The Best TV Show Ever

St. Elsewhere is the best TV series ever made. There, I said it. Now, nearly 25 years after its debut, the first season is finally coming out on DVD.

Before HBO started making original series for the demographically gifted, and before fX even existed, NBC began experimenting with high-brow entertainment for that hard-to-get but gotta-have audience of young, big spenders. In the fall of 1982, when St. Elsewhere premiered, the third-place network, after a series of disastrous seasons, had stumbled onto the idea of blue-chip niche programming. They gathered up a collection of low-rated but highly acclaimed series and dumped them all on Thursday night, which they heavily promoted as “the best night of television on television.” Fame and Taxi would be cancelled at the end of the season, but Cheers and Hill Street Blues would play an important role in making NBC the dominant network on Thursday nights for over 20 years.

Hill Street Blues, of course, deserves the credit for turning TV into art, for starting the “quality TV” revolution. One could see ads for Mercedes and diamonds on this show, and even though it ranked 83rd out of 97 series after its first season, Hill Street’s killer demographics earned its production company not only a renewal, but a development order for a similar project, known then as “Hill Street Blues in a hospital.” The result, St. Elsewhere, would trump its predecessor in terms of quality and sophistication. And though it made it into the Nielsen top 50 (placing 49th, actually) in only one of its six seasons, NBC president Grant Tinker claimed that, in terms of advertising, it was the fourth best-selling show on the network by 1985.

Within a few years, TV began to escape its designation as the “boob tube” and the “idiot box.” Artsy film auteurs like David Lynch and Michael Mann partnered with Hill Street Blues alums to produce, of all things, television shows. Barry Levinson paired up with St. Elsewhere’s best writer, Tom Fontana, to do the same. Other St. Elsewhere producers and writers went on to work on classy series such as Moonlighting, China Beach, L.A. Law, NYPD Blue, ER, Chicago Hope and Deadwood. David Chase worked with St. Elsewhere creators John Falsey and Joshua Brand on Northern Exposure before going on to create The Sopranos.

So what was so great about St. Elsewhere?

The acting was superb and the directing highly ambitious for the small screen. But it was the complex, rich writing that in my opinion has yet to be topped by another series.

Consider the following simple scene. Two of the senior doctors have just sat down to a meal in the hospital cafeteria. One is lamenting the fact that his medical talents are being wasted on administrative work, the other regretting a self-inflicted injury that is keeping him from performing surgery.

DR. CRAIG: Boy oh boy, Donald, you take the cake.

DR. WESTPHALL: Sorry, it was the last slice.

CRAIG: I’m talking about you sitting here slogging over those DRG [report]s…St. Eligius’s ever capable desk jockey.

WESTPHALL: It’s not a title I relish, believe me. It’s taking my focus as a doctor away from the patients.

CRAIG: Well at least you’re still cutting the mustard as director of medicine. Me, I’ll never catch up…I’ve spent almost three months trying to rehabilitate this hand…but whenever I move my fingers I’m peppered with pain. Well at least I can slice my own meat again. I used to be one of the saltiest cardiac surgeons in the state. Then I lost my temper and shattered a picture. Now I’m paying the price…(looking at his food) What is this? Pressed ham?

It’s a competently written scene that advances two story lines. But, like most scenes in the show, there’s so much more going on. For one thing, it’s sprinkled with condiment-based metaphors: relish, mustard, ketchup (“catch up”), pepper and salt all help season this short exchange. As a bonus, a few naughty masturbatory double entendres—slicing my own meat, pressing the ham—get slipped under the plate for good measure.

Dirty jokes were a standard motif of St. Elsewhere, in fact. Since network standards and practices departments were still very nervous about s-e-x in the 1980s, this material was veiled in the vestments of clever verbiage. There are hundreds of examples from throughout the series—here are three of my favorites:

1. A doctor learns his patient has been diagnosed with acute angina. “A good thing,” he says, almost inaudibly. “She’s got ugly legs.”

2. In a throwaway line, someone asks, “What happened to Constance, the daughter, after the Lingus family reunion?”

3. There is a long scene featuring a post-operative prostate cancer patient who has just received a prosthetic penile implant. In the scene immediately following—if you listen very, very carefully—you can hear the voice on the hospital public address system announce: “Paging Mr. Rise, Mr. Peter Rise.”

Juvenile? Yes. Sophomoric? No question about it. But it made St. Elsewhere the best interactive show on TV: you didn’t just watch it, you played along.

And then there was the ceaseless run of sly popular culture references. A doctor named Kimball is searching for his missing amputee patient (The Fugitive); an autopsy is being performed on “Patient 4077; Blake, Henry, believed to have died in a helicopter crash” (M*A*S*H); observing the longevity of the hospital barber, whose name is Floyd, a doctor says, “He may bury us all” (The Andy Griffith Show); “Move that gurney, Hal!” an orderly yells (Hal Gurnee was the director of Late Night With David Letterman). That was just one episode, and just a small sampling from that episode.

When was the last time you heard dialogue in Lost that had so much happening at once?