The doctors are in on ‘Grey’s Anatomy’

If someone wanted to write a book called “How to Create a Hit Show,” “Grey’s Anatomy” would be an excellent case study. 

It’s a medical drama that’s hitting its stride as perennial ratings winner “ER” continues its long, slow descent into irrelevance. Because the medical drama is a tried-and-true archetype for successful television, there’s no need to reinvent the wheel. Take a good-looking group of doctors, add an attractive group of guest stars as patients, sprinkle with a liberal amount of sexual tension and a dash of rare and compelling medical mysteries, and voila — compelling television.

To go with that tested format, the producers came up with a top-notch ensemble cast, featuring talented actors and actresses without the genuine “stars” that can distract viewers from everything else that’s going on.

There was That Girl from “Old School” (Ellen Pompeo), The Cool One from “Sideways” and “Arli$$” (Sandra Oh), and of course “The 80s Heartthrob Who Everyone Sort of Forgot About” (Patrick Dempsey), all of whom were recognizable, but none of whom are big enough to throw focus on the actor as opposed to the character Add additional cast members such as T.R. Knight, Isaiah Washington, Chandra Wilson, Katherine Heigl, Justin Chambers and James Pickens Jr, and the result is a group where any combination can carry the show for any given week.

In that group are a number of different character types geared towards establishing a rapport with the audience. Pompeo as Meredith Grey is the central figure, but Knight’s George O’Malley is the conscience, designed to be the audience favorite even as he sometimes makes choices that makes viewers want to throw things. Wilson’s Dr. Bailey is the no-nonsense supervisor, and so on. It takes an effort not to find someone on the show with whom to identify.

The same is true for the show's relationships, which in true TV tradition are fraught with complications and the whiff of inappropriateness. There’s the one between Dr. Christina Yang (Oh) and Dr. Preston Burke (Washington), which is above reproach except that Burke is one of Yang’s supervisors. There’s the obligatory love triangle between Grey, Dempsey’s Dr. Derek Shepherd, and Shepherd’s on-again, off-again wife, also a doctor at the hospital. And there’s the who-knows-what-the-heck-is-going-on relationship between Dr. Izzie Stevens (Heigl), Dr. Alex Karev (Chambers), and a patient who may or may not be dying of organ failure. There’s literally something for everyone; those searching for stable relationships, and those more into trainwrecks.

Once the cast was set, the show started off with the best lead-in ABC had to offer, the megahit “Desperate Housewives.” That meant it didn’t need to count on clever promos or critical reviews to gain an audience; all it needed was for the viewers to be too lazy or tired to change the channel.

Character-driven action
But the show soon took off on its own, and now "Grey's" looks as if it could carry a night even if it was preceded by the one-episode-only “Emily’s Reasons Why Not.”  Episodes are well-written and expertly filmed, and the pacing is usually languid enough that it’s comforting to follow.

There’s medical drama — this season already has featured a man with an unexploded bomb in his abdomen, and a pair of commuters impaled on the same beam after a train accident — but very rarely does the show adopt the rapid-fire high-intensity pacing of a traditional hospital drama. Because "Grey's" is character-driven, the medical cases usually don’t need to take up most of the action.

Does the hospital seem to get more than its fair share of tragic figures, random illnesses, and injuries unlikely to occur in real life? Sure, because it’s hard to get viewers interested in things like sprained ankles and the stomach flu. But "Grey's" is also reminiscent of shows like “ China Beach ,” or maybe “ER” before the days when every Thursday was a “Very Special Episode You Can’t Miss Because This Show Costs Too Much And We Really Need the Nielsens.”

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