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illusion that you are watching real doctors. For these shows to be enjoyable, viewers have to be comfortable knowing that this is information they’re not supposed to understand.
    Conventionally, narratives demarcate the line between texture and substance by inserting cues that flag or translate the important data. There’s an unintentionally comical moment in the 2004 blockbuster The Day After Tomorrow where the beleaguered climatologist (played by Dennis Quaid) announces his theory about the imminent arrival of a new ice age to a gathering of government officials. His oration ends with the line: “We may have hit a critical desalinization threshold!” It’s the kind of thing that a climatologist might plausibly say—were he dropped into an alternative universe where implausible things like instant ice ages actually happened—but for most members of the audience, the phrase “critical desalinization threshold” is more likely to elicit a blank stare than a spine tingle. And so the writer/director Roland Emmerich—a master of brazen arrow-flashing—has a sidekick official next to Quaid follow with the obliging remark: “That would explain all the extreme weather we’re having.” They might as well have had a flashing “Door Unlocked!” arrow on the screen.
    The dialogue on shows like The West Wing and ER, on the other hand, doesn’t talk down to its audience. It rushes by, the words accelerating in sync with the high-speed tracking shots that glide through the corridors and operating rooms. The characters talk faster in these shows, but the truly remarkable thing about the dialogue is not purely a matter of speed; it’s the willingness to immerse the audience in information that most viewers won’t understand. Here’s a typical scene from ER :

    Cut to KERRY bringing in a young girl, CARTER and LUCY run up.
    The girl’s parents are also present.
    KERRY: Sixteen-year-old unconcious, history of villiari treesure.
    CARTER: Glucyna coma?
    KERRY: Looks like it.
    MR. MAKOMI: She was doing fine until six months ago.
    CARTER: What medication is she on?
    MRS. MAKOMI: Emphrasylim, tobramysim, vitamins A, D, and K.
    LUCY: The skin’s jaundiced.
    KERRY: Same with sclera, does her breath smell sweet?
    CARTER: Peder permadicis?
    KERRY: Yeah.
    LUCY: What’s that?
    KERRY: Liver’s shut down, let’s dip her urine. (To CARTER) It’s getting a little crowded in here, why don’t you deal with the parents, please. Set lactolose, 30 ccs per mg.
    CARTER: We’re gonna give her some medicine to clean her blood, why don’t you come with me?
    CARTER leads the MAKOMIs out of the trauma room, LUCY also follows him
    KERRY: Blood doesn’t seem to clot.
    MR. MAKOMI: She’s bleeding inside?
    CARTER: The liver failure is causing her blood not to clot.
    MRS. MAKOMI: Oh God.
    CARTER: Is she on the transplant list?
    MR. MAKOMI: She’s been status 2a for six months but they haven’t been able to find her a match.
    CARTER: Why not, what’s her blood type?
    MR. MAKOMI: AB.
    CARTER and LUCY stare at each other in disbelief.
    Cut to MARK working on a sleeping patient. AMANDA walks in.

    There are flashing arrows here, of course—“The liver failure is causing her blood not to clot”—but the ratio of medical jargon to layperson translation is remarkably high, and as in so many of these narratives, you don’t figure out what’s really happening until the second half of the scene. There’s a kind of implicit trust formed between the show and its viewers, a tolerance for planned ambiguity. That tolerance takes work: you need to be able to make assessments on the fly about the role of each line, putting it in the “substance” or “texture” slot. You have to know what you’re not supposed to know. If viewers weren’t able to make those assessments in real time, ER would be an unbearable