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Long-running Medical Drama that redefined the genre. It was the first to show graphically realistic emergency procedures and reproduce the disorganised clutter of a real metropolitan hospital. Its creator, Michael Crichton, based many of Season 1's stories on real patients he'd had during his time as a doctor, though he handed the reins to John Wells starting in Season 2 and had little involvement with the show from then on.

Set in Cook County General Hospital, the show followed an ever-changing, ethnically diverse cast of doctors, nurses, administrators and medical students as they deal with the day-to-day angst of saving lives. Their personal lives took a back seat to taut scenes of trying to help patients with their various physical and emotional emergencies. The main character arc was that of John Carter (Noah Wyle), who evolved throughout the course of the show from an uncertain medical student to the wise and infinitely capable chief resident.

Due to its long run (15 seasons) it had Loads and Loads of Characters. The original cast consisted of Anthony Edwards, George Clooney, Sherry Stringfield, Noah Wyle, Julianna Margulies, and Eriq La Salle, with Gloria Reuben and Laura Innes joining them as regulars in Seasons 2 and 3, respectively.

Not to be confused with the 1984 sitcom E/R, which also took place in a Chicago hospital and also featured George Clooney.


This show provides examples of:

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    A-F 
  • Absentee Actor: Episodes that focused solely on one character usually meant that others were completely absent. Often, characters were randomly omitted with zero explanation—Susan isn't in "Hell and High Water", Kerry isn't in "Fear of Flying", etc.
  • Abusive Parents: Many of the doctors working in the ER have screwed up parents. Some of the patients also turn out to be victims of parental abuse.
  • Actor Allusion:
  • Adult Fear: Many scenarios feature patients facing job loss due to illness, injury, or simply having to take time off work to come to the ER in the first place. Elderly husbands or wives watch their spouses of many years succumb to stroke, heart attack, or any of the many other ravages of old age. Parents agonize as their sick or injured children are treated; some parents have kids with chronic or terminal illnesses that can never be cured. The main cast themselves experience all of these and more; specific examples include, but are certainly not limited to:
    • Mark receiving word that his wife and daughter have been involved in a car accident. This leads to yet another Adult Fear—this is how he discovers that Jen's been having an affair and intends to leave him for the other man.
    • Mark later suffering from a brain tumour twice, the consequences of which lead to Elizabeth losing her husband.
    • Susan losing her niece, whom she'd been raising as her own, in a custody battle—the episode in which this is finalized features several flashbacks which are (perhaps deliberately) framed in such a way that it looks as though the baby is lost and crying for Susan while Susan, also in tears, demolishes her apartment trying to locate her.
    • Jeanie contracting HIV from her husband.
    • The premature birth of Benton's son, who remains in fragile condition for several weeks.
    • The stabbings of Carter and Lucy, and Lucy's death.
    • Mark being violently assaulted and nearly killed in a random attack in the hospital men's room, with no motive ever given and his assailant never identified or brought to justice.
    • Kerry watching her mentor Dr. Lawrence start to decay in the first stages of Alzheimer's, and both of them coming to realize that Lawrence will eventually succumb to full dementia.
    • Mark getting word that his daughter overdosed on ecstasy...then walking into the trauma room to find that it was his infant daughter Ella, not his eldest Rachel.
    • Kerry facing the possibility of ostracization and loss of her position at County when she is outed as a lesbian, and later fighting with her deceased partner's homophobic parents to retain custody of their son.
  • African Terrorists: The doctors of County General have faced both the Mai Mai in the Congo and the Janjaweed in Sudan while treating their victims.
  • all lowercase letters: The opening credits.
  • Ambiguously Jewish: Mark. He claims that one of his parents was an agnostic Jew, although which one is not made clear (probably his mother), and he knows a bit of Yiddish and some Jewish prayer. However, Mark seems to have no expressed faith.
  • And Starring:
    • Eriq La Salle, for Seasons 1-8.
    • Paul McCrane, for Seasons 9-10.
    • Laura Innes, for Seasons 10-13.
    • Angela Bassett, for the final season.
  • And the Adventure Continues: The series finale. Crosses over with Book-Ends, as a Greene enters and leaves the hospital with Carter.
  • Angry Black Man: Benton has shown shades of this. He's initially reluctant to go out with Elizabeth because she's white; the relationship later ended because Eriq La Salle had a problem with it being shown as "less problematic" than his relationships with black characters. Later he's reluctant to continue a relationship with Cleo because, as a bi-racial woman, she doesn't understand the "needs" of the African-American community, which rings fairly hypocritical considering that Jeanie (or at least, Gloria Reuben) was also half-white and Benton never considered it an issue, hiring her especially to take care of his mother. It's a wonder he was ever happy.
  • Annoying Patient: Dozens, throughout the show's 15-year run. Some to the point of Asshole Victim—when the serial rapist who's been terrorizing the city is brought in, the unhurried atmosphere in the trauma room is in stark contrast to what we've seen hundreds of times.
  • Anyone Can Die: Used in conjunction with Killed Off for Real and Tonight, Someone Dies. Memorable examples include:
    • Lucy Knight being stabbed to death in Season 6.
    • Mark Greene succumbing to brain cancer at the end of Season 8.
    • Robert Romano being crushed by a helicopter in Season 10.
    • Michael Gallant being blown up by a roadside bomb in Iraq in the penultimate episode of Season 12 (something that was spoiled by a teaser beforehand).
    • Greg Pratt suffering from wounds due to an explosion in the final season premiere.
    • Several other recurring characters were killed off as well (some of them after being involved with the show for many seasons), including Raul Melendez, Dennis Gant, Carla Reese, and Sandy Lopez.
    • And that's not even mentioning the various actors who guested more than once as the parents/grandparents of various characters — did any of them (other than Elizabeth's and Abby's mothers) survive the 15-year run?
  • Arc Words: "You set the tone."
  • Artistic License:
    • A lot of scenes have the ER staff doing things that in Real Life would be done by the nurses or other physicians in other sections of the hospital.
    • In "Love's Labor Lost", there's is no way OB/GYN wouldn't have taken over the case, especially since it was a high-risk case. Not only is Mark's treatment of the woman woefully incompetent, it went on for hours, enough time to call in an OB-GYN from another hospital or practice or even another city if necessary.
    • Midway through Season 5, a woman named Amanda Lee is hired as the new ER chief. It's eventually discovered that she's a nutcase who never even went to medical school. It's highly unlikely this wouldn't have been discovered beforehand—she would have needed to submit numerous credentials, all of which would have to be verified (it's offhandedly explained at one point that she passed the credentials of an actual doctor with a similar name off as her own, but there's no elaboration on how nobody saw through this). Afterwards, there's never any mention of the incident again, even though the hospital would likely be facing massive lawsuits should anyone discover they were treated by a fake physician.
    • A business example—when Romano was under consideration for the chief of staff position in Season 6, a meeting of department heads is set up to discuss it, with Romano present. Mark and Kerry agree beforehand that they need to try to prevent Romano's promotion (because they both hate him). At the meeting, none of the department heads raise an objection to Romano getting promoted until Mark speaks up and says that Romano rubs a lot of people the wrong way. Kerry, who had not spoken before then, is asked if she agrees, and she says no, that she's fine with Romano getting the job. Mark is understandably furious that she threw him under the bus, but she tells him later that she could tell from the mood of the room that Romano was going to get the job and if they both spoke against him it would just poison him against the entire ER. But in reality, it never would have happened like that; there's no way Romano would have been present during a meeting discussing his promotion, so that people would be able to speak freely without fear of retribution. As well, such a decision would never have been made so rapidly. Quite glaring when you recall that only a season earlier, the search for an ER chief took over a year but was ultimately unsuccessful. Yet within one day, Romano is made Chief of Staff, appoints Kerry ER Chief at the same time, and a few years later, the two switch positions within roughly the same time frame.
    • When Abby reports to Mark that she witnessed Carter injecting himself with pain medication, Mark calls Carter into the lounge with himself, Kerry...and Abby. There's no way that the person making such a complaint would be present when the person in question is being confronted—it puts them at great personal/professional risk. If Carter had been so inclined, he could have given her a poor evaluation as payback.
    • In Season 7, Kerry has Abby assigned to the ER, apparently without asking Abby's supervisor or even Abby herself. Aside from the fact that Kerry would have no authority to do this—as stated, such moves would be handled by the nursing supervisor—as an OB nurse, Abby would likely be out of her element in the ER. In fact, this had been a plot point earlier in the series, as management intentionally assigned senior nurses approaching retirement to departments they were unfamiliar with, in the hopes that they'd screw up and get disciplined, so that they could be fired before maxing out their pensions.
  • Ascended Extra:
    • Carol Hathaway, Jeanie Boulet, Kerry Weaver, Anna Del Amico, Robert Romano, Dave Malucci, Jing-Mei Chen, Abby Lockhart, Michael Gallant, Greg Pratt, Archie Morris, Tony Gates, and Simon Brenner were all credited as guest stars in their respective first appearances before being promoted to the main cast. Carol in particular was actually supposed to succeed in her suicide attempt in the Pilot, but Michael Crichton and John Wells were impressed with Julianna Margulies (as were test audiences, who were also intrigued at the hints of her past with Doug) and kept her on, making her a Breakout Character. Unfortunately, this makes her suicide attempt something of an Out-of-Character Moment.
    • This evolved into pretty much being the producers' official means of auditioning new cast members in the last several years: Bring a bunch of new people on as recurring characters each season and promote the best ones to the main cast later on.
    • Played With for Nurse Chuny (Laura Cerón). She never actually "ascended" to the main cast, but she appeared in more episodes than any other main or recurring cast member after Noah Wyle and Laura Innes.
    • Averted with Maggie Doyle. Doyle got a lot of air-time, consistent with the guest stars that become main cast members, and she was an ER resident. But before she could ascend Jorja Fox was offered more substantial roles in other shows, beginning with The West Wing and culminating in CSI, so instead Doyle just disappeared. Tellingly, Doyle's the only character on the wall of locker tags seen in the final season not to have been a main cast member.
  • Author Tract:
    • Any of the "Doctors Without Borders" episodes. Not even the cast liked those episodes very much, and in interviews have said they would have preferred it had the show just stuck to Chicago.
    • Prior to this the show, like many American medical series, expressed its views on the hopelessly corrupt American medical system as well as several hot button topics, like HIV/AIDS. Unlike the MSF episodes, however, these were rarely so heavy handed.
  • Back for the Finale: For the final season, every living main cast member from Season 1 popped up once or twice. Most appear in the series finale itself:
    • John Carter takes on a primary role again in the last few episodes of the show, returning to Chicago and potentially joining back up with County for good. This comes after getting a life-saving kidney transplant and opening up a medical clinic for the underprivileged.
    • Mark Greene and Robert Romano were seen on a video Mark made to try and teach new doctors about ER situations, and additionally appeared in the episode "Heal Thyself" as part of a flashback had by Catherine Banfield.
    • Doug Ross and Carol Hathaway return in "Old Times" (their first appearance since Season 6) and inadvertently save Carter's life by getting the right kidney needed for his transplant (they were not made aware the name of the patient it was going to).
