The Charge

"Do you know what people call this place? Not St. Eligius. St. Elsewhere. A dumping ground, a place you wouldn't want to send your mother-in-law."

Opening Statement

Nominated for 63 Emmy Awards and winner of 13, St. Elsewhere is the grand-daddy pedigree medical drama show, the retired heavyweight champ from back in the day. A longstanding holdout on DVD, St. Elsewhere: Season One brings this influential award-winning medical drama to our living rooms. But how has the show held up after all the years? Has it been supplanted by newer, flashier shows?

Facts of the Case

St. Eligius may not be the newest teaching hospital in Boston—okay, definitely not the newest—but it prides itself on quality care despite the leaking roof, cramped conditions, and malfunctioning equipment. Within the medical community, the hospital has been dubbed with the unfortunate nickname "St. Elsewhere"—a dumping ground for more well-equipped hospitals to send their undesirable patients, a second-rate decaying hospital. But for the doctors and nurses who spend endless hours toiling there, it often takes precedent over their real, private lives…if they manage to have private lives, that is.

Dr. Donald Westphall (Ed Flanders, MacArthur)
The head of St. Eligius, Westphall is the father figure for the entire hospital—hard on his residents, but in a kindly sort of way. Though not always in touch with the image problems his hospital suffers in the public's eye, he is a superb doctor, works late hours, and is the driving force behind the hospital.

Dr. Daniel Auschlander (Norman Lloyd, Dead Poets Society)
Gentle and kind, Dr. Auschlander is like the grandfather everyone wishes they had. His residents admire his work and his kindly nature. Unfortunately, he is a young man trapped in an old man's body. When he begins to suffer ill effects from cancer remission, he must come to peace with his age and declining health.

Dr. Mark Craig (William Daniels, Knight Rider)
Opinionated, bigoted, and exasperating, Dr. Mark Craig has an egregious bedside manner and arrogance that is dwarfed only by his talent with a scalpel. As the Chief of Surgery at St. Eligius, he terrorizes the young surgery residents, including Dr. Ehrlich.

Dr. Ben Samuels (David Birney, Nightfall)
Samuels is the archetypal doctor: confident, kind, handsome, and charming, dwarfed by his massive ego and weakness for the ladies. When his old girlfriend comes to town as a new staff member, he finds himself in conflict between his personal feelings and his professional responsibilities.

Dr. Annie Cavanero (Cynthia Sikes, J.A.G)
Cavanero is a successful and talented doctor, but her professional detachment gives her an icy demeanor that puts her into conflict with the nurses at St. Eligius. She struggles with the decision of having mortgaged much of her personal life in order to succeed in her profession.

Dr. Victor Ehrlich (Ed Begley, Jr., Arrested Development)
Tall and blond, Ehrlich, for all his surgical potential, would rather be surfing back in California than suffering under the tutelage of Chief of Surgery Dr. Mark Craig. He struggles to keep up with the grueling pace and the steep learning curve, and Craig seems to enjoy picking on him more than any other resident.

Dr. Wayne Fiscus (Howie Mandel, Howie's World, Deal or No Deal)
Sardonic and wisecracking, Fiscus has the sharpest tongue on the staff and a keen eye for the women. More than any other resident, he draws his strength from the relentless pace of the hospital and grinds endlessly in the E.R, enjoying the excitement and unpredictability of the job. However, when he starts up a relationship with the eerie female mortician, his privacy suffers at work.

Dr. Jack Morrison (David Morse, House)
Being a young resident at St. Eligius is tough work. Morrision is a kind and dedicated doctor, but the long hours begin to strain his relationship with his wife. He is headstrong, stubborn, and quite content to bend the rules, if it means getting what his patient needs.

Dr. Phillip Chandler (Denzel Washington, Training Day)
Chandler is bright and handsome, but has quite the chip on his shoulder, routinely tangling with nurses he feels are "incompetent." As the only black doctor on staff in a city with increasingly growing racial tensions, the challenges he faces are unique.

Dr. Hugh Beale (G.W. Bailey, Police Academy)
The head of psychology at St. Eligius, many would argue that Dr. Beale is as wacky as the patients he treats. Disarming, casual, and charming in a Southern sort of way, he has a wonderful rapport with his patients.

Dr. Peter White (Terence Knox, Lois & Clark: The New Adventures of Superman)
Out of all the young residents, White seems to struggle the hardest. His dedication to his job effectively ends his marriage with his wife, and the financial burden of supporting her and two children begin to drain his pocketbook. Strung out and frantic, he has the look of someone who may snap at any moment.

