“Donald, do you know what people call this place? Not St. Eligius. St. Elsewhere—a dumping ground—a place you wouldn’t want to send your mother-in-law.” – Dr. Mark Craig, “Pilot” (Written by Joshua Brand and John Falsey)

When St. Eligius officially opened its doors to the general public on Oct. 26, 1982, its initial slate of regulars consisted of Flanders, Bailey, Begley, Knox, Mandel, Morse, Sikes, and Daniels, as well as Christina Pickles (Head Nurse Helen Rosenthal), David Birney (Dr. Ben Samuels), Kavi Raz (Dr. Vijay Kochar, anesthesiologist) and a certain young actor, cast as first-year resident Philip Chandler, by the name of Denzel Washington. By the time the show ended its sixth and final season, only Begley, Daniels, Mandel, Morse, Pickles and Washington had held a spot in the opening credits from the pilot to “The Last One.” (Flanders departed memorably in the third episode of the sixth season, though he did return as a guest star for two more episodes that year.) As integral a part of the show as Lloyd’s Auschlander became, his character also had been marked for an early exit in the first season, introduced as an expert on diseases of the liver who found himself suffering from terminal liver cancer. Lloyd and Auschlander both proved too precious to let go.

The digital clock that would appear periodically in the corner of the screen read 9:03 p.m. at the beginning of that first episode. (Craig later references the new clocks he’s managed to acquire for the hospital, which are all supposed to say the same time.) The first recognizable face we see belongs to Eric Laneuville as Luther Hawkins, wheeling a maintenance cart and checking pay phones for loose change. Laneuville, another White Shadow alumnus, would also evolve with the show; he eventually made it to the opening credits and started a burgeoning directing career which continues to this day, as his character went from being a cleanup guy to studying to be a physician’s assistant. Characters came and went throughout the run. St. Elsewhere, despite some performers’ names listed beneath “starring” or “also starring” credits, truly worked as an ensemble. No one person stood out as the lead or the main character.

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“I thought the star of the show was the actual St. Elsewhere, the building, the hospital,” Pickles said. “The story was really about the heart and soul of this extraordinary, crumbling, generous place, filled with people trying to do their best work against all odds. When we left the hospital and went to somebody’s home . . . I thought it was never as exciting as staying in those halls and corridors and nurses’ stations.” Looking back at the first season now—which is all most people in the U.S. can see, since 20th Century Fox Home Entertainment holds distribution rights to the MTM library and only released the first season on DVD or for streaming—the initial 22 episodes of St. Elsewhere come off as rather straight-forward by comparison with some of the more surrealistic and flat-out wacky aspects that came along in later years. ”The first season was sedate compared to the others,” Begley said. That first year definitely lifted medical dramas on television to a higher, more realistic level that separated it from past medical series such as Ben Casey or Marcus Welby. “Our intention was to make it feel real. That was pretty much our guiding principle,” Brand said, referring to himself and co-creator Falsey. “We got a lot of reviews from medical journals and doctors and it was very gratifying to see how they felt that it was by leaps and bounds that it was much more reflective of what reality was than what had been projected on television prior to that.”

At St. Eligius, patients didn’t always recover. According to Brand, “A lot of people seemed to have felt the first year was darker. Some people might have found it depressing. There was humor, but it was black humor for the most part. I think that Falsey and I were somewhat affectionately called Dr. Death and Mr. Depression because we didn’t think you were going on vacation or going to The Love Boat when you went into a hospital. There was sort of a high body count that first year.”

The laughs extended beyond dark comedy though, especially through the interplay between Craig and Ehrlich. Daniels and Begley’s chemistry rivaled that of any of the romantic pairings that the show created over the years. Those two actors together guaranteed gold, though both got to display more dramatic sides by themselves as well. Even though Birney’s Samuels departed after the first year, he also received his share of comedy and tragedy, including his memorable entrance in the pilot episode: Samuels, one of the hospital’s lotharios, finds that he’s contracted gonorrhea and proceeds to try to remember all the female staff members he has slept with, so he can advise them to be tested (he was a conscientious lothario). Samuels informs one nurse about his condition, only to learn that, though they did go out, he fell asleep and they didn’t have sex, befuddling him further. “That was such a funny way to start in the first show. That sense of comic bewilderment,” Birney said.