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Series / Code Black

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"Center Stage is where rules go to die."
code black:
An influx of patients so great, there aren't enough resources to treat them.
The average ER is in code black five times per year.
Angels Memorial Hospital in LA is in code black 300 times per year.
Opening Screen

Code Black (2015 - 2018) is a CBS Medical Drama starring Marcia Gay Harden as Residency Director Dr. Leanne Rorish. It was inspired by a 2013 documentary of the same name that detailed the efforts of the emergency room staff at Los Angeles County Hospital, the busiest in the nation.

The show focuses on the overworked and understaffed emergency room of Angels Memorial Hospital in Los Angeles as they try to deal with the swaths of people who come through their doors seeking help. Joining the experienced staff of doctors and nurses is a new group of residents, eager to prove themselves but quickly overwhelmed by the high-pressure environment.

The series very much took its cues from the groundbreaking ER, with graphically detailed medical procedures, plenty of showing the research, and a focus on the chaos faced by an incredibly busy urban public hospital.

Praised for its creativity and medical realism, the show earned a small but devoted fanbase, but fell into a gulch of declining ratings. After a shaky run for three seasons and mixed reviews online, CBS decided to pull the plug. The last season had a condensed run of 13 episodes, bringing the overall series total up to 46 episodes.

Tropes related to the characters can be found here.

This program provides examples of:

  • Aborted Arc: In season one resident Heather Pinkney was stealing prescription painkillers and using Chief of Surgery Will Campbell prescription pad to do it. When he discovers this he threatens to remove her from the Hospital. Until she threatens to expose that the two are in a sexual relationship. Painting her as a manipulative addict willing to use blackmail to protect her position and Campbell as a idiot who couldn’t keep it in his pants. Come season two, no mention of her addiction or blackmail is mentioned. There is no indication that the two were previously in a relationship. In fact their new status quo is a an improvment with him becoming the gruff mentor to her more optimistic student.
  • Affectionate Nickname:
    • Dr. Guthrie quickly dubs Leighton "Young Squire".
    • Rorish and Jesse are known around the ER as "Daddy" and "Mama", after their respective roles to the residents. Even Carla Niven and Mike Leighton, former residents who moved on to positions at other hospitals, call them these when they return.
    • Jesse dubbed Elliot "Sugar Bear" on his first day, and the name stuck.
      • In the Season 3 episode "Step Up," some teenage dance team girls start calling him "Hercules," and that name sticks as well.
  • Aloof Dark-Haired Girl: Leanne Rorish, unsurprisingly given her actress. Incredibly experienced (and something of a maverick) with a Sugar-and-Ice Personality, Leanne is widely admired in her profession but is to almost everyone cool, reserved, and utterly in control, with the mature beauty and long dark hair that are a hallmark of this trope.
  • All Just a Dream: "Unfinished Business" from Season 2 takes place almost entirely in Guthrie's head from a combination of the drugs given to him during brain surgery and and a near death experience while he's on the table.
  • Anachronic Order: "Diagnosis of Exclusion," which follows the hospital's investigation of the stabbing of Gina Perello and the attempted rape of Malaya Pineda and repeatedly flashes back to the actual event from the particular witness' point of view.
  • Armchair Military: Or Armchair Medicine in this case, both played straight and subverted. When in an argument with CEO Ed Harbert over the fact that whoever will succeed her as residency director needs Board approval, Leanne Rorish points out — accurately — that nobody on the Board knows a damn thing about training doctors or practicing emergency medicine. Harbert concedes the point, but then points out that actually, he knows what he's doing, because he's worked as an ER doctor and still has an M.D. after his name (with the clear implication that he will keep the Board from doing anything too stupid). Leanne has to concede his point after that.
  • Artistic License – Engineering: An episode with a major multi-vehicle pileup on a highway bridge has one patient trapped in his car by a cement truck that broke open and filled the car with concrete. One of the residents says the drying concrete is expanding and will crush him, but concrete actually contracts as it dries because the water content is evaporating (leaving less mass behind to fill the space).
  • Artistic License – Medicine:
    • C-Booth (the real life version of Center Stage) has been supplanted at real-life hospitals in favor of individual beds in semi-isolated trauma bays. In the documentary, younger staff at the real Los Angeles County Hospital occasionally say they wish for the rush and excitement of C-Booth, but older staff remind them that patients were highly exposed during very vulnerable moments of their lives and that the new system provides a certain level of dignity to patients and their loved ones.
    • Angus and Mario have a mock sword fight with pieces of rebar that they removed from a patient's thigh. There is no way that would ever happen in a real hospital as any foreign object removed from a patient is immediately put in a proper receptacle for proper disposal because of the danger of blood-borne diseases. But that wouldn't have been nearly as funny.
