Wednesday, November 19, 2025

Landmark TV Episode Anniversary Commemorations Chicago Hope: ‘Leave of Absence’ 30th Anniversary (2600th Article)

 

 

Note: Of all the landmark episodes I've done to this point, this may be the first one that is of a TV series all but forgotten today.  So I'm going to need a somewhat more advanced introduction to explain just why this is one of the most significant episodes in TV history.

During the 1990s the Holy Trinity of writers that would lead the revolution of HBO were busy working on network TV.  David Chase would be one of the head-writers of I'll Fly Away and Northern Exposure, two undervalued classics of the genre. David Simon would eventually become one of the major writers of Homicide, which would not exist without his book. And David Milch was the force behind NYPD Blue one of the most groundbreaking series in TV history to that point.

Yet even with all their skills time and again at the Emmys all of them had to kneel at the court of another David who during the 1990s was synonymous with prestige television: David E. Kelley.  Between 1992 and 2000, at least one drama series he was the creator for would be nominated for Best Drama every single year.  He was such an unstoppable force that his fellow David's often struggled to breakthrough against him. At the 1993-1994 Emmys, Milch's NYPD Blue would win seven Emmys but lose Best Drama to Kelley's Picket Fences. In 1999 not even the incredible first season of The Sopranos could come out ahead of Kelley's The Practice. That year he made history as he became the first showrunner in history to win Emmys for Best Drama and Best Comedy in the same year as Ally McBeal managed its first and only win in that category. Kelley remains the only showrunner in history to ever accomplish that feat.

I'm not willing to say that in many of those cases the Emmys got it right: indeed it wasn't until the 2000s that the Academy would begin to abandon the safe, conventional series for Best Drama and finally start recognizing in increasing numbers the groundbreaking dramas of cable. What I will say is that as someone for whom Kelley was my gateway drug into appreciating the world of Peak TV his work in the 1990s was in its own way just as revolutionary and groundbreaking at the time as The Wire, Deadwood and Mad Men would be in the 2000s.

To be sure Kelley's work during this decade – and in fact well into the 2000s – was formulaic and conventional compared to what we would get later on. But considering that network television was the only game in town when Kelley broke into the business (he started his career on the revolutionary series L.A. Law in 1987) he was working with the same kind of rigidly enforced guardrails that his colleagues were at the time. And in that sense a show like Picket Fences was so bizarre and weird by the standard of what we were getting on television that its clear he was pushing at in a tonal sense rather than the boundaries of character the way other showrunners later would.

So when it was announced in 1994 that he was creating a new hospital drama called Chicago Hope the consensus was it was going to be the breakout hit of the 1994-1995 season.  The fact that NBC was trying to schedule another Chicago medical drama against it on the same timeslot made everyone thing that this was another sign that NBC was going in the wrong direction. How dare they give the holy slot of L.A. Law to a show with complete unknowns against the man who had just won back-to-back Emmys for Best Drama?

These days if Chicago Hope is remembered at all, it is as a trivia question: what was the other Chicago medical drama that debuted against ER in the fall of 1994? Indeed the battle was over so quickly that by November CBS chose to surrender and move Chicago Hope to Monday nights at 10 PM.  Kelley had a decent sense of humor about it: during the first season he frequently made in-jokes about just how popular ER was, even when Picket Fences actually crossed over with the series in the middle of the season. (Worried about one of her patients Jill Brock says: "Maybe we should take him to that other hospital."

Full disclosure: it took me a long time to appreciate how brilliant a drama ER was and I actually came to Chicago Hope first. I basically watched the second season in summer reruns and followed it loyally the rest of the time it was on the air, with some intervals. When the show went into syndication on Lifetime in the summer of 1998 I finally got to see the first season and would eventually record most of it for posterity. It's a good thing I did; not only is the show still unavailable on streaming, it would never be released on DVDs in America and is still only available on European ones. And it was then I got to finally see the first season which looked radically different from what I'd watched the last three years.