Nurse Helen Rosenthal (Christina Pickles, Friends)
The head nurse at St. Eligius, Rosenthal works just as hard as any doctor on staff, if not harder. Keeping a place like St. Eligius running is no small feat, and dealing with the demands of patients is not an easy task. She shares a special rapport with the Chief, Dr. Westphall.

The Evidence

An admittance of sorts: St. Elsewhere hit its stride on television a little before my time. Hell, in 1984, Sesame Street was more my speed. It goes without saying that the show's reputation for quality has preceded itself in my eyes, but what surprised me the most about St. Elsewhere was how immediately accessible and familiar it felt for an audience member raised on modern-day programming. I expected it to be good, but I didn't realize exactly how good it would be.

Groundbreaking for its time, St. Elsewhere helped set the standard for two decades of serialized drama: intertwining plot arcs, hand-held "documentary"-style cinematography and long takes, authentic dialogue, and no hesitation to kill off the occasional main character; all of that was years ahead of anything else on television (with the exception of Hill Street Blues, coincidentally created by the same people). It became the de facto medial drama on which all future medical dramas built their foundations upon. In fact, were it not for the noticeably slower pace and egregious hairstyles, St. Elsewhere could easily pass for a series of ER episodes.

St. Elsewhere must have been something of a revelation for those who caught it during its initial run. It was "good television" before people even realized television could be used for anything else other than sitcoms and game shows. Despite never once ranking higher than 49th place out of 100 shows in the ratings, NBC doggedly stuck with the show for six seasons, exploring a previously untapped market of viewers attracted to its gritty realism, sharp writing, and black comedy. This new audience was a market that traditionally had never found much use for television: young, savvy, educated alpha consumers who bought BMWs, the kind that Aaron Sorkin later built his career on the backs of. Perhaps most important, NBC stuck with St. Elsewhere because they truly loved the show, abysmal ratings and all. You don't see much of that kind of network dedication today.

Medical shows of the past like Marcus Welby, M.D. and Ben Casey portrayed doctors as mythical beings of Olympian stature; demi-gods of righteousness and integrity with healing prowess that bordered on the mythical, unflinching and incorruptible. Take a stroll through the battered hallways of St. Eligius, and you find tired, cranky, racist, strung-out residents barely making ends meet at home with their family and their checkbooks. Nurses steal medication from their patients or, worse, often ignore them altogether. The homeless stream in to escape the cold, with all manner of horrible maladies afflicting them. Fights break out in the hospital between Irish and black gangs. Poor building conditions lead to outbreaks of Legionnaire's Disease. The glamour had been replaced by black comedy, but with this transition came an entirely new form of social realism unseen on American television. Television had never seen medical drama like this.

Oh, sure. I can hear people saying, "Enough of the history lesson!" Fair enough. After all, what does it matter how the show fared in the past? It's the 21st Century, man. We've got DVDs to review. Luckily, in the case of St. Elsewhere, time has not dulled its appeal one bit. Yes, some elements date the show terribly. The haircuts are painfully unhip, and Howie Mandel sports some feloniously tight white denim jeans now and again. And odds are good that hospitals no longer test on animals in laboratories tucked away in basements anymore. Or if they do, they certainly don't advertise it.

Ignoring such chronological discrepancies, the very elements that made St. Elsewhere such a resounding success in the past are the same elements that make it fantastic today. Its emphasis on heavily involved character development and interpersonal relationships is unblemished by the passing of time. For the staff at St. Eligius, who spend almost every waking moment at the hospital working, the only thing suffering worse than their patients is their personal lives. For all the ins and outs of their daily routines at the hospital, treating trauma patients and psychological loonies, performing surgeries and rounds, it is an almost universal challenge for each character to balance their personal lives with their professional ones.

From Dr. Morrison, who laments never seeing his wife, to Dr. White, whose financial troubles and residency pressures end his marriage, or Dr. Cavanero, who is coming to terms with her loneliness, the hospital takes from each of its staff as much energy as they put into healing their patients. These are complex, multi-layered, and realistic characters whose stories gradually overflow through a complex series of interconnected story arcs. The series takes no shortcuts and has no trouble slowing its pace down to properly illustrate all the complex nuances and anxieties of its protagonists, content to lay the foundation for a confrontation or situation down the road. And we won't even mention one of the most hotly-debated twist endings for a series finale ever—but we'll have to save that for Season Six.