    • Peter Benton, Kerry Weaver, Susan Lewis, Elizabeth Corday, Kem Likasu, and Reese Benton all return in the series finale to support Carter when he opens up the medical clinic (with it being named after his and Kem's son Joshua). Additionally, that season, Benton had appeared in "Old Times" to help oversee Carter's surgery, Elizabeth had returned in "Dream Runner" to interview Neela for a position at Duke University, and Kerry had shown up in the flashback from "Heal Thyself".
    • Having officially left the cast at the end of Season 14, Luka Kovač returns one last time in "The Book of Abby" to pick up Abby so that they can leave for Boston.
    • Ray Barnett comes back in a recurring role, finally uniting with Neela romantically after she decides to leave County and work with him at a Medical Center in Baton Rouge.
    • Jerry Markovic returns in the final season to fill in at his old job after having been away in Alaska for a few years (reflecting Abraham Benrubi's decision to leave ER for the ABC series Men in Trees and then return after it had been cancelled).
    • David Morgenstern returned in "A Long, Strange Trip" (his first appearance since Season 4), providing information about the work that his mentor, Dr. Kosten, had done to help the hospital.
    • Nurse Lydia Wright had been absent since the start of Season 10, but returned in the series finale to wake up Morris so that he could assist with an emergency, serving as a Call-Back to the way she woke Mark Greene up in the Pilot.
    • Rachel Greene appears in the series finale, having grown into a prospective medical student. The ending implies that Carter will serve as a mentor for her just as her father did for him at the start of the series.
  • Back to Front:
    • There was a backwards-running episode which "began" with a defenestration from a hospital window. Subsequent scenes showing earlier and earlier events revealed the reason for the suicidal character's desperation.
    • Another one "starts" with two staff members being brought into the hospital following a car accident. The flashbacks reveal that this was the culmination of a horrible day for one of them and that the reason he was driving recklessly was because of his mishandling of a patient's care.
  • Bait-and-Switch: In one episode, Kerry treats a little girl present when her father was shot. When Kerry questions her, the girl admits that she shot her father. When Kerry gently asks why, and if he was abusing her, the girl matter-of-factly answers "He wouldn't let me watch TV." For a moment, it appears that she's an Enfant Terrible, until she elaborates and says that he threatened to shoot her if she turned on the TV while he was sleeping, "so I shot him first", thus revealing that he was an abusive parent after all.
  • Bait-and-Switch Tyrant: Kerry Weaver and Donald Anspaugh. In the final two seasons, we get Kevin Moretti and Catherine Banfield.
  • Benevolent Boss: Dr. Morgenstern.
  • Better as Friends: Elizabeth suggests being Friends with Benefits to Benton, citing their mutual attraction and interests, as well as busy schedules that don't leave them much time for dating people outside of work, then suggests being this trope when she realizes that he'll never get over his discomfort about dating a white woman.
  • Between My Legs: This shot is used when Abby is taking pictures of Neela.
  • Big Good: Donald Anspaugh.
  • Bilingual Bonus:
    • In one episode, Luka recited part of Hamlet's "To be or not to be" soliloquy, and lapsed into Croatian after a few lines. Crosses over to Actor Allusion also, as Goran Visnjic's biggest role up to that point had been a Croatian production of the play.
    • In one Season 3 episode, after their brief affair, Chuny, speaking Spanish, more-or-less confirmed to another nurse that what they say about bald men is true and that all Mark ever seemed to want was sex.
    • In a Season 6 episode, when Carol is nearing the end of her pregnancy Luka comes in and says she looks great. Carol responds that she looks like an overgrown pumpkin. Luka then responds "I'd say more of a lubenica" and then (in fear of offending her) claims he forgot how to say it in English. "Lubenica" is Croatian for watermelon.
    • Pretty much anytime a foreign language was spoken, no subtitles were provided, leaving only viewers who spoke it themselves to understand.
  • Birth/Death Juxtaposition:
    • A woman dies in childbirth in "Love's Labor Lost".
    • Susan's sister Chloe gives birth at the beginning of "Motherhood", and Benton's mother dies at the end of the episode.
    • Literally in "Great Expectations"—Carol gives birth to one of her twins in one room, while an elderly woman dies of renal failure in the room next door.
  • Black Dude Dies First: Not first considering this is ER, but two regular black male cast members (out of three) eventually die on the show, both blown up. One in The Teaser with a voice over. Long before that, Dennis Gant threw himself in front of a train.
  • "Blackmail" Is Such an Ugly Word: Subverted. An unsuspecting Benton walks in on Dr. Keaton and Carter snuggling in her office during their affair (since she's an Attending and he's an intern, this is a major no-no that could have gotten her instantly fired if found out); aside from surprise, he doesn't evince any reaction. But when he later asks Keaton about taking on another pediatric surgical fellowship (something she had earlier refused to allow him to do), she naturally assumes the worst.
    Benton: Dr. Keaton, I came to see if you would reconsider recommending me for another pediatric surgery fellowship.
    Keaton: And what if I don't? Will you report my relationship with Dr. Carter?
    Benton: ...You think I'm threatening you?
    Keaton: Are you?
    Benton: Dr. Keaton, if your recommendation of me isn't based on my skills as a surgeon...then I don't want it.
  • Blood from the Mouth: Countless patients, including Pratt.
  • Bolivian Army Cliffhanger: Just about every season.
  • Book-Ends:
    • Dr. Mark Greene calls to third-year medical student Carter in the Pilot. Carter calls to prospective medical student Rachel Greene (Mark's eldest daughter) in the series finale.
    • Also in the pilot, Dr. Morgenstern tells Mark, "You set the tone, Mark. You get the unit through this," referring to Carol's suicide attempt. The departing and dying Mark later says the same to Carter, and the departing Carter says the same to Morris, after which he recants and says "Never mind" upon seeing how hungover Morris is.
    • During Mark's pep talk to Carter in the pilot, he notes with casual relief how it's stopped raining. He off-handedly says it again during their final conversation in Season 8.
    • Later in the pilot, Mark offers some words of encouragement to rookie med student Carter. Carter uses more-or-less these exact same words with rookie medical student Gallant.
    • The pilot was the first day for rookie medical student Carter; the series finale was the first day for rookie physician Dr. Julia Wise.
    • Both the pilot and finale begin with Nurse Lydia Wright waking up a senior member of the ER. In the pilot, it's Mark; in the finale, it's Morris.
    • Even the pilot itself has bookends, because it starts and finishes with Mark being awakened by Lydia.
    • A lighter variant: In the pilot, Mark has to treat a patient complaining of a hangnail amidst all the "real" emergencies. Years later, his very last patient (possibly the same woman) says "I have this hangnail, and it is very painful." He replies "I have a brain tumor, and it's inoperable. (Beat) I win."
  • Bottle Episode: The vast majority of episodes took place over the course of one day and within the hospital. Some took this even further and focused on only one story, while one took place in real time over only 45 minutes.
  • Bratty Teenage Daughter: Rachel Greene was a sweet little girl, but then became any parent's worst nightmare as a teenager. Rumor had it that was the reason the part was recast to a slightly older actress, despite the continuity errors it caused.
  • Breather Episode: Many of the hard-hitting, wrenching episodes ("Love's Labor Lost", "The Storm, Part 2", "All in the Family", "It's All In Your Head"), were followed by episodes that were more upbeat or mundane, making the fallout from the previous episode the B-plot rather than the main focus or ignoring it altogether—"Middle of Nowhere", which followed "The Storm, Part 2", even left the ER completely, following Benton to Mississippi.
  • Brick Joke:
    • Annoyed with Kerry's confidentiality-serving abbreviation system, Carol wonders if "BE" stands for "Barium Enema." In the last scene of the episode, she suggests giving one to a patient with food poisoning who dumped an elderly man on the ER staff to free up his weekend.
    • The Hesselbach Triangle takes about a season and a half from the episode it's first spoken of until it finally lands right in the middle of an operation, and not from the expected source.
  • Building of Adventure: The earlier series are set entirely within the hospital.
  • Bumbling Sidekick: The medical students. With very few exceptions, all the students seen on the show that get assigned to ER rotation are incompetent and incapable of doing anything useful. Apparently this is not an uncommon occurrence, as in the Pilot Susan hopes they get some good students because "the last ones were really useless."
  • Butch Lesbian: Maggie Doyle is a pistol-packing lesbian doctor, although unlike most examples of this trope, she's long-haired and pretty, making her a combination of this and a Lipstick Lesbian.
  • But for Me, It Was Tuesday: An early Season 1 episode has the heroic variety. Mark encounters a former patient who rushes into the ER on the one year anniversary of the doctor saving his life from some medical issue. The patient hugs, and lifts Mark off the floor, while loudly and happily proclaiming it to be "Dr. Greene Day" and he was going to reward the doctor with ribs. Mark, for his part, is first shocked and confused, but hides the fact this man was one of easily a dozen or more patients he encounters and whose lives he tries to save on a daily basis.
  • But We Used a Condom: Frequently comes up, with at least two notable examples:
    • Jeanie tells Benton to get an HIV test, reasoning that while they were careful they weren't that careful. He tests negative for HIV.
    • Benton finds Carla in the ER waiting room, waiting to see the OB Attending. He is baffled by her pregnancy as they used protection. As it turns out, after Benton has invested years in the resulting child, Reese turns out not to be his biological son.
  • The Bus Came Back:
    • Jing-Mei returned as a regular in Season 6, after being a recurring character in Season 1.
    • Susan returned as a regular in Season 8, after a five-year absence. This makes Sherry Stringfield both the first and last original cast member to leave.
    • Carter's four-episode arc in Season 12.
    • Jeanie shows up in the Season 14 episode "Status Quo", after her son suffers an injury in a Physical Education class. She reveals that she had remained a counselor for young people with HIV status and that her ex-husband Al had died of AIDS in the time since she departed.
    • And, of course, all the departed regulars from the original cast (including, via flashback, Mark) returned for guest appearances in the final season.
  • Call-Back:
    • Mark's last day at County featured a lot of references to the Pilot as well as a few of the patients he saw that day.
    • Susan returns to Chicago the same way she left...by train.
    • When Mark finds out he has a tumour and then finds out the tumour has recurred, he goes to the bathroom to check his inter-cranial nerves before washing his face both times.
  • The Cameo: David Schwimmer had an uncredited, unseen cameo as Doctor Karubian in the first episode of Season 3.
  • Carrying a Cake
  • The Casanova:
    • Doug and Carter were both very popular with women.
    • Mark, amazingly, managed to take after Doug following his divorce and Susan's leaving, scheduling three dates on the same day (they all find out about it). Following that incident, Mark has several abortive relationships with many attractive women.
    • Luka, being a taller, more European version of Doug, with a similar (if not worse) degree of emotional scarring.
  • Celebrity Paradox: ER and Third Watch take place in the same universe, but Michael Beach appeared on both, on ER as Al Boulet (Jeanie's ex-husband) and on Third Watch as Monte "Doc" Parker. Lisa Vidal also appeared on both—as Dr. Morales on Third Watch (Doc's love interest) and firefighter Sandy, Kerry's eventual wife on ER. ER was also referenced as a being a TV show on Third Watch.
