By Virginia Baldwin Gilbert
Of the Post-Dispatch

April 18, 2000

Dr. Carrie Weaver, acting director of the emergency room in "ER," can't get a tube down a patient's throat and is waiting for special equipment.

Dr. Mark Green steps in and asks, "Mind if I try?" He suggests a new "burping" procedure and shows a nurse how to help him. It works.

Weaver leaves in a huff.

After that episode in the fall of 1997, doctors and emergency medical technicians called "ER" producers to say they tried the new technique and it worked. A few medical schools and EMT training programs requested clips to show their students.

Such response from medical professionals is "a side effect," says Dr. Joe Sachs, executive story editor for the popular TV show, which airs at 9 p.m. Thursdays on Channel 5. "But it reminds us we have a real responsibility to be accurate and current in our portrayals."

Sachs, a board-certified emergency medicine physician, went to film school while he was still in medical school - both at Stanford University.

"I've been doing educational films all along," he said. During his residency in the late 1980s, Sachs wrote and directed film segments on health for medical TV. He joined "ER" for its first season in 1994.

But Sachs is adamant that ER's first job is not education.

"Our stories start with the dramatic situation," Sachs said. "We put characters in extraordinary situations - the medical stories we throw them into - and allow the audience to gain insight into them as people, how they interact with one another. It's all about human beings in a stressful work environment - how they balance career and family, co-workers, advancement and power," Sachs said.

For instance, the new intubation technique "came to me when we needed a scene where Green undermines Weaver's authority," Sachs said. "One of the things that would undermine authority would be if Weaver was unable to do a procedure and Green does it on the first try."

In the same way, "We don't go in and say, 'Let's do a story about Alzheimer's disease.' That's not our mission."

But the program did run a five-episode package last fall featuring Alan Alda as a doctor -Weaver's mentor - who was suffering from Alzheimer's. She had to ask him to leave the practice of medicine.

"As a side effect, people learned the early signs of Alzheimer's," Sachs said.

"We're writing about theme and characters. But within the setting, we try to portray accurate state-of-the art medicine," he said.