Portal de Periódicos da CAPES

The Short but Happy Lives of TV Backgrounders

2004; Lippincott Williams & Wilkins; Volume: 26; Issue: 4 Linguagem: Inglês

10.1097/00132981-200404000-00025

1552-3624

Burton K Fox,

Radiology practices and education

Getting into the back of the golf cart, I bumped my head on the plastic roof. I was bleeding slightly, but I wasn't worried because I was traveling with two emergency physicians, and we were headed to the ED of County General Hospital. We pull up to a crowded ambulance bay, park, and walk through a waiting room filled with anxious and sick patients, some bent over in discomfort, others bleeding from facial wounds. In the eyes of some glints an angry, not-been-seen-yet confrontational stare. My injury is minor, but I blend in nicely with the mix of patients. One thing, though, I don't have to wait. We are quietly ushered inside, handed wireless headsets, and provided with director chairs to sit in. Directly in front of us, amber video monitors display a doctor headed toward one of the examining rooms and a young boy sitting on the edge of a bed. If we look over the monitors, we can actually see the physician reach the door of the room, stop, and have an intense conversation with a nurse. Our headsets, with intimate clarity, let us listen to every word. SAMANTHA: Mom's still sleeping off her bender. She got about 30 stitches. Head CT was negative, but surgery wants to watch her overnight. BP's 110 over 78 after three liters and her crit's 41. GALLANT: That's pretty good. Listen, if they're going to discharge her in the morning, why don't we just keep the kid here with her overnight? SAMANTHA: DCFS won't let us do that. They'll want to place him with a foster family. (She exchanges a look with Gallant.) It's only one night. The director shouts, “Cut.” “Uno mas,” yells the first director. An alarm bell rings once and then again. “Sound,” somebody says. “Clap it,” another voice. “Backgrounders,” the first director says again loudly. Then the director calls for action in a big voice filled with authority, emotion, and professionalism all projected in that single word. The same doctor starts walking toward the room where the 9-year-old sits on the edge of the bed and stops again at the door to speak with the nurse. SAMANTHA: Mom's still sleeping off her bender. She got about 30 stitches.... County General, of course, is the fictitious Chicago hospital that is the setting of the television show “ER.” Dr. Judith Tintinalli and I sit in our director chairs. The emergency department is a typical county-like facility, slightly frayed and worn, filled with standard medical equipment. Patients fill almost every bed, some on oxygen, some with their injuries still untreated. Once the first director calls for backgrounders, the department becomes a beehive of activity. Volunteers bring visitors in from the waiting area, nurses draw blood and check IVs. Doctors rush from bed to bed. Consultants arrive in white lab coats, and read charts before checking on their new patients. Security guards roam the hallways. There is lots of movement, something is happening everywhere. In this emergency department, though, as real as it looks, and it looks very real sitting in our director chairs, everything stops on the director's command. Suturing stops, the stretchers that have been rolled in to the treatment rooms reverse and head back to the ambulance bay, a very sick patient reaches under his gown for a cell phone, a nurse stops drawing blood and resumes knitting. And the only real blood in this emergency department are the small droplets that are congealing on my head. On the popular TV show “ER,” backgrounders try to look busy and not make eye contact with the camera The scene we have been watching, a small part of the episode titled, “Get Carter,” that aired Feb. 5, features Linda Cardellini as Nurse Samantha and Sharif Atkins as Dr. Gallant. These two actors, along with more than a dozen others who have major speaking roles, and some 50 to 100 backgrounders and stand-ins, make up the visible staff of County General Hospital. The entire production staff of actors and technicians, if they were in fact health care professionals, could easily handle a yearly census of more than 50,000 patients. But Dr. Tintinalli and I are not in the County General ED just to observe. The supervising producer, Joe Sachs, MD, a practicing emergency physician, has invited us to appear as backgrounders in two scenes. Dr. Sachs has assured us that even though we will be seen in a wide shot behind the main action of the primary actors, our family and close friends will be able to recognize us. In preparation for our role as backgrounders we are taken by our guide Nurse Mary to the wardrobe room for our lab coats and then to the prop master. The prop master operates from a large locked mechanics tool chest. Her key opens drawers full of those kinds of wearable minutiae that defines a person's profession without a word being spoken. Dr. Tintinalli and I are issued stethoscopes, pens, penlights, and County General ID badges. I look at my ID badge and find an ophthalmologist who is pale and bald. I am swarthy and hairy and would rather be a trauma surgeon. Dr. Tintinalli is unconcerned about who she is, and balances her stethoscope around her neck with practiced indifference. The prop master looks at my balancing efforts, and adjusts my stethoscope saying, “That's better.”Figure: Burton Fox and his wife, emergency physician Judith Tintinalli, MD, recently achieved stardom as extras on the television show, ER.The next scene starts in the main hallway and moves to the nurse's station. It is the first scene that Dr. Tintinalli and I will be in as backgrounders. We are placed on opposite sides of a female patient's bed. Dr. Tintinalli and I are reminded that the cardinal rule for backgrounders is not to look at the camera and watch what is happening. We are to be busy doing what we do and promise not to make camera eye contact. Rehearsals begin. During one of the rehearsal breaks, Dr. Tintinalli looks at the patient. DR. T: I am a real doctor. Really. Do you have any medical problems? You can tell me. The “patient” looks confused. PATIENT: (smiles) No, I'm OK. Rehearsals complete, the first director calls for the first take. Eight takes later, the director accepts the last take, and says the requisite command required before moving on to the next scene: Check the gate. We break for lunch. Dr. Tintinalli and I walk through the swinging doors to the doctor's lounge, and we are behind the set. We mingle. We wait on a short food line with nurses, volunteers, visitors, patients, and the unseen injured. I am behind a large bald man. He is one of eight walking wounded patients in the cast call. His head has been lacerated in several places, and blood covers his face and has dripped onto his shirt. He gets an empty plate and fills it with barbecued chicken, cole slaw, and salad. Thankfully his injuries have not affected his appetite. After lunch, our lab coats unsullied by sauce, Dr. Tintinalli and I go back to the set. The video village has been moved to a different part of the set, near the triage desk where the next scene starts. Nurse Mary, our guide, takes us to the centrally located clerk's desk, the usual hub of activity in an ED. She positions us in a corner of the oval desk. In our second scene as backgrounders, we have been promised even more exposure and on-camera time. In this scene, Dr. Tintinalli enters, following Abby Lockhart, a medical student who is also a nurse, played by Maura Tierney. Dr. Tintinalli comes to the clerk's desk and stands next to me while Abby heads toward the triage desk. We have been told that our role is to consult with each other while we busy ourselves reviewing charts. During rehearsals, we develop our own silent dialogue and action. It goes like this: After Dr. Tintinalli joins me, she reads her chart, and I read my chart. Then she hands me her chart. I look at her chart, review her notes, and then sign it and return her pen. We finish conferring, and leave the scene together. Because we cannot look at the actors during the scene for a visual cue, we have to listen. Our verbal cue is the word “sex.” When we hear that word, we start to move out of the scene. I loved Maura Tierney in the film “Scotland, PA.” I thought she was intriguingly wacky, attractive, and sexy. So listening for the word sex in a scene with her is easy. ABBY: Look, about earlier. Don't get the wrong idea about Luka. He's a good guy. SAMANTHA: I'm not looking for anything right now. ABBY: I just thought you should know. SAMANTHA: Thanks, but independence works pretty good for me. (Pauses.) Although I wouldn't mind some regular sex. ABBY: No kidding. Hell, I'd settle for irregular sex. Dr. Tintinalli and I are headed toward the hallway out of the scene when Ms. Tierney speaks her last line in the scene. Fifteen takes and two hours later, Abby's desire for intermittent carnal pleasure is still palpable. The director, though, is satisfied, happy even, and has commanded: Check the gate. The scene is over. At this point, Dr. Tintinalli is introduced to the actors and crew. PRODUCER: (to the production crew and actors) This is Dr. Judith Tintinalli, editor-in-chief of the Study Guide in Emergency Medicine. We have referred to it several times in different episodes. It is a pleasure to have you here today, Dr. Tintinalli. Members of the crew and actors say “hello” and “nice to meet you.” “A real doctor.” PRODUCER: Dr. Tintinalli, do you think you could sign your book, the one we keep here on the “ER” set? Dr. Tintinalli signs her book, and we shake hands. We say goodbye to the County General cast and production crew of “ER.” We return our lab coats to wardrobe and our props to the prop master. We walk out through the visitor's lounge to the ambulance bay. There is a golf cart waiting to take us to Universal Studios where another “ER” scene is being filmed. In the golf cart, Dr. Tintinalli and I talk. What fun, she says. I agree. She has in her hand some papers from the last scene. Souvenirs, the Emergency Physician Record. I had scribbled and doodled on a similar form for 15 takes. But not Dr. Tintinalli. After thousands of emergency department hours, Dr. Tintinalli cannot change her habits, a true professional. A real doctor even on the “ER” set, she has circled and completed the medical form for her patient: chief complaint: facial droop; severity: severe; altered sensation; difficulty swallowing; and decreased ability to walk. Her patient's history indicates a pacemaker, appendectomy, and hysterectomy. For allergies, she checks, “See nurse notes.” Next to the line for physician signature on the form, she has legibly signed her name. As we head to the Congolese village after eight hours in County General ED, we discuss her patient. It's a collegial conversation.