  • Chekhov's Gun: Kerry uses the sternal saw she so vigorously lobbied to purchase for the ER one season earlier to crack Lucy's chest open after Lucy is stabbed by a mentally ill patient in "All in the Family".
  • Chekhov's Gunman: Halfway through Season 12, a wealthy cancer patient hires Sam to be his private nurse. At the beginning of Season 13, when the ADA is attempting to press charges against her for killing her abusive ex-husbandnote , he uses his connections to get a her a top notch lawyer as well as convince the DA not to bother pursuing a case against her.
  • Cheerful Child: Zig-Zagged. Children on this show are either angels or demons.
  • Chicago: Although filmed in California, the show shot exterior scenes in Chicago (the show's setting) pretty often. One can often see the Chicago Tribune building.
  • Chuck Cunningham Syndrome: Doug and Carol are noticeably absent from Mark and Elizabeth's wedding in Season 7 and then Mark's funeral in Season 8. This is especially jarring because, during the entirety of Doug's tenure, he and Mark were depicted as best friends. George Clooney explained that he didn't want to come back for the funeral scene in Season 8 because he didn't want his appearance to overshadow Mark's death (which is understandable, given NBC's outrage at not being told about Clooney's uncredited cameo in "Such Sweet Sorrow"). Still doesn't explain his and Carol's absence, nor the lack of explanation, from the wedding, and in Carol's case, her absence from the funeral and lack of explanation for it.
  • Claustrophobia: Jeanie and Neela.
  • Closest Thing We Got:
    • Downplayed in "Family Practice". Mark is in San Diego visiting his dad in a military hospital when the doctors there get swamped due to a helicopter crash. While Mark is certainly that kind of doctor, he's not on the staff, nor is he licensed to practice in the state of California, but the military docs aren't feeling picky about it given the circumstances. They compromise by having him talk an intern through a procedure rather than doing it himself.
    • In reality, military and government hospitals allow any licensed physicians to practice regardless of what state carries the doctor's license. Mark's Illinois medical license would've been perfectly valid at a military hospital in California.
  • Cloudcuckoolander: Morgenstern.
  • Code Silver: There had been a few hostage situations and shootouts in the hospital.
  • Comforting the Widow:
    • Subverted with Ray towards Neela. In the Season 12 finale "21 Guns", after learning that Pratt is the only non-family member to attend Gallant's funeral, Ray tells him that he's been trying to contact Neela, his former roommate-turned-love interest and Gallant's widow. Pratt gently tells him to give her some space and not complicate things. Ray looks guilty at the insinuation, but he takes Pratt's advice and refrains from engaging in a relationship with her.
    • Played Straight with Gates towards Neela. Despite learning that Gallant was killed in action, Gates gets into a relationship with Neela in the second episode of Season 13, only weeks after Gallant's funeral, by kissing her when she's drunk. This doesn't sit well with Ray throughout the rest of the season.
  • Comic-Book Time:
    • Averted. Most episodes take place over the course of a day (although episodes are, for the most part, non-consecutive) and each season takes place over the course of a year, with characters, who don't get killed off, aging, getting married and having children, and leaving the hospital as would be appropriate.
    • Played Straight at least once. Rachel suddenly ages two extra years to match the age of her replacement actress, Hallee Hirsh. This was probably done because Rachel's three main storylines following the switch, that of her taking drugs, asking Elizabeth for birth control, and following in her father's footsteps by applying to medical school in the series finale, probably wouldn't have been appropriate for the slightly younger Yvonne Zima. Nevertheless, there is an incongruity, as Rachel celebrates her sixth birthday in 1995.
  • Continuity Nod:
    • Occasionally, stories or dialogue would allude to some of the show's classic episodes from previous seasons—when Mark was sued for the wrongful death of a patient, the family's lawyer brought up the events of "Love's Labor Lost".
    • Throughout the final season, departing cast members, starting with Abby, are taken to the basement to have their name plates placed on the wall. A Freeze-Frame Bonus reveals that the name plates of all doctors who have left the staff/cast over the years are present.
    • The series finale has plenty of references to the Pilot, starting with Nurse Lydia Wright waking up Mark/Morris for their shift, and it continues from there.
  • Cool Old Guy: Mark thinks that Anspaugh will turn out to be a prick, only for him to be this instead. Anspaugh, as it transpires, does have his cantankerous moments, but he's generally a kind and understanding person (see Carter's transfer to Emergency Medicine).
  • CPR: Clean, Pretty, Reliable:
    • As far as "clean" and "pretty" are concerned, typically played straight. In terms of "reliable," usually somewhat averted, as virtually all patients who are in cardiac arrest require defibrillation, and most require ACLS drugs. And of course, many patients don't make it.
    • Averted in one episode where Carter is vomited on when he tries to give CPR to an overdosing medical student.
    • Carter breaks an elderly man's rib once during CPR while awaiting a defibrillation.
    • Averted in "Hell and High Water", when Doug spends about half an hour doing CPR unsuccessfully on a young, hypothermic drowning victim. It ultimately takes a bypass machine to revive him.
    • Deconstructed in "All in the Family", when Romano cracks Lucy's chest open to attempt internal heart massage while she is dying of a pulmonary embolism. He is unsuccessful.
  • Creepy Cockroach:
    • One episode has a woman who gets a small cockroach removed from her ear. She immediately freaks out and stomps on it.
    • Carter visits Anna's studio apartment and sees a cockroach climbing along one of her cupboards. She crushes it. She's later embarrassed by the incident and Carter having to see how poorly she lives when she finds out that Carter is absolutely loaded.
  • Crossover: With Third Watch.
  • Curse Cut Short:
    Carter: What a couple of SHPOS.
    Susan: What?
    Carter: It means Sub-Human Piece Of—
    Susan: I know what it means!
  • Death by Childbirth: One of the most famous, most well-regarded episodes of the show's entire run was in "Love's Labor Lost", in which Mark spends most of the episode trying to save a pregnant woman with eclampsia. He fails.
  • Defrosting Ice Queen: Doug and Kerry initially don't get on very well (they have past history) and Doug does a rather insensitive impression of her that she happens to walk in on. However, Doug sees her good side when they treat a deaf girl and Doug sees that Kerry is also very good with children.
  • Democracy Is Flawed: Luka expresses a belief similar to this to Carter in the first episode of the "Doctors Without Borders" arc.
  • Description Cut:
    Morris: You going to Ray's gig tonight?
    Neela: Oh, to hell with Ray. He's probably upstairs having a blast.
    (Cut to Ray in the toxicology lab)
    Ray: Jerry, it's Ray. Save me. I'm bored stiff.
  • Disappeared Dad: Doug's father abused alcohol, him and his mother, and then eventually up and left. Ironically Doug is one himself—he has a son with an unnamed woman who he has never met or seen before, and the circumstances of the boy's birth and Doug's lack of involvement are never explained.
  • Distracted by the Sexy: In "The Human Shield", Pratt, Ray and Abby are forced to attend a demonstration headed by Eve and Clemente. During the demonstration, Neela comes over wearing a Little Black Dress. Pratt does a Double Take, Clemente comments on how sexy she looks, and Ray never takes his eyes off her.
  • Double Standard:
    • The female staff staring at handsome male coworkers/patients/relatives of patients and commenting on their good looks is seen as perfectly normal and not the least bit unprofessional. Male staff ogling gorgeous female coworkers/patients/relatives of patients and commenting on their good looks are viewed as lecherous perverts. A very striking example of this is when Pratt is accused of groping a female patient (he didn't, but his efforts to put her at ease by telling jokes backfires on him). All the women not only instantly assume that he's guilty, they accuse all male doctors of having gone to medical school solely to have a chance to ogle women, while sanctimoniously—and falsely—insisting that they have never had an inappropriate thought about an attractive male patient.
    • Also, it's totally acceptable for the medical doctors to bitch about unpleasant things that happen to them on their jobs, many of which are caused by sick or injured people who can't help puking or bleeding all over their caretakers, but any doctor from the psych department complaining about the behavior of their patients is treated to disgusted looks and snide remarks from the other staff.
    • Elizabeth accuses her mother of neglecting her or practically abandoning her in favour of her work, but her father gets a free pass. Her mother calls her out on this. Likewise, Carter confronts his mother for abandoning him and for not being there for him after his brother died, but the fact is that Carter's father was equally absent from Carter's life and his father gets absolutely none of Carter's angst.
  • Downer Ending:
    • Many episodes, but "Love's Labor Lost" really stands out.
    • At the end of a two-episode arc in Season 12, a young woman who had woken up from a six-year coma slipped back into it as Luka frantically tried to keep her conscious.
  • Driven to Suicide: Dennis Gant throws himself in front of a train because of Benton's treatment of him. Officially it's ruled an accident, but Benton and Carter know the truth.
  • Dropped a Bridge on Him: Few of the main characters' deaths were dignified and done with respect. Romano had a helicopter fall on him. Gallant in Iraq. Pratt in an explosion. And many more.
  • Drowning My Sorrows: Ray does this in "I Don't", after he witnesses Gates caressing Neela's cheek on the balconynote . Ray bitterly leaves the scene and, unfortunately, doesn't witness Neela pushing Gates' hand away and implying that she wants to break up with him. Unaware of Neela's true intentions, Ray gets drunk at the bar, verbally and physically fights with Gates over her, gets drunk again at another bar, and then gets run over by a truck.
  • The Documentary: The Season 4 premiere "Ambush", which was performed live.
  • Dr. Jerk:
    • A few doctors like these come and go, especially Romano. Morris flirts with this trope, before becoming a Jerk with a Heart of Gold.
    • Benton was über-driven, and incredibly unforgiving of anyone he felt didn't have the same level of drive that he did.
  • Dysfunction Junction: Most of the ER staff are this:
    • Doug's father was abusive and ultimately abandoned him and his mother.
    • Carter's relationship with his parents was never that great (they're never around) and his grandfather refused to accept his career choice, insisting that it was just a phase and instead wanting him to run the family business.
    • Subverted with Mark. He and his father have a difficult relationship and he resents him for being a tough military type, unwilling or unable to show any affection for Mark. Doug, who really did have an abusive father, pointed out that his dad was always there for him and told him to "get your head out of your ass!" As it transpires, Mark's father sacrificed his chances at making admiral to come home and help him with a bully (taking a desk job instead). His mother, however, didn't want him at first. She had only been on a couple of dates with his father and wasn't ready to settle down. Mark eventually admitted to his eldest daughter Rachel that he didn't even remember why their relationship was so bad, only saying that it was "probably my fault."
    • Kerry's mother gave her up for adoption, and for years Kerry grappled with the fact that it might've been due to her congenital hip dysplasia (as it turns out her birth mother knew nothing about it).
    • Abby's father left her when she was very young and her mother and brother have bipolar disorder. She herself is a recovering alcoholic.
    • Same thing with Pratt's father, though he tried to get back with Pratt's mother, but she never answered his letters.
    • Sam comes from a family of alcoholics.
  • Early Installment Weirdness:
    • The Pilot's upbeat, cheerful version of Benton.
    • The two mentions of Doug's son.
    • The hospital layout changes slightly.
    • Morris is actually reasonably competent when he first joins the staff, only to turn into an idiot a few episodes later. He becomes competent again towards the end.
