus hit too close to home throughout her short-lived tenure on the show, and was relieved when she learned Lucy was being killed off.
6* ActorSharedBackground:
7** Maggie Doyle offhandedly mentions that she's a vegetarian and a lesbian -- "No meat, no men." So is her actress, Creator/JorjaFox.
8** Both Creator/MichaelMichele and Creator/ThandiweNewton and their respective characters, Cleo and Kem, are biracial, though the mixes are different--Michael and Thandiwe's fathers are white, while Cleo and Kem's mothers are.
9** Neela mentions playing the viola in "Damaged" and "Alone in a Crowd", and she plays to her visiting parents in a deleted scene from the former. Creator/ParminderNagra does actually play the viola.
10** Ray Barnett is originally from Baton Rouge, and he spends Seasons 11 and 12 as a rock musician. Creator/ShaneWest is actually from Baton Rouge, and he's also a punk rock musician.
11** Creator/GoranVisnjic and his character Luka Kovac not only both hail from Croatia, they had traumatic experiences in UsefulNotes/TheYugoslavWars. Though Luka's experiences were as a doctor, not a combatant, and far worse than Goran's--losing his entire family.
12* AwardCategoryFraud:
13** Possibly to avoid canceling each other out--as possibly happened to Creator/AnthonyEdwards and Creator/GeorgeClooney along with Creator/NoahWyle and Creator/EriqLaSalle--Creator/JuliannaMargulies was nominated for Best ''Supporting'' Actress during the time when Creator/SherryStringfield, who was nominated for Lead, was a cast member, even though the two had roughly the same amount of screen time and storylines.
14** It began to feel like the actors were nominated based on where their names fell in the credits. Creator/NoahWyle was a co-lead by Season 3, but he still fell into the Supporting Actor category. Starting with Season 3, Creator/JuliannaMargulies was properly moved up to Lead Actress, but Creator/LauraInnes, who was easily as prominent from Seasons 3-9, never made it out of the Supporting Actress category.
15* {{Blooper}}: In "Love's Labor Lost", as Mark futilely tries to revive the patient, Carol can clearly be seen taking off her glasses in the background. When the patient is pronounced dead and we get the individual reactions of everyone in the room (Susan, Carol, Lydia, Carter and Jing-Mei), Carol is seen taking off the glasses again.
16* CaliforniaDoubling: Set in UsefulNotes/{{Chicago}}, filmed in UsefulNotes/LosAngeles. They would occasionally travel to Chicago to film scenes in exteriors and on the L, shooting bits for multiple episodes in blocks.
17* TheCastShowoff:
18** Yvette Freeman (Nurse Haleh Adams) would get to sing about OnceASeason, often in the ChristmasEpisode. As she has a lovely voice, nobody's complaining.
19** In the last few seasons, the torch passed to Creator/ScottGrimes (Archie Morris).
20* CastTheRunnerUp:
21** Creator/JuliannaMargulies originally read for the part of Mark's first wife Jen before being cast as Carol.
22** Creator/LisaZane tested for the part of Susan. She would later play Diane Leeds, one of Doug's temporary love interests.
23** Creator/LauraInnes auditioned for the role of Diane Leeds before being cast as Kerry.
24* CrossCastRole: Cisgender man Creator/VondieCurtisHall plays transgender woman Rena Carlton, Carter's patient, in the Season 1 episode "ER Confidential".
25* TheDanza:
26** Lily Mariye, one of only six actors to appear in all 15 seasons, plays Nurse Lily Jarvik.
27** Conni Marie Brazelton plays Nurse Conni Oligario from Seasons 1-10.
28** In the Season 6 episode "Humpty Dumpty", Rosalind Chao plays a neurologist named Doctor Chao.
29* DawsonCasting:
30** In 1995, Rachel Greene celebrates her 6th birthday. Assuming a birth year of 1989, by 2001 Rachel would have been 12. Yvonne Zima, who had played Rachel up to this point and who was exactly 12, was replaced by 14-year-old Creator/HalleeHirsh.