There were many reasons for this, not the least of which of all the many series Kelley would produce over his career this one had by far the most behind the scene disputes. The series was originally cast with a much older set of actors then ER had: a trend keeping with Kelley's tendency both at the time and later on to write more comfortable for older actors. It was a fairly prestigious cast: Mandy Patinkin, E.G. Marhsall, Adam Arkin, Roxanne Hart, Peter MacNicol, Roma Maffia and Hector Elizondo.

By the time the show reached its Christmas hiatus there was chaos behind the scenes and Marshall and Maffia were written out. The bigger problem was that while it was originally intended to be an ensemble show, much of the writing was beginning to focus on Patinkin's character of Dr. Jeffrey Geiger, the number one heart surgeon in the country with an ego to match.

Jeffrey Geiger was a character unlike that most TV shows at the time were used to: arrogant, openly hostile to his co-workers (save for his best friend Aaron Shutt), hitting on female colleagues with bizarre fetishes over the surgical table, disrespectful to everyone except his patients. One could argue that he was a prototype of Gregory House a decade later and Kelley would himself pursue these type of characters in the legal dramas he did in the 2000s. Unlike all of those characters Geiger was not just toxic but even his best friend thought he was certifiable, something even he didn't deny. In one first season episode he's actually leading a band of inmates in an institution and they say to each other knowingly: "He's one of us."

Patinkin's work was one of the most riveting performances in TV history. (He would deserved win the Best Actor in Emmy in 1995 for his work over George Clooney and Anthony Edwards in ER and would be the only actor to defeat Dennis Franz the first four years NYPD Blue was on the air.) As Aaron Shutt (Arkin) admitted at one point: "Jeffrey had enough demons for ten men." With good reason. By the end of the second episode we learned that his wife (Kim Greist) had drowned their infant son Joey and had since been institutionalized. Jeffrey had been unable to divorce her and regularly came to see her in her care facility. In one of the harder storylines for him, she told him that not only did she want a divorce but that their marriage had been difficult even before she had killed Joey.

It is primarily because of Patinkin's performance that I believe, on an episode by episode basis, the first season of Chicago Hope holds up as well as the groundbreaking first season of ER. In many ways Chicago Hope is a prototype of Grey's Anatomy had the series decided to deal more with groundbreaking surgery and less about the sexual habits of its staff.  Kelley was transitioning to a new form of drama and he chose to deal with groundbreaking procedures. In the first episode Geiger worked to separate two conjoined twins, in later episodes he would transfer a baboon heart into a dying man as a stopgap and would perform surgery to repair a hole in the heart of a newborn baby. (More on that later.) Nor was he the exception to this rule: Aaron Shutt would perform groundbreaking neurosurgery and the show dealt with patients who came her for the kind of things they wouldn't get anywhere else.

And it keeping with the often bizarre nature of Kelley in general, many of the cases would have that same quirky nature. In one episode after a man swallowed a finger, a doctor would remove it from the stomach to have it reattached – only to find that the man had actually swallowed another finger and they'd reattached the wrong one.  In order to save a man trapped in a car, Dr. Billy Kronk (Peter Berg) would cut off a leg with a chainsaw – and the man was about to be drafted as a kicker in the NFL. A patient faced with a terminal diagnosis of AIDS was infected with malaria in an effort to give him a longer life. Much of this seemed like voodoo science and the show itself frequently mentioned how Chicago Hope would be viewed negatively in the public eye for it. But it worked.

And in the second half of the season the show began to cast new actors who would stay with the series for the lion's share of its run, many of whom were then unknown and would become more significant in both TV and film later on. In the third episode Thomas Gibson was cast as Daniel Nyland, the head of the ER and the hospital's resident Lothario. (His sexual escapades were looked down on by the hospital staff.) Peter Berg would arrive as Kronk in the middle of the season. Vondie Curtis-Hall would be cast as Dennis Hancock and give a very urban feel to the hospital, as he operated a clinic adjacent to it. And Jayne Brook was Diane Grad, the head of scientific research.