  • Empathic Environment:
    • In the Pilot.
    • Also in "Blizzard", bordering on Exactly What It Says on the Tin, as an actual blizzard outside coincides with—and causes—a massive influx of patients. This was the first, and arguably the best, of the show's "mass casualty" episodes.
  • Enfant Terrible: A few over the years. In the final season, there's one utterly blase about the fact that she keeps trying to hurt her sister.
  • Everybody Is Single: Originally Averted—Mark was married (the only doctor in the ER who was), but the Pilot made it clear that his marriage was rocky. Played Straight after he got divorced, although he eventually married Elizabeth, only to die and leave Elizabeth widowed and therefore single. Keep in mind that the original cast was made up of actors chiefly in their early thirties, except for Noah Wyle, who was in his early twenties, and of them only Anthony Edwards was recently married (George Clooney was recently divorced), making this a less egregious use of the trope.
  • Excuse Me, Coming Through!: Done with a runaway bottle of compressed air.
  • Expy:
  • Fake Guest Star:
    • Laura Cerón (Chuny) and Deezer D (Malik) appeared in more episodes than anyone other than Noah Wyle and Laura Innes...all with guest star billing.
    • Emily Wagner (paramedic Doris Pickman) appeared in 168 episodes, and was featured in every single season, but was always credited as a guest star.
    • Yvette Freeman as Haleh Adams was one of only four actors (the other three being the aforementioned Laura Cerón, Deezer D, and Emily Wagner) from Season 1 who stuck around to the end, and appeared in more episodes than Anthony Edwards or Eriq La Salle. She and Deezer D literally were a part of the show from the Pilot to its last, and neither were ever promoted to the opening credits.
    • Leland Orser as Dr. Lucien Dubenko in the final five seasons.
  • Family Relationship Switcheroo: An example of the child doing this. Sam's son Alex, to whom she gave birth at age 15, has told his friends she's his older sister. They think she's hot.
  • Fanservice:
    • Abby's nurse costume in one of the Halloween episodes was definitely not a regulation nurse's outfit. There have been other examples, too.
    • ER desk clerk Randi Fronczak's outfits in general; she designs her own clothes.
    • Cynthia Hooper (Mariska Hargitay) turned up in the doctor's lounge in nothing but lingerie and a trench coat to seduce Mark.
    • The naked Finnish air hostess, fresh from the shower, greeted Mark and Doug upon arriving at Doug's apartment in "Do One, Teach One, Kill One".
      Doug: You know, the Finns are remarkably un-self conscious.
  • Flanderization: Romano's prickish tendencies became more exaggerated with each passing year. Originally, the only indication the viewer had that Romano was a racist was him asking Benton if he liked Chris Rock.
  • Flashback:
    • When Mark is having surgery to remove his brain tumour he has a seizure and sees a bunch of things from his past (possibly a case of his life flashing before his eyes). Among them are visions of his mother, his father (blowing smoke) and Jen holding a crying baby Rachel and complaining that Mark didn't come home when he said he would.
    • In "Time of Death", Charlie Metcalf has apparent flashbacks to aspects of his life while being treated. Most of it involves him trying to get his past self to reunite with or be there for his son, instead of going to prison.
    • In "Heal Thyself", Catherine Banfield has a flashback on the anniversary of her son's death to her first time coming to County Hospital, which is when and where he ended up dying. It also serves as a way of bringing Mark back to the show, as it turns out he ended up treating her son shortly before he died.
  • Framing Device: "Take These Broken Wings", while technically being in the same "one day" format as most episodes, is interspersed with Susan's therapy sessions, which clearly—given the different outfits she's seen in—take place over several days.
  • Freudian Slip: There's this conversation between Ray and Neela in "Two Ships", which is the first episode to indicate that his feelings for her run deeper than being just roommates:
    Ray: Heard from Gallant?
    Neela: Not yet. He got stuck.
    Ray: He's still coming home, right?
    Neela: Not at the moment.
    Ray: Oh, that's cool! (Neela gives Ray a funny look, and he hastily retracts) I mean, too - too bad.
  • Friend to All Children:
    • Doug is remarkably good with children.
    • Kerry, despite being unable to deal with adults, is also very good with children.
    • Luka has a rapport with children and, like Doug, dates a woman with a kid for a while, getting close to her through the kid.
  • Funny Background Event:
    • Wendy skidding around the hospital on rollerblades in "Blizzard".
    • In "Hole in the Heart", there's a really funny moment when Kerry is ranting angrily at Mark. Anna slips by in the background and the "man, glad I'm not on the receiving end of that" grimace on her face as she exits the scene is priceless.
    • Mark himself gets a moment like this in "Blood, Sugar, Sex, Magic", as he's at the nurse's desk when Malucci begins screaming at Kerry. Ostensibly to make a phone call, but if you watch carefully, he isn't paying any attention to the call and is watching Kerry getting reamed out with what a Television Without Pity recapper very aptly described as "unabashed interest".
  • Fun with Acronyms: When Pratt gets accused of inappropriately touching a female patient, Morris makes a crack about how he "TUBEd her." He realizes too late that Kerry is nearby and that she will not be amused by what "TUBE" means: Totally Unnecessary Breast Exam.

    G-L 
  • Grumpy Bear:
    • Peter Benton.
    • Occasionally, Mark Greene.
  • Halfway Plot Switch
  • Have I Mentioned I am Gay?: The show's first recurring stated gay character is Yosh Takata, a long-running but relatively minor supporting character who never gets a substantial storyline of his own, let alone a romantic one. The only reason we know he is gay is because another character once describes him as a "fairy", prompting others to stand up for him.
  • Hellish Copter: A helicopter crashes down in the Hospital's courtyard and kills Romano, who was in said courtyard specifically because he wanted to avoid it after having his arm chopped off by one a year earlier.
  • Heroic B.S.O.D.: Basically everyone at one point or another:
    • Mark had a massive one after losing a mother during a delivery.
    • Benton had a few. One after losing his mother. Another after almost killing a baby when Dr Keaton expressly told him just to close up. A third after Dennis Gant's (suspected) suicide. A fourth after his son is born prematurely.
    • Doug had one after a woman he had been with OD'ed and died in the ER.
    • Neela has one so bad after being notified of Gallant's death that she turns around and picks up two charts to go back to work, as if nothing has happened.
  • Heterosexual Life-Partners:
    • Doug and Mark. The fact that Mark is Doug's boss often puts their friendship in jeopardy.
    • Abby and Neela.
  • High-Pressure Blood: On numerous occasions.
  • Hoist by His Own Petard: After Doug lands a position as a Pediatric Attending, he puts a rule in place that if one of the regular ER doctors sees a pediatric patient, then the Pediatric Attending has to sign off on their chart after the fact. Of course, with Doug's luck, this leads to the ER getting jammed with pediatric cases his first day on the job, and with him being the only Pediatric Attending at the time, he's there until late into the night. When Kerry sees his dedication to it, it's the final step in their formerly antagonistic relationship becoming somewhat friendly.
    Doug: (smiling as he looks at the large stack of charts Kerry has just brought him)
    Kerry: What?
    Doug: You're loving this, aren't you?
    Kerry: (grinning) You know, maybe this pedes ER Attending thing wasn't such a bad idea after all. Good job today, rookie.
  • Hollywood Atheist:
    • Doug, who instead jokingly claims to be Pagan—though he crosses himself several times during the episode "Fathers and Sons", implying that he was raised Catholic even if he's now lapsed.
    • Also possibly Lucy.
    • In a deleted scene from "On the Beach", Mark says outright that he doesn't believe in God.
  • Hooker with a Heart of Gold: Loretta.
  • Hospital Hottie: Hospital full of hotties, more like.
  • Hospital Paradiso:
    • Mark in the Pilot, to the letter.
    • Averted with Benton. Not only does Benton pursue work in such a place, he takes it. This was because he needed to be around to take care of Reese and Romano wouldn't/couldn't offer him the hours he needed at County.
    • Also at the beginning of "Hell and High Water". Having been fired from the hospital in the previous episode, Doug is seen interviewing at one of these. Despite the higher pay and better hours, he's clearly not happy about it, and his heroics in the episode prompt the hospital to rehire him.
    • Despite working in an inner-city emergency room, Carter seems to think he's playing this trope out, writing a huge check to benefit a grungy clinicnote , and ultimately going to work in Africa.
  • Hypocrite: Pratt accuses Weaver of being this after she disciplines him for performing a breast examination without a nurse present, as his demeanor had made the patient uncomfortble.
    Pratt: Do you have a nurse in the room when you do breast exams?
    Weaver: I am a woman!
    Pratt: Who sleeps with other women!
  • I Got You a Drawer: Doug asks for one as a sign he wants to get serious with Carol.
  • Immediate Sequel: A handful of episodes pick up within minutes of the previous one's ending.
  • Improbable Hairstyle: A lot of the long-haired women were often seen wearing their hair loose. Most female medical professionals won't do this—aside from the fact that hair isn't sterile and could therefore contaminate an open wound, it could also get in the way, be grabbed onto, or get soiled by body fluids.
  • Incredibly Lame Pun:
    Abby: What kind of car do you think Alexis drives?
    Carter: ...A Lexus?
    —-
    Patient: Don't drop my baby!
    Abby: Don't worry, Dr. Carter used to be in the circus. I think he was a clown.
    Carter: I was the human cannonball, 'til they fired me.
    —-
    Susan: I was going to drain [the abscess] down here, but I appreciated a deep perirectal component.
    Romano: And we all know what a pain in the ass that can be.
  • Innocent Cohabitation: Ray and Neela.
  • Inspirationally Disadvantaged:
    • Kerry. Despite her disability, she is consistently depicted as an uber-competent doctor. In fact, her abrasive personality (rather than warm and fuzzy) might even make this a subversion.
    • At the end of Season 13, Ray is hit by a truck and loses both of his legs. He reappears in the final season, having recovered, left Emergency Medicine, and now specializing in Physical Medicine and Rehabilitation, fully capable and mobile thanks to state-of-the-art prosthetics, and truly enjoying his new specialty. He outright says that seeing how accomplished he is gives hope to the disabled military personnel he often works with.
  • Instant Sedation: Both Averted and Played Straight.
  • The Intern: Several are seen through the series.
  • Internal Affairs: The hospital has M&M, wherein the treating doctors present cases in which a preventable accident/injury/death occurred, in front of the hospital board and several other doctors. Frequently a place for doctors to assign blame to either the patients (i.e., their difficult medical conditions) or other doctors.
  • Irony:
    • Mark raises the possibility of pre-eclampsia in one patient one week, only to completely mis-diagnose a patient actually suffering from it a few weeks later.
