That Championship Season: St. Elsewhere, Season Four


To the degree that enormous permanent changes to any form of media can be pinpointed to a single event, to a pivotal moment, the entire landscape of television underwent a seismic shift on January 15, 1981. That marked the debut of Stephen Bochco’s police drama Hill Street Blues, a series unlike any that had come before. Its innovations were simple and yet profound, led by a grittiness that recalled the cinema of the nineteen-seventies, a bracing embrace of realism in the way it was shot and a structure that spread storylines across multiple episodes, allowing characters to undergo significant transformations in the process. The latter quality wasn’t exactly unheard of in television, but it was largely considered an approach reserved for daytime soap operas and their more polished but equally trashy nighttime brethren. Drama series that aspired to be serious and of high quality still adhered to the tried and true tactic of wrapping up stories in a single episode and making certain that practically any challenge that beset a character was fully resolved by the closing credits, effectively smacking the reset button on the fictional world. A viewer could miss an episode and completely understand what was going on when they tuned in again. Quincy was still the same old medical examiner, Jim Rockford was still the same charmingly downbeat detective.

There was a perfectly logical reason for this: television was a medium built on fleeting experiences. Programs could be watched when they were aired, and that was about it, at least until they cropped up as a rerun, usually several months later, probably in the summer when the splendorous outdoors beckoned. Move a master plot too far forward and risk losing all the viewers who happened to be out that particular Thursday night, with no DVDs, streaming video or online recaps to bring them up to speed. Even home recording devices were few and far between. It took a certain amount of daring risk alienating viewers by confusing them with progress they hadn’t witnessed. But there was a mighty counter-argument taking place in the summer of 1980, when Hill Street Blues was sitting on a shelf waiting to be aired. There was a dual sensation in those soapier corners of television with daytime viewers rapt over the troubled romance of Luke and Laura on General Hospital and essentially the whole country asking “Who Shot J.R.?” in response to the cliffhanger Dallas aired at the end of its third season. Whether or not these circumstances were a direct influence on Hill Street Blues, there was definitely a new notion in the air. Maybe complicated continuity was actually a way to hook viewers instead of drive them away.

But that screenshot up there isn’t of the Hill Street Blues logo, is it? While nearly every current drama of cultural significance (and, even more remarkably, a sizable percentage of the comedies) can trace its lineage to Bochco’s triumph, there were also a few notable shows that followed immediately behind it, employing its novel (and novelistic) approach in an effort to duplicate its unlikely success with the critics and general viewers, although the ratings didn’t come around until the show managed to snare an impressive batch of Emmys after its first season. For a while, any show that had interlocking, extended plotlines and an embrace of realism was inevitably compared to the landmark series. When St. Elsewhere aired its first episode in the fall of 1982, it was immediately tagged as “Hill Street Blues in a hospital.”

It may have been a reductive view of the show, but there were a few extenuating details that added to the perception, particularly that it came from the same production company, MTM. The company founded in the late nineteen-sixties by Mary Tyler Moore and her husband-at-the-time Grant Tinker was a relatively selective production home with a reputation for quality that began with Moore’s eponymous sitcom in the seventies and extended across well-respected offerings like The Bob Newhart Show, The White Shadow and WKRP in Cincinnati (and, naturally, the many successful spin-offs of Moore’s own show). St. Elsewhere fit nicely in their roster, providing the continuing story of a group of medical professions toiling in Boston’s St. Eligius, a hospital in the heart of the city that was termed, sometimes derisively, as a teaching hospital because of the heavy reliance of young internists to fill out the staff. The title of the series referred to the nasty nickname bestowed on the hospital because it was also in a lousy state of repair, with equipment failing, dingy walls and doors that would occasionally fall right off the hinges. A clear descendent of the Paddy Chayefsky-penned 1971 black comedy The Hospital, the program also anticipated the dire state of affairs in the American health care system yet to come. In that respect, St. Elsewhere wholly earned its comparison to Hill Street Blues in that it took a well-worn television setting and entirely upended it with irreverent but realistic deglamorization.