By the end of Season 1, after a shaky start, Chicago Hope had found its groove and while no one pretended it was E.R., it seemed to have a bright future. It was nominated for nine Emmys including Best Drama. It had already been nominated for multiple Golden Globes and SAG Awards. It looked like it was going to be a force in quality TV for years to come.

And then during hiatus the roof fell in as it was given two severe blows. The first was that David E. Kelley was exhausted from the burden he felt being the head-writer of two series and decided to step back from both of them. For Picket Fences it would be temporary but he would be gone long enough for fans and critics to turn against it, even after he returned halfway through the season. By the end of the 1995-1996 season it was cancelled.

Kelley's hiatus from television wouldn't last long: by the summer of 1997 he would be back with The Practice. But he meant it with Chicago Hope and though he wrote a few scripts during the second season he would depart it on what many believed was a permanent basis.

This was a heavy enough blow on its own. What made it even worse was that even before the Emmys took place Patinkin had also announced that he was leaving Chicago Hope.  The reasons for his departure remain unclear to this point, but it is worth noting Patinkin was always something of a prima donna when on Broadway and that reputation would be just as clear for much of his TV career. A decade later he would be cast as Dr. Ben Gideon on Criminal Minds but then resign after two seasons, mainly because he was outraged at being part of a series that in his mind glamorized violence and monsters.  When he took the role of Saul Berenson on Homeland, by contrast, he argued that this show was about how we as a society must fight those monsters. (I'm inclined to agree with him on both counts.)

All that aside one can't deny that the role of Jeffrey Geiger has to have been immensely draining for Patinkin. The Season 1 finale had Geiger being forced to undergo a competency hearing which almost seemed inevitable given what the viewer had witnessed.  That he managed to pass the hearing can't disguise the fact that it must have been equally exhausting playing the kind of character who was so toxic to be around. Any normal person would have been drained by it.

So faced with the kind of blows that few series could recover from Kelley decided to confront it head on. In the season 2 premiere the show cast Christine Lahti as Kathryn Austin, a female heart surgeon who had been signed at half Geiger's salary. From the start the two of them clashed and it was a lot of fun watching the two of them tilt at each other. (Lahti and Patinkin, along with Arkin, had actually been in the cast of the 1992 film The Doctor so there was a certain familiarity.) Austen said that she might someday be chief of surgery and his boss and Geiger would say that she should be back in the kitchen baking brownies – right before getting into an elevator with her.

There was also a certain amount of leaning into the story of Alan Birch, the hospital attorney who was known as 'The Eel', played by Peter MacNicol. Considering Kelley's comfort with legal dramas MacNicol took on the role of his surrogate and you could see that this was a prototype of the character MacNicol would play on Ally McBeal two years later. MacNicol was known mostly as a comic actor at the time (most famously from Ghostbusters II) and while there was quite a bit of humor in his continuously put-upon character ("Not respect" was essentially his catchphrase) he was generally given more serious things to do. They found a niche for him during Season 1 when he was called into help a fifteen year old girl who had a baby with a hole in her heart. At one point the Shutts considered adopting her but Aaron was reluctant so eventually Alan did.

Not long after Geiger asked Birch about the child he'd named Alicia: "She has a hole in her heart. You are a single parent. A working single parent. With everything you do, can you do this?" Alan looked at Jeffrey: "It's the easiest thing I've ever done."

Much of Alan's story in Season 2 was about his trying to be a good father and find a mother for Alicia. By this point he clearly had a crush on Diane but she was oblivious of it and was trying to set him up with her single friends. During the second season Alan was naming the godparents of his child. It was supposed to the Shutts but by this point Aaron and Camille were getting divorced and Aaron begged off. Alan chose to name Jeffrey as his son's godfather.

So after seven episodes the set-up was complete. And that the show still managed to take us completely by surprise in 'Leave of Absence' is a tribute to everything that was done.

This episode was highly respected when it came out. It would be nominated for three of the sixteen Emmy nominations Chicago Hope got that year: Editing, Cinematography and Directing. Jeremy Kagan would win for the latter, defeating among others Mark Tinker for NYPD Blue and two ER episode, including 'Hell or High Water', considered one of the highpoints for that show. And in many ways it was one of the most radical episodes that television had yet seen and a harbinger of what 21st century TV has been about.