    • Similarly, Carol blasts a nurse for two major errors—(1) giving a patient the wrong medication, which almost killed him, and (2) icing a patient's football instead of his severed foot, leaving surgeons unable to reattach it and him crippled for life. (The woman was overwhelmed by the fast pace of the ER). A few months later, Carol is similarly overwhelmed trying to do the work of three nurses and makes a similar mistake—giving a patient the wrong type of blood, killing him. And even more ironically, Carol ultimately decides not to report the nurse for the medication error, citing that even the best of nurses could become flustered. Even though precisely the same thing happens to her and her supervisors tell her the same thing, indicating that they're willing to let her off the hook, Carol insists on the incident being reported and taking whatever punishment is doled out
    • Furthermore, when the incident happens, Kerry makes it clear that she admires Carol for refusing to lay the blame on others and being willing to accept whatever punishment comes. Fast-forward a few years later when Kerry is among those responsible for the death of a patient (she was not present to supervise the other doctors treating him and therefore correct their mistakes) and proceeds to do exactly the opposite—lying through her teeth about her involvement in order to escaped unscathed.
    • Because Carla put Benton's name on Reese's birth certificate she would have no legal right to challenge his paternity, which is why she doesn't when Benton sues the McGraths for trying to take Reese with them to Germany. Ironically, after she dies, Roger is perfectly welcome to challenge Benton's paternity, which he does.
    • Despite being a skilled surgeon, Benton reacts like any other loved one in regards to his mother's increasing illness and frailty—with complete denial.
  • Ironic Echo: When a patient dies, Benton gives his relative a standard "I'm sorry" speech. Later in the episode, he is paged about his mother and rushes to her nursing home to find that she has died. The doctor proceeds to give him the exact same speech, which while perfectly acceptable when Benton gave it, now sounds horribly generic and detached while in another physician's hands.
  • It's Personal
  • I Want My Beloved to Be Happy:
    • The reason Luka breaks up with Abby the first time. Luka bends over backwards to try and make Abby happy but she's always miserable and content with being so. It gets to the point where they have a fight, Luka says a lot of things he didn't mean and they break up.
    • In a deleted scene from "On the Beach", Mark says that he has no problem with Elizabeth marrying again, reasoning that he'll be gone and that he wants Elizabeth to be happy and Ella to have a father. Despite this, most of Elizabeth's relationships after Mark's death fail for one reason or another.
  • Jerkass:
    • Most of the characters who initially behaved like this have later gone on to be examples of Jerk with a Heart of Gold instead.
    • Romano. However, there are numerous episodes which show him as being a Jerk with a Heart of Gold—"All in the Family" springs to mind. He ultimately reverted to full Jerkass status.
    • Benton is often arrogant, narcissistic and completely self-serving, to the point that he never seems to care about anyone other than himself. Like Romano, however, he has his moments, and the birth of his son changes him a bit.
    • Zig-Zagged with Carter. He started out as an idealistic young medical student, then went through a period of jerkassery in Season 2, mainly in imitation of the cutthroat surgeons (namely Benton) he was working alongside then. By Season 3 he had mostly gotten it out of his system, although in his last few seasons he reverted a bit. He came back in the final season as almost saintly.
    • After Mark got beat up he became cynical and rather unpleasant to both his co-workers and his patients. Fortunately a trip to California with Doug is enough to snap him out of it.
    • Doug himself during the first three seasons. His promiscuity is heavily implied to be the result of some deep-seated issues (abuse, abandonment) rather than him just being an unfeeling jerk, and even if not, he's consistently shown to be an excellent and compassionate pediatrician.
    • Surgical intern/resident Dale Edson (Seasons 2-5, 8-9). Unlike the previous examples, Edson never developed into a Jerk with a Heart of Gold.
  • Karma Houdini:
    • Mark's assailant is never caught.
    • Whoever was killing Elizabeth's patients—it's implied that it's Alexander Babcock, but this is never followed up.
    • Romano caught Morris smoking a joint on the job in the bathroom and dragged him out to tell him to wait in a seat and touch nothing, as he would be dealt with later. Morris does wait, but Romano is killed by the helicopter, so no one is there to report Morris' crime.
    • Jen Greene makes Mark feel guilty about trying to advance his career at County and tries to get him to follow her career and move to Milwaukee. She constantly rags on him for being friends with another woman (Susan)—but she's the one who cheats on him and leaves him for the other man, and instead of incurring Mark's wrath in the form of divorce court proceedings and custody battles, they both eventually relent and decide to split amicably. When she decides to move her and Rachel to St. Louis, Mark puts up absolutely no resistance.
    • Mark never suffers any legal ramifications for his Murder by Inaction of a serial killer, but on the other hand he did get cancer and die.
    • Kerry. From Season 6 onward, she began to pull numerous duplicitous stunts in order to advance her career and never once incurred punishment for any of them, eventually becoming Chief of Staff. She finally gets a taste of karma in Season 13, when after making the huge mistake of hiring Victor Clemente, a dangerous paranoid schizophrenic, as an Attending, Anspaugh demotes her below Luka, who ultimately ends up axing her due to budget cuts.
  • Last Episode Theme Reprise: After dropping it following Season 12, the original theme song was played over the beginning and end of the series finale.
  • Later Installment Weirdness: It began as a fairly realistic portrayal of a hospital emergency room, but later seasons included kidnappings, explosions, arms being chopped off, helicopter crashes, shoot-outs and many other things. Also the entire cast was different.
  • Leaning on the Fourth Wall: Following Mark's death, Kerry and Carter have a conversation about the future of the hospital under Carter's leadership, subtly referencing how Noah Wyle was the last actor from the original cast to have stayed with the series all the way up until this point:
    Kerry: Mark's gone. That means you've been here longer than any other doctor. People will look to you to step in and fill the void.
    Carter: (Beat) Big void.
    Kerry: Yes, it is.
  • Lethal Diagnosis
  • Limited Advancement Opportunities
  • Live Episode: The Season 4 premiere "Ambush". The cast did it twice. Once for the East Coast USA and once for the West Coast USA. The set up was a documentary crew put up cameras around the hospital to watch the staff.
  • Loads and Loads of Characters: Not just limited to the revolving door main cast. Because the show is set in a hospital, there are also a lot of supporting characters and recurring guest stars.
  • Lonely Funeral: Elizabeth is the only one to attend Romano's memorial service.
  • Long-Runner Cast Turnover: The series transplanted most of its original cast over the fifteen seasons; while some (Susan Lewis) came back and then went away again, and some of the characters came back in the final season, the final cast was composed of none of the members of the original cast. Lampshaded more than once:
    • The first few minutes of Susan's Season 8 return (by which point only half the original cast remained) had her running into people she didn't recognize. It took forever for her to encounter Mark, Kerry, Carter, the nurses, etc.
    • Jeanie has a similar reaction when she came back in Season 14, by which point none of the original cast, nor Kerry, who she specifically asked for, remained.
    • Once in the final season. Two of the newer characters—Neela and Sam—meet two of the original characters—Doug and Carol—and they realize that the staff of the hospital has changed so much over the years that they have only one common acquaintance, surgeon Donald Anspaugh. Most of the people who worked in the hospital when the original characters left had already stopped working there by the time the new characters arrived; however, Doug mentions Kerry and Susan, two people whom Neela and Sam do know, they just don't work there anymore.

    M-R 
  • Magical Defibrillator: Defibrillators are actually generally portrayed accurately on this show. There was maybe one exception, and it was mentioned that they were desperate and trying everything they could at that time.
  • Married to the Job: Almost everyone. Part of the Character Development for both Mark and Benton is the discovery that other things are more important. In Season 1 both cannot break away from their jobs to be with their families, ultimately leading to divorce for Mark and the death of Benton's mother. By Season 8 Benton decides to leave County to get a job with better hours so that he can be with his son, and Mark eventually leaves the hospital to spend time with his daughter in Hawaii (though in Mark's case, it's more that he's dying and doesn't have much time left, rather than him reducing his working hours).
  • Maybe Magic, Maybe Mundane:
    • Benton's generation of random Christmas miracles wherever he goes in "Do You See What I See?"
    • Two seasons earlier, the mysterious, Santa-like, toymaker who vanishes while Carol is treating him.
  • Meaningful Echo:
    • "You set the tone" was a commonly repeated phrase in the series:
      • It was first told to Mark by Dr. Morgenstern in the Pilot.
      • When Mark is leaving County to die from his tumor, these were his last words to Carter.
      • And when Carter was leaving he told this to Morris. Though it did take Morris a few years to be ready to set it, he would become one of the best doctors in the hospital.
    • There's also the line "It's okay to miss him/her. Missing him/her keeps him/here." Doug said this to Mark after Susan's departure, Mark said this to Carol after Doug left, and Susan said it to Carter after Mark's death.
    • The pep talk Carter gives new student Gallant after the latter freaks out during a gruesome trauma is identical to the one Mark gave Carter in the pilot. This was done intentionally.
  • Na´ve Newcomer: The medical students that weren't outright incompetent were often this. Carter and Lucy are good examples.
  • Never My Fault: Played With. While the doctors internally feel a lot of guilt when routine procedures go haywire and the patients are left dead or irreparably damaged, often times they deflect the blame onto someone or something (i.e., the patient's pre-existing medical conditions) else. Most notably seen in the aftermath of "Love's Labour Lost".
  • Nipple and Dimed: During one scene a woman's bare breasts were visible as a realistic representation of what doctors have to do (e.g. cut someone's shirt off) during emergency medical treatment. The woman was elderly to minimize the risk that it would be perceived as titillating. There were plans to do this again, but then that Janet Jackson thing happened and they were shelved.
  • No Good Deed Goes Unpunished: The type of tumour Mark is diagnosed with, Glioblastoma Multiforme, can be caused by ionizing radiation, such found in x-rays. It is quite possible that Mark's illness and eventual death was purely a by-product of being a good and caring doctor, by going with his patients to x-ray.
  • Obviously Evil: Ellis West, the slick pharmaceutical bigshot whose company is attempting to buy the hospital in Season 4 and who might as well have "SHARK" tattooed on his forehead. He's also played by Clancy Brown. Yeah, The Kurgan just looks so trustworthy.
  • Official Couple: While almost everyone in the main cast had temporary romantic relationships with each other, the following couples got a lot of focus and became endgame for good:
    • Doug and Carol.
    • Mark and Elizabeth, until Mark's death. She reveals to Benton in the series finale that she hasn't been serious with anyone else since Mark.
    • Benton and Cleo.
    • Kerry and Sandy, until Sandy's death. Kerry reveals in "Breach of Trust" that she hasn't been able to move on since Sandy's death, and that moving to Florida with their son Henry will help her move on.
    • Luka and Abby.
    • Ray and Neela.
  • Oh, Crap!: Kerry has this reaction when, while demonstrating flu shots on live TV, she forgets to switch needles. She's left staring at the camera in horror. She has another when she sees Jing-Mei arriving at the hospital with a lawyer and realizes that Jing-Mei has found out that she lied about not receiving any pages the night a patient died—she misplaced her beeper, leaving her unable to be reached.
  • One of Our Own: Frequently. Hospital staff, cops, and paramedics get preferential treatment, which is Truth in Television in real-life emergency departments.
    • The first and best example of this is Carol's suicide attempt in the Pilot. The entire staff practically come to a standstill after seeing Carol come in. Some want to know why she did it, something they don't usually care about. Mark says to Morgenstern that they have to try everything, for morale if nothing else.
    • Lampshaded, albeit tragically, in "All in the Family", when Benton operates on Carter after his stabbing. Benton is so distraught at Carter's condition that he nearly removes a salvageable kidney and has to be talked down by a senior surgeon. Meanwhile, Romano insists on trying to revive Lucy, whereas with a patient he had no connection to, he would have been objective enough to acknowledge that she was gone.
    • When treating his infant daughter for a drug overdose in "Damage is Done", Mark hesitates to do everything that he knows deep down is medically necessary, to the point where Kerry gently but firmly takes over the case, pointing out that had this been anyone else's child, he would have intubated her immediately, but is reluctant to cause such discomfort to his own.
    • Catherine Banfield experiences a form of this with her son—he had acute leukaemia but she failed to see the symptoms, when Mark was treating him she, meaning well, inadvertently tried to obstruct him—and the incident forms part of her backstory. Incidentally her son was treated by Mark not long after his aforementioned incident.
  • The Oner: One of the trademarks of the series, with camera following entire procedure of doctors working on a patient. Due to the amount of details presented in those shots, it's one of the main reason why the show redefined Medical Drama ever since.
  • One Steve Limit: Usually Subverted:
    • There were two characters named John in Season 1—John Carter and John Taglieri—but avoided any confusion by using nicknames for both men.
    • There were two characters named Abby—Abby Keaton and Abby Lockhart—but as they appeared at different times (oddly, both were love interests to the aforementioned John Carter), there was no confusion.
    • There were three important characters named Ray throughout the show, two recurring and one main: Ray Ross (Doug's father), Ray Shepard (Carol's paramedic boyfriend), and Ray Barnett. However, the second one always went by his nickname "Shep", and the one time he and Doug's father appeared in the same episode—Season 2's "The Healers"—they didn't share any scenes together. Also, both Doug's father and Shep only appeared in Season 2, while Barnett joined the cast long afterwards in Season 11, so there was no confusion.
  • Operation: Jealousy: In Season 13, Ray deliberately asks out a medical student named Kateynote  right in front of Neela, solely because he's bitter over the latter's relationship with Gates, and he makes it clear that he doesn't care about Katey. When Neela expresses her jealousy over his new "relationship", Ray calls her out on it because she already chose Gates and, therefore, has no right to care about who he dates. However, Neela's jealousy causes Ray to completely forget about Katey, and he tries to pursue a relationship with Neela after they share their First Kiss. When Katey reveals that Ray hasn't called her in months and asks if it was because he started dating Neela, he laughs nervously and asks if they can talk. Katey easily sees right through him and breaks up with him. Although Ray briefly looks guilty for using her, he quickly gets over it and focuses on trying to enter a relationship with Neela.
  • Papa Wolf: Quite a few doctors are this to their patients:
    • Luka is one of the most prominent ones.
    • Benton becomes one when Reese is born. To see Benton go from being an arrogant and egotistical doctor to a loving, doting father is rather startling. He also displays inclinations of this toward Carter, training him, working much closer with him and treating him much better than he does his other students (Gant especially). Benton is genuinely hurt when Carter switches from surgery to Emergency Medicine, complaining that Carter went to Anspaugh, and not him, first (although Carter once tried to go to Benton for advice on the Dale Edson situation and he brushed him off).
    • Carter in turn shows signs of it towards Lucy, but only after they shared a kiss but didn't let things progress any further.
  • Pet the Dog:
    • Benton, who had been "kind of a jerk" to Carter throughout his first year at County, can be heard advocating him to Dr. Angela Hicks for the surgical position (saying "But I've been training him all year"). Not only that, but Benton gave Carter a glowing evaluation (which made Carter feel guilty as he gave Benton a 16 out of a possible 40 on his evaluation) and, before Carter left for the summer, took the time to tell him he's going to be a great doctor. He did something similar the next year, only to lapse into being his usual rough self at beginning of the following year.
    • Romano signing to Reese, "Take care of your father."
    • Also quite literally, with Romano's dog coming to the OR for a procedure.
      "Perhaps if you showed the same compassion towards people as you do towards animals..." (Death Glare)
    • A dog randomly hit in the hospital parking lot gets mouth-to-mouth from Carter in Season 1.
    • Also happens pretty much every time Romano and Elizabeth are on screen together. Elizabeth may have been his only friend, but by damn, she was a good one.
    • Jeanie's relationship with Kerry. The firing incident aside, Jeanie's the only person who doesn't have a contentious relationship with Kerry. Kerry, without hesitation, offered to take care of Jeanie and make sure her condition doesn't worsen. Kerry also kept her secret until Mark found out.
    • Doug's attempt at doing an ultra-fast detox on an eight month old baby who was born addicted to methadone. Doug tries to do the procedure in secret and Carol insists on helping him. The baby then goes into respiratory arrest and Mark hears the monitor alarms going off, stumbling upon the procedure. Mark and Kerry are very pissed at Doug for once again violating the rules but the anesthesiologist at the Pedes ICU and the senior members of the hospital staff are actually very supportive of what Doug did and allow him to continue the procedure agreeing that while he stepped over the line what he did was morally right. Perhaps as a result Doug gets offered the position of Pedes Attending.
  • Placebo Effect: In one episode, a doctor plans to give a patient some "Obecalp" to satisfy her and her parent's fears about something being wrong. When Kerry finds out about this, by the intern trying to find "obecalp" in the book of medicines, she calls the doctor out on the recklessness of this action and if something went south because of this "medicine" they could sue the hospital for the whole affair.
  • Portmanteau: Benton and Carla come up with Reese's full name by combining their last names.
  • Precision F-Strike:
    • In Mark's final regular episode, his body was really failing and he collapsed to the floor. Frustrated and not wanting his family to see, he screamed "Shit!" (on network TV). Word of God says they got clearance from the FCC to do this, citing situational necessity.
    • Several physical versions as well. A just-shy-of 18 teenage boy gives Doug the finger after the latter revives him. The kid had end-stage Cystic Fibrosis, he didn't want resuscitation but, being under-age, his mother, who didn't want to let him go, reneged on the DNR order.
  • Prom Baby: Sam explains this to be the case with her son Alex.
  • Promotion to Opening Titles: This happened with all of the aforementioned Ascended Extras:
    • Carol Hathaway was a guest star in the Pilot and became a main cast member in the subsequent episode.
    • Jeanie Boulet was a recurring character in Season 1 and joined the main cast in Season 2.
    • Kerry Weaver was first introduced in Season 2 and got upgraded in Season 3.
    • Anna Del Amico appeared in the last three episodes of Season 3 and became a starring cast member in Season 4.
    • Robert Romano was a major presence throughout Seasons 4 and 5 before he officially became a main cast member in Season 6.
    • Dave Malucci was credited as a guest star in his first few appearances in Season 6 before getting upgraded later that season.
    • Jing-Mei Chen was a recurring character in Season 1 and, after a five-year absence, returned as a main cast member in Season 6.
    • Abby Lockhart was a guest star in Season 6's "Great Expectations" and was upgraded later that season.
    • Michael Gallant was a guest star in his first few episodes in Season 8 before getting upgraded later that season.
    • Greg Pratt was introduced towards the end of Season 8 before being declared as a main cast member in Season 9.
    • Archie Morris was a recurring character in Seasons 10 and 11 before becoming a main cast member in Season 12.
    • Tony Gates was briefly featured in Season 12 and then added as part of Season 13's main roster.
    • Simon Brenner came in during the latter half of Season 14 and was made part of the main roster in the final season.
  • Put on a Bus:
    • While many characters were put on this, the most upsetting is Ray, who is first hit by a truck and then departs on a literal bus at the end of Season 13, and then is put on a figurative bus in Season 14. For all its cruelty, at least he finally becomes a couple with Neela in the final season.
    • All the original cast members eventually left, but until the show got rid of its opening theme after Season 12, you could still see "incidental" shots of them from the Pilot.
    • The Bus Came Back for several, especially in the final season.
  • Race for Your Love:
    • At least two notable Aversions:
      • Doug rushes to Carol's engagement party to deliver the abovementioned Anguished Declaration of Love...she screams at him to leave her alone, and her fiancé punches him. It works out in the end.
      • Mark runs to the train station to catch the departing Susan, only to have her gently rebuff him and leave anyway. He eventually found someone else.
    • Played Straight:
      • Carter buying a $9,000 plane ticket to Japan so that he can get past security and get to the gate to give one last kiss to his departing girlfriend Kem.
      • Carter again racing through the streets of Paris to get to Kem's place and declare his love for her.
      • The best example is of Carol rushing to catch a plane to Seattle in the hopes that it's not too late to reconcile with Doug.
    • Subverted in "Shifting Equilibrium", when Brenner rushes to the airport to catch Neela before she leaves to reunite with Ray. It's not to declare his love and beg her to stay, but to hash out their unresolved issues and be able to part as friends.
  • Real Life Writes the Plot:
    • Kerry had her hip dysplasia surgically corrected in Season 12 because ten years of walking with a crutch had begun to cause hip problems for her actress, Laura Innes.
    • The Real Life pregnancies of several of the show's actresses—Ming-Na Wen, Alex Kingston, and Sherry Stringfield—resulted in their characters being pregnant as well.
    • Many characters were written out because the actors playing them wanted to do other things. Most notably, George Clooney left both because his film career was starting to take off and because he felt that all of Doug's potential storylines had been exhausted. Anthony Edwards left to spend more time with his family.
    • Benton's brief, troubled relationship with Elizabeth is partly because Benton can't get over his discomfort with dating a white woman, thus echoing his portrayer's sentiments.
  • Refuge in Audacity: The crew helps a homeless girl who turns out to be on the run from a Cure Your Gays-institution. A person from the facility shows up to take her back, but Carter refuses to release her...by claiming that she is pregnant. What are they going to do, say that that is impossible?
  • Relationship Reveal: "Baby Shower" had a minor, lighthearted one with a patient. A young man and woman come into the ER, the woman about to give birth. After she has her baby, another couple arrives...and it turns out that rather that being two heterosexual couples, the men are a gay couple and the women a lesbian couple. The women used their gay friend as a surrogate father and made him and his partner both the godfathers.
  • Replaced the Theme Tune:
    • The theme was dropped after Season 12, but was brought back for the series finale.
    • The original theme tune had two different lead-ins. Either the music would start with a "hard" lead-in (the sound of a heartbeat) or a "soft" lead-in.
  • Replacement Scrappy: invoked
    • Invoked. Reilly, for Raul Melendez, Shep's best friend and partner who got burned and died after trying to save some children. Not only is Reilly incompetent and a wet-behind-the-ears rookie, he reports Shep for use of excessive force when Shep shoves a teenager into a coffee table. However, Strawman Has a Point—Shep is clearly out of control and Reilly correctly states that Carol's covering for him isn't going to help his PTSD at all.
    • Invoked by Carter for Lucy. Carter originally isn't thrilled about Lucy's joining the hospital, partly because she's fairly useless and partly because Anna had just left to live with her recovering drug addict boyfriend in Philadelphia, which hurt Carter who had unresolved romantic feelings for her.
  • Retcon:
    • Early on, Benton insisted that he had not checked the "African-American" box when applying to med school because he wanted to succeed solely on his own merits (which would seem to fit with his incredibly driven characterization). A few seasons later they changed this and he was revealed to have checked the box and gotten into med school ahead of some more-qualified white applicants.
