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  • Acting in the Dark: The production could only afford to occasionally shoot on location in Chicago so the actors and crew would be given briefs and snippets of scenes for multiple episodes that they would have to rush to complete without knowing the context of what they were doing. Sometimes the writers didn't even know what was going on, often being told to take scenes pre-shot in Chicago and to build episodes around them.
  • Actor-Shared Background:
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    • Maggie Doyle offhandedly mentions that she's a vegetarian—"No meat, no men." So is her actress, Jorja Fox.
    • Both Michael Michelle and Thandie Newton and their respective characters, Cleo and Kem, are biracial, though the mixes are different—Michael and Thandie's fathers are white, while Cleo and Kem's mothers are.
    • Neela mentions playing the viola in "Damaged" and "Alone in a Crowd", and she plays to her visiting parents in a deleted scene from the former. Parminder Nagra does actually play the viola.
    • Ray is originally from Baton Rouge, and he spends Seasons 11 and 12 as a rock musician. Shane West is actually from Baton Rouge, and he's also a punk rock musician.
    • Goran Visnjic and his character Luka Kovac not only both hail from Croatia, they had traumatic experiences in The Yugoslav Wars. (Though Luka's experiences were as a doctor, not a combatant, and far worse than Goran's—losing his entire family).
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  • Award Category Fraud: Possibly to avoid canceling each other out (as possibly happened to Anthony Edwards and George Clooney along with Noah Wyle and Eriq La Salle), Julianna Marguiles was nominated for Best Supporting Actress during the time when Sherry Stringfield, who was nominated for Lead, was a cast member, even though the two had roughly the same amount of screen time and storylines.
  • Blooper:
    • In "Love's Labor Lost", as Mark futilely tries to revive the patient, Carol can clearly be seen taking off her glasses in the background. When the patient is pronounced dead and we get the individual reactions of everyone in the room (Susan, Carol, Lydia, Carter and Jing-Mei), Carol is seen taking off the glasses again.
    • During a surgery scene in Season 3, Abby Keaton charges into the OR walking forward, pushing the door open with her hands. No surgeon would ever enter an OR like this—it would contaminate their hands.
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  • California Doubling: Set in Chicago, filmed in Los Angeles. They would occasionally travel to Chicago to film scenes in exteriors and on the L, shooting bits for multiple episodes in blocks.
  • The Danza: In S06E07 "Humpty Dumpty", Rosalind Chao plays a neurologist called Doctor Chao.
  • Dawson Casting:
    • In 1995, Rachel Greene celebrates her 6th birthday. Assuming a birth year of 1989, by 2001 Rachel would have been 12. Yvonne Zima, who had played Rachel up to this point and who was exactly 12, was replaced by 14-year-old Hallee Hirsh.
    • Kat Dennings was 19 when she played 14-year-old Zoe Butler, Ray's underaged groupie, in Season 12.
  • Deleted Scene: The DVDs feature numerous deleted scenes from various episodes, all of them unedited (certain sound effects or special effects needed to be added in post-production). Interestingly some of the scenes were subplots that were scrapped so they could be re-used or re-worked for later episodes. "On the Beach" had a wealth of deleted scenes, showing (amongst other things) Mark watching Ella take her first steps, Mark and Elizabeth writing his letter to the ER (as seen in "The Letter"), and Elizabeth talking to Benton at Mark's funeral.
  • Development Hell: The Pilot was written in 1974 and filmed 20 years later. Despite the huge time gap, few changes were necessary, aside from making at least one of the doctors a woman instead of a man (Susan), and another a black man instead of a white one (Benton).
  • Directed by Cast Member: Several main or recurring cast members helmed episodes of the show. These included Anthony Edwards, Paul McCrane, Laura Innes, Eriq La Salle, and Vondie Curtis-Hall. For a few of them, they continued to direct after their characters left the show.
  • Disabled Character, Disabled Actor: Matthew Watkins, who plays Reese, is deaf in Real Life.
  • Dueling Shows: With Chicago Hope, another drama series set at a hospital in Chicago, Illinois that happened to premiere one day before ER did. The two ended up competing directly against each other on Thursdays at 10:00 P.M. (with ER on NBC and Chicago Hope on CBS). ER ended up easily winning commercially, maintaining a place as one of the most-watched shows on television for its first ten years and managing to stay on the air for fifteen seasons, whereas Chicago Hope ended up finishing its run after its sixth season. At the Emmy Awards, the two tended to trade off, with ER being the only one of them to win the Drama Series prize, but Chicago Hope winning more often for its main cast members.
  • Fake American: Gloria Reuben (Jeanie) is Canadian.