The episode begins on what appears to be a light tone. The teaser has Jeffrey rushing in on Kate and Aaron telling them that he has just achieved his goal of being ranked the number one heart surgeon in the country. "You're not on the list," he tells Kate. Kate goes through it annoyed. "Don't bother they only go to 100." This really inflames Austin who even now has been taking on the tones of a feminist.  "I'm guessing they think someone who looks like you can't be that great a surgeon. Myself I don't see it. You're not that much too look at." Before she can react he says: "I jest," and kisses her on the lips. "Great country!" he shouts and she brushes it off.

In the next scene Jeffrey always thin-skinned says that they're being too glum. Aaron points out he might be directed things considering his ex-wife remarried in the previous episode. Jeffrey says all he wants is to share his joy with his best friend and Aaron appeases him. As he leaves Jeffrey leaps into the air and clicks his heels. (Mandy Patinkin still had his Broadway moves.)

We then cut to Alan and Diane walking through the L after a disastrous date. "I can't believe you set me up with a married pregnant lady!" Alan is shouting as they move through the subway. As they leave they bump into a bunch of young African-Americans. They try to walk away but one of them holds a gun at him and demands his wallet. Alan is unsettled and says please. "Yeah right." Then the gunman empties his gun into Alan before running away.  Alan collapses in a stunned Diane's arms.

He's brought to Chicago Hope and every available surgeon is called in as Alan's been shot six times in the chest. Among those who come is Chief of Staff Philip Waters (the brilliant Hector Elizondo) who we have yet to see in an OR. While things unfold Camille goes to Alan's home and tells his nanny what is happening. The episode reaches its first commercial break with Aaron and Camille in the observation room. (A lot of the action in this show takes place in that room.)

While this is going on Diane is with the police and she identifies the boys who shot him. One of them is brought in to a lineup and when he steps forward he shouts "Bang!" and Diane flinches.

Finally they decide to take him off bypass. We all wait for something to happen. "Come on, Eel," Jeffrey says. "Be a man." "Come on, Alan!" Philip says. And there's a rhythm and both inside the OR and outside people rejoice. As Jeffrey closes them up he talks to Kate who he has been perfectly civil to in the OR. (This is a rarity for them over the course of their stint.) "I think that ranks as number one," he says.

Much of the second act of the episode takes place on two parallels. The first is waiting for Alan to wake up and when he starts to urinate everybody rejoices. "The Eel is pissing!" Kronk shouts in joy. Then there comes to the point when while arresting the gang the young gunmen is brought in with bullet injuries to the OR. At the time Diane is there.

In a moment that we never saw on ER (at least to that point) Diane walks up to the injured man and says: "Does this hurt?" Then she squeezes his wound as harshly as possible. The boy screams louder. Eventually she is pulled off when one of the attendings notices her. "I got scum right here!" she shouted. "I hope you die! I hope you suffer and die!" she shouts as she's all but hauled off.

Jeffrey and Philip then go to the Alan's bedside where it looks like Alan is on the road to recovery. Philip notes they haven't had much luck chasing down his next of kin. In a touch that speaks to what we get from the kind of thing on David E. Kelley Alan has left an 'ethical will', a set of values that he wants as a record of how he thinks people should live in memory of his death. Jeffrey also points out that Alan will be pissed when she hears what Diane did: "He's going to be worried about another lawsuit."

Then Alan regains consciousness. The first thing he says is "Alicia." Jeffrey says she's with Camille eating ice cream. Alan points at Jeffrey and says: "You." He wants Alicia to stay with Jeffrey while he's recovering. (While this has been happening Camille has been moving Alicia's stuff to her office in preparation for his long recovery and taking Alicia home.) Philip tells Alan to take it easy: "You were shot six times in the chest." Alan manages to work up the strength to say: "Not respect."

During the next ten minutes the viewer is lulled into the sense that everything's going to work out. Alan seems to be becoming his old self (when Diane sees him he does say he's worried about another lawsuit) Jeffrey is nervous about washing a baby Alicia's private parts ("I don't want to be accused of statutory scrub' he tells Aaron before handing her over to Camille) and there's discussion about the odd dynamic between Kate and Aaron (they're still trying to go on a date) and Camille's awkwardness about Alan asking Alicia to be with Jeffrey.  Even though readers of the few TV journals there were in 1995 knew that MacNicol was going to be written out of the show along with Patinkin (the rumor had been he was going to freeze to death in his car) the fact remained that in 1995 the killing of series regulars was essentially limited to prime time soap operas and conflicts with cast members (Henry Blake in MASH being the most famous example). Even the previous year when a similar conflict had come up with David Caruso on NYPD Blue Steven Bochco and David Milch – both among the few showrunners who were willing to kill of series regulars at the time – chose simply to have him forced out of his job rather than kill off his character outright.

And that made the events that followed all the more stunning.

Alan starts shaking in his hospital bed and the doctors debate over what to do. They consider a shot of epinephrine but that could cause him to bleed out. They want to put him in the OR but that could be a risk with Alan having been in surgery so recently. Waters's snaps: "Make a decision!" They decided to wheel him back in.

This time only Geiger, Austin and Kronk go in while most of the staff is the observation room. Waters says grimly: "Pulmonary embolism. And its massive." The doctors work on sewing it up and they finish. They take him off bypass.

There's no heartbeat this time. They try to defib him but nothing happens. Austen tells Geiger 'Massage'. In the observation room Waters begs for Alan to live. Geiger frantically pumps for a long time until he's told to stop. He keeps pumping. He's told again. He pushes the guy next to him away. Finally Austin with a tenderness we never hear says its over. Jeffrey walks way. Austin takes off her mask to announce time of death and she's in tears. And Geiger collapses on the OR floor in utter despair, broken in a way we've never seen him.

These kinds of things simply didn't happen in 1990s TV. Even when HBO began breaking the rules of television a few years later, most of the character deaths were sudden and while there would be build-up usually the end was violent. (Nate Fisher's protracted death near the end of Six Feet Under was one of the few exceptions to this rule.) And if they were rare on cable TV, on network TV they would be even rarer. It was not until Bobby Simone's death on NYPD Blue nearly four years later (again in a hospital setting) that viewers would see something that surpassed what happened here in sheer terms of not only time spent and the anguish the surrounding characters went through in the aftermath. And its worth noting Alan's death took place in what was Act Three. The last fifteen minutes would be even more devastating.

Austin finds Geiger feeding the pigeons and she lets him off the hook saying that they did the right thing. Geiger says they don't know that and it was his call. Waters calls the staff together to try and deal with what has happened but its clear he's still so shattered by it he can barely raise token words of comfort. (Indeed he will spend the next several days essentially in mourning and only begin to rouse himself with the day-to-day running of the hospital.) Diane heads to the bed of the gangbanger with plans of vengeance in his heart but Hancock has posted guards as a precaution and she will be reeling from this longer than Philip will. She never returned Alan's affection but her proximity to his murder will be a hold over her.

Jeffrey then goes to Camille who is tending over Alicia. Very gently he talks to her and tells her that while he knew they were both named godparents it was clear Alan wanted Alicia to be with Jeffrey. Camille ascents to this and says she doesn't know what to tell his daughter. Very gently Jeffrey says: "Your daddy went to be with God."

After that we cut to Philip's office. "A leave of absence?" he shouts. Jeffrey says three months, maybe six. Just until he works things out with Alicia. Philip thinks this is madness and storms out. While this is going on Aaron looks at his friend.  "You're leaving." "Temporarily. I'll be back," he says to Aaron.

"No you won't." Aaron says firmly. "I know you. You'll shake my hand and talk about getting back soon but I know. The idea of a temporary state is not something you can handle." He argues that he Jeffrey can't tolerate the idea of screwing up and that this is penance for doing so for Alan. "Jeffrey I love you but you are not a stable individual. And outside of the operating room, I don't know if you can function."