31** In Season 7, Carter is relentlessly teased for dating Rena Trujillo, a 19-year-old Pediatric intern. Her actress, Creator/LourdesBenedicto, was actually 26 at the time, and is only three years younger than Creator/NoahWyle.
32** Creator/JessicaChastain, in her acting debut, was 26 when she played the 19-year-old daughter of a patient in the Season 10 episode "Forgive and Forget".
33** Creator/KatDennings was 19 when she played 14-year-old Zoe Butler, Ray's underaged groupie, in Season 12.
34* DeletedScene: The [=DVDs=] feature numerous deleted scenes from various episodes, all of them unedited (certain sound effects or special effects needed to be added in post-production). Interestingly some of the scenes were subplots that were scrapped so they could be re-used or re-worked for later episodes. "On the Beach" had a wealth of deleted scenes, showing (amongst other things) Mark watching Ella take her first steps, Mark and Elizabeth writing his letter to the ER (as seen in "The Letter"), and Elizabeth talking to Benton at Mark's funeral.
35* DevelopmentHell: The {{Pilot}} was written in 1974 and filmed 20 years later. Despite the huge time gap, few changes were necessary, aside from making at least one of the doctors a woman instead of a man (Susan), and another a black man instead of a white one (Benton).
36* DirectedByCastMember: Several main or recurring cast members helmed episodes of the show. These included Creator/AnthonyEdwards, Creator/PaulMcCrane, Creator/LauraInnes, Creator/EriqLaSalle, and Creator/VondieCurtisHall. For a few of them, they continued to direct after their characters left the show.
37* DisabledCharacterDisabledActor: Matthew Watkins, who plays Reese Benton, is deaf in RealLife.
38* DuelingShows: With ''Series/ChicagoHope'', another drama series set at a hospital in Chicago, Illinois that happened to premiere ''one day'' before ''ER'' did. The two ended up competing directly against each other on Thursdays at 10:00 P.M. (with ''ER'' on NBC and ''Chicago Hope'' on CBS). ''ER'' ended up easily winning commercially, maintaining a place as one of the most-watched shows on television for its first ten years and managing to stay on the air for fifteen seasons, whereas ''Chicago Hope'' ended up finishing its run after its sixth season. At the Emmy Awards, the two tended to trade off, with ''ER'' being the only one of them to win the Drama Series prize, but ''Chicago Hope'' winning more often for its main cast members.
39* FakeAmerican: Creator/GloriaReuben (Jeanie Boulet) is Canadian.
40* FakeMixedRace: Inverted. Creator/GloriaReuben is of mixed race (black mother, biracial father). Jeanie Boulet is apparently not--we never learn much about her background, but she never mentions either parent being white.
41* FocusGroupEnding: More like a focus group ''beginning''. The pilot episode was to feature Nurse Carol Hathaway committing suicide via a drug overdose. However, test audiences liked her character and were intrigued by the relationship hinted at between her and Dr. Doug Ross. As a result, Carol miraculously recovered and became one of the show's best-known heroines.
42* HideYourPregnancy:
43** Creator/GlenneHeadly was pregnant when she signed on to do her story arc as Dr. Abby Keaton in the third season. Originally, the writers floated the idea of writing the pregnancy into the show, but then decided that audiences would have difficulty accepting John Carter having a relationship with a heavily pregnant woman. In the later stages, Headly had to be photographed behind gurneys and in ill-fitting surgical scrubs to hide her bump.
44** Creator/ParminderNagra (Neela) was pregnant towards the end of the final season. There were attempts to disguise her bump by filming her scenes from the chest up, having her sit, wearing surgical scrubs, keeping her coat on, using her bag to cover up, or placing her behind counters or gurneys, but it was still visible in wide shots.
45** Subverted with Creator/MingNaWen (Jing-Mei), Creator/AlexKingston (Elizabeth) and Creator/SherryStringfield (Susan). Although their pregnancies were written in, the actresses were much further along than their characters, resulting in this trope for several months until they could catch up.