  • Fake Mixed Race: Inverted. Gloria Reuben is of mixed race (black mother, biracial father). Jeanie is apparently not—we never learn much about her background, but she never mentions either parent being white.
  • Hide Your Pregnancy:
    • Glenne Headly was pregnant when she played Abby Keaton in Season 3, but this was disguised with surgical scrubs, having her frequently sitting or lying down and placing her behind counters or gurneys.
    • Parminder Nagra (Neela) was pregnant towards the end of the final season. There were attempts to disguise her bump by filming her scenes from the chest up, having her sit, wearing surgical scrubs, keeping her coat on, using her bag to cover up, or placing her behind counters or gurneys, but it was still visible in wide shots.
    • Subverted with Ming-Na (Jing-Mei Chen) and Alex Kingston (Elizabeth Corday). Although their pregnancies were written in, the actresses were much further along than their characters, resulting in this trope for several months until they could catch up.
  • Hostility on the Set: Noah Wyle (John Carter) and Kellie Martin (Lucy Knight) did not get along, resulting in her character not being used very much or developed (once he nixed plans for her to be his girlfriend) note  and her deciding to leave the show.
    • Wyle's attitude apparently also affected other co-stars—he has admitted to being hostile to other newcomers such as Erik Palladino and Michael Michele. Reportedly, when Wyle once complained about the buffet for cast and crew, Goran Visnjic (Luka Kovac) snapped "How dare you complain about this food when there are people all over the world who would give their lives for a fraction of what you have!" (Apparently this was due to the Croatian Visnjic's experiences as a veteran of the The Yugoslav Wars.)
  • In Memoriam: When creator Michael Crichton passed away in 2008, Eriq La Salle gave out a speech about Crichton's passing.
  • McLeaned: Lucy Knight was murdered by a schizophrenic patient when her actress Kellie Martin wanted to leave the show, wanting to pursue other projects as she'd never really fit in during her time on the show.
  • Mid-Development Genre Shift: Michael Crichton wrote the Pilot in 1974, with the intent of it being a film rather than a TV show.
  • Name's the Same: John Carter, huh.
  • The Other Darrin: Several supporting characters were played by different actors:
    • Perhaps most notably, Mark's eldest daughter Rachel Greene was originally played by Yvonne Zima in Seasons 1-6 and then by Hallee Hirsh for the rest of the series.
    • Jeanie's first husband Al Boulet was played by Wolfgang Bodison in Season 1 and then by Michael Beach in Seasons 2-4.
    • Carol's mother Helen was played by Georgiana Tarjan in Season 1 and then by Rose Gregorio in Seasons 3-5.
    • Rather egregiously, Roger McGrath (Carla's husband) was played by Victor Williams in Seasons 4-7, but in Season 8 he was suddenly played by Chicago Hope's Vondie Curtis-Hall, who previously guest-starred as Carter's suicidal transgender patient in Season 1.
    • Jing-Mei's father Mr. Chen was played by George Cheung in Season 10 and then by Henry O in Season 11.
    • Sam's son Alex was originally played by Oliver Davis in Seasons 10 and 11, but due to Davis' commitment to the show Rodney, he was replaced with Dominic Janes for the rest of the series.
  • Playing Against Type: Linda Cardellini has said that the reason why she took the role of Sam Taggart is because she never played a working class woman before, and it sounded like something she wanted to do, as she had only played much younger girls and comedic roles prior to ER.
  • Post-Script Season: Season 15 was necessary to give the series a proper sendoff, as the planned final season—Season 14—coincided with the 2007-8 writers' strike.
  • Reality Subtext:
    • Maggie Doyle offhandedly mentions that she's a vegetarian—"No meat, no men." Her actress, Jorja Fox, is one as well, as was her character in CSI, Sara Sidle.
    • Benton's brief, troubled relationship with Elizabeth is partly because Benton can't get over his discomfort with dating a white woman, echoing his portrayer's sentiments—Eriq La Salle believed that having Benton date a white woman played into dubious ideas about successful black men being "above" dating black women.
  • Real-Life Relative:
    • Miguel Ferrer (George Clooney's cousin) and Rosemary Clooney (Clooney's aunt and Ferrer's mother) both had roles in Season 1, although neither interacted with Clooney on-screen.
    • David Brisbin, who plays Alexander Babcock, is married to Laura Innes. They got to interact at least once, when Kerry is in the ICU screaming at Doug for doing a procedure in secret and without parental consent.
    • Anupam Kher and Kirron Kher, who play Neela's parents, are married.
    • Courtney B. Vance is married to Angela Bassett, who plays Catherine Banfield. He plays her husband Russell.
  • The Red Stapler: Applications to ER medical residency programs skyrocketed after the series premiered.