The pace of the show is a bit slower than most television today, but one quickly adjusts. A surprisingly strong ensemble cast of veteran actors and newcomers whose careers launched quite nicely (Denzel Washington, Howie Mandel, David Morse, etc.) churned out consistently excellent performances. The large cast allows actors to wander in and out from the show in a fashion that feels entirely normal, just like how some days at work; you may not run into a particular co-worker. The show kept itself fresh with a serious revolving door of young cameo contributions from actors that would go onto make names for themselves. In Season One alone, keep your eyes out for painfully young versions of Tim Robbins, Ray Liotta, Christopher Guest, Doris Roberts, Candace Cameron, Ally Sheedy, Jane Kaczmarek, and Howard Duff, among numerous others.

If St. Elsewhere: Season One has a weak point, it lay buried in self-irony. The very elements that make the show satisfying also hinder it to the casual viewer. With its strong interconnected plot, huge sprawling story arcs, and heavy serialization, St. Elsewhere is not the kind of show you can wander into blind. Each episode literally takes place immediately following the last, repeatedly making self-references and allusions to previous events that would have confounded anyone haplessly wandering in mid-season. Continuity is absolutely crucial, but the faithful will be rewarded by an amazingly organic, natural television show with incredible attention to detail, plot, and gradual character development unrivaled by most television today.

Though the transfer is surprisingly clean in terms of print damage or degradation, it shows every day of its 25 years. Filmed on some seriously nasty film stock, the washed-out picture quality often looks as grainy as a snowy day. Depending on the lighting and the camera angle, some of the sequences have so much grain that you can actually see them coming apart before your eyes, like Captain Kirk teleporting off the Enterprise. I noticed some frame jitter a few times here and there, but nothing to get upset about. Still, this is about as clean and effective as the source material could reasonably be presented.

The stereo presentation does the job very well with no noticeable flaws. Bass response is negligent, and the series has little in the way of music, save for occasional re-workings of the show's theme song here and there. Some of the audio balancing is uneven, and sudden bursts of emergency room activity can send you diving for your remote control to turn down the volume. Most of the dialogue is clear, but the ambient noises and wandering camera angles occasionally muffle some of the more intimate dialogue between characters coming from off-screen. Luckily, the excellent subtitles are verbose and accurate, compensating for any fragments of missed dialogue quite nicely.

In terms of extras, only one episode has a commentary track—"Cora and Arnie," a heartbreaking episode about the homeless in Boston with actress Doris Roberts (the Everybody Loves Raymond actress won an Emmy for her performance in this episode) and director Mark Tinker. It is an odd pairing, but they get through it okay, mixing up nicely between cast biographies, technical behind-the-scenes information, and some of the impact that St. Elsewhere had on medical shows today.

Four featurettes are also included, but truth be told, some are of questionable quality. "Cora and Arnie: An Outstanding Episode" focuses on a single episode as the archetypal St. Elsewhere episode, a mix of social issues and solid drama, but is fairly redundant when paired with the commentary track on the same episode. "Tim Robbins: The Punk Gets Responsible" focuses on Robbins's cameo, which is a waste of a featurette. "St. Elsewhere: The Place To Be" and "Dr. Jack Morrison: The Spirit of Care & Empathy" are stronger pieces, with some nice ensemble interviews from David Morse, Christina Pickles, writer John Tinker, and Howie Mandel. Not a terrible offering, but we'll see if the content levels keep up over subsequent seasons.

One big downside is the lack of a "play all" feature—a simple omission, but a glaring one for all us marathon television watchers.

The Rebuttal Witnesses

My main gripe with Season One is the Bird Man. Ralph is an extremely overused, annoying character, even in short doses. Why they make him the focal point for like, ten episodes, I have no idea. For a show so caught up in keeping itself intellectually honest and factually plausible, the notion that any hospital would let such a nut job have free run of the place is ludicrous.

Okay, we get it. He's crazy. He thinks he's a bird. Now let's move the @#$% on already.

Closing Statement

Arguably one of television's finest achievements, St. Elsewhere is still surprisingly accessible and enjoyable even after a quarter of a century. But it is the influence of St. Elsewhere still felt today in contemporary medical and ensemble dramas that may be the show's greatest achievement.

Personally, I find it satisfying to know that the archetypal medical drama still deserves its lauded reputation. For a 25-year-old stiff, this body is remarkably well-preserved.

The Verdict

Oh, for the days when you could smoke openly in hospitals. Not guilty on all charges.

Similar Decisions

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• Warm Springs
• True Colors
• Empire Falls

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