'ER' is not a world away despite the doubletalk

TV Scope: Hands up, anyone who hasn't been to see a doctor in the last 12 months

TV Scope: Hands up, anyone who hasn't been to see a doctor in the last 12 months. Maybe you've been with an elderly relative whose health is failing, with a sick child or misbehaving teenager?

Do you know someone who faces an undesirable outcome to a pregnancy, alone, against the cacophony of conflicting moral opinion? Perhaps you can relate to the case of the nine-year-old boy whose diabetes goes out of control because of chaotic childcare. These are just some cases from the emergency room of County General Hospital, Chicago. Ireland is no different we all have people with issues like these in our families, neighbourhoods and workplaces.

A recent episode of ER was called The Greater Good. While providing high quality care, the staff act out their own background histories. Dr Pratt has had a harsh upbringing, and is beginning his medical career.

Dr Kovac grew up in Croatia and has recently worked in the Congo. Dr Pratt wants to bring the facilities of modern technology to a little baby, born 16 weeks prematurely to Denny, who says she doesn't want him if there's any chance he won't be perfect.

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Dr Kovac quotes the hospital's policy intervention only if the baby weighs over 500 grams. He weighs in at 506g and resuscitation proceeds full steam ahead. Now there's a dilemma of individual rights and autonomy for ER viewers to discuss over coffee the next day.

Dr Lewis visits the elderly Ben Hollander who lives alone with his books, hobbies and classical music. His sight is failing rapidly. Wry exchanges about the quality of life and living lead, later in the programme, to their sharing stories of loss, and of relationships which both allowed wither on the vine. A new puppy brings optimism (evidence-based medicine confirms the advantage to older people of having and loving a pet).

Against a background of ER's tachyarrhythmic theme tune, patients arrive flanked by fluent paramedics presenting 30 facts in 20 seconds. Other patients' cases are presented to the attending physician and loud arguments follow about whether it is right, or of any benefit to the patient, to order batteries of expensive tests routinely. We hear volleys of medical acronyms, raised voices, questions asked. "If we ordered less tests, we could afford to treat more people" (Kovac) - a debate which echoes throughout Irish healthcare, every moment of every day.

Despite the frenzied atmosphere, the "greater good" does prevail. Denny bonds with her baby, Mrs Collins consents to the donation of her late husband's organs, Kovac delivers a ranting soliloquy on under investment in the development of drug therapies for third world diseases. There's humour, compassion and camaraderie.

As the credits roll, we know that Mr Collins' organs will benefit about 50 sick people, we like most of the staff despite their human frailties, and we hope they will go for a pint to refresh themselves before facing another day in ER.

Dr Catherine Hayes; medical doctor.

ER is broadcast on Sunday on RTÉ 1 at 9:30 pm.