Test Pilot #19: St. Elsewhere

Debut date: October 26, 2982

Series’ legacy: Another jewel in the MTM crown, one of — if not the — most-heralded medical drama of all-time

Authorship is a really tricky thing and perhaps no more so than in the world of television. Numerous scholars have discussed the problems with analyzing television with an authorship slant with all of them rightfully pointing out that any production has countless cooks in the kitchen, within individual episodes and across multiple efforts just the same. With so many writers, directors, producers, co-producers, executive producers, story editors and everything else, it is difficult to say that a series is reflective of one person’s sole vision. Even an egomaniac like Matthew Weiner doesn’t do everything on Mad Men, no matter how much he might think he does.

But despite the complex issues related to authorship, the MTM Enterprises book edited by Jane Feuer introduces an intriguing concept of “corporate authorship” wherein a collective (featuring those from both production and business) can produce something of a corporate signature that reflects certain ideals, standards and expectations. In the case of MTM, Feuer argues that the production power of the ’70s and ’80s reflected a signature of quality, not unlike the way HBO and AMC co-opted those ideas of taste and distinction for their respective cable channels years later. These ideas of authorship and quality really stuck with me and inspired me to dive into the MTM oeuvre for this quartet of Test Pilot files. The two things I want to discuss are 1.) this idea of “quality” and whether or not, at least from my perspective, the MTM series are “quality” and 2.) How MTM did or did not put a specific stamp on some of the series it produced, comedy or drama.

For today’s exploration of the MTM empire, we turn our attention to the production company/studio’s more dramatic offerings. After garnering much critical and commercial success with its post-Mary Tyler Moore comedy output in the mid- and late-70s, MTM struggled a bit to make the transition into drama. Their first drama series 1977’s Lou Grant was relatively well-received by critics but less so with viewers (at least in the early going) and follow-ups like Paris and The White Shadow didn’t attract the same kind of mainstream attention as MTM’s comedy output.

Hill Street Blues changed all that, but not off the bat. Its critically-acclaimed 1981 first season had the dubious distinction of being lowest-ranked series in the Nielsen ratings (I believe it was #81 that year) to be renewed for a second season. However, after dominating the Emmy awards in the fall of 1981 right before its second season (HSB had 11 nominations in the major categories and won in Drama Series, Writing for a Drama Series, Directing for Drama Series, Lead Actor and Supporting Actor), audiences caught on. In season two, Hill Street settled into the 10 p.m. Thursday slot and became a Nielsen success.

By 1982, MTM had “proven” its ability to develop quality, gritty and complex dramas that emphasized characters over plot. What Hill Street Blues did for the police drama, St. Elsewhere attempted to do for the medical drama. Today, we determine if St. Elsewhere actually accomplished those goals. Along for the ride today is good friend of the blog, Myles McNutt. You can find Myles’ great work over at his personal site Cultural Learnings and at The A.V. Club. You probably already are, but you can follow Myles on Twitter as well. I had difficulties finding someone who could actually provide a veteran presence so I just went out and grabbed someone who wasn’t joined me yet. I think Myles and I will make it through this entry just fine. Myles, your thoughts on St. Elsewhere?

Do we still consider the medical drama as a generic component of quality television?

NBC’s St. Elsewhere, emerging out of the harrowed halls of MTM Enterprises, placed the medical drama at the heart of the quality movement, and its position was picked up by series like ER and Chicago Hope in the 1990s.

However, things have changed in the past decade. Quality has been associated with series that do not fit into typical generic categories like “The Cop Drama,” “The Legal Drama,” or “The Medical Drama,” series like HBO’s The Sopranos or AMC’s Mad Men that narrow their generic footprint and embrace intense serialization.* In that climate, medical dramas like FOX’s House or ABC’s Grey’s Anatomy have been distanced from “quality” more quickly. Both series were initially embraced by critics, viewers and Emmy voters in a fashion similar to their forebears, but they seemed to fall from those positions more quickly, and both series are absent from more academic considerations of quality television in the twenty-first century.

*Some quality programs have remained connected to a genre, in particular the “Cop Drama” (see: The Wire, The Shield), but seem to be actively deconstructing genre conventions in their storytelling.

However, watching the St. Elsewhere pilot for the first time made clear that the medical drama actually hasn’t changed that much. Administrators are used as a window into the business of running a hospital, doctors are used as a window into the unpredictable and emotionally draining environment they work in, and patients are used to create episodic storylines and draw out character details from the doctors. It’s a pretty foolproof formula, which is why that description could describe the basic generic makeup of Grey’s Anatomy and any other medical drama in the same vein.

What struck me while watching St. Elsewhere is how widely it casts its generic net within “The Medical Drama.” While House focuses on the hyper-specific practice of diagnostic medicine, and Grey’s Anatomy mostly focuses on surgeons (although that broadened over time), St. Elsewhere could more accurately be considered a serie about a hospital rather than a subsection of people within that hospital. The pilot is almost like a series of vignettes taking place in the same location, the camera following one conversation before veering off into another one entirely. This is not to say that the series’ characters are not important, as a quick perusal of Wikipedia suggests some pretty substantial character development took place over the course of the series, but that this isn’t where St. Elsewhere chooses to start.

