Recap / ERS 1 E 01 Twenty Four Hours

Season 1, Episode 01:

Directed by Rod Holcomb

Written by Michael Crichton

24 Hours

You set the tone, Mark.

A new day dawns at Cook County General Hospital, one of the city's busiest medical sites.

In one of the hospital's examination rooms, chief resident Dr. Mark Greene is getting some sleep after a long day when he is woken up by Nurse Lydia Wright, and informed that a patient is waiting for him. Upon rousing himself from bed, he leaves the exam room and finds pediatrician Dr. Doug Ross, who is inebriated and singing at the front desk. Upon seeing Ross, Greene brings him to a nearby exam room, with their dialogue explaining that this is a regular occurrence for them. Greene prescribes some aspirin and fluids for Ross before going back to bed, but he barely gets any more sleep before he is woken up a short time later by Lydia, and gets ready to start his day proper.

As staff members arrive for their shifts, second-year student Dr. Peter Benton arrives and watches a newscast in the lobby about a building collapse in the Chicago Loop area, causing several critically-injured patients to be sent to County. Nurses begin to prep as injured patients are wheeled in, with Ross being roused and attending to an older woman who coughs blood on him, Benton stabilizes a patient's heart rate and second-year emergency medicine resident Dr. Susan Lewis attends to a patient who tries to hit on her. In the aftermath, Greene is tasked with breaking the news of a patient's death to his son, who rails at him before collapsing in grief.

Some time later, the resident doctors relax in the hospital staff room and discuss various topics, including the coffee and the pay, before Greene is called to the cafeteria. There, he finds his wife, Jennifer Greene, and their daughter, Rachel, and they have a discussion about the former's work habits. Jennifer mentions an appointment Mark has scheduled — an interview for a job at a private practice — and Mark promises to go, specifically after she tells him he's barely home due to his job.

Later on that morning, head nurse Dr. Carol Hathaway is dealing with multiple requests for items from nurses and doctors when she runs into Ross, who flirts with her about their respective professions and her work duties. After Ross leaves, she becomes sad and regretful before walking off...

Ross, Benton and Lewis are standing in the medical lobby when they motion Greene over and show him a new individual who's arrived at the hospital — first-year medical student John Carter. The team members introduce themselves to Carter, and Benton tells him that he'll be acting as his mentor for the time being. After a discussion about whether Carter knows about basic ER procedures like suturing and running an IV, Carter helps Benton perform a suture on an older woman with a wound on her arm, and later does his first successful IV on an Officer Martin, who shot himself in the foot and lost blood. Despite his unease, he manages to make it through both procedures. Benton later orders Carter to take a lunch break, explaining that doctors never know when things might get busy and they may not be able to get away for hours.

The ER staff continue their day, dealing with pediatric cases (a woman giving birth and a screaming child), a 13 year-old teen wheeled in with gunshot wounds and the remaining injured workers from the building collapse. Greene steps out for an hour to attend the appointment Jen reminded him of, and meets the head of the private practice across the street from the hospital. Despite the doctor's promise of much higher pay and easier hours, Greene is unswayed and leaves the office without accepting the offer. Afterwards, Ross and Greene hang out in the staff lounge and discuss the potential job offer and Greene's faithfulness to his wife. Greene later hears a similar notion from Ms. Raskin, a longtime patient of the ER, who mentions how cute Dr. Lewis is for Greene's benefit... before reminding him to go home to his wife.

At 5 p.m., Hathaway heads home for the night, while the rest of the doctors continue to see cases. Lewis treats a patient, Mr. Parker, who is revealed to have a mass in his lungs. After trying to downplay her concerns, Mr. Parker asks her to give him the bad news, and she tells him that it is most likely terminal cancer, and he may have only months at most. After breaking down momentarily, Mr. Parker thanks her for telling him the truth. Elsewhere in the hospital, Ross deals with the case of a boy who swallowed his mother's housekey, while Carter sutures the wound of a woman who crashed her father's car, and later diagnoses a 13 year-old teen as having an ectopic pregnancy after consulting with Benton.

Soon after, Greene and Lewis sit in the cafeteria and eat dinner. They discuss the job offer from the private practice, and Greene tells her that he didn't go for the job because it wasn't "real medicine". After discussing each other's respective relationships (Lewis telling him that he can't let Jen's influence run his life, and Greene commenting on her ex-boyfriend, Paul), Greene receives a call on the cafeteria phone and reels in shock. He tells Lewis that they have to get to the ER immediately.

As they arrive, many of the staff members are standing in shock, with Ross suffering from a Heroic BSoD and asking "how it could happen". Greene tells the rest of the staff to get a room ready, and goes to meet an ambulance as they wheel in their patient... Hathaway, who is revealed to have overdosed on pills.

Greene begins to diagnose her condition, as Hathaway's roommate tells the doctors that she raided a medicine cabinet after drinking scotch. Ross waits outside the room, distraught at the situation, while Hathaway is intubated and Nurse Lydia informs Greene that Dr. David Morgenstern, the senior resident, is on his way to the hospital. Soon after, Morgenstern arrives and has a discussion with Greene about Hathaway's condition, with the latter admitting it doesn't look good, but that the staff will do everything they can to save her. Morgenstern imparts some words of wisdom, telling Greene that he will "set the tone" for the unit, and that no matter how the staff feels about Hathaway, they still have a job to do.

A short time later, Benton receives word that a patient with a gunshot wound is coming in, but upon intake of the patient, Benton realizes that it's a stab wound. The trailing Carter gets sick upon seeing the wound and is forced to exit the hospital. Outside, Greene goes to check on him and tells him that it's normal to be sick when seeing injured patients, and makes light of the situation by claiming that Benton (who had told Carter off when he asked to leave) was also sick in medical school, revealing that both doctors had attended together. Afterwards, Benton apologizes to Carter for his behaviour. In the meantime, Ross sees a child who has been beaten by his parents, and informs the babysitter (who brought him in) that he will be calling Child Protective Services, while Greene attends to a patient who burned her legs and attempts to flirt with him — to no effect.

Benton receives a patient who is complaining of chest pains a short time later, and discovers he has a ruptured aneurysm and is bleeding internally. Realizing that the man may only have a short time to live, Benton makes the call to run his own solo surgery, and asks Lewis to call Morgenstern for help. Despite Lewis and several of the staff members expressing doubt, they prep an OR room for him and he begins the surgery, finding a tear in a blood vessel. He is able to hold it closed by hand until Morgenstern arrives and takes over, initially chastizing Benton for being reckless. However, he also admits that Benton made the right call, and praises him for his decision. Outside the OR, Benton pumps the air in happiness.

As the night draws to a close, Ross meets the mother of the child who had been burned and beaten that he has called CPS, despite her protests, and orders her to get legal representation before leaving the room. Outside, he goes to the babysitter and tells her that she did the right thing and that the baby will be safe. Elsewhere, Greene and Carter see their final patients for the night, just before they find a quiet place to rest.

Just as before, Greene is woken up by Lydia at 6:30 a.m. to begin his day, and makes light of the situation before resuming his duties...

Tropes:

• Actually Pretty Funny: After the mother of a boy who swallowed a key tells Ross that she it was their housekey and they can't back into their apartment, and after Ross has recommended that the mother check the son's stool after he passes the key, both Ross and the boy start cracking up at the absurdity of the situation.
• Afraid of Blood: Carter initially freaks out when he sees a patient with severe abdominal trauma, prompting Greene to step in and offer words of comfort.
• Agony of the Feet:
  • Carter's first patient is an "Officer Martin", who shot himself in the foot while on duty.
  • Carter later sutures a foot wound for a woman who totaled her father's new car.
• Arc Words: Said when Morgenstern effectively cedes control of leadership to Mark.
  Morgenstern: You set the tone, Mark.
• Ascended Extra: Juliana Marguiles (Carol Hathaway) was originally intended to die in the pilot, with her only being credited as a guest star in the pilot. However, audience feedback regarding Marguiles' portrayal of the character and her chemistry with George Clooney led the producers to hastily change the script to keep her character alive.
• As You Know: While the pilot generally averts this, Benton does explain several general ER techniques, such as running an IV and suturing a wound, for the benefit of Carter, who is just beginning his first day of ER rotation.
• Audience Surrogate: Carter, who is beginning his first day in the ER and admits that he has very little knowledge of standard emergency procedures, having elected to study specialty courses instead of general practice.
• Benevolent Boss: Dr. Morgenstern, who holds a largely-dispassionate role as the chief surgeon, being Older and Wiser.
• Blood from the Mouth: Invoked right from the get-go with a patient who coughs up, and eventually spits up, blood on Ross' clothing.
• Book Ends: The episode begins and ends with Greene being woken up abruptly by Nurse Lydia to begin his day. A deleted scene also would have shown Susan (in the original intended final scene) finding a bed in one of the exam rooms to lay on and turning off the light, in the inverse of what Lydia does at the beginning of the episode.
• Brutal Honesty:
  • Lewis tells her patient, Dr. Parker, that he only has six months to live, after he asks her for an upfront diagnosis.
  • Mark also tells the son of a patient admitted into the ER that his father has died, after the latter asked him to tell him the news directly instead of pulling him into a quiet room to talk.
• Bumbling Sidekick: To the point of being an in-universe Running Gag. The medical students are generally seen as incompetent and unable to do anything useful, with Susan later claiming that she hopes County will finally get some good students because, "The last ones were really useless."
• The Cameo: Miguel Ferrer, in an uncredited role as a smoker who is told he has terminal cancer by Lewis.
• Can't Get Away with Nuthin': In a deleted scene, Susan's ex-boyfriend, Paul, wins her back, but seconds after they start to kiss, a nurse walks in on them, spoiling the mood.
• The Casanova: Ross, who goes around bragging to Greene and others about his conquests. Turns into a case of Break the Haughty when Carol overdoses and he becomes stricken with grief.
• A Day in the Limelight: For the ER staff as a whole, being the pilot episode (and an ensemble series). All of the main characters are introduced, and each get several moments of focus on their personal and professional lives. This also is referenced in the episode title, which covers 24 hours in the life of the hospital.
• Distaff Counterpart: Tracy Young is the only other intern at County given prominence, alongside fellow intern Carter, and it's implied that she'll have more focus in later episodes. However, due to script changes, she disappears completely after this episode and is never mentioned again.
• Driven to Suicide: Carol attempts to take her own life, via overdosing on pills. It's suggested, but not explicitly stated, that she did it in despair over Doug's affairs.
• Dropped After the Pilot: Intern Tracy Young, who was written out after the producers made it so that Carol survived her overdose.
• Early-Bird Cameo: An injured cop named "Officer Martin" is brought in and becomes Carter's first patient in the ER. He later returns, six seasons later, in "Such Sweet Sorrow" and becomes the ER's new desk clerk.
• Early-Installment Weirdness:
  • Being the pilot episode, there are a handful of Out of Character moments that aren't borne out by later episodes in the series. Benton is cheerful and smiles at many points (even pumping the air in triumph at one point), a far cry from the ultra-serious doctor he would become for the rest of his tenure on the show, while Hathaway's attempted suicide is a far cry from how she'll be portrayed through the rest of the season (and series).
  • The resident doctors are seen hanging out and chatting at several points in the lounge throughout the episode, including one where they see the New Meat, John Carter, and give their overall impressions of him. Later episodes would largely do away with this, as characters would generally be too busy with their operations/ to get together en masse and comment on the overall state of the hospital.
  • The hospital is explicitly referred to as "Cook County General Hospital", placing it in the real-life Cook county in Chicago, Illinois. Later on, it is only ever referred to as just "County General Hospital" and more commonly just "County."
  • The standard opening credits aren't seen, with only a brief title card before the episode begins proper. Likewise, the cast credits play over the first scene, instead of during the credits themselves.
• Empathic Environment: The weather appears to "react" to certain situations, with it snowing heavily when the pregnant patient (in a state of distress) is hauled out of the taxi, rains heavily when Lewis reveals to Mr. Parker that he has terminal cancer, and becomes calm and clear when Carter and Greene have their conversation outside by the ambulance bay.
• Expospeak: Subverted, when Benton calls out a fellow doctor, Steve Flint, for providing a long-winded, highly-technical explanation for an otherwise easy-to-explain injury.
  Benton: A bullet, Steve. A bullet!
• Extra-Long Episode: Originally aired as a two-hour pilot episode on a Monday (the only episode in the show's run to air in that timeslot).
• Fake Guest Star:
  • Juliana Marguiles as Carol Hathaway, who was originally intended to die after she overdosed on pills, only to have the script changed to keep her alive in response to audience demand.
  • Yvette Freeman as Haleh Adams, who, by the end of the show's run, is one of only two members of the cast (the other being Deezer D) to be present from the pilot episode to the series finale, yet neither were ever promoted to the opening credits.