  • As Himself:
    • Alton Fitzgerald White from the cast of The Lion King ("The Son Also Rises")
    • Odell Beckham, Jr. ("Hail Mary")
  • Big Brother Instinct: Mike Leighton is very protective of his younger brother Angus, giving him multiple pep talks and defending him to their father. This proves to be critical when Angus, in an emotional crisis following the attacks on Gina Perello and Malaya Pineda, becomes addicted to Adderall.
  • Blackmail: When Campbell threatens to turn Heather in to the DEA for writing prescriptions under his name, she quickly convinces him not to by showing him the bedroom selfies she took of them on her smartphone and threatening to claim he sexually harassed her.
  • Book Ends: Jesse is giving another new class of residents the same speech again in his last scene in the Season 2 finale.
  • Break the Haughty:
    • In the first season, Rorish made a point of doing this to Savetti, who is brilliant but, to put it bluntly, a complete ass to his colleagues. She hammers home the lesson that medical professionals depend on the people around them just as much as on their own skill set, and that skill set doesn't matter if you can't work with the people around you.
    • In the third season, Guthrie does the same to Avila.
  • But I Can't Be Pregnant!: A young woman, the first of her family to got to college, presents with pregnancy symptoms. The mother reacts badly and accuses the doctor of being racist. Then when the tests confirm the diagnoses, the Mother is angry at the girl, who insists she is a virgin. It turns out that, as the episode's title says, "Sometimes it's a Zebra": The girl has a rare brain tumor that produces the same protein that pregnancy tests look for. After she learns this, she quips that she'd rather go back to being pregnant.
  • Call-Back: Jesse's orientation speech to the new residents in the opening scenes of the Season 2 premier, "Second Year," is an almost word-for-word repeat of the one he gave the new residents in the opening scenes of the pilot.
    Hello, residents. I'm Jesse Sallander, senior E.R. nurse. And for the next three years, I'm your mama. I can promise you nothing goes on in this house your mama don't know about....
  • Casting Gag: Penn Jillette plays a magician in his guest spot. He's even wearing his own stage clothes for most of the episode.
  • Character Development: A number of characters experienced major life developments over the course of the show.
    • Rorish decides to step down as Residency Director (ultimately handing the job to Angus Leighton's older brother Mike) and take a leave of absence in order to properly grieve her family and figure out who she is without them — but not before getting temporarily dragooned into serving as ER director in the interim between Gina Perello's death and Mark Taylor's return. Her development continues in Season two, culminating in her taking in an orphaned 13-year old as her foster child because she realizes she's been "living in a graveyard" and isolating herself ever since losing her family.
    • Neal, after clashing with Campbell, decides to switch specialties and takes a position as a surgical attending covering the ER.
    • Angus becomes increasingly confident as a doctor but suffers emotional trauma after intentionally letting Malaya's attacker bleed out, and then develops an Adderall addiction, and clashes with his father when asserting his authority as his brother Mike's medical proxy.
    • Mario slowly starts to come out of his shell and learns to work with other people.
    • Christa learns to trust her gut and not hesitate to act in critical situations, and also how to cope with treating ill children after losing her own son to cancer.
    • Over the course of Season 2, Campbell becomes less of a Jerkass and more willing to bend rules.
  • Chekhov's Gun: "Doctors With Borders" has one presented and fired fairly quickly. The very first scene is Neal explaining that while he and his mother have Indian heritage, she moved to London as a child and is so British that "God Save the Queen" is her ringtone. Later, when Neal realizes that there's been a possible disease outbreak at a convention his parents are attending, he calls his mom. And "God Save the Queen" starts playing from behind one of the curtains in the med bay.
  • Cliffhanger: The first season ends with Neal and Christa's relationship status uncertain, Angus just beginning to confront his Adderall addiction, and Leanne ready to leave Angels entirely when Taylor returns as ER Director with Mike Leighton as her successor as head of the residency program. Fortunately, the show was renewed for a second season.
  • Code Emergency:
    • "Code Black" is the term used to describe a situation where a hospital is officially at overcapacity and cannot adequately provide care to those that need it. Codes Green, Yellow, and Red are also announced at different points to indicate the situation getting better - or worse.
    • During a suspected contamination situation, Dr. Taylor jokes about being in "Code Brown":
      Taylor: From your mouth to the CDC's ears. Prepare for Code Brown, where the CDC crawls so far up my colon I'll be crapping federal bureaucrats for a week.
  • Color-Coded Characters: ER staff wear scrubs in various shades of blue while surgical staff wear green scrubs.
  • Contamination Situation:
    • In "Doctors With Borders", most of the neurosurgeons and their families attending a nearby medical conference at a local hotel — along with Neal's mother and father — come in with severe respiratory symptoms; per medical procedure, it has to be treated as a potential contagion. Ultimately subverted. Turns out the culprit is actually chlorine gas burns on the airways, which causes sloughing of the tracheal lining, and the patients are suffocating. Once Neal figures this out, the quarantine tent comes down and the rest of the ER gets to work saving them.
