10 Harsh Realities 16 Years After the Finale

When ER concluded in 2009, it left behind a television landscape forever changed. The medical drama didn’t just succeed – it redefined what hospital-based storytelling could be. From Grey’s Anatomy to House to more recent shows like The Good Doctor and Nurse Jackie, the DNA of ER can be found in every major medical series that followed. Its impact is undeniable.

However, like most long-running shows from the 1990s and 2000s, ER isn’t without its flaws. The writing was often groundbreaking, yet certain creative decisions aged poorly. Upon rewatching ER, it becomes clear that some storylines aren’t just relics of their time – they’re actively uncomfortable and difficult to excuse, no matter how revolutionary the show was in other respects.

That doesn’t erase the fact that ER remains one of the greatest medical dramas ever made. Its thrilling blend of medical tension, human drama, and powerhouse performances cement its legacy. Still, when revisiting it today, some glaring issues feel impossible to ignore, even for the most dedicated fans.

The Show Didn’t Care Much About Accuracy

ER’s Approach To Medical Realism Often Sacrificed Accuracy For Drama

Compared to the heightened realism of later medical dramas, ER frequently prioritized shock value over accuracy. Scenes like doctors using defibrillators on flatlined patients or improvising life-saving procedures with household items make for great television, but they don’t reflect actual hospital practice. Over time, these inaccuracies stand out more than they once did.

For audiences in the ‘90s, the spectacle outweighed the science. However, with shows like Grey’s Anatomy hiring medical consultants and striving for realism, ER’s looser approach feels more dated than groundbreaking. Its dramatic flair now risks undermining its credibility as a medical drama, especially in a genre built on trust in authenticity.

It’s a harsh reality because ER openly prided itself on intensity and realism during its time on the air. Rewatching in 2025, however, the cracks in its medical accuracy are clear, reminding viewers that the series often leaned into spectacle rather than clinical truth.

Dr. Romano Is Simply A Bad Character

Romano’s Cruelty And Soap-Opera Death Derail Er’s Dramatic Tone

Dr. Robert Romano (Paul McCrane) was written as abrasive, but rewatching ER makes it clear he never evolved beyond cruelty. His racist remarks, homophobic tendencies, and relentless arrogance leave little room for redemption. Attempts to humanize him never land, leaving viewers with a character defined purely by toxicity.

The problem is compounded by how he exited the series. His infamous death – crushed by a helicopter falling off the hospital roof – is more daytime soap than prestige drama. Compared to the dignified and heartbreaking farewell of Dr. Mark Greene (Anthony Edwards), Romano’s demise undermines ER’s serious tone.

Rather than adding depth to the ensemble, Romano lingers as one of television’s most frustrating antagonists. On rewatch, he’s not complex or layered, just unbearable – and his death feels like ER admitting it didn’t know what else to do with him.

ER Is Surprisingly Sexualized

Some Storylines Are Deeply Uncomfortable When Viewed Today

For a show hailed as gritty and realistic, ER was surprisingly cavalier in its sexualization of storylines. One of the most egregious examples is Ray (Shane West) unknowingly sleeping with a 14-year-old, presented more like a scandalous twist than the horrifying crime it actually was. Even worse, the sequence was played as a sex scene.

Similarly, Dr. John Carter’s (Noah Wyle) history of sexual assault is downplayed rather than treated with the seriousness it deserves. Instead of addressing the gravity of the issue, the show glosses over it, making it a passing beat in his storyline. These choices feel jarring now and are impossible to excuse when rewatching.

What makes this so glaring is that ER was ahead of its time in many ways, but in handling sexual issues, it was shockingly insensitive. These problematic depictions are not just outdated – they tarnish its credibility as a drama that prided itself on realism.

Gates Is Kind Of Annoying

John Stamos’ Talent Couldn’t Save Gates’ Inconsistent Writing

John Stamos should have been a top-tier addition to the cast of ER. He brought charm and charisma to the role, but the character of Tony Gates is frustratingly written. Rewatching episodes centered on Gates reveals how inconsistent and unfocused his arc was, making him one of the show’s least compelling doctors.

The problem isn’t John Stamos – it’s the writing. Gates is portrayed as both reckless and self-righteous, yet without the depth or growth to justify his flaws. He’s too messy to root for, yet not engaging enough to serve as an anti-hero. This leaves him stranded in narrative limbo.

For longtime viewers, Gates is a reminder of ER’s later-season struggles. His presence often drags episodes down rather than elevating them, making it difficult to appreciate Stamos’ performance when the character feels so poorly conceived.

Jeanie Boulet’s Story Should Have Been Handled Better

A Groundbreaking HIV Storyline Was Undermined By Poor Framing

Gloria Reuben’s Jeanie Boulet brought an important storyline to ER as a physician’s assistant living with HIV. Initially, her story was powerful, offering much-needed representation at a time when television rarely addressed the subject with sensitivity. Unfortunately, the show mishandled key aspects of her arc.