    • Rachel Greene (Mark's eldest daughter) was 5 when the series began, and aged naturally year by year. When Yvonne Zima (b. 1989) was replaced with Hallee Hirsh (b. 1987), the character was made two years older: 14 when she should have been 12. This worked out for the series finale, since it made Rachel exactly the right age (22) to be applying to medical school in 2009.
  • Re Tool: At the beginning of season 5 with the introduction of Lucy Knight, starting a new student-mentor arc with Carter moving up to the mentor role. Although Carter had been a mentor to students before, Knight's introductory episode was more openly a soft relaunch for the series, with a lot of effort put in to explain things for new viewers. For instance, every character gets an introduction using their full name, there are multiple As You Know moments to bring viewers up to speed, and several scenes of Lucy and other students walking around the ER, to show off the set.
  • The Reveal:
    • In "Night Shift", a patient who is badly mangled after jumping (or falling) onto the tracks in front of an elevated train is rolled into a trauma room. Benton tells Nurse Lydia to page his "favorite" medical student Dennis Gant, and everyone is horrified when the patient's beeper goes off—it's Gant on the table!
    • When Mark discovers his wife is having an affair. Although, much like Carter's wealth, there were subtle hints beforehand that Mark just didn't pick up on.
    • When Kerry discovers Carter and Lucy bleeding to death on the floor of a patient's room.
    • When Neela discovers that Ray had both of his legs amputated following his accident.
  • Revolving Door Casting: By the end of the series, none of the original cast (or the extended cast members from Seasons 2 and 3) remained. They did all return for guest appearances during the final two seasons.
  • Rising Water, Rising Tension: Occurs in "Hell and High Water", as Doug tries to rescue a boy trapped in a storm drain. There's a very scary moment when you realize that they're both going to drown if he can't free the kid.

    S-Y 
  • Scary Surprise Party:
    • A Running Gag where the staff would trick a co-worker into thinking they were needed for a medical emergency, only to happen upon their surprise birthday party/welcome back party/going away party/bridal shower/baby shower.
    • Averted with Susan in Season 3. The staff plan one of these, but then they get caught up in an actual medical emergency and can't give her a proper send-off.
  • Self-Harm: In one episode, a self-injurer is treated at the clinic.
  • Sequel Hook: A fair amount of episodes in Season 8, as well as the descriptions for the DVD box-set read like a sales pitch for the Anthony Edwards/Mark Greene-less Season 9. Particularly egregious is the season finale, which completely undercut the powerful and sad "On the Beach" for a completely obvious sequel hook that could have easily been the Season 9 premiere instead.
  • Sexy Shirt Switch: Played Straight plenty of times, but Subverted with Ray and Neela. Neela wears Ray's shirt to bed because it's comfortable, not because they're sleeping together. This is later important because the two develop feelings for each other and she offers it back when she moves out.
  • Ship Sinking: Benton and Jeanie fall in love over the course of Season 1, beginning an affair as it ends. However, she soon ends it, declaring that she's not ready to end her marriage. She resurfaces a few episodes after that, having left her husband after all, but there's too much tension and anger for any talk of resuming their relationship. The final nail in the coffin is when he's a completely unsympathetic and unsupportive jerk to her over her HIV status.
  • Ship Tease: Tons, but none more merciless than Ray and Neela.
  • Shirtless Scene: Plenty.
  • Shout-Out:
  • Slut-Shaming: Played with. At one point during Jing-Mei and Pratt's relationship, she lets Susan borrow a blouse after Susan's gets stained during their shift. When Susan and Abby later do a procedure which requires a Wood's Lamp (a blacklight), they notice an obvious, and suggestive, series of blotches on the front of the blouse. When Susan returns the blouse and tries to tactfully ask about this, Jing-Mei explains she'd spilled club soda on it while at the bar the previous night — reminding Susan that dried club soda also flouresces under black light — which was why she'd had it hanging up in the staff room to dry, and asks Susan if they really thought she was "the ER slut coming into work with spunk all over her?" Susan feels guilty and tries to apologize, but the offended Jing-Mei walks out. As she leaves the building, however, she takes the blouse and tosses it in a trash can, implying that the stain actually was from Pratt's semen.
  • Smoking Is Cool:
    • Jerry smokes a cigar occasionally.
    • In the first three seasons Susan also smokes occasionally, which is odd considering the vast amount of lung cancer patients she has treated.
    • Mark starts smoking after his beating, but eventually quits after seeing a dying lung cancer patient.
    • Carter smokes after his stabbing and quits after deciding that he'll get serious about rehab.
    • Abby smokes and drinks.
  • Something Completely Different: Every season of the show featured an episode that was completely unlike the others. Notable highlights include: "Love's Labor Lost" (one story as opposed to multiple), "Hell and High Water" (similar), "The Long Way Around" (took place mostly outside the hospital), "Ambush" (live, "documentary style"), "Fathers and Sons" (took place completely outside of the hospital and over several days rather than the 24-hour format of most episodes, had nothing to do with medicine, and focused on only two of the main characters), "Secrets and Lies" (A Breakfast Club-type episode in which four of the doctors and Abby attend a sexual harassment seminar), and "Time of Death" (took place in real time).
  • Status Quo Is God: This was all but guaranteed anytime it seemed that a character might be leaving the hospital for another job. As long as it was known that their portrayer didn't intend to leave the show, there was no reason to angst:
    • Doug is fired a third of the way into Season 2 and by the beginning of the next episode, accepts a job offer at a prestigious clinic. However, said episode was the legendary "Hell and High Water". By the episode after that, the hospital administration was so impressed by his heroic actions that they offered him his previous job back.
    • In the Season 2 finale, Carol gets fed up with the red tape she constantly has to deal with and quits. By the Season 3 premiere, she's back at work, with absolutely no explanation as to how she got her job back and aside from one other person snarking, "Well, you could always quit again" when she was complaining about something, no references to it were ever made.
    • At the beginning of Season 9, Elizabeth was shown to have returned to London (with her husband's death, she no longer had any ties to Chicago. It was also completely plausible, given the longer time frame). By episode's end, being very unhappy and having realized that she no longer fits in in England, she decides to return to Chicago. By the very next episode, she's back at work, having resumed her job and moved back into her house without the slightest blip.
  • SteadiCam: The show's visual trademark was a "oner" of doctors working on a patient, filmed using a SteadiCam, with the camera operator circling the room. Often it involved going to the second room in a track shot, cover the situation there and return to the first patient with another doctor joining the procedure.
  • Suspiciously Similar Substitute:
    • Following his departure, Doug was replaced with three people in Season 6—Cleo (a skilled and dedicated pediatrician), Luka (brooding hunk with a troubled past and a yearning for Carol, and a resemblance to him), and Malucci (brash, impulsive, problems with authority).
    • As the other original cast members left, others characters were often introduced in either the abrasive go-getter mold, or the plucky Na´ve Newcomer.
    • Except for Carter, one of the only characters to be in every season, even if he's only mentioned in passing. The others being minor characters that never receive main cast billing.
  • Team Mom: Angela Hicks, to Benton and Carter. The two are literally on her team, and she takes care of and counsels both Benton and Carter before Carter switches to Emergency Medicine and Benton joins Romano's team.
  • There Are No Therapists:
    • Averted. Susan sees a therapist after losing baby Suzie (who she raised as her own after Chloe abandoned her) to her sister.
    • Carol tries to get Shep to see a psychiatrist to deal with his PTSD, but he outright refuses to go, or even admit he has a problem. Carol, as a result, breaks up with him. She sees him months later with another, blonder, woman.
    • Doug sees a shrink (offscreen) after one of his one night stands ODs and dies in the ER.
    • Played Straight with some patients. Often times the ER doctors will try to get patients who obviously need psychiatric help admitted to the psychiatric department (or psych, as they call it) only for these patients to be turned away for various reasons. These patients inevitably either come back, having harmed themselves or others, or turn up dead. Most notably, in "Be Still My Heart", Lucy and Carter call for a psych consult on a schizophrenic patient but are kept waiting long enough for the patient to have a psychotic break and stab both Lucy and Carter, ultimately killing the former and permanently damaging the latter both physically and psychologically.
    • Subverted in one episode in which Luka appears to be talking to a therapist before it's revealed that she's a prostitute.
  • There Is a God!: The episode "Whose Appy Now?". Carter's upset because he's being denied the chance to perform an exciting surgery and reassigned to an appendectomy instead.
    Dr. Angela Hicks: You haven't seen the patient yet.
    [Carter looks out the window and sees Benton being wheeled down the hall on a gurney]
    Carter: Ohhhhhhhh there is a God!
  • This Is a Work of Fiction: The hospital is called Cook County General Hospital. It wasn't intended to be a fictionalised version of the real-life Cook County Hospital, now named the John H. Stroger, Jr. Hospital of Cook County. However, the head of Emergency Medicine at the actual hospital was so infuriated at the depiction of the hospital in the show, partly because some of the stuff depicted actually happens in the real-life hospital, that he tried to lean on the ER producers to rename it. They eventually relented somewhat and the hospital is usually referred to as County General. However, as this article points out, by doing so, the ER producers missed a veritable gold mine of story ideas based on the strange stuff that actually goes on in the real County Hospital.
  • Tonight, Someone Dies
  • Took a Level in Dumbass: Neela in Season 13. Instead of properly mourning Gallant's death by staying single for a while, she enters a relationship with Gates only weeks after Gallant's funeral. Then, despite being angry at Gates' constant lying and issues with Meg and Sarah, and despite clearly being miserable in the relationship, she doesn't break up with him. Then, after she and Ray share their First Kiss and he tries to pursue a relationship with her, she tells him that she needs time to figure out her feelings for both him and Gates, even though she has genuinely been enjoying spending time with him again. Thankfully, she gets better—first, she admits to Ray that she made a mistake by rushing into a relationship with Gates because she was On the Rebound from losing Gallant, and she would've felt guilty if she used him as her rebound. Then, she breaks up with Gates. Then, she spends all of Season 14 single. Then, she comes to terms with her love for Ray in the final season, culminating in her leaving County Hospital to reunite with him in Baton Rouge.
  • Took a Level in Jerkass:
    • Benton's sister Jackie after the murder of her son. Comes to a head during the custody battle over Reese between Benton and Roger McGrath when she tells Roger to butt out of their life and that Reese is "theirs." This is despite the fact that Roger also views Reese as his own son and treated him as such.
    • Benton himself, who had the same attitude, even refusing Roger's completely reasonable offer to give him full custody as long as he could visit. When the judge hands down a custody agreement that is virtually identical to the offer Roger made, Benton's behavior becomes especially pointless.
    • Mark after Susan leaves, and then after getting beaten up.
  • Twofer Token Minority:
    • Raul Melendez, the paramedic and Shep's partner, is both Hispanic and gay.
    • Kerry's girlfriend Sandy Lopez is Hispanic, gay, and a woman.
    • The show had no less than three bi-racial women, including Gloria Reuben (Jeanie Boulet), Michael Michele (Cleo Finch) and Thandie Newton (Kem).
  • Two First Names: Doug Ross, Susan Lewis, John Carter, Archie Morris, Frank Martin, Tess and Kate Ross, and Carla Reese, among others.
