ER
NBC

From "St. Elsewhere" to "Scrubs," the die-with-dignity morality play has always been the hallmark of television medicine. You know the story line: A sweet grandmotherly type, diagnosed with some horrible ailment you wouldn't wish on Regis Philbin, politely declines to be kept alive by tubes and machines and dies, usually to an Enya accompaniment, on her own terms.

It's always a poignant moment, giving philosophical counterweight to the high-tech gadgetry and miraculous doctoring in the rest of the episode. The doctors are always puzzled at first, but they know in their hearts that the old broad is right. They could keep her alive, but what would be the point?

If network executives had only been paying attention during these moments, we'd have all been spared the last few seasons of "ER." Once the most driving drama on television, the show is now a miserable old coot begging to die.

Lately the show has been relying on tired devices such as washed-up guest stars, hard-to-swallow plot convulsions and an alarming number of natural disasters. But it's hitting a new low now, as it slowly — very slowly — kills off Dr. Mark Greene, the emotional core of the show.

Anthony Edwards' departure from a show that has already lost most of its talent should end it once and for all. But it won't. "ER," like a lot of what's on TV, won't take its own advice and take its leave when times are good.

Greene and John Carter (Noah Wyle) are the only main characters left from the original cast (besides Sherry Stringfield, who left, only to return this season), and writers have used both like voodoo pincushions.

Carter has endured a stabbing, a drug addiction, the death of his brother, his parents' breakup, the death of his grandmother, the overdose of his cousin, several strange relationships and a bad Al Gore beard. Greene has devolved from a promising golden boy to a crumbling husk of a guy whose life splinters everywhere it's exposed to a camera. You want sad? Let's have Mark lose a pregnant patient. You want sadder? Let's turn Mark into a racist, homicidal freak. Still not enough? Let's give him a brain tumor.

Are we looking for Job-like levels of misery here? Okay, we'll have his marriage fall apart and have his daughter nearly kill his other daughter.

Granted, "ER" still pulls in the ratings, and it's still a better show than anything involving talking babies, lusty office workers or Katie Couric.

But it's a ghost of its former self. A half-decade removed from winning an Emmy as best drama, it has grown about as thrilling as HMO bureaucracy. The swirling shots of young doctors trying to save a crash victim, once filled with tension and edge-of-the-seat anguish, seem wan and tiresome. And maybe that's the point — medical drama, once you've seen it for long enough, just isn't that dramatic anymore.

Rather than cash in its chips and leave on a good run, the show is cashing in commercially on its ability to recycle itself endlessly with new medical students and new exotic diseases to be exploited. There are thousands of sharp objects that we haven't yet seen protruding from some schmo's abdomen. ER can't breathe on its own, but the machinery is in place to breathe for it.

So, better settle in at the bedside, children, because even though they're yanking out Dr. Greene, the patient's not dead yet. Even without a heart, ol' Grandma isn't giving up the ghost just yet.

— Michael Penn (mpenn@facstaff.wisc.edu)