Groundbreaking hospital drama ER draws its last breath this week after 15 years of blood, sweat and tears that changed storytelling on US television and put fictional County General Hospital on the world’s stage.

Tomorrow’s two-hour season finale on the NBC network, preceded by a retrospective special, brings to an end a drama series that nearly never got made, yet boosted the careers of stars including George Clooney and won 22 Emmy awards, US television’s top honour.

But just as the fast-paced ER episodes over the years left many stories unresolved, viewers should not expect a neat ending or grand emotional farewell with many former stars appearing on the final show.

Clooney, who left the show in 1999, and other ER alumni including Julianna Margulies, Anthony Edwards, Eriq La Salle and Noah Wyle appeared earlier in this 15th and final season.

“We’ve spread them out over the season,” Executive Producer John Wells, who wrote the finale, told Entertainment Weekly magazine. “I didn’t want to do something like somebody dies, or there is a celebration, or the hospital closes, so that’s why everybody comes back (during the season). I wanted it to be natural.”

Author Michael Crichton, who died of cancer last year, wrote the screenplay for ER in 1974 based on his experiences as a medical student in a busy hospital emergency department.

But it went nowhere until Crichton worked with director Steven Spielberg on the 1993 film Jurassic Park, and later the two turned their attention to a TV pilot that eventually aired on NBC in September 1994.

ER’s frenetic pace, complex medical jargon and multi-stranded plots were at odds with the self-contained medical mystery format used on most prior hospital TV shows.

But the format and characters played well to audiences. Between 1995 and 1999, ER was the top-rated drama on US television.

It also has played in 195 countries in Europe, Africa, Asia and South America and has been dubbed or sub-titled in 22 languages.

“We were in Kenya, in Nairobi, in the airport and everyone knew who I was,” said ER actress Alex Kingston at a Hollywood party celebrating the show. “It was kind of strange, but that’s just how big the show is.”

As the original cast members departed over the years, the likes of Goran Visnjic, Maura Tierney and John Stamos put on their scrubs. Guest stars have included Zac Efron, Ray Liotta, Dakota Fanning and Cynthia Nixon.

Viewership slipped in recent seasons, and the show now attracts around 7 to 8 million viewers per episode – less than half of the audience at the height of its popularity.

“You know 15 years is a long time for a television show to be on the air. So the timing is good,” said Gloria Reuben, who appeared in more than 100 episodes.

Reuters

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