    • Happens in the Season 2 two-part finale when a very aggressive form of hemorrhagic fever begins infecting patients and hospital staff resulting in the entirety of Angels Memorial being placed under CDC control and guarded by armed soldiers.
  • CPR: Clean, Pretty, Reliable: Yeah, uh... not in this show. Nobody ever tries to shock a flatline. Last-ditch CPR tends to involve cutting open the rib cage (usually at Center Stage) and starting internal cardiac massage, and this only works rarely, as in real life. Most situations with successful CPR involve an abnormal heart rhythm that's restored with only a few shocks, as in real life; by the time the patients are in cardiac arrest, the doctors' resuscitation efforts usually fail.
  • Crapsack World: The real life reason why Angels Memorial (based on the real Los Angeles County Hospital) experiences Code Black so often: medical insurance, and therefore preventive care, is unaffordable to a large portion of the population so they put off seeking medical attention for as long as possible and swamp emergency rooms due to a law that says that all ERs must provide care no matter if the patient can pay or not. Patients are then funneled to public hospitals (like Angels) because private hospitals will only do the bare minimum to keep a person alive in order to maintain their profit margins.
  • Danger Deadpan: A constant feature in the ER.
    • Even as patients are dying in front of them, the ER's attending physicians remain calm and collected while quizzing the residents about what sort of procedures should be performed RFN, only raising their voices to be heard over all the commotion. This is a trait that they're trying to teach their residents.
    • Hudson's parents come into the ER because his mother is suffering from severe respiratory distress and his father is incredulous to see Hudson quizzing the residents as his own mother is dying before him — and apparently unaware of the fact that Neal is visibly holding back sheer panic. She lives.
    • Especially abundant in the Season 2 finale among the doctors who end up quarrantined in the "hot zone" after contracting viral hemorrhagic fever.
  • Dark and Troubled Past: true of just about all of the main characters.
    • Leanne lost her entire family to a drunk driver in a car accident; she was the only survivor.
    • In Season 1, Guthrie Sr. mentions that he needs to "get right with God," for reasons left unexplained. In Season 2, we learn that he was so haunted by the loss of his daughter as an infant that he was unable to realize that his wife was depressed and becoming suicidal.
    • At age 15 Guthrie, Jr. found his mother's body after she'd shot herself.
    • Christa's son died of cancer after a long battle, leading to the breakup of her marriage.
    • Mario confides in a patient that his parents once completely forgot about him and he had to spend a weekend with his teacher. When his parents finally showed up he didn't want to leave his teacher's house with its clean sheets and full refrigerator.
    • Angus' father continually put Angus down while openly favoring his brother Mike.
      • Diego Avila has similar problems with his father, Oscar.
    • Ethan had some rough experiences in Afghanistan.
    • Campbell's wife deserted the family because she couldn't cope with their daughter's handicap.
    • Elliot was in foster care as a child.
    • Noa Kean is unable to have children as a consequence of the eating disorder she developed as a teenager.
  • Dark Secret: Angus and his brother are keeping it to themselves that Angus deliberately allowed Malaya's attacker to bleed out.
  • Deadpan Snarker:
    • Most of the nurses snark at the residents and their naivete.
    • Leanne snarks at everything, particularly when she's getting emotional and doesn't want to be.
    • Jesse snarks at Leanne. A lot. Half his job is mothering the new residents, and the other half is keeping Leanne from taking herself too seriously.
    • Ethan can get pretty snarky at times. No wonder he becomes such close friends with Leanne.
  • Dictionary Opening: The show opens with a definition of its title. ("An influx of patients so great, there aren't enough resources to treat them all.") It then explains that while the average ER is in Code Black five times a year, the hospital where the show takes place experiences that three hundred times a year.
  • Doctor's Orders: Despite himself being an M.D. with a valid license, in the ER, CEO Ed Harbert will defer to Leanne Rorish in a crisis. Notably, when a Secret Service agent demands that his protectee be removed from Center Stage for safety reasons and Rorish refuses, the agent asks Harbert to overrule her and is turned down flat.
    Harbert: I'm not in charge here. If Dr. Rorish says they stay, they stay.
  • Dr. Jerk: Not all of the doctors in the ER believe that being polite is a necessary part of the job.
    • Dr. Rorish doesn't believe that her job requires her to be kind to her residents, or her colleagues for that matter, because working in emergency medicine requires important decisions be made quickly to save lives.
      Rorish: [to Hudson] You're the doctor they want. I'm the doctor they need.
    • Dr. Taylor, the Chief of Emergency Medicine, has a habit of making blunt/rude asides to interrupt arguments and conversations in the ER because the staff should be focusing on the patients and not their own interpersonal issues.
