Colorful "Grey's Anatomy" owes its style to St. Eligius crew

A hospital is a perfect setting for a TV show. Smart people work long hours under heavy pressure, patients provide a never-ending supply of life-or-death situations, and the overnight on-call rooms turn the place into a hotel of sorts, an ideal microcosm for a roiling cauldron of serialized melodrama. Is it any wonder the doctor show is one of the most enduring genres on American television?

"Grey's Anatomy," one of TV's top-rated programs, combines the format and pacing of "ER" with the stylized urban romance and hyper-analytical narration of "Sex and the City." But doctor shows didn't always look and sound so bold. Something happened between "Marcus Welby, M.D.," whose title character was a model of paternal perfection, and Dr. Miranda Bailey of "Grey's," whom colleagues call "the Nazi."

What happened was "St. Elsewhere," an NBC hospital drama that debuted in 1982 and radically redefined the TV doctor. Its first season was released recently on DVD.

"St. Elsewhere" did to medical dramas what "Hill Street Blues" did to police shows: It crowded the screen with a large ensemble cast, padded the script with a bewildering number of ongoing stories and introduced human flaws to a breed of professionals that television previously had presented as superhuman.

The title character in "House" (Hugh Laurie) owes his existence to "St. Elsewhere's" acerbic-but-brilliant Mark Craig (William Daniels). Others on the staff of St. Eligius Hospital — from the righteously serious Dr. Phillip Chandler (Denzel Washington) to the comic Dr. Wayne Fiscus (Howie Mandel) — continue to be echoed in characters on current hospital shows.

"St. Elsewhere" was a literary achievement, filled with sophisticated dialogue, complex stories and an attention to narrative detail never before seen in a TV series. Although critics loved the show, it never achieved real ratings success over its six-year run.

But "ER," which premiered in 1994, juiced up the formula, quickly achieving the star status that eluded its predecessor. While "St. Elsewhere" at its best had become postmodernist theater of the absurd, "ER" was about doctors.

"Grey's Anatomy" follows in the footsteps of "St. Elsewhere" and "ER," though creator Shonda Rhimes has never seen "St. Elsewhere," said co-executive producer Betsy Beers.

In "Grey's" there's a core of young interns under the guidance of more experienced medical tyrants; within these characters, ego and libido battle with Hippocratic commitments.

Now in its third season and thriving on Thursday, TV's most competitive night, the show has become the thinking person's soap opera, "The O.C." for big kids.

It's hard to imagine the doctor shows of yesterday attempting to pull off what "Grey's" can. The first medical TV shows appeared in the early 1950s, but it was in the 1960s that the form was really established. This was the decade that introduced a bright and shining trio of the most perfect, caring, compassionate healers you could ever hope to meet, in a time before the HMO.

"Dr. Kildare," starring Richard Chamberlain, debuted on NBC in 1961. Four days later, Vince Edwards brought "Ben Casey" to ABC. "Marcus Welby, M.D.," also on ABC, rounded out the team in 1969, with Robert Young bringing to the title role the same gentle authority he wielded on "Father Knows Best."

This was an era of the doctor as demigod. Dedicated visionaries with impeccable bedside manners, these three gave intimate personal attention to their patients and were willing to make house calls.

In the 1970s, shows such as "MASH" brought a more modern sensibility to the genre, and by the 1980s the doctor-as-hero was on the verge of extinction.

Emmy laureate Mark Tinker, who has directed episodes of "St. Elsewhere," "ER," "Chicago Hope" and "Grey's Anatomy," classified "Kildare" and its earlier counterparts as "Mom and Dad's doctor show."

" 'St. Elsewhere' broke that mold, featuring a hospital that was no place you wanted to go when you were sick," he said.