  • Role-Ending Misdemeanor: Lisa Nicole Carson, who plays Carla Reese (the mother of Benton's son) had concurrent roles in both ER and Ally McBeal. She was fired from both for drug use and erratic behavior, as well as being in and out of mental hospitals. The ER producers were tired of her "unpleasant attitude."
  • Star-Making Role:
    • For George Clooney.
    • Also counts to a lesser extent for Julianna Marguiles, Noah Wyle and Mekhi Phifer.
    • This was true for most of the original main cast, subsequent main cast, and supporting cast, although none of them have reached the heights Clooney has. Anthony Edwards is the exception—he was already well-known before the show, appearing in major roles in Revenge of the Nerds and Top Gun, and he was the de-facto star of the show for the first eight seasons.
    • While Linda Cardellini got her big break with Freaks and Geeks, she has said that she became more easily recognizable after she joined the show in Season 10.
  • Those Two Actors:
    • Three actors from Top Gun—Anthony Edwards (Goose/Dr. Mark Greene), Rick Rossovich (Slider/Tag), and Michael Ironside (Jester/Dr. William "Wild Willie" Swift)—appeared on the show.
    • Four actors from Life Goes On—Kellie Martin (Becca/Lucy Knight), Troy Evans (Artie/Frank), Chad Lowe (Jesse/George Henry), and Chris Burke (Corky/George)—appeared on the show at various times, though never together.
  • Wag the Director: According to some reports, the romantic relationship between Dr. Benton (played by the African-American Eriq La Salle) and Dr. Corday (played by the white Alex Kingston) ended because La Salle thought that it had Unfortunate Implications suggesting that successful middle-class black people were "above" dating other black people.
  • What Could Have Been:
    • The show was going to be set in Boston until it was realized that this was too similar to St. Elsewhere.
    • Julianna Margulies originally read for the part of Mark's first wife Jen.
    • Carol was originally slated to die in the pilot, committing suicide after her break up with Doug. Julianna Margulies' performance in the pilot convinced the show-runners to have her recover and make her a regular in the subsequent episode.
    • Lisa Zane tested for the part of Susan. She would later play one of Doug's temporary love interests.
    • Laura Innes auditioned for the role of said love interest before being cast as Kerry.
    • Remember those Law & Order and Homicide: Life on the Street Crossover episodes? At one point, TPTB wanted to include ER, but ER's producers either declined outright or the collective group couldn't figure out how to work ER into the storyline.
    • The producers wanted to pair Carter and Lucy, but Noah Wyle was adamantly opposed to this, feeling that it would be out of character for Carter to pursue an inappropriate relationship—Lucy was still a medical student and therefore Carter's subordinate.
    • Sam Rockwell was considered for John Carter.
    • Sissy Spacek was originally cast as Kerry's mother, but the role was eventually played by Frances Fisher.
    • Noah Wyle was originally supposed to appear in a handful of episodes in Season 13, but this was pushed back to Season 14 (which was supposed to be the final one). However, the 2007-2008 Writers' Strike led to NBC renewing ER once again, so he ended up appearing again in Season 15 (along with several other cast members).
  • Written-In Infirmity: 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.
  • You Look Familiar: The producers apparently had a rule that they would never cast the same actor twice, but they still flubbed it quite a few times:
    • Shiri Appleby played a patient in the Pilot and then Dr. Daria Wade in the final season.
    • Ken Lerner played two different patients—a salesman in Season 1 and then a prostate cancer patient in Season 8.
    • Vondie Curtis-Hall played Carter's suicidal transgender patient in Season 1 and then Roger McGrath in Season 8.
    • J.P. Manoux played a mime in Season 2 and then Dr. Dustin Crenshaw in the last three seasons.
    • Diane Delano played an abused girlfriend in Season 3 and then a hypochondriac patient in Season 9.
    • Jesse Borrego played an HIV positive patient in the Season 4 premiere and then desk clerk Javier in Season 14.
    • Justina Machado played a patient's sister in the Season 4 premiere and then police detective Claudia Diaz in the final season.
    • Jenette Goldstein played a patient's mother in Season 5 and then a helicopter medic in Season 7.
    • George Cheung played a cancer patient's son in Season 5 and then Jing-Mei's father in Season 10.
    • Keiko Agena played a hearing-impaired patient's mother in Season 5 and then a patient's wife in the final season.
    • Steven Culp played Dr. Charles Cameron in the Season 6 premiere and then a teacher in Season 10. Coincidentally, both characters were temporary love interests for Elizabeth.
    • Steven Christopher Parker played a patient in Season 11 and then Dr. Harold Zalinsky in Season 14.
    • Julia Ling played a patient in Season 12 and then medical student Mae Lee Park in Season 13.

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