    • Guthrie, Jr., in contrast to his father, has a huge ego and bosses everyone around. He quickly learns to be polite to the ER nurses after Jesse makes it abundantly clear that anything else will not be tolerated.
    • Dr. Perello, though actually a very good-hearted person, is tough as nails due to coming up the ranks in a largely male-dominated profession, and comes down hard on people who don't follow proper protocol. Her time at Angels does get her to loosen up a little, but she also teaches Angels a couple of valuable lessons about the reasons why those rules exist.
    • Dr. Avila, a new resident introduced in season three who carries a camera around because he's wanting to make a documentary about his residency, is, in Guthrie Sr.'s words, "arrogant and entitled."
  • Early-Installment Weirdness: The pilot portrays working at Angels as a slow, exhausting apocalypse in slow motion with a "ticking clock" motif in the form of the ER's status slowly ticking up from normal operating conditions to Code Black, where there aren't sufficient resources left to treat every patient. The rest of the series has much more of a Case of the Week format.
  • Fake Boobs: Lampshaded and Played for Laughs during a Vitriolic Best Buds bickering session between Jesse and Rorish. The full exchange is too long to quote here, but it ends with Rorish "reassuring" Jesse that her (rather impressive) bust is, in fact, all hers.
  • Fictional Counterpart: For all intents and purposes Angels Memorial is Los Angeles County Hospital, right down to using the iconic edifice for landmark exterior shots. L.A. County really did open in 1930, its trauma room really was the birthplace of modern emergency medicine, C-Booth (called Center Stage in the show) was very real, and it really is the busiest emergency room in the nation. This is, of course, because the show was inspired by a documentary of the same name — a documentary filmed at L.A. County Hospital.
  • Formula-Breaking Episode:
    • "Unfinished Business": what seems like a typical episode is revealed to be All Just a Dream under the effects of anesthesia during brain surgery.
    • "Better Angels" is, in part, a Musical Episode. (Don't worry, It Makes Sense in Context.)
    • The final two episodes of the series have a "formula breaking" plot arc—Ethan Willis arguing with a hallucination of his deceased brother Robert—in what are otherwise normal episodes.
  • Ghost Story: The episode "Corporeal Form" is one, complete with a Maybe Magic, Maybe Mundane ending.
  • Grave-Marking Scene: Angels CEO Ed Harbert visits Gina Perello's gravesite shortly after she is killed, with a bouquet of daisies to lay there. Leanne Rorish happens to run into him at the site, and is surprised to learn that Harbert and Gina were romantically involved; though stoic as usual, he is visibly grief-stricken at losing her. Leanne, having been through a similar situation, offers him utterly genuine condolences.
    Harbert: Gina loved daisies. She said they were uncomplicated, but wild.
  • Grey-and-Grey Morality: There are no traditional heroes or villains amongst the characters, and good or bad doesn't come into play as much in this show's universe. Then again, this is a series with No Antagonist.
  • Grief-Induced Split: Christa Lorenson became a doctor out of a sincere desire to help others in the wake of her young son's death from cancer. The stress of his illness destroyed her marriage.
  • Hair of Gold, Heart of Gold: Christa Lorenson, the only true blonde among the main cast, is also the most openly emotional and tenderhearted. Just to finish things off, she even has the Innocent Blue Eyes.
  • Headbutt of Love:
    • Neal does this to help settle a very upset Christa, touching his forehead to hers and putting his hands at her waist, right before kissing her for the first time and initiating their relationship upgrade. It also serves the same purpose as a Cooldown Hug, though he doesn't actually hug her — and the scene is, surprisingly enough, even more intimate because he doesn't.
    • Leanne does this with her eventual foster daughter Ariel, following a sincere promise to never lie to her and followed by a gentle kiss to her forehead. As with the above, it also serves the purpose of a Cooldown Hug in soothing a very frightened Ariel, though in this case the overtones are obviously maternal instead of romantic.
  • Heroic BSoD:
    • Malaya has one on her first day back after the attack.
    • Leanne, after her unsuccessful attempt to save Charlotte.
    • "Unfinished Business" has several, most prominently Elliot when he's unable to revive an infant who's stopped breathing and Rollie finding himself unable to comfort a child whose mother keeps attempting suicide.
  • Hidden Heart of Gold: Dr Rorish's seemingly cold demeanor is implied (and later outright stated) to be a reaction to previous trauma, as other characters have noted that she was much warmer before the accident. She does care; she just doesn't want to, and thinks it gets in the way of her doing her job.