This seems backwards by modern standards, where a medical drama needs a hook. CBS’ A Gifted Man, the closest thing to a medical drama ordered by the networks for this upcoming season, is about an elite neurosurgeon who is visited by the ghost of an ex-lover who helps guide him towards a new medical journey. While the series will still fit into the same structure discussed above, it doesn’t want to be associated with that structure, and does everything in its power to distance itself from it in its pilot. By comparison, St. Elsewhere highlights its structure immediately, threading together a collection of small episodic storylines as a way of introducing the series’ characters in their natural habitat. This isn’t intended to be a monumental stretch of days at St. Eligius; they are simply days where scrubs need to be ordered, tests need to be done, rounds need to be attended, and patients need to be helped.

St. Elsewhere would be an interesting test subject for someone who grew up in the era of narrative complexity being synonymous with quality (and who doesn’t study television for a living). The pilot doesn’t perform complexity on a large scale, choosing instead to emphasize the range of potential stories they could tell without giving any single storyline first billing. There is some narrative pleasure to be found in the way that the sudden collapse and death of a patient that Morrison handles ends up being the solution to the mystery of the disappearing patient, but it’s more clever than complex at the end of the day. Dr. Samuels’ sexual exploits make for a funny running joke as he goes around telling women he’s slept with (or thinks he’s slept with) that he has gonorrhea, but none of the interactions point to an extended “Will They, Won’t They” relationship. The pilot features a number of interesting storylines, but it features so many that none emerge as a logical point of complexity or serialization.

While I would argue that modern narrative complexity manifests itself as “What will happen next?”, St. Elsewhere builds its pilot around “What could potentially happen?” It’s a more subtle form of complexity, one that might prove too subtle for modern viewers used to seeing pilots where the stakes are immediately established to drive viewer interest and inform them that this is a “quality” drama interested in intense serialization. It’s also a form of complexity that has become associated with procedurals, which are becoming less and less associated with quality as serialization becomes more common. It’s even gotten to the point where a series like FX’s Justified, now considered a “quality” program after two strong seasons of serial development, was initially written off by some for its episodic case structure early in its run.

That MTM Enterprises had such success cultivating a sense of quality from a wide range of genres (and across both comedy and drama) remains an impressive feat, but over time those generic signatures have become disassociated from the direction of quality television. While cable networks (including HBO, Showtime, FX, and AMC) have found success using branding to establish an aura of quality around their programming, they have had less success with programs that have clear relationships with basic generic structures like “The Medical Drama.” Even The Good Wife, which is merging about three different genres with great success on CBS, is still being discounted because it’s “A Legal Drama” on the surface (although that it’s on CBS, a broadcast network, is also part of the problem in that instance).

St. Elsewhere is unquestionably “A Medical Drama,” and its pilot announces this with no sense of shame and with no attempt to hide its generic identity. It’s a subtle approach that we would never see in the twenty-first century, an approach that doesn’t gird itself against audience impatience, allowing quality be discovered instead of displayed. Of course, quality is relative: it is quite possible that this pilot does display quality, just what quality meant in the early 1980s. Watching St. Elsewhere made me realize how much HBO’s appropriation of quality television has altered our generic expectations, and the degree to which a series like St. Elsewhere being elevated to the level of The Sopranos or Mad Men may be at an end.

At least until HBO decides to reinvent the medical drama – however, don’t expect them to be so subtle about its quality.

–MM

And now, my thoughts:

I tweeted this last night as I was watching the episode but it is worth repeating here: St Elsewhere is weird. When I say “weird,” I don’t necessarily mean it in a negative way. But I am also not entirely sure if I mean it in a positive way either. This pilot episode has its high points and its lower moments, but I couldn’t help coming back to that one adjective. Weird.

There are a lot of different reasons for why St. Elsewhere’s initial episode could feel weird to someone watching it 31 years after it aired for the first time. Clearly, time and context are both major factors. It is relatively old and therefore what could have appeared to be “different,” “complex” or “quality” in 1982 certain won’t look that way to fresh eyes three decades later (Myles did a really nice job of discussing this phenomenon). However, I can’t help but thinking that St. Elsewhere is trying too hard and that’s where the weird-ness pops up. At times, it is trying too hard to be “different,” too hard to appear overly sweeping in its focus or even trying too hard to replicate the aesthetic and thematic successes of Hill Street Blues. I saw one review call the series “Hill Street Blues in a hospital” and unfortunately, that is the exact vibe I got from St. Elsewhere throughout this pilot episode. Some of that might stem from the fact that I’m just now watching the first season of HSB, but even if I had seen that series’ pilot episode years ago instead of weeks ago, I think I would still notice the similarities.

Like Hill Street, St. Elsewhere is not entirely concerned with the actual content of the characters’ job. This series is not worried with medicine, surgical procedure or anything of that sort. It is almost entirely invested in telling stories about how these various interrelated medical responsibilities impact the psychological and emotional well-being of the people carrying them out. David Morse’s Boomer is the most obvious example of this, as he spends most of this first episode running around exhausted, exasperated and stress until that final moment where he blows up and lays it all on the table. The requirement of his job and the people he has to share them with really drive him nuts and he is going a little crazy trying to keep it all together.