The conflict with Dr. Kerry Weaver (Laura Innes) was particularly troubling. Jeanie accused Weaver of firing her due to her HIV status, despite budget cuts being the cited reason. The storyline positioned Jeanie’s fight as opportunistic rather than sympathetic, undercutting the significance of her struggle.

Instead of offering a nuanced exploration of discrimination, ER framed Jeanie’s legal threat as manipulative. For modern audiences, this feels like a betrayal of what could have been one of the show’s most impactful and resonant storylines.

One Character Was A Terrible Depiction Of Mental Health

Carol Hathaway’s Arcs Trivialized Serious Issues Like Suicide

Carol Hathaway (Julianna Margulies) remains one of ER’s most beloved characters, but her early storylines are tough to watch today. Her suicide attempt in the pilot, followed by a quick return to work, is treated with minimal exploration of her mental health. The gravity of the event is never properly addressed.

As the show progressed, Carol was often written as overly dramatic, with her emotional struggles presented more as character quirks than genuine battles with depression. This reduces her complexity and does a disservice to mental health representation.

Rewatching now, Hathaway’s storylines in ER feel like a cluster of missed opportunities. What could have been a groundbreaking portrayal of mental health instead comes across as dated, careless, and dismissive of the seriousness of her struggles.

ER Dangerously Mishandled Transgender Characters

Harmful Portrayals Reflect The Show’s Lack Of Understanding

One of the most troubling aspects of ER is its treatment of transgender characters. Season 1’s “ER Confidential” introduces a trans woman in a storyline rife with harmful stereotypes and medical staff mocking her gender identity. Dr. Carter’s reaction in particular is shockingly disrespectful, played more for awkwardness than empathy.

Season 9 doubled down with another troubling storyline in the episode “Next of Kin”. After a car accident reveals a young girl is transgender, characters make light of the revelation in hushed tone (and, sometimes, not so hushed ones too). Instead of focusing on her trauma, the episode ends with her being sent to live with unsupportive family members, compounding the harm.

For a show celebrated for its progressiveness, these episodes of ER are painful reminders of how trans issues were mishandled. Rewatching today, they stand out as not just insensitive, but actively damaging in how they shaped public perceptions of trans people.

Doug Ross’s Womanizing Hasn’t Aged Well

George Clooney’s Charm Can’t Hide Ross’ Toxic Behavior

Dr. Doug Ross (George Clooney) was one of ER’s breakout stars, but his womanizing and arrogance haven’t aged well. His relationship with Carol Hathaway often showcased him as selfish and self-centered, constantly putting his own needs above hers while expecting forgiveness.

Ross’ so-called Hero Complex also comes across as dangerous. His willingness to bend rules to “save” patients might seem noble, but on rewatching, it reads as reckless and egotistical. These choices endangered patients and made him more of a liability than a savior.

Clooney’s charisma carried Ross at the time, but rewatching through a modern lens makes his flaws impossible to ignore. What once felt like a charming rogue now feels like a case study in toxic masculinity.

George Clooney Is A Distraction

Clooney’s Superstardom Makes Doug Ross Hard To Believe

By the time George Clooney left ER in 1999, his career had skyrocketed. Watching the show now, it’s nearly impossible to see Doug Ross as anything but George Clooney, one of the biggest movie stars in the world. His later fame casts a long shadow that makes immersion difficult.

This isn’t Clooney’s fault – his work as Ross was career-defining – but rewatching in 2025 feels different. Every scene is loaded with the knowledge of who he became, making his presence distracting rather than seamless. It’s harder to invest in Ross when Clooney’s global stardom looms so heavily.

Ironically, George Clooney’s rise is proof of ER’s power in launching careers. Yet it also means rewatching his episodes now feels less like enjoying a character and more like watching a superstar in waiting.

The Countdown To Mark’s Death Can’t Be Ignored

Knowing Mark Greene’s Fate Casts A Shadow Over Every Scene

Dr. Mark Greene’s death in season 8 remains one of ER’s most devastating and beautifully executed storylines. His final scene, set to Israel Kamakawiwoʻole’s “Somewhere Over the Rainbow,” is unforgettable. However, rewatching the show means every earlier scene with Greene feels like a morbid countdown.

Even in lighter episodes, knowing Greene’s tragic fate lingers in the background. His interactions with colleagues and his family feel heavier, as if they’re building toward an inevitable loss. It makes rewatching bittersweet, as his presence is haunted by what’s to come.

Greene’s death was brilliantly handled, but the emotional weight of it never leaves. On a rewatch, it overshadows entire seasons, making his story one of the most poignant yet hardest aspects of ER to revisit.

ER

8/10

Release Date

1994 – 2009-00-00

Showrunner

Michael Crichton