  • Hospital Hottie: As with so many other cliches, this trope encounters this show — and loses. While the attractiveness of certain characters is occasionally commented on — Christa, for instance, is hit on at least twice — the doctors and nurses wear exactly what you'd expect doctors and nurses to wear in the country's busiest ER. Simple ponytails, basic scrubs, and subdued makeup are the order of the day, and characters frequently wind up covered in blood (and other things). And finally, when a patient takes an (unrequited) interest in Malaya Pineda, it ends with Malaya in critical condition and Gina Perello stabbed to death in the hospital locker room, which sparks a Board inquiry and traumatizes the entire cast. Gina actively warns Malaya that the appearance of impropriety can sometimes be as damaging as actual impropriety, and the whole thing culminates on a lesson against victim-blaming the subjects of sexual assault and a warning about how careful women (and men, but particularly women) need to be in these sorts of professions.
  • Immodest Orgasm: Angus and Mario try to deal with a schoolteacher suffering from an intense and prolonged orgasm. They give up because everything they do sets her off and neither wants to deal with an ethics inquiry. Jesse eventually takes matters into his own hands. He stuffs pepper up the teacher's nose and causes her to sneeze, allowing her to release the tension she's been holding in in one explosive burst.
  • Jerkass: Dr. Campbell, the chief of surgery, in spades.
  • Jump Scare: Mario gets one when the patient he thought was only suffering from severe heat stroke suddenly stands up behind him, bleeding out of everywhere. There's even a Scare Chord before it cuts to commercial.
  • The Lancer:
    • Neal Hudson is this to Leanne Rorish. Whatever her plan du jour is, he usually has some sort of objection to it. Leanne's approach is very much "Rules, what rules?" while Neal at least tries to be more respectful of protocol. Interestingly, he isn't the Blue Oni to her Red — they're both passionate, dedicated, "patients first" doctors with little patience for bureaucracy and administration. The true Blue Oni to Leanne's Red is Angels CEO Ed Harbert, who doesn't serve a Lancer role because he doesn't work in the ER.
    • Similarly, Rox Valenzuela does her best to temper Ethan's cowboy tendencies but usually winds up helping him with whatever crazy stunt he's planning anyway.
  • Leaning on the Fourth Wall: Diego Avila's Show Within a Show documentary is called Code Black and begins with the same opening screen as the show we're watching.
  • Like Brother and Sister: Ethan Willis clicks with Leanne Rorish right from his very first appearance, and as they continue working together they develop a very close, mutually supportive but often teasing friendship. Ethan is one of the few people to whom Leanne will actually cede command of a critical care situation, while Ethan often looks to Leanne for support during his many crazy schemes.
  • Lipstick Lesbian: Pineda is a lesbian, and the only member of the cast who appears to have a personal life outside of work.
  • Love Dodecahedron: By the middle of Season 1, Angus has a crush on Heather the surgical resident, who is simultaneously hooking up with Angus' best friend Sevetti and sleeping with her boss Dr. Campbell. Meanwhile, Neal and Christa's relationship is disrupted by the presence of Neal's old flame Grace — and if that wasn't bad (or complex) enough, his professional nemesis Campbell is hitting on Grace right in front of him, among other cheap shots. This basically vanishes in season 2, however.
  • Mama Bear/Team Mom: Gender-flipped. Jesse Sallander labels himself the ER residents' mama and that he'll look out for them and that they should never even think of lying to him because they'll be caught.
  • MacGyvering: The cast will sometimes jury-rig a temporary fix from whatever's available if the material they have is inadequate (which, in the middle of a Code Black, is frequently). Such as making a tourniquet for a severed femoral artery by using the piece of rebar that severed it to twist a blood pressure wire taut.
  • Married to the Job: All the doctors and nurses at Angels to some degree, simply by virtue of the demands of their profession. However, Leanne Rorish takes it to extremes; in episode 1x10, it's stated that she hasn't taken a day off in a month, and that she hasn't taken vacation in three years. Those numbers are not a coincidence; it's pretty much outright stated that she had as normal a family life as possible (for an ER doctor at a hospital like Angels, anyway) before her husband and two kids were killed in a car accident. Later she admits to Neal that she let her work fill the void where her family used to be, and that she actually doesn't know who she is without them.
  • Meatgrinder Surgery: The ER doctors are simply there to ensure that their patients don't die. This often means using hasty and crude procedures without much care for finesse as patients lose copious amounts of blood.
    • Lampshaded by Campbell when he derides Neal's surgical technique as "blue collar."
    • Rorish performs a clamshell thoracotomy on an accident victim. This is a last-chance procedure where doctors open up the patient's chest laterally (practically cutting the body into two parts) to get access to all the internal organs at once.
    • In one notable instance, Rorish and Savetti improvised a tourniquet for a severed femoral artery with a blood pressure wire and a piece of rebar that had just come out of their patient.
    • Dr. Guthrie, Jr. occasionally finds himself having to perform hasty surgeries at Center Stage because either the patient is about to die or there are no operating rooms available. Sometimes both.
