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Grey’s Anatomy may have a lot in common with long-running hospital shows like ER on the surface. But TV showrunner Shonda Rimes revealed the slight details that made them very different from each other.

‘ER’ and ‘Grey’s Anatomy’ focused on two completely different things

The cast of 'ER'.
Alex Kingston, Paul McCrane, Ming-Na, Michael Michele, Anthony Edwards, Goran Visnjic, Noah Wyle, Maura Tierney, Eriq La Salle, Sherry Stringfield, Laura Innes | NBC/Getty Images

ER and Grey’s Anatomy would inevitably have things in common, with both being successful medical dramas. But the genesis of each show was different. ER was created by Michael Crichton, and was based on his own experiences going to law school. Meanwhile, after watching a TV show, Rhimes was inspired to make Grey’s Anatomy.

Before Rhimes came up with Grey’s, she was actually working on a war series. But current events dissuaded her from going any further with the show.

“A few years ago, I did a pilot for ABC. It was about journalists covering a war,” she once said in an interview with Oprah. “I really loved it, but then we went to war in Iraq, and the pilot suddenly felt like poor taste because the characters were having too good a time. Real soldiers were dying. It would have been weird to air it. Later ABC wanted another pilot.”

Rhimes had a natural fascination with surgery shows, and her obsession with them led to Grey’s Anatomy.

“My sisters and I would call each other up and talk about operations we’d seen on the Discovery Channel,” she said. “There’s something fascinating about the medical world—you see things you’d never imagine, like the fact that doctors talk about their boyfriends or their day while they’re cutting somebody open. So when ABC asked me to write another pilot, the OR seemed like the natural setting.”

But it wouldn’t be like the medical drama that preceded it. Rhimes asserted that Grey’s Anatomy would be more intimate for viewers.

“ER is high-speed medicine,” she said. “The camera flies around, adrenaline is rushing. My show is more personal. The idea for the series began when a doctor told me it was incredibly hard to shave her legs in the hospital shower. At first that seemed like a silly detail. But then I thought about the fact that it was the only time and place this woman might have to shave her legs. That’s how hard the work is.”

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The two shows also had something in common in terms of their longevity. ER aired on television between 1994 and 2009. Within that time, it delivered 331 episodes. Grey’s Anatomy has enjoyed a similar lifespan. 

The show first aired in 2005, and is still running almost two decades later. It’s even surpassed ER‘s numbers, as it’s aired 423 episodes. And this number is sure to grow after it recently returned for its 20th season.

Unlike with ER, however, there’s no end in sight for Grey’s Anatomy. Although Rhimes has definitely had the show’s ending in mind over the years.

“I’ve written the end of that series, I want to say, a good eight times,” Rhimes told Variety not too long ago. “I was like, ‘And that will be the end!’ Or, ‘That’ll be the final thing that’s ever said or done!’ And all of those things have already happened. So I give up on that, you know what I mean?”

Rhimes has since handed over the reins of Grey’s Anatomy to Krista Vernoff. She mostly stays out of the way of the show’s new creative team. However, she shared that the show’s ending would always come down to her.

“Am I the person who decides when the show is over? Yes. And I take full responsibility for that when or if everybody gets mad at me,” she said.

The fact that others are mostly in charge of the show now has made coming up with an ending even more complicated.

“If you’d ask me this question three years ago, or prior to Krista arriving, I would have said, ‘Yes, I can tell you exactly how it’s going to end,” she added. “But once you hand off the ball for real, it’s just different. So I don’t know yet.”