HBO Max’s emergency room drama has garnered praise for its remarkably immersive quality. This is achieved through a unique real-time filming technique that mirrors the fast-paced environment of a hospital’s emergency department.

Real-Time Filming and Set Design

Each episode unfolds over a single hour, mirroring the reality faced by staff at the fictional Pittsburgh Trauma Medical Center. The show’s realism stems from its meticulously designed set, which remains static throughout filming.

Director of Photography, Marie Coelho, explains that the fixed set allows for camera placements that would be impossible in a real emergency room. This static nature enables viewers to mentally map the Emergency Department (ED) and feel grounded in the environment.

Challenges in Choreography and Lighting

Precise choreography is essential due to the simultaneous movement of actors and the film crew. Traditional lighting stands are absent to maximize space and facilitate this choreography.

Instead, custom onboard camera lights illuminate actors, supplemented by mobile pole-operated lights and 3D-printed diffusion frames attached to ceiling fixtures.

Pre-Script Design and Color Palette

Production designer Nina Ruscio played a vital role by designing the set before scripts were finalized. This ensured a seamless synergy between the physical space and the narrative.

The pre-script design allowed writers to craft a story that flowed naturally within the set’s layout, enhancing the continuous feel of the show. Extensive testing – over 50 shades of white – was conducted to find a paint color that would complement diverse skin tones and provide optimal lighting diffusion.

Ingenious Solutions to Reflections

Reflections posed a significant challenge due to the set’s abundance of glass surfaces. The solution? Dressing the camera, lighting, and audio crew in hospital scrubs.

This allowed accidental reflections to blend in as background personnel, maintaining the immersive experience.

Technical Specifications and Collaboration

Marie Coelho, a French native and the show’s Director of Photography for both seasons, collaborated closely with executive producer John Wells to establish the show’s visual language. She shares behind-the-scenes footage revealing the dynamic energy of the set and the multiple takes required to perfect complex choreography.

The Arri Alexa Mini LF camera, chosen for its large format and cinematic quality, is used for both primary cameras, paired with Angenieux Optimo primes and Ultra compact zooms. This combination allows for close-ups while maintaining a shallow depth of field, enhancing immersion and replicating the human eye’s perspective.

The process involves numerous takes, often starting from the beginning of a scene to ensure continuity and allow for dynamic editing.