St. Elsewhere

First airing in 1982, St. Elsewhere was a US medical drama that redefined the genre, pushing boundaries in storytelling, tone, and character development. Set in the fictional, run-down St. Eligius Hospital in Boston, the series focused on a team of overworked doctors and staff trying to deliver quality care in an institution more often dismissed as a last resort – hence the nickname “St. Elsewhere.”

Where previous medical dramas had leaned into glamour or idealism, St. Elsewhere offered something more raw, complex, and human. It was pioneering in its blend of gritty realism, dark humour, and ongoing serialised storytelling – something still relatively uncommon at the time in American television. Patients didn’t always get better, doctors made mistakes, and personal problems often bled into professional lives.

The ensemble cast, which included the likes of Ed Flanders, Norman Lloyd, William Daniels, Denzel Washington, Howie Mandel, and Ed Begley Jr., delivered consistently strong performances, portraying characters who felt flawed but deeply real. The writing was sharp and often daring, with plots tackling issues ranging from AIDS and addiction to euthanasia and mental illness – subject matter that was rarely dealt with so openly on television in the early 1980s.

Perhaps what made St. Elsewhere so distinctive was its willingness to defy convention. While it could certainly be moving and dramatic, it wasn’t afraid to experiment with structure and tone. Episodes sometimes veered into surrealism, fantasy, or self-referential parody, without ever losing sight of the emotional stakes. This level of creative ambition set it apart from more formulaic contemporaries and earned it a devoted following.

The series also made headlines for its controversial final episode in 1988, in which it was revealed that the entire six-year story may have taken place inside the imagination of an autistic boy, Tommy Westphall. While divisive, the ending has since been the subject of much academic and fan discussion, and it further cemented the show’s legacy as bold and unconventional.

Though it never enjoyed huge ratings, St. Elsewhere was critically acclaimed and highly influential, often cited as a forerunner to later prestige dramas such as ER, The West Wing, and Grey’s Anatomy. It helped usher in a new era of television where characters could be morally ambiguous, plots could span seasons, and genre expectations could be upended.