    • Colonel Ethan Willis, introduced in Season 2, loves performing medicine this way, often bragging about how he performed one procedure or another while under fire or in the back of a moving Humvee.
    • Campbell finds himself performing surgery with Ethan Willis on a Russian naval submarine.
    • During a blackout, Heather and Elliot are stuck in an elevator with a woman in labor. With the baby stuck in the birth canal and without any working equipment, Heather hastily performs a symphisiotomy (cutting the woman's pelvic cartilage to widen the birth canal), a procedure she describes as "a medieval procedure that nobody does anymore".
    • During the same blackout, Mario and Noa first try to perform a thoracotomy on a sidewalk before hastily moving the patient into an ambulance and performing the procedure in the middle of a traffic jam.
  • Nepotism: Angus Leighton asked his father, a member of the Angels Memorial board, to pull some strings to get him an emergency room residency. He initially finds himself overwhelmed and regretting his decision, but time and experience have increased his confidence.
  • No Antagonist: There is no villain or Big Bad, the only conflict comes from medical procedures going wrong or bureaucracy.
  • Noodle Incident: Dr. Guthrie once accidentally amputated the wrong testicle from a patient. He tells Leighton this in an attempt to make him feel better about his own screwup.
  • "Not So Different" Remark: Mario is resentful at having to treat a gay HIV-positive patient, believing that the man's condition is due to irresponsibility. The patient takes it all in stride and actually gets through to Mario by saying that they aren't very different and that he sees the same burning resentment in Mario's eyes that he felt in the 80s.
  • Oh, Crap!: Leighton and Savetti, panicking, open up a man's chest believing that he's gone into cardiac arrest only to discover a healthily beating heart. They can only stare and wonder just how much trouble they're in.
  • One Head Taller: CEO Ed Harbert is played by the 6'2" Jeff Hephner, while Leanne Rorish is played by the 5'4" Marcia Gay Harden. Given their slowly blossoming UST, this might not be a coincidence.
  • Outliving One's Offspring: This bonds Christa and Leanne together; Christa lost her son to cancer (which inspired her to go to medical school) and Leanne's children were killed in the same accident that took her husband.
  • O.O.C. Is Serious Business: We know things are looking bad for Leanne in "Fallen Angels" when Jesse is unable to respond in kind to Leanne's Danger Deadpan.
  • Papa Wolf: Leanne Rorish is "Daddy" to Jesse's "Mama", and will protect her residents with everything she's got. For example, when Malaya takes to task a mother who has been feeding her daughter prescription thyroid medication to make her lose weight:
    Mother: Are you going to let her talk to me like that??
    Rorish: [without hesitation] You bet your ass I am.
  • Platonic Life-Partners:
    • Leanne Rorish and Jesse Sallander are by far the closest relationship either of them has, proving to be not just close colleagues but best friends and confidantes. Neal Hudson actually has to point out to Leanne that Jesse isn't the only person she can rely on.
    • Malaya Pineda and Angus Leighton are repeatedly shown to be incredibly close, to the point where their relationship is almost sibling-esque, and are also the closest relationship either of them is shown to have.
  • Poor Communication Kills: Inverted in "Hell's Heart". Ariel is walking with a patient when he collapses from a heart attack and she revives him with CPR. Unfortunately, he has a DNR and the hospital is now in legal trouble. She knew about the DNR, but didn't know what it meant and Dr. Savetti brushes her off when she asks about it.
  • Product Placement: Justified, Enforced, and Played With. As part of a federal initiative to reduce trauma deaths from blood loss, Angels Memorial as well as other real-life hospitals are encouraged to have bleeding control kits. In 2016, the cast recorded a PSA about the initiative, the kits and how to use the materials in them. Played with in that the kits are real, but while brand logos may be shown, they are not mentioned. Further, the brands themselves are not being promoted, just the concept.
  • Put on a Bus: Neal and Christa departed Angels Memorial in the gap between Seasons 1 and 2 with no mention of them having left or where they wentnote .
  • Rape Is a Special Kind of Evil/You Monster!:
    • "Sometimes It's A Zebra": After learning that a burn victim, far from being another patient's father, is really a delusional psycho who kidnapped her, has been keeping her as his Sex Slave, and fathered patient number three on her, Dr. Hudson tells him that while he's never intentionally harmed another human being in his life, he's now giving it serious thought.
    Dr. Hudson: [seething and glaring] You know, I've never hurt another human being before.
    • Angus lets Malaya's rapist bleed out.
    • The rapist in "Hero Complex", who posed as the victim's rescuer and tried to shift the blame to the real rescuer, gets a full dose of this from his girlfriend.
    Vanessa: [after learning her boyfriend is the real rapist] You're the animal.