Many of the other characters and moments fit similar Hill Street Blues comparisons. The running gag about the STD breakout would fit nicely beside Belker’s odd antics or Phil’s weird relationship with a woman 35 years his junior. Dr. Westphall’s calm leadership isn’t unlike Frank Furillo’s role in Hill Street Station. Like Hill Street Blues, Elsewhere bounces around from character to character, story to story, without much regard for simplicity or traditional (for the early ‘80s) coherence. And like HSB’s pilot, this episode tries hard to establish a certain kind of gritty, manic energy running through the building. It wants to present a more realistic hospital full of severely flawed individuals that could theoretically work in your local hospital – just as Hill Street does for the police force.

I don’t want to belabor the similarities too much, but they are too obvious not to mention and they reflect some of the larger points that I wanted to hit. The big point of this whole theme is to discuss the possibility of looking at MTM as this singular authorial force and when comparing St. Elsewhere with Hill Street Blues it becomes difficult to argue against the fact that MTM does have something of a “house style” as Feuer calls it in the MTM book. These two series have fairly identical pilots and based on what I know about St. Elsewhere as a series, both of them also continue in similar fashions. So sure, we can totally acknowledge that MTM’s dramas (at least post-HSB) accentuate character over plot and focus more on relationships than anything else. They also cast wide storytelling nets with arcs that highlight certain little corners of an established, recognizable world.

But once you create a template, formula or style, is there something lost in the follow-up iterations to the original? I really loved the HSB pilot but did not really care for this one, it felt like someone took the bare-bones framework of Blues and just applied it to a new professional location. Of course, this happens on television all the time. Rarely does a series reinvent the aesthetic, thematic or narrative conventions we expect from television. This is especially true for networks or production companies who find major success with one kind of formula or style. Once you grab hold of that winning template, it is surely difficult to let go. That can manifest itself in one really terrible way via spin-offs or franchises (think CSI:) or in the way that defines the relationship between HSB and St. Elsewhere (for a modern example, think of how all Shonda Rhimes’ series are basically the same or perhaps more obviously, all of USA Network’s series).

Without these resemblances, maybe we never consider authorship. Without authorship, we don’t wonder what is that makes all USA Network’s series so successful or most of Shonda’s non-Grey’s Anatomy offerings failures. But here we are and looking at all of MTM’s output through one specific prism (this idea of quality) raises some questions. If you’re USA Network, the similarities in your programming are OK, because you aren’t really presenting yourself as “quality.” USA’s about escapism, summertime and blue skies, its programming is not concerned with quality and taste distinction. But MTM and its series are positioned with a certain air of quality. And from my perspective, quality implies a sense of difference or newness or uniqueness. Maybe St. Elsewhere was a quality re-writing of the medical drama in 1982, but within the frameworks of MTM Enterprises, it loses that quality sheen.

Thus, the concepts of formula/template/style are relatively difficult to manage alongside concepts of quality. If I can point out all the touchstones of your production house style and the only major difference between one series and another is the setting, I have a hard time getting to quality. We might view HBO as this overarching corporate author that airs a certain kind of series, but that viewpoint is somewhat externally applied after-the-fact. Structurally, aesthetically and even thematically, there are differences between The Sopranos, The Wire, Deadwood, True Blood and Game of Thrones or Sex and the City and Curb Your Enthusiasm. Critics and scholars can concoct the “HBO style,” but it isn’t necessarily overtly present in the texts themselves. With Hill Street Blues and St. Elsewhere, it is. The arguments for likeness between the two are easily visible within both series. And again, that isn’t necessarily a problem. I have no qualms with a structural formula and visual style. But I do take some issue with automatically calling the MTM stable quality when things are so similar.

What does this mean for MTM-as-quality argument? I’m not entirely sure. When you look at Hill Street Blues versus the police dramas that came before it or St. Elsewhere against the medical dramas that came before it, there is little question that both series made major strides in complexity and character-based storytelling. In their respective generic categories, these series kick ass. But taken together with an eye towards MTM Enterprises as a whole, things get more complicated. I cannot totally get behind the quality argument when I line these series up against one another, but against other competition, it makes sense.

Perhaps this is the problem with authorship analysis. Forcing a comparison based on who produced these series definitely makes St. Elsewhere look less innovative and frankly, enjoyable, than it reportedly is. There is always going to be value in being the first, a benefit Hill Street Blues has and St. Elsewhere lacks. If St. Elsewhere reinvented some of the storytelling and aesthetic conventions of the medical drama genre, it deserves legitimate credit for that. Maybe then this series needs to be evaluated and discussed with genre in mind. Because with authorship on the brain, the similarities are too present, the MTM style is too overt and ultimately, St. Elsewhere looks derivative as a result.

–CB

Conclusions on legacy: Clearly a medical drama — with its “quality” label somewhat in question