And then Jeffrey is honest in a way he is with no one else. "I don't want to go back into that room. Not ever. Alan left an ethical will. And I'm going to follow it. I'm going to be the kind of father Alan was going to be with Alicia, I'm going to be the father I would have been with Joey (his dead son) and it absolutely can not happen in that room."

The final minutes show the hospital staff watching as Alan's body is wheeled to the morgue to take him to a funeral room. Slowly Kronk leads a round of applause: "All hail the Eel." The entire staff is there by the end.

The final minutes show Jeffrey packing up. Kate walks in and says goodbye. "You're a great doctor, Katherine," he says. "I'll deny saying that if anyone asks." Then he picks up her carrier and begins to sing as he leaves. "Skidderinkie dinky dink, skiddie-me-rinkie doo, I love you."

One of the highlights of the show was how Geiger, like Patinkin, would break into song in the operating room. He's singing to his child as he goes. As he leaves he tells Aaron: "I'll be back." "Sure you will," Aaron humors his friend.

This combination of departures – Kelley, Patinkin and MacNicol – should have permanently crippled the show forever. At a certain point I will write about the show again but while the series never became a ratings powerhouse it was a critical and audience hit for the next four seasons.

The show rebuilt with Christine Lahti at its center and she would finally receive the acclaim she never really did as a film star. She would be nominated for Best Actress in a Drama all four seasons she was on the show and win an Emmy in 1998. The series would be nominated for Best Drama in 1996 and again in 1997 with Elizondo and Arkin receiving multiple Emmy nomination for Supporting Actor. (Elizondo would win in 1997.) Patinkin would make multiple guest appearance during the rest of Season 2 and sporadic ones for the next three years before returning along with Kelley in 1999. (I'll deal with that in a later article.)

I consider 'Leave of Absence' a landmark episode for many reasons beyond those listed here. First it was the first occasion I saw a series regular killed off onscreen on network television. (Law & Order and Homicide would do so multiple times during the 1990s but only after the actor playing the character had left.) It would also start a trend for how David E. Kelley would become a pioneer as 'an angel of death' for network television, something that he was one of the few pioneers in as television officially entered its Golden Age. The deaths of Billy Thomas on Ally McBeal in 2000 and Richard Bey on The Practice in 2001 were portents of how network television was changing to meet the standards of cable, though it would not become gospel until 24 debuted.

Second despite Kelley's departure it firmly established me as a fan of his work going forward. For the next fifteen years a David E. Kelley series of any type was going to be a draw. Not all of them were gems (The Brothers of Poland, New Hampshire?) and as I've written 9/11 and the War on Terror did much to diminish his effect as a writers by the 2010s. He wouldn't get his mojo back until he completely changed format on Big Little Lies in 2017 and officially began his second act in Peak TV.

And most significant this episode and much of what was to follow would officially set in my mind the standard for what a hospital drama should be, even more than ER initially did. (As I've written it took me longer than most to accept how much of a masterpiece it was.) For me medical dramas should be about ground breaking medicine, stirring character stories and great emotional points not the bedroom habits of the interns and residents. It's why I never truly warmed to Grey's Anatomy, why I would prefer series like Transplant and have become a fan of shows like The Pitt and Brilliant Minds.  On Chicago Hope the doctors were concerned about many things but their love lives were less critical and when they did, they formed relationships and bonds that lasted throughout the series, not hopping from bed to bed. I may not have loved the rigid feminism of Kathryn Austin but compared to what passes for it from Meredith Grey and so many of her fellow interns, you could never say she didn't care about medicine. (By the way the show never really had many interns during its run and when they did show up, they always listened to their attendings and respected the chain of command.)

As of this writing Chicago Hope is one of the longest running dramas that has yet to appear on streaming in any form. Given that in recent years shows like Picket Fences and Ally McBeal have appeared on Hulu and Amazon, I expect that it will soon change. I hope it does so that people can discover it and see just how groundbreaking episodes like 'Leave of Absence' truly were for the first time.

 

 

 

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