    • In the final episode of the series, after Oscar Avila tries to date rape Noa, his son Diego sides with her against his father.
  • Reasonable Authority Figure:
    • Gina Perello gives a strong first impression of being an Obstructive Bureaucrat, but in tight situations she does what's best for the patient and her staff instead of getting caught up in protocol.
    • Ed Harbert, Angels' CEO, turns out to be one; he is not only very good at his job but a bona fide M.D.note , and he cares about Angels just as much as Leanne does. He does his best for the hospital while balancing the tensions of a minuscule budget, overcrowded and under-staffed ER, and demands from the Board and the donors who provide so much of Angels' funding.
    Ed Harbert: My job is, first and foremost, to protect this hospital.
  • Red Oni, Blue Oni: The fiery, passionate Leanne Rorish is the Red to analytical, reserved Ed Harbert's Blue. Part of their respective character arcs is learning to see the other person's point of view, and who wins in any given argument depends on who has the better point.
  • Relationship Reveal: "Diagnosis of Exclusion" reveals that Ed Harbert and Gina Perello were romantically involved prior to her death. Leanne runs into a devastated Harbert at Gina's grave; he's carrying daisies, because they were Gina's favorite flowers.
  • Relationship Upgrade:
    • Neal and Christa get theirs in "First Date", when Neal kisses her while trying to calm her down from losing a patient. Interestingly, it's not a Big Damn Kiss, because the circumstances surrounding said upgrade are so sad and so his kisses are tender, sweet, and not at all dramatic.
    • Ethan finally confesses his feelings to Rox in "The Business of Saving Lives" when she asks point-blank what the hell he actually wants from her. They immediately thereafter seal the deal with an incredibly sweet Official Kiss.
  • The Reliable One: Nurse Risa Park (Angela Relucio), who rarely speaks but is always there with whatever the doctors need, sometimes even before they ask for it. Other nurses can also serve this role, but Risa is the most prominent, and the most liable to be called by name.
  • Ripped from the Headlines: The main plot of the first season finale concerns an explosion at a debate between presidential candidates — and just so happened to air in the heart of the 2016 primary election season.
  • Roadside Surgery: This is basically Leanne's specialty. When Ethan Willis comes along, she meets up with someone even better at it than she is — and proceeds to soak knowledge in the subject up from him like a veritable sponge.
  • Rule of Funny: Savetti and Leighton having a mock sword-fight at the end of "Doctors with Borders" using two pieces of rebar that were removed from one of their patients. This would never be allowed in real life due to potential blood-borne pathogens (the rebar would have been disposed of as a biohazard), but it's a pretty funny scene nonetheless.
  • Screw the Rules, I'm Doing What's Right!:
    • Rorish and Hudson live by this trope, though Hudson usually tries to work within the rules first.
    Leanne: Center Stage is where rules go to die.
    • Ethan is practically made of this trope.
  • Sergeant Rock: Jesse, as the senior admitting nurse, occupies this position in the ER, heavily depended upon by the attending physicians while mentoring the residents on the nuances of working at Angels Memorial.
  • Ship Tease: "Sometimes It's a Zebra" (1x04) starts overtly hinting at a possible romance between Christa and Dr. Neal Hudson, with her first confiding in him about her son's death and later him suggesting they go get breakfast (she asks for a raincheck). Subsequent episodes include many Held Gazes (sometimes across the entire breadth of the ER) and Hudson obviously showing a bit more concern for her safety (both physical and emotional) than for that of his other residents, though never to the point where it's unprofessional. It also goes the other way; in "Doctors With Borders", Christa voluntarily goes inside the quarantine area (where Neal is essentially trapped) with the clear implication that he is the reason she volunteered so quickly.
  • Shown Their Work:
    • The showrunners work hard at making sure that the show accurately depicts medical conditions and medical procedures. See the CPR: Clean, Pretty, Reliable entry above. Doctor Mike, a YouTuber who is also a practicing doctor, praised it as one of the most accurate medical dramas he'd ever seen, saying that "It really felt as if a doctor wrote the script and then it was fluffed up instead of the other way around."
    • The episode title "Sometimes It's a Zebra" is derived from an old saying impressed on new doctors: "When you hear hoofbeats, think horses, not zebras."note 
    • The foam that Ethan injects into a shark bite victim to stabilize him for transport in "Second Year" is a real thing.
  • Show Within a Show: Before going to medical school, Charlotte had a starring role in the Artemis film series.
  • Sibling Rivalry: Subverted. At first it looks like this trope is in play between Mike and Angus Leighton, as Angus feels like he's perpetually in his older, amazingly successful, brilliant brother's shadow. But when Mike actually appears on the show, it turns out that he is actually incredibly supportive of Angus, defending him to their father and showing that he has complete faith in his brother's ability to be a great doctor.
