If the surgical safety checklist were an actor, it would have earned a Screen Actors Guild card for the role it played in last week's pivotal episode of the medical drama ER.
The safe-surgery tool saved the day - and a donor kidney destined for the ailing Dr. John Carter - in a crucial scene in what was likely one of the most anticipated episodes of the show, which saw the return of actor George Clooney.
The team that designed the surgical checklist, which was tested in a study published earlier this year, was thrilled by the spotlight ER focused on a tool they believe can have a major impact on reducing deaths and complications due to surgical errors around the world.
"I have to tell you it got to me in a way I never anticipated," the team's leader, Atul Gawande of the Harvard School of Public Health, said in an e-mail. "Producing a checklist that could save lives is what we on our team at the World Health Organization spent the better part of two years working to make happen. And underneath it all is a cultural change for surgery exactly like ER depicted on a screen - a change from seeing ourselves as solo agents to effective teams.
"But you begin to wonder if anyone is going to get it. What those few minutes showed me is that everyone will."
Dr. Carter (Noah Wyle) had been suffering from kidney failure and waiting for a transplant. When a donor organ arrives, he's rushed to the operating room under the care of a brusque and arrogant surgeon.
Dr. Carter's mentor of old, Peter Benton (Eriq La Salle), asks to observe the procedure. When the surgeon in charge moves for a rapid start to proceedings, Dr. Benton intervenes, pulling out a laminated card and asking to run through the safe-surgery checklist.
To the evident irritation of his colleague but with the support of other surgical team members, Dr. Benton establishes that everyone knows each other, their role, the operation to be undertaken, that Dr. Carter has no known drug allergies and that he is receiving intravenous antibiotics to lower the risk of infection.
When he asks if any member of the surgical team has any concerns, a nurse pipes up that there is no reperfusion solution in the operating room. The surgeon snipes that it won't be needed, but solution is ordered.
Later, when the surgery hits a snag, having the solution at hand ensures the success of the transplant - a point Dr. Benton drives home. A junior member of the operating team asks Dr. Benton where he can get a copy of the checklist.
"It couldn't have been better," said Sandra de Castro Buffington, director of the Hollywood, Health and Society program at the University of Southern California's Annenberg Norman Lear Center, who brought Dr. Gawande to meet with the writers of ER last fall.
The program makes medical experts available to Hollywood writers and producers with an aim of increasing the accuracy of the portrayal of medical and health issues in television programs and in films.
In addition to taking calls from writers, the program occasionally pitches experts to shows in the hopes of bringing attention to particular issues.
Having heard of Dr. Gawande's work, Ms. de Castro Buffington thought it was a natural for some of the shows the program works with. "I asked Atul [Gawande]: 'If you could reach 20 million people in one hour with three messages about the safer surgical checklist, what would they be?' " she explained.
Ms. de Castro Buffington said the organization had no idea it would play such a prominent role in an attention-grabbing episode of ER, which featured the long-awaited return of former cast member George Clooney as Doug Ross, along with Julianna Margulies as Carol Hathaway, Mr. La Salle, Mr. Wyle and a guest appearance by Susan Sarandon.
"We're thrilled," Ms. de Castro Buffington said. "We know this is going to have tremendous impact."