  • Unexpected Inheritance: With Romano's death, the Hospital was the beneficiary of a great sum of money. Knowing he was homophobic, Kerry decided to put it to a treatment center for the LGBT community.
  • Unexpected Positive: An episode had Carter demonstrating to several medical students how to examine a patient's lymph nodes—only to discover a lump in the neck of the student he was examining. After doing a biopsy, he gently informed him that he had lymphoma.
  • Unfortunate Implications: invoked
    • Invoked. After returning from Doctors Without Borders, Luka becomes obsessed with doing the bare minimum for his patients, as that is what doctors in countries like the Congo have to work with (really he was just trying to keep from doing unnecessary tests and procedures to save them money). Pratt calls him out on this, telling him "Maybe you should just go back to Africa." Luka's response? "Maybe you should go to Africa!" Pratt is black. This understandably pisses him off quite a bit, although in Luka's defense, he only meant it in the sense of "Try doing medicine under those conditions and get back to me." Ironically, Pratt did go to Africa in Season 12, on Luka's orders no less.
    • Invoked. In "Blizzard", Caucasian Doug mistakes African-American Angela Hicks for a nurse—to the point where he's giving her orders, etc.—before she coldly informs him that she's a doctor. He winces at the mistake, realizing how badly he's come across. It's a pretty cringeworthy moment for someone who's heretofore shown no signs of being a racist nor sexist, despite his womanizing. In Doug's defense, he had no idea who she was and had apparently assumed that she was a nurse sent up to help with the busy day.
    • Eriq LaSalle felt this about his character's relationship with Elizabeth, not liking that Benton had had failed relationships with African-American women, only to have a normal one with Elizabeth. Viewers felt this about his feelings, as though he were insinuating that an interracial relationship were something to be ashamed of.
  • Unfortunate Names: Tess Ross, eldest daughter of Doug and Carol. Both fine names, but put them together and it doesn't work as well.
  • Ungrateful Bastard: The patient whose life Kerry saves by performing an exceedingly-controversial late-term abortion, polarizing the opinions of the cast in the process. Kerry meets up with her later in recovery, and she reveals that she's been pregnant several times before and had an abortion every time because her husband doesn't want kids. When Kerry tries to tell her to use birth control, the patient brushes it off with "More likely you just never get any yourself."
  • Unrequited Love Switcheroo: This happened very often with the show's Love Triangles:
    • Doug spent the first half of Season 1 pining for Carol, who rebuffed him, as she'd moved on and gotten engaged. By the second half of the season, he'd begrudgingly accepted this and moved on into a new relationship himself, only for Carol to be the one to be jealous every time she saw them together.
    • Carter spends Season 7 mooning over Abby, who's with Luka. By the time she breaks up with Luka, Carter's with Susan.
  • The Unseen: Starting from Season 3, Benton's brother-in-law Walter (played by Ving Rhames) stopped appearing and was only ever mentioned.
  • Vengeful Vending Machine: The series pulls this gag at least once a season.
  • Viewers Are Geniuses: Aside from averting As You Know, this was the main reason for leaving the bulk of the medical jargon "untranslated"—when writing the Pilot, Michael Crichton reasoned the audience would be able to rely on context and observation to figure out what was going on.
  • Vomit Indiscretion Shot:
    • At least once a season.
    • Averted in "All in the Family". When Kerry steps outside into the ambulance bay to puke into a trashcan after seeing the results of a schizophrenic patient's attack on Lucy and Carter, her head is obscured by the lightbar of a police vehicle in the foreground.
  • Walk and Talk: John Wells, producer of ER, went on to take the helm of The West Wing.
  • Wall Glower
  • Welcome Episode
  • Welcome to Hell: In "Doctor Carter, I Presume?"
  • Wham Episode:
    • One of the most notable was also one of the first, "Love's Labour Lost", featuring Mark trying to save a pregnant woman and her child. He succeeds with the latter, but not the former.
    • "Be Still My Heart" is a very run-of-the-mill episode...until the final minutes, when Carter is stabbed. As he collapses, he—and we—see Lucy in even worse condition.
    • The follow-up episode "All in the Family" is just as intense, but it appears that Carter and Lucy will be okay...until she develops a pulmonary embolism and dies.
  • Wham Line:
    • In "Last Rites", Carla plans to move with Roger to Germany and they plan to take Reese with them. Carla and Benton are arguing and Carla suddenly yells out "You may not even be his father!" Benton is stunned and staggers for a bit, before he asserts himself and says "Reese is my son."
    • A patient commits suicide in the ER after having been on a Jerry Springer-esque talk show where it was revealed to her that her boyfriend was "really" her long-lost brother. As her mother sits beside her body, she tells Mark that "It was a lie"—she just wanted to get her daughter onto the show.
    • In "The Letter", a fax is sent to the hospital from Mark, going on and on about how much he loves and respects everyone there. Carter reads it, then pauses to deliver an addendum from Elizabeth. Even though everyone on and off-screen knew it was coming, it still has this effect:
      "Mark died this morning..."
  • Wham Shot: In the Season 13 finale, Neela finally tracks down the missing Ray in another hospital after learning he was hit by a truck. She sees him being wheeled to his bed and smiles. Then the wheelchair is pulled back further and she—and we—see that both of his legs have been amputated.
  • What Happened to the Mouse?:
    • Remember Tracy Young, the third-year medical student beginning her ER rotation in the Pilot? Neither does anyone else. She was intended to be Carter's Distaff Counterpart and a possible love interest for Doug, but she was Dropped After the Pilot when TPTB decided to have Carol recover from her drug overdose.
    • In Season 1, it's mentioned at least twice that Doug has a son. Scant details are given about this except the boy's age (8) and that Doug doesn't even know the boy's name. His son is never mentioned again throughout the rest of his time on the show, not even during key storylines where it would make sense—his abusive father resurfacing and later dying, and then his and Carol's decision to have a baby. At one point, when someone asks Doug if he has any kids, he replies "no."
    • Some recurring characters just flat out disappeared, notably Dr. Angela Hicks, "Dr. Bob", and several others. Oddly enough, in Season 6, Hicks' locker is clearly next to Kerry's, even though Hicks stopped appearing after the second episode of Season 4, "Something New".
    • Child prostitute Charlene "Charlie" Chiemingo (played by Kirsten Dunst) had a six-episode arc in Season 3, where Doug tries to get her off the streets. In the Season 3 finale, Doug and Anna treat her after she overdoses on hardcore drugs, but she escapes the ER to go back on the streets. They give up on her after failing to locate her, and she's never mentioned or seen again.
    • Maggie Doyle originally disappeared without explanation, but then it was implied by Kerry that she was forced out when her sexual harassment case against Romano fell apart because Elizabeth refused to testify.
  • What the Hell, Hero?:
    • In Season 2, Benton tells a grandfather that Doug completely missed his grandson's bone cancer when he came in for treatment four months ago. He did this even though Mark specifically told him not to (it wouldn't have helped the patient and would have put the hospital at considerable risk of lawsuit) and even though it wasn't really Benton's case. Understandably Doug was really pissed off, as were the rest of the hospital staff (some of who outright refused to work with him) and Mark, who called him on it and claimed Benton was just angry that he couldn't do anything about Carl Vucelich's manipulation of research data. Only Jeanie thought he did the right thing. Then again, they were having an affair at the time.
    • In Season 3, Mark violates Jeanie's privacy by snooping through her medical records in order to find out if she's HIV positive. Upon finding out that she is, he displays a stunning level of ignorance for a regular person, much less a doctor—yanking her away from treating patients, being very reluctant to let her stitch up his cut forehead, etc.
    • Carter gets this in Season 4 when he's in charge of treating a serial rapist who had sent several elderly women to County earlier in the season. Rather than use the ER's last unit of blood on the rapist, Carter uses a riskier method of treatment (auto-transfusion) that could have resulted in the patient's death. When the rapist survives, Carter not only gets the cold shoulder from some of the other staff for saving the guy, Anna lays into him for taking chances and endangering his patient.
    • Carol massively lays into Doug in Season 5 after his decision to help a distraught mother euthanize her terminally ill son leads to her clinic being closed, Mark and Kerry facing disciplinary charges, and a possible criminal investigation being opened by the boy's estranged father (though nothing ultimately comes of the last one).
    • In the Season 6 finale, when Luka refuses to take his less critically injured patient off a helicopter in favor of Benton's more severely injured one. Why? As he says to Benton, "Your patient killed people!" (the patient was a school shooter who had been himself shot by the police; Luke had taken one of his victims into the helicopter instead). Benton tells him that that's not their call to make, to no avail. Sure enough, the man dies because he's unable to reach the hospital in time. In fact, Luka has many moments like this throughout his tenure on the show, tending to treat his Asshole Victim patients with utter contempt rather than remaining objective. Considering where Luka comes from and his backstory, it's entirely understandable.
    • Benton again gets a moment like this in the Season 7 finale, where he ignores a patient's repeated assertions that he doesn't want any treatment and is ready to die, to the point where he prepares him for a blood transfusion and surgery once the man passes out. It's pretty bad for a doctor who's been objective almost to a fault to so blatantly ignore and override his patient's wishes like that.
  • Will They or Won't They?: Several throughout the series:
    • Doug and Carol, during the first three seasons. They Do.
    • Mark and Susan, again during the first three seasons. They don't.
    • Luka and Abby. They Do.
    • Ray and Neela. They Do.
  • Woobie, Destroyer of Worlds: Curtis Ames loses his health, hand, livelihood, money, and even family from Luka's error, finally snapping and making Luka—at gunpoint—break his own hand via vise, giving him Ames's pain and hurting his own livelihood. And when Luka finally invokes My God, What Have I Done? and apologizes for Ames's Trauma Conga Line, Ames is Driven to Suicide, having nothing left.
  • Worst Aid:
    • Typically Averted, though some of the CPR scenes practically qualify as Narm.
    • Most of the erroneous CPR was justified: performing completely realistic-looking CPR on an actor could be dangerous. The trope still applies to the more egregious examples, though.
    • Averted in the Season 6 finale. At the scene of a mass shooting, Luka told a police officer to stop giving CPR to somebody whose brains were splattered all over the concrete.
  • Write Who You Know: invoked
    • Someone writes a torrid soap-opera romance novella set in an emergency room and featuring characters that are all romanticized—or in Kerry's case, vilified—versions of the ER staff. Word of God says the author was Kerry.
    • Michael Crichton was a physician. Many of the events of the Pilot were based off his experiences, particularly the bit where Mark leaves a "wake up" note on an exam room door.
  • You Called Me "X"; It Must Be Serious: When Sam's ex-husband plans a prison escape (faking an illness serious enough to get taken to the hospital, and having accomplices in place to help), he also forces Sam (at gunpoint) to help. Abby sees Sam escorting people out of the hospital (something that typically isn't a nurses job), and asks if Sam's seen Luka (who was tied up and drugged by one accomplice). Sam tells her that she should look for Luka in the suture room (where he is), then ends by saying "Okay, Abigail?" Since virtually no one calls her that, Abby immediately senses something is wrong, and the situation spirals into a shootout between the escapees and some cops that are in the ER.

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