The formula for the 80s cop drama Hill St. Blues proved so successful that Hollywood execs decided to try it in a hospital setting. The result was St. Elsewhere, a poignant  and gritty drama that kept fans entertained for six seasons as the followed the daily goings on of a staff of doctors and collection of colorful patients at a run down Boston teaching hospital, St. Eligius.

The series, which debuted in 1982 didn’t waste any time getting into the controversial stuff, with the first episode revolving around a newly discovered virus called AIDS. Episodes often were too big to be contained in a single week, leading to many two-part offerings, such as the 50th anniversary of St. Eligius, which provided plenty of backstory on the various characters history. And just when you least expected it, St. Elsewhere loved to throw audiences plenty of plot curveballs, so much so that NBC wondered if it was too much for its viewers to handle and considered pulling the plug after the first season.

But there was something undeniably special about St. Elsewhere, and clearer heads at the network prevailed. The risk was rewarded when the show started racking up numerous Emmy Awards and ratings suggested that a significant portion of the population was thoroughly hooked.

In the show’s sixth season, the hospital was taken over by corporate interests, leading to Dr. Westphall’s resignation and in the final episode, producers couldn’t resist shocking their viewers one last time, when Donald Westphall, a regular old blue collar worker removes a St. Eligius themed snowglobe from the hands of his young autistic son, suggesting that the entire series was nothing more than a young boy’s vivid imagination at play. Some shows might not have been able to get away with such a far-fetched premise, but the producers of St. Elsewhere knew the tastes of their followers, who likely would have been disappointed with any ending that didn’t have a very strange twist.