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This means believable medical action takes place behind
the drama, and audience focus has to be with the story
rather than background activity.
For example, a scene may begin with a hypoxic woman
being rolled in through the ambulance entrance. Dialogue
continues as she is rolled through the halls into the
trauma room, where she is transferred to a gurney. Then
medical props are introduced, such as IVs, monitors,
oxygen, etc.
Nothing is random, and each line of dialogue requires
a certain action to take place. In the middle of all
the action is the real nurse, who is pivotal in maintaining
the flow.
It can take a full day to shoot such complex scenes
because of their intricacy and because many things can-and
do-go wrong. The IV bag being passed might block an
actor's dialogue, an unscripted shoe might squeak or
the special effects guy hiding under the bed might squirt
the fake blood too aggressively and hit actor Noah Wyle
in the face instead of the chest (a true story). Or
someone might bump into the camera operator as he weaves
around the bed. Then the director says, "Reset,
back to one," and the lengthy process of starting
over begins.
"I have a greater appreciation for the complexity
of acting," Melette LeBlanc-Cabot, NP, RN, said.
LeBlanc-Cabot has been part of the "ER" cast
since the first season and knows the difficulty of translating
usual medical procedures for television.
She had just been accepted to the Stanford University
Medical Center primary care associate program when she
heard from Lance Gentile, MD, a friend and co-worker.
Gentile was starting work with the "ER" creators
and was looking for nurses to work as extras.
LeBlanc-Cabot said that for actors, learning words
like "tracheobronchoscopy" or "lymphogranulomatosis,"
and then being able to say them comfortably as part
of normal conversation, is tricky.
On top of the vocabulary is new equipment, such as
a handheld ultrasound, accompanied by stage directions.
That's why, LeBlanc-Cabot said, tech rehearsals are
so important. Things such as teaching the actor to look
toward the monitor and not the blood pressure cuff when
he says, "pulse ox is dropping," are vital.
For seasoned actors, it's much easier. But an influx
of new actors on the set has reminded everyone that
medical language and equipment truly are foreign.
Some of the actors have an easier time, LeBlanc-Cabot
said: Wyle, who plays Dr. Carter, is not only a gifted
and well-trained actor, but his mother is a nurse.
"This is probably the hardest job I have, but
I love it," Avignone said.
Avignone was working in the L.A. County ER when the
TV writers came through to gather stories and background
information. Avignone told them she had enough stories
to last 10 years. A week later, they called to hear
her stories, along with an offer to become an extra
on the show.
Avignone said that the first day she was on the set,
she expected to be a background extra. She hadn't even
told friends about her new acting opportunity. Her first
scene involved a full arrest on a 10-year-old child,
and she was thrown in with actors George Clooney, Anthony
Edwards, Julianna Margulies and Wyle, passing everything
from blood-drawing material to syringes and medications
on cue and acting along with the principal actors.
Every time they did a scene, they had to break and
do it over. Avignone had to replicate that same scene
so the views would look exactly the same. She spent
15 hours her first day. Somewhere around the fifth hour,
she realized what hard work it was.
Early on, she remembers hearing Clooney asking for
"another round of e-p-i." It took a pause
to realize he meant "epi," for epinephrine.
Margulies also announced that the "lits were in
and the potassium was at 7.2." That was corrected
to lytes, or reporting electrolyte results.
Problems still crop up with medicines, as they use
generic rather than brand names. Valium becomes diazepam,
and Benadryl becomes diphenhydramine hydrochloride,
for example.
All the nurses who were there remember the live show
they did. Annemarie Jowell, EMT, who is studying for
her RN, recalls how actors Edwards and Clooney wanted
to do a live show. They rehearsed for seven straight
days, with scripts, TV cameras and personal cameras,
because everyone wanted to get a picture of the process.
They did two live shows, one for the East Coast and
a second for the West Coast. It was even shown on the
Times Square marquee.
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