One of the reasons I always preferred St. Elsewhere to its police station predecessor is that the irreverence of the show also manifested as a wicked sense of humor and a sly, meta deconstruction of its world. St. Elsewhere didn’t exactly call attention to the fiction it operated in (at least not until the final scene of the final episode, but we’ll get to that later), but it found continually amusing ways to acknowledge it without disrupting the integrity of its storytelling. In a somewhat famous example, producer Bruce Paltrow met with NBC executives after the first season and one of them suggested that the drab ratings might be helped if the hospital were a “lighter, brighter place.” Rather than simply spruce up the sets during the hiatus, the second season premiere had paint crews actively at work in the hospital hallways, prompting one character to explain that the effort is “a gift from the Chairman of the Board,” a person who supposedly believes that “brighter walls will let our patients live longer.”

To my eyes, these witty, charming qualities reached a sort of apex as the show entered its fourth season, in part because the creators of the perennially under-watched program decided that they didn’t have anything to lose any more. Despite a variety of efforts to appeal to a wider audience, they weren’t adding viewers and yet the show was well-liked enough by key members of the NBC brass (especially, by most reports, Entertainment Division head Brandon Tartikoff, who had so much goodwill for turning around the previously moribund network with major hits like The Cosby Show and Miami Vice that he was allowed to keep at least one show on the air for little other reason than he personally enjoyed watching it) that it still had a decent shot to get renewed, even if most years it was one of the last shows to get invited back for another year.

That freedom inspired a greater playfulness in the story structure, even as it also empowered the writers to get darker in crafting the travails the characters were put through. And getting darker was no small feat for a series that once revealed a fairly major character was a rapist who had been terrorizing female employees of the hospital. That friction between clever, meta-fictional humor and bleak turns for the characters gave the show an extra burst of grandly unpredictable liveliness. They could cast Jack Riley to play a psych ward denizen named Mr. Carlin, in direct allusion to his recurring role on The Bob Newhart Show, in the same episode that a fellow patient believed himself to be Mary Tyler Moore Show protagonist Mary Richards with such commitment that he mistook a visitor to the hospital for Sue Ann Nivens. That visitor was of course played by guest star Betty White. The same series could shockingly, unpredictably kill the son and daughter-in-law of one of the lead characters, have others get attacked in ways that left lasting damage and had one of the doctors contract AIDS, the first regular series character to do so on network television (and the reigning People magazine Sexiest Man Alive, no less!).

Sealing my conviction that this was the best single season that St. Elsewhere ever had is the presence of the consensus high point of the entire series, a two-part episode called “Time Heals” that tracks the hospital’s history on the occasion of its fiftieth anniversary.


Hopping back and forth freely in time, the episode tracks how several familiar characters first became a part of the hospital staff or had even earlier interactions with the institution, encounters that are made entirely reasonable by the hospital’s status as a longtime fixture of the urban neighborhood. These interlaced pasts never come across as contrived, a common failing of this sort of story, and instead develop a resounding sense of the way a place, especially a place of healing, can become an essential part of a person’s emotional and spiritual self. At the heart of the episode is the guest performance of Edward Hermann, masterfully playing previously unseen St. Eligius founder Father Joseph McCabe. He brings such effusive charm and impatient compassion to the performance that it colors the remainder of the series, giving the modern-day characters that soldier on in the challenging conditions of St. Eligius the added dignity of worthy legacy.

The legacy of St. Elsewhere is a little more curious. Though it was one of the most acclaimed series of its day, it never made it past the first season on DVD, a realm of the media universe that’s often ridiculously thorough, and its significance has been all but entirely eclipsed by the admittedly more complex dramas that followed. These days it’s undoubtedly best known for the closing moments of its final episode, which suggested that the entire series was nothing more than the daydream of an autistic child as he stared into a snow globe all day long. That famed ending, combined with a few key, unlikely crossovers, inspired a theory that posits most of the entire television universe spring from this one fictional boy’s mind. It’s not quite the same as breathless praise whenever the unassailable greats of television are discussed, but it has a brassy, knowing cheekiness that may actually be the most fitting way for St. Elsewhere to be remembered.


An Introduction
Buffy the Vampire Slayer, Season Five
Cheers, Season Five
The Sopranos, Season One

8 thoughts on “That Championship Season: St. Elsewhere, Season Four

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