46* HostilityOnTheSet:
47** Creator/NoahWyle (John Carter) and Creator/KellieMartin (Lucy Knight) did not get along, resulting in her character not being used very much or developed once he nixed plans for her to be his girlfriend. However, Wyle also truthfully pointed out that such a relationship would be inappropriate--Carter was a resident while Lucy was a medical student, therefore she was his subordinate--and out of character for Carter.
48** Wyle's attitude apparently also affected other co-stars--he has admitted to being hostile to other newcomers such as Creator/ErikPalladino and Creator/MichaelMichele. Reportedly, when Wyle once complained about the buffet for cast and crew, Creator/GoranVisnjic (Luka Kovac) snapped "How dare you complain about this food when there are people all over the world who would give their lives for a fraction of what you have!" (Apparently this was due to the Croatian Visnjic's experiences as a veteran of the UsefulNotes/TheYugoslavWars.) Wyle would later admit that he often felt jealous of Visnjic and "always felt like [he] was losing a scene to him."
49* InMemoriam: When creator Creator/MichaelCrichton passed away in 2008, Creator/EriqLaSalle gave out a speech about Crichton's passing.
50* MidDevelopmentGenreShift: Creator/MichaelCrichton wrote the {{Pilot}} in 1974, with the intent of it being a film rather than a TV show.
51* TheOtherDarrin: Several supporting characters were played by different actors:
52** Perhaps most notably, Mark's eldest daughter Rachel Greene was originally played by Yvonne Zima in Seasons 1-6 and then by Creator/HalleeHirsh for the rest of the series.
53** Jeanie's first husband Al Boulet was played by Wolfgang Bodison in Season 1 and then by Michael Beach in Seasons 2-4.
54** Carol's mother Helen was played by Georgiana Tarjan in Season 1 and then by Creator/RoseGregorio in Seasons 3-5.
55** Rather egregiously, Roger [=McGrath=] (Carla's husband) was played by Victor Williams in Seasons 4-7, but in Season 8 he was suddenly played by Creator/VondieCurtisHall, who previously guest-starred as Carter's suicidal transgender patient, Rena Carlton, in Season 1.
56** Jing-Mei's father Mr. Chen was played by George Cheung in Season 10 and then by Henry O in Season 11.
57** Sam's ex-husband Steve Curtis was played by Cole Hauser in Season 10 and then by Creator/GarretDillahunt in Seasons 11-13.
58** Sam's son Alex was originally played by Oliver Davis in Seasons 10 and 11, but due to Davis' commitment to the show ''Rodney'', he was replaced with Dominic Janes for the rest of the series.
59* PlayingAgainstType: Creator/LindaCardellini has said that the reason why she took the role of Sam Taggart is because she never played a working class woman before, and it sounded like something she wanted to do, as she had only played [[DawsonCasting much younger girls]] and comedic roles prior to ''ER''.
60* PostScriptSeason: Season 15 was necessary to give the series a proper sendoff, as the planned final season--Season 14--coincided with the [[UsefulNotes/TVStrikes 2007-8 writers' strike]].
61* RealitySubtext:
62** Maggie Doyle offhandedly mentions that she's a vegetarian--"No meat, no men". Her actress, Creator/JorjaFox, is one as well, as was her character in ''Series/{{CSI}}'', Sara Sidle.
63** Benton's brief, troubled relationship with Elizabeth is partly because Benton can't get over his discomfort with [[WhereDaWhiteWomenAt dating a white woman]], echoing his portrayer's sentiments--Creator/EriqLaSalle believed that having Benton date a white woman [[UnfortunateImplications played into dubious ideas]] about successful black men being "above" dating black women.
64** Creator/JuliannaMargulies admits in [[https://web.archive.org/web/20210421133102/https://people.com/tv/julianna-margulies-says-she-had-organic-chemistry-with-george-clooney-on-er-that-cant-happen-if-you-dont-crush-on-each-other/ this 2021 People Magazine interview]] that she and Creator/GeorgeClooney had a "huge crush" on each other throughout their time on the show. To this day, they remain very good friends and even call each other "Doug" and "Carol".
