one of the er dynamics i find most fascinating is kerry weaver vs robert romano. the mutual dislike and disrespect is often funny to watch and sometimes painful, but it’s really interesting imo to compare the two of them and what’s driving them. they’re both highly ambitious people who got very far by means that were not always fair, but each one of them comes from a completely different place. i think the main difference between kerry and romano’s ambition is that romano wants power because it makes him feel bigger, while kerry wants power because she genuinely believes she knows what to do with it.
romano is fundamentally a small, insecure man who needs other people to feel smaller than him. he believes he is superior to almost everyone around him, and yeah as a surgeon he often has the skill to support the belief that he is brilliant. but being brilliant in the operating room can only give him professional respect (that he doesn’t really get because of how unpleasant he is as a person). moving higher up the hierarchy gives him something much more satisfying: status, and the power to force people to defer to him. every new title becomes proof that he is more important than the people around him and deserves to stand above them. that is what drives so much of his ambition. he wants the prestige of being known as an exceptional surgeon, but he also wants the authority of an administrative position where he can control departments, careers and decisions far beyond his own operating room. once he has that power, he uses it to intimidate people, humiliate them, remind them that their jobs are in his hands and, in some cases, straight-up abuse his position and fire them. disrespect affects him so strongly because his sense of superiority depends on other people acknowledging it. when someone challenges him, laughs at him or refuses to be intimidated, he reaches for rank and authority to put them back beneath him.
he does have good moments and he is not just a cartoon villain looking for ways to sabotage and abuse county employees, but his view of power is deeply fucked up. once again,he is objectively brilliant at his job as a surgeon and i am not denying that, but his ambition is rooted in ego and domination. he keeps climbing because surgical excellence alone cannot give him what he really wants: the hospital hierarchy itself confirming that he is above everyone else.
kerry is absolutely ambitious too, and there are moments when her ambition makes her ruthless, self-serving or willing to compromise people she cares about for personal gain. but unlike romano, she does not only want the position for the sake of having it. she genuinely believes she is the best person for the job because she understands how the er works, sees what needs to change and is usually willing to take responsibility for the decisions everyone else avoids. the fact that the department regularly seems to collapse whenever she is absent only reinforces that belief.
in contrast to romano’s insecurities, kerry is remarkably secure in her own competence. she can be abrasive when people undermine her authority, and she is obviously hurt by the way people speak to and about her, but it does not bruise her ego in the same way it bruises romano’s. the insults aimed at kerry are almost always personal. people call her cold, unpleasant or difficult; they mock her disability, resent her ambition and treat her as though there is something fundamentally wrong with her. what they rarely (if ever) question is whether she is a good doctor, because she is a damn good one and everyone at county knows it (a strong example of that is ella’s overdose. mark, elizabeth, and jing-mei all strongly dislike her at that point but they know she’ll give ella the best treatment). she does not depend on their approval to feel competent, and being disliked does not make her doubt that the job she’s doing is good. she may be wounded, angry or defensive, but she does not need to make someone else feel smaller in order to restore her sense of herself. romano is possibly the only exception in that case, but as i said, with him it’s more of a mutual lack of respect that she doesn’t even have with doug.
i also think her being a disabled woman is relevant to the kind of administrator she becomes. kerry has spent her entire life moving through institutions that were not designed to accommodate her and proving that she belongs in rooms where people instinctively underestimated her. that can make her overly controlling and deeply invested in being indispensable, but it also means she notices failures in the system that other people are likely to ignore or gloss over. she understands that good intentions are meaningless if nobody is willing to fight for resources, enforce standards or make difficult decisions. a great example of that is when carter leads a walkout and she makes him face a hard choice: you can get what you want right at this moment, but it will be at the cost of three nurses that you have to choose (i’m still angry that there was no follow up to that episode or the aftermath of carter firing three nurses).
and beneath all of that, kerry is an extremely compassionate person. she can be abrasive, defensive, arrