In many respects, medical shows on TV can be divided into two eras: B.S.E. and A.S.E. Despite its ventures into outlandish areas, St. Elsewhere injected a level of realism to the medical series that had been missing from the dramas that preceded it on the tube. “It was the best of all the medical shows and the medical shows that sort of spun off from it. They learned a lot from St. Elsewhere,” said Lloyd, who turns 98 on Thursday. In fact, several of the cast members and guest stars bridged those time periods, having appeared on earlier series, and later showing up on the next generation of medical shows of every stripe. In the first three episodes of the second season, Laurie played stroke victim Fran Singleton. The actress first appeared on a medical drama in a 1963 episode of Ben Casey as a favor to her friend Mark Rydell, who was beginning his directing career. To play Fran, Laurie said, “I think I went to Santa Monica Hospital and I met someone who got me to meet some people who suffered strokes and I also talked to some doctors.” Some of the cast had to prepare as well for Fran’s memorable entrance via the car driven by husband Jerry (Arkin) plowing through the ER wall. “I remember I gave Piper Laurie mouth-to-mouth resuscitation on the first show she was on,” Sikes said. “I actually did mouth-to-mouth—I had to learn how to do it, which is great. I had to really learn medical procedures.”

The performers also had to learn complicated medical terms as well. When Stephen Furst first began playing Dr. Axelrod, he couldn’t wrap his vocal cords around some tricky words but, thanks to a very cooperative extra in an ER scene, Furst employed the old Brando trick and taped the lines to the side of the woman’s face where he could read them. “The writers used to love to give us these long medical terms,” Cindy Pickett said. “I had a devil of a time trying to memorize it. Whenever they would give you one, they would all come down and watch you flub up for a while. They got a kick out of watching us struggle with these long medical terms. Me, especially.“ One of Pickett’s favorite moments on the show involved Dr. Novino at work, but it involved examination, not long words. “Ray Charles was my patient one time. He wanted to come on St. Elsewhere and play a homeless man and so I was his doctor. People kind of stayed away from him because he was such an icon, a legend. I would sit beside him, take after take. I had this one scene where I had to . . . take (a retinoscope and look into his eyes) and I always felt like I was violating something,” Pickett said. “I'm probably the only other person in his life other than his doctor who was looking into this beautiful man's blind eyes. It was strange and I thought, ‘Gosh, I hope he doesn't dislike me for doing this, somehow. Somehow I felt very vulnerable because it seemed like a very vulnerable thing to do, especially with a legend, but he was so gracious about it and he would make me laugh.”

Whether playing doctors or patients, performers of all ages had to learn about medical techniques or specifics about their ailments or disorders to make it look real. While Laurie was an adult researching the behavior of stroke victims, Chad Allen was only 8 years old when he auditioned for the role of Tommy Westphall, Donald Westphall’s autistic son. “I didn’t really know what autism was when I was 8 years old and approaching the idea of playing Tommy Westphall, and I had to learn a lot,” Allen said. St. Elsewhere became the first series to feature a recurring autistic character. The only other regular series prior to that to feature an episode centered on an autistic child was a 1978 installment of Quincy M.E. titled “A Test for Living.”  “When you are that young, it’s hard to understand the depth of character. I remember my mother explaining to me when we were going on the audition that autistic children are stuck in their own world and it’s hard for them to relate to people on the outside of that,” Allen said. “I had a very active imagination as a kid and I loved to play pretend and I had my own world that I invented so I related to the character in that way. That’s how I approached it—I played pretend like I always did but I insisted on staying in that world and not coming back to reality.” Five years after the end of St. Elsewhere, Allen returned to a series about medicine, though it went back in time instead of forward—Dr. Quinn, Medicine Woman. Laurie returned to a fictional emergency room again when she played George Clooney’s mother on ER. What changes struck the actress the most in the portrayal of TV medicine in those decades? “They became so sophisticated it seems to me that all they’ve got on television are sick people, doctors and detectives—and people being murdered—but the actual medical stuff is so sophisticated,” Laurie said. Edward Herrmann returned as an elderly Father McCabe in the fifth season as the priest suffered the ravages of Lou Gehrig’s disease or ALS. Previously, Herrmann had starred as Gehrig himself in a 1978 television movie A Love Affair: The Eleanor and Lou Gehrig Story with Blythe Danner playing Mrs. Gehrig. “I learned a great deal from Mrs. Gehrig when I did the film,” Herrmann said. As for the different approaches to playing two very different men in different times afflicted with the same disease, the actor said, “McCabe had a very vital and vivid faith and he looked as an Orthodox Catholic would look at suffering . . . as a gift that you could participate in the suffering of Jesus.”

“At St. Elsewhere, we broke some rules and took the old Ben Casey/Dr. Kildare kind of ideas and turned them on their heads much the same way Hill Street turned the old cop shows on their heads,” Mark Tinker said. Begley has played a lot of doctors since Ehrlich, but he also appeared on quite a few serious, not-so-serious and seriously creepy hospital-set shows dating back to his days as a young actor with an appearance on Medical Center. Since St. Eligius closed its doors, Begley acted on the short-lived Gideon’s Crossing, Scrubs (alongside other St. Elsewhere alums Daniels, Furst and Laneuville), the U.S. adaptation of the horror miniseries Kingdom Hospital and Rob Corddry’s twisted comedy Childrens Hospital on The Cartoon Network, on which Pickles also has appeared as a nurse. “Medical shows starting with St. Elsewhere got quite real. ER and Chicago Hope—those are very good shows,” Begley said. “They got good with St. Elsewhere and I think they got even better with ER and Chicago Hope and Grey’s Anatomy—these are all wonderful shows. We definitely raised the bar as far as medical shows but ER took it to another level.” Of his mini-reunion with his former co-stars on the first season episode of Scrubs titled “My Sacrificial Clam,” Begley said, “We had a ball. At that point, we hadn’t been together for awhile.” Daniels recently filmed a stint on Grey’s Anatomy, playing a doctor whose first name happens to be Craig.

Tinker holds a unique perspective on medical dramas. Not only was he the most frequent director on St. Elsewhere and currently executive produces and frequently directs Private Practice, he directed at least one episode of Chicago Hope (which his brother John executive produced for several seasons), ER and Grey’s Anatomy as well. His behind-the-camera point-of-view offers its own take on the changes in medical shows. “By the time I got to those other shows, the technology of shooting the shows and the presentation of those shows in terms of the editing and the pace and the density of the writing had changed quite a bit,” Tinker said. “Today, the editing pace is faster—I think you can blame MTV or congratulate them, whichever way you look at it, for shortening people’s attention spans or making them need to have more visual stimulation. The stories were sort of all the same, just the style in which they were executed were different.” Lloyd, not only an acting veteran of stage, screen and television but an experienced director and producer as well, has witnessed many filmmaking changes in his long career. Though referring to movies when he said this, it applies to the changes in TV editing styles of which Tinker spoke as well. “I may seem that I’m an old fogey as I’m approaching my 98th year, but it seems to me there was a period of great storytelling. I don’t see that now,” Lloyd said. “The mechanical changes have affected the way people tell stories. There is a very modern way now of cutting and jump cutting. For my own tastes, the great storytellers were in the business long ago but not today. We didn’t have to go into special effects or people from outer space all the time . . . As good as those pictures are, we were about the human condition.” More than 54 years may separate me from Lloyd in age, but I tend to agree so that must make me an old fogey as well.

As for the medical shows since St. Elsewhere, I admit personal bias. St. Elsewhere spoiled me for other medical shows for a long time. I never got into ER or Chicago Hope (in fact, my favorite Chicago Hope scene happens to be a tossed-in gag in an episode of Tom Fontana’s later series, Homicide: Life on the Street). I love Hill Street Blues, but the police genre allows for more elasticity so I could enjoy later series such as Homicide, The Shield or The Wire (though The Wire painted on a much broader canvas than simply police work). It wasn’t until Scrubs and House that I found medical shows I could watch again. Somewhere around the second season of St. Elsewhere, while being wheeled into outpatient surgery to have tubes placed in my ears, I asked how real those staffers thought St. Elsewhere was. One of the nurses replied, “There isn’t as much sex around here.” I also inquired as to whether there would be music in the O.R. and there was, only in real life doctors, nurses and the rest don’t have to deal with the ever-present greed of the music industry or work up sound-alike cover versions as St. Elsewhere had to do to avoid paying fees that never  end. (Even an imitation Led Zeppelin song was too much for that notoriously stingy band, which made them pull the fake from the rarely seen syndicated version.) The only real version the show ever bought the rights to use was ZZ Top’s Legs for Luther’s dream sequence.

I only digressed because it so happened that a lengthy hospital stay led to me watching House in the first place, which I loved when it was great (though that came mainly in its first four seasons) and because of Hugh Laurie’s magnificent performance. Morse even appeared early on as police Detective Michael Tritter, a cop that Dr. House treats so poorly during his hated clinic hours that Tritter pursues a vendetta against House and any of his colleagues who don’t cooperate, one of the heavies that he felt compelled to play after the excessive amount of abuse piled upon Morrison. When I asked if that’s really what made him be so mean to poor Dr. House, Morse answered, “It is why I’ve been so mean to everyone since then.” Like House, I take glee in tormenting administrators and doctors not doing their jobs (though unlike the limping TV doctor, nurses tend to love me, and I lack a Vicodin addiction), but I’d be that way if I’d never seen any of those endless House marathons on USA. “(House) is an original character, but he is the kind of character that reminds me of the kind of characters that we had on St. Elsewhere,” Gibson said. “He was a really terrific, very specific kind of character. Consciously or not, there’s certainly a bit of Mark Craig in him.” Gibson also happens to be the only person I interviewed who agreed with me somewhat that if you look for a natural successor to St. Elsewhere, you won’t find it in the hour-long dramas that came after it, but instead you’ll spot that sensibility more often on Scrubs. Gibson thinks I’m keying in on the comedic element. “St. Elsewhere was written very specifically always to have an element of humor,” he said, but Scrubs, at its best, aimed for more than just laughs. Patients died—sometimes going out with a musical number, sometimes just quietly. Even recurring characters could meet their end, only to return in one of the show’s many fantasy sequences. They addressed the financial issues of medicine just as seriously as St. Elsewhere did, whipsawing the viewer between the sad and the silly within moments of a single episode. Perhaps what struck me as so familiar was its awareness of itself as a television show with Jimmie Walker, Colin Hay or Ed McMahon making inexplicable cameos and guest stars from a different generation of TV shows such as St Elsewhere or The Love Boat. Finally, Scrubs also took place in a teaching hospital and, though they weren’t surgeons, the relationship between Dr. Perry Cox (John C. McGinley) and Dr. John “J.D.” Dorian (Zach Braff) definitely contained echoes of Craig and Ehrlich. Scrubs might have been a half-hour shorter and classified as a comedy, but Sacred Heart always seemed to be a first cousin to St. Eligius to me. I loved House at its best, but there I thought the medicine served as its MacGuffin. You watched for the main character, not for the cases.