  • Slipping a Mickey: In "The Business of Saving Lives," hospital Board member Oscar Avila does this to Noa.
  • Smooch of Victory: After successfully executing a risky procedure to keep Jesse from dying of complications from a heart attack, Leanne is so overjoyed that she actually gives him a smooch right on the mouth. It's entirely unromantic — they're Platonic Life-Partners.
  • The Stoic: Ed Harbert, CEO of Angels Memorial, faces down everything that comes his way with a raised eyebrow and unruffled, cool competence — even when that thing is Leanne Rorish on a mission. This makes his obvious grief at Gina's grave even starker in contrast.
  • Surgeons Can Do Autopsies If They Want: Both played straight and averted.
    • While patients are usually handed off to the required specialists as needed, several times a Code Black situation (or just a plain medical emergency) has had Rorish deciding a patient needs a particular procedure Right The Hell Now, only to be told that there aren't any specialists available — at which point Rorish, while not always doing the specialized procedure required, will cowboy it up and improvise something that will keep the patient alive until a specialist is available. Justified in that in all of these cases, if Rorish doesn't do something, the patient will definitely die, whereas if she does, there's at least a chance they'll survive.
    • Hudson trained to be a surgeon before switching to emergency medicine. He ends up performing endoscopic surgery on a patient because no other surgeons are available, but it's explicitly stated to be against hospital rules and Taylor is clearly more than a little angry at how Hudson went behind his back.
  • Survivor Guilt:
    • Leanne is revealed to be suffering from a whopping great dose of this after surviving the accident that killed her husband and two children.
    • A patient responsible for his younger brother's death due to driving drunk also goes through this.
    • Ethan is dealing with losing his brother in Afghanistan... or not dealing with it, in this case.
  • Suspiciously Similar Substitute: Notably averted. All Neal Hudson and Ethan Willis have in common is surgical trainingnote , a Like Brother and Sister relationship with Leanne Rorish, and a strong dislike of Dr. Campbell. Otherwise, they have very different styles as physicians and are quite distinct from each other personality-wise. Even their relationships with Leanne differ; Neal was The Lancer to her and tried to temper her maverick tendencies, while Ethan is even more of a cowboy than she is.
  • Take That!: The writers get in a dig at American foreign policy during one of the many arguments between Ed Harbert and Leanne Rorish.
    Harbert: It's not forever.
    Leanne: [snippily] That's what they said about Afghanistan.
  • Teacher's Pet: Pineda is eager to prove that she knows her stuff (and she does, to her credit), but Jesse is quick to remind her that she's still just a resident and that she has to do a lot of drudge work before getting to work on more complicated cases.
  • Tender Tears: Christa Lorenson cries a lot, including while in the middle of performing CPR. This fits with her openly emotional, Hair of Gold, Heart of Gold characterization.
  • There Are No Therapists: Pointedly averted, repeatedly and with prejudice.
    • Angus Leighton's background in psychology is called upon at least once as a major plot point.
    • Christa Lorenson "spent enough time in group therapy" after losing her son to cancer to be able to see similar loss in other people i.e. Leanne.
    • At the end of "The Fifth Stage", we see Leanne at a therapy appointment, because she's trying to put her life back together at last.
    • Season 2 introduces recurring character Dr. Amanda Nolan, a psychiatrist on staff at Angels — and lo and behold, she is actually seen doing psychiatry in almost every appearancenote .
  • Title Drop: The very last words in the first season finale, spoken by Mama.
  • Unresolved Sexual Tension:
    • Seems to be brewing between Leanne Rorish and Dr. Ed Harbert, the CEO of Angels Memorial, after he dragoons Leanne into serving as ER Director between Gina's death and Taylor's return. The lingering gazes, warm smiles, constant bickering and tension between administration and the practicalities of medicine, and the way Leanne tucks her hand into Harbert's elbow while walking him around the ER are all shippers' fuel galore.
    • There's a certain frisson between Ethan Willis and psychiatrist Amanda Nolan; he opens up to her more than anyone except possibly Leanne, and his scenes with Leanne distinctly lack the romantic tension seen in his scenes with Amanda.
    • In season three, Ethan's Will They or Won't They? relationship with his paramedic partner, Rox Valenzuela, is so intense it's practically a wildfire. They're clearly crazy about each other but both have varying levels of Commitment Issues (and other issues) that keep getting in their way. They eventually get together.
  • Vitriolic Best Buds:
    • Rorish and Jesse good-naturedly trade insults to keep the other motivated during busy shifts.
      Jesse: I love you so much I wanna break you in half.
      Rorish: I love you so much I wanna punch your face in.
    • Leanne and Ethan's primary form of communication is snarkery, but they become thick as thieves practically from the word 'go', and he is clearly one of the closest friends she has.
  • Wham Line: "Rollie, open your eyes."