There must have been something in the air during 1994 which would prove to be a pivotal year for the NBC network. Within the space of the same week, the American network would launch two series that would allow it to dominate the Nielson ratings for the next decade and prove to be pivotal series in defining the 90s and its era.

One of those shows was Friends. The other was ER.

Created by Michael Crichton, with John Wells subsequently in the role of showrunner and Steven Spielberg producing through the television arm of Amblin Entertainment, ER arrived with a ferocious intensity that was unheard of from a medical drama.

Like cop shows, crime procedurals and law dramas, the medical drama has frequently felt like a mainstay of television, a genre that television executives can rely on to draw in ratings, with the 80s having given us St. Elsewhere, while on the UK side of the Atlantic, the BBC had Casualty, which would officially become the longest running medical drama in the world, while post-ER would see Shonda Rhimes give the world the long running Grey’s Anatomy.

Medical dramas have always been a mainstay of television networks and can run the gamut of being formulaic in their own way, or ground-breaking, as would prove to be the case with ER.

Initially developed as a movie script by Crichton with an eye for Steven Spielberg to direct, ER wasn’t even the only medical drama that was premiering that television season; CBS was also unveiling Chicago Hope, the latest from David E. Kelley which many expected to be a bigger hit, but in the end it was ER that would prove to be not only a bigger hit, amassing ratings that would make it the most watched series in the US, eventually peaking at an audience of over forty million, but it would also rip up the rule book when it came to how medical dramas would be produced and filmed.

Right from the off, ’24 Hours’ feels more like a feature film than a television episode. Calling television shows cinematic may be a recurring thing these days, but the fact that ER was initially conceived as a feature film project wouldn’t have come as a surprise. As mentioned before, television has always been awash with medical dramas, but with its two hour pilot, frenetic pace, a pace that would flow into every subsequent episode of the series, and flowing Steadicam shots that reminded one of a Brian De Palma movie at points, ER could almost have been classified as an action movie as much as medical drama.

While previous medical dramas managed to combine stories of medical mishaps, accidents or whatever else they could think of, everything about ER right from the beginning felt fast, reflecting the hustle and bustle of a Chicago emergency room in a manner that literally felt like the genre had been given a shot of adrenalin in a manner that it had never done before.

While George Clooney became ER’s biggest star, it was actually Mark Greene (Anthony Edwards) who proved to be its heart and soul.

Sometimes rewatching pilots after a show has  long finished or in the throes of its run can sometimes be a strange experience, as if you’re seeing something that you know is good but is still to be perfectly formed, but ’24 Hours’ is ER in a perfect microcosm. The pace is there, the pounding music score courtesy of James Newton Howard, and subsequently continued by Martin Davich, is there, although we’d have to wait another week for the theme music and title sequence to make its debut, while the casting would prove to be one of the most impactful of its era.

The first generation of ER cast is the ensemble that everyone remembers with nostalgic affection, for obvious reasons. Subsequent seasons would also give us some wonderful additions, not least Alex Kingston, Ming-Na Wen, Linda Cardellini, Goran Visnjic and Parminder Nagra, but Anthony Edwards, George Clooney, Sherry Stringfield, Julianna Margulies, Noah Wyle and Eriq La Salle are synonymous with the show’s classic period, and would launch their careers massively, with Margulies subsequently going on to star in The Good Wife, while George Clooney…well we all know.

As for Margulies, she wasn’t originally going to be one of the regulars; credited as a guest star for ’24 Hours’, her character proved a popular one with test audiences and network executives that the drug overdose that was supposed to kill her in this episode subsequently failed and she would stay with the series for a further six seasons and also become the only cast member to win an Emmy for her work on the series.

While Clooney as Doug Ross was undeniably the biggest star on the series for many, the lead actor was in fact Anthony Edwards and its arguable that the character of Mark Greene was in fact the true heart and soul of the series that would follow.

Not only are the characters introduced brilliantly, but certain character relationships and paradigms that would define the series are as well; the complicated relationship between Doug and Carol, as well as the mentor/protégé relationship between Benton (La Salle) and Carter (Noah Wyle).

ER burst on to screens with so much confidence and bravado that based on the ninety minutes that was produced here, it feels like it truly arrived on screen as a hit series fully formed. Like many medical dramas before and since, it would last for a record-breaking run, airing for fifteen seasons, a record that has only been broken recently by Grey’s Anatomy.

Everything that can be summed up by ER is here; the graphic medical scenes, the pace, the sweeping camera moves, its ability to be almost unbearably moving and emotional in dealing with loss and death. It’s all there and it would remain there for fifteen seasons.

Medicine on television would never be the same again.

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