• Foreshadowing:
  • The first time the staff sees Carter, Benton remarks that he's the only intern he's ever seen who's dressed in a tailored medical coat. This comes several episodes before the reveal that Carter is Secretly Wealthy.
  • Lewis mentions that Hathaway has a fiancee that she's planning to get married to in three months.
• Functional Addict: What Doug's very first scene establishes him as — he's drunk, but is still able to carry a tune and knows exactly what combination of drugs need to be described to help him get better. Soon after, he snaps out of his stupor, puts on his medical coat and expertly diagnoses a trauma patient, before commenting that the trauma team should get an actual surgeon in.
• Heroic BSoD: Doug goes into a brief one after Carol overdoses.
• Hospital Paradiso: Mark is given the opportunity to join a private practice that has better pay and much less stress, but is unswayed by the job offer and elects to stay in his current role at County General.
• I Want You to Meet an Old Friend of Mine: Miguel Ferrer — George Clooney's cousin — as a lung cancer patient being treated by Susan.
• Jerkass:
  • Befitting his mindset in later seasons, Benson has shades of this.
  Morgenstern: (to Carter) Learn everything you can from him... except the attitude.
  • The hospital administrator Lewis talks to regarding Hathaway is less concerned about the latter's condition, and more concerned about what the press will think if the new gets out about her condition, claiming it's "bad publicity".
• Kavorka Man: A downplayed example with Greene - despite the fact that he acts aloof, is constantly overworked and is balding, Lewis tells him that one of the fourth-floor residents has a crush on him, and the college-age patient he treats for burns on her inner thighs aggressively flirts with him at the end of the episode. Yet, he insists that he is faithful to his wife.
• Kick the Dog: Benton antagonizes Carter after the latter starts to feel sick after seeing a patient with a severe knife wound. To add insult to injury, Benton says he didn't need Carter's help anyway. Fortunately, Mark overhears this and goes to comfort Carter, telling him that Benton used to get sick all the time in med school.
• Ladykiller in Love: It's established in the very first scene that Doug is the hospital's resident player, as he charms Mark with an anecdote about a one-liner he gave to a woman he was with. Yet, it's made abundantly clear later on that he's in love with Carol, and is distraught when he discovers that she'd overdosed.
• Manly Tears: Mr. Parker, after Dr. Lewis tells him he most likely has six months to a year to live due to terminal cancer.
• Married to the Job: Greene, who foregoes a significant pay bump and easier hours at a private practice to continue his ER work. He later admits he "can't give this up" after seeing a patient, even when he is later unable to call his wife due to the busy schedule.
• Motor Mouth: In a deleted scene, Mark attempts to talk to a "Ms. Kasinski" during an intake at the hospital's inpatient wing, but gets fed up when she begins to rant to him in unsubtitled, rapid-fire Italian... all while her grandson is busy hitting Mark's leg with a giant plastic sword. He quickly excuses himself and leaves the area immediately.
• Naïve Newcomer: Both Carter and Young are introduced as first-year students with little-to-no practical experience, necessitating Benton and others teach them about basic techniques like suturing a wound and running an IV.
• One of Our Own: Discussed by Mark and Morgenstern after Carol's overdose.
  Mark: It doesn't look hopeful, but for the morale of the unit, we've gotta do everything. She was — is — very popular.
  Morgenstern: The unit's looking to you, Mark. You set the tone. She was one of us. We loved her. We worked with her, and now something's happened to her. It makes us feel guilty, it makes us feel angry, it scares the hell out of us... but we take care of her, and then we go on with our jobs.
• Out-of-Character Moment: Considering how she is portrayed in later episodes, Carol's suicide attempt comes across as this, being given little foreshadowing. Invoked by Morgenstern, when he tells Mark that the reason why she did it doesn't matter, and that the ER staff will do everything they can to save her life.
• P.O.V. Cam: From the perspective of a mother as she's being wheeled into an exam room, looking at Carter as he tries to hold her unborn baby's head in between her legs.
• Screw the Rules, I Have Connections!: The mother who Ross discovers has abused her child tries to threaten the latter by claiming that she's an attorney and will sue him and the hospital. He counters that Child Protective Services doesn't take kindly to parents who cause head fractures and burns to their own children.
• Ship Tease: Ross gets this with the intern, Tracy Young, though this would never be capitalized on due to the character disappearing for good at the end of the episode.
• Uncertain Doom: The episode ends with Hathaway still in critical condition, with Greene commenting that her survival "doesn't look good".
• Underestimating Badassery: When Benton comments that he's ready and willing to run an operation to save a trauma patient's hand, the orthopedic surgeon on call shuts him down, commenting that he's years away from being able to oversee such a thing. However, he soon gets his chance to run his own solo surgery, and his instincts on opening a patient up to fix a ruptured aneurysm later prove to be correct, as the patient would have died otherwise. Morgenstern later compliments him on his instincts.
• What Happened to the Mouse?:
  • Tracy Young was intended to be a love interest for Doug and a Distaff Counterpart to Carter, but she was Dropped After the Pilot after the producers elected to have Carol survive her drug overdose.
  • Carol's roommate, who has speaking lines and is beside herself with grief over Carol's overdose, doesn't appear again.
  • Susan's original boyfriend, who had a subplot running through the episode (dressing up as a patient to get into the ER ward to see her, and rekindling their relationship) doesn't appear in subsequent episodes, with the plot changed by the following episode to show her dating Dr. Cvetic instead.
• What the Hell, Hero?: Greene (and Lydia, via the look she shoots him) gives Ross a brief moment of this, ordering him to "get some coffee" and leave the room after he attempts to explain Hathaway's mood earlier in the day. It is implied, but never explicitly stated, that Greene was aware of Ross' prior relationship with Hathaway and made the connection that he said or did something to her that may have impacted her mood.
• You Bastard!: Said verbatim by the son of a patient, after Mark informs him that his father has died.

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