65** Creator/AnthonyEdwards and Creator/MareWinningham had been friends for years before she had an arc in Season 5 as the loopy and fake Dr. Amanda Lee. 23 years later, the two married.
66* RealLifeRelative:
67** Creator/MiguelFerrer (Creator/GeorgeClooney's cousin) and Rosemary Clooney (Clooney's aunt and Ferrer's mother) both had roles in Season 1, although neither interacted with Clooney on-screen.
68** David Brisbin, who plays Anesthesiologist Alexander Babcock, is married to Creator/LauraInnes. They got to interact at least once, when Kerry is in the ICU screaming at Doug for doing a procedure in secret and without parental consent.
69** Creator/AnupamKher and Kirron Kher, who play Neela's parents, are married.
70** Creator/CourtneyBVance is married to Creator/AngelaBassett, who plays Catherine Banfield. He plays her husband Russell.
71* RecycledScript: Luka's downward spiral in Season 9 is very reminiscent of Doug's in Season 5, right down to a rehash of "The Storm, Part 1"--Luka getting into a car accident and seriously injuring his female passenger.
72* TheRedStapler: Applications to ER medical residency programs skyrocketed after the series premiered. Administrivia/TropesAreNotBad, since ER residency is a good start for medical career.
73* RoleEndingMisdemeanor: Lisa Nicole Carson, who plays Carla Reese (the mother of Benton's son), had concurrent roles in both ''ER'' and ''Series/AllyMcBeal''. She was fired from both shows for drug use and erratic behavior, as well as being in and out of mental hospitals. The ''ER'' producers were tired of her "unpleasant attitude."
74* StarMakingRole:
75** For Creator/GeorgeClooney, who became an overnight sensation.
76** Also counts to a lesser extent for Creator/JuliannaMargulies, Creator/NoahWyle, and Creator/MekhiPhifer.
77** This was true for most of the original main cast, subsequent main cast, and supporting cast, although none of them have reached the heights Clooney has. Creator/AnthonyEdwards is the exception--he was already well-known before the show, appearing in major roles in ''Film/RevengeOfTheNerds'' and ''Film/TopGun'', and he was the de-facto star of the show for the first eight seasons.
78** While Creator/LindaCardellini got her big break with ''Series/FreaksAndGeeks'', she has said that she became more easily recognizable after she joined the show in Season 10.
79* ThoseTwoActors:
80** Three actors from ''Film/TopGun''--Creator/AnthonyEdwards (Goose/Dr. Mark Greene), Rick Rossovich (Slider/Tag), and Michael Ironside (Jester/Dr. William "Wild Willie" Swift)--appeared on the show.
81** Four actors from ''Series/LifeGoesOn''--Creator/KellieMartin (Becca/Lucy Knight), Creator/TroyEvans (Artie/Frank Martin), Creator/ChadLowe (Jesse/George Henry), and Chris Burke (Corky/George)--appeared on the show at various times, though never together.
82* TransCharacterCisActor: Cis male actor Vondie Curtis-Hall as a trans woman, and cis female actress Megan Vint as a trans girl.
83* UnderageCasting: In Sam's backstory, she was 15 and Steve Curtis was 23 when they had their son Alex. Cole Hauser, who portrayed Steve in Season 10, is only three months older than Creator/LindaCardellini.
84* WagTheDirector: According to some reports, the romantic relationship between Dr. Benton (played by the African-American Creator/EriqLaSalle) and Dr. Corday (played by the white Creator/AlexKingston) ended because La Salle thought that it had UnfortunateImplications suggesting that successful middle-class black people were "above" dating other black people.
85* WhatCouldHaveBeen:
86** The show was going to be set in Boston until it was decided that would make it too similar to ''Series/StElsewhere''.
87** Carol was originally slated to die in the {{Pilot}}, committing suicide after her break up with Doug. Creator/JuliannaMargulies' performance in the pilot convinced the show-runners to have her recover and make her a regular in the subsequent episode.
88** Remember those ''Series/LawAndOrder'' and ''Series/HomicideLifeOnTheStreet'' {{Crossover}} episodes? At one point, TPTB wanted to include ''ER'', but ''ER'''s producers either declined outright or the collective group couldn't figure out how to work ER into the storyline.
89** The producers wanted to pair Carter and Lucy in Season 5, but Creator/NoahWyle was adamantly opposed to this, feeling that it would be out of character for Carter to pursue an inappropriate relationship--Carter was a second-year resident while Lucy was a third-year medical student and therefore Carter's subordinate.
90** Creator/SamRockwell was considered for John Carter.
91** Creator/SissySpacek was originally cast as Kerry's mother, but the role was eventually played by Frances Fisher.
92** Creator/TonyTodd was considered for the role of Dr. Peter Benton.
93** Creator/NoahWyle was originally supposed to appear in a handful of episodes in Season 13, but this was pushed back to Season 14 (which was supposed to be the final one). However, the 2007-2008 Writers' Strike led to NBC renewing ''ER'' once again, so he ended up appearing again in Season 15 ([[BackForTheFinale along with several other cast members]]).
94** A number of actors initially cast in recurring roles were offered or considered being upped to regular status but either declined the offer or didn't end up working out. These include Michael Ironside, Ron Eldard, Creator/JorjaFox, Creator/CCHPounder, Creator/BusyPhilipps and Glenn Howerton, among others.
95* WrittenInInfirmity:
96** The RealLife pregnancies of several of the show's actresses--Creator/MingNaWen, Creator/AlexKingston, and Creator/SherryStringfield--resulted in their characters being pregnant as well.
97** The injuries that Doug sustained while rescuing Ben in "Hell and High Water" are real cuts that Creator/GeorgeClooney received while filming the scenes.
98** Clooney also sprained his ankle prior to filming the Season 3 episode "Whose Appy Now?" Ergo, so did his character Doug. This also resulted in a hilarious IronyAsSheIsCast moment when he and Kerry are limping down the hall in tandem and she snaps at him before he explains his predicament. ''Her'' limp is the fake one, as Creator/LauraInnes is not disabled in RealLife.
99* YouLookFamiliar: The producers apparently had a rule that they would never cast the same actor twice, but they still flubbed it quite a few times:
100** Creator/ShiriAppleby played a patient in the {{Pilot}} and then Dr. Daria Wade in the final season.
101** Ken Lerner played two different patients--a salesman in Season 1 and then a prostate cancer patient in Season 8.
102** Creator/VondieCurtisHall played Carter's suicidal transgender patient, Rena Carlton, in Season 1 and then Roger [=McGrath=] in Season 8.
103** J.P. Manoux played a mime in Season 2 and then Dr. Dustin Crenshaw in the last three seasons.
104** Creator/DianeDelano played an abused girlfriend in Season 3 and then a hypochondriac patient in Season 9.
105** Jesse Borrego played an HIV-positive patient in the Season 4 premiere and then desk clerk Javier in Season 14.
106** Justina Machado played a patient's sister in the Season 4 premiere and then police detective Claudia Diaz in the final season.
107** Creator/TarajiPHenson played one of Benton's relatives in Season 4 and then a patient's girlfriend who gets attacked by her rival in Season 5.
108** Jenette Goldstein played a patient's mother in Season 5 and then a helicopter medic in Season 7.
109** George Cheung played a cancer patient's son in Season 5 and then Jing-Mei's father in Season 10.
110** Keiko Agena played a hearing-impaired patient's mother in Season 5 and then a patient's wife in the final season.
111** Steven Culp played Dr. Charles Cameron in the Season 6 premiere and then a teacher in Season 10. Coincidentally, both characters were temporary love interests for Elizabeth.
112** Paul Adelstein played a patient's father in Season 6 and then a patient's husband in Season 8.
113** Sal Lopez played a patient who goes to an illegal backroom clinic in Season 6 and then a patient's grandfather in the final season.
114** Steven Christopher Parker played a patient in Season 11 and then Dr. Harold Zalinsky in Season 14.
115** Julia Ling played a patient in Season 12 and then medical student Mae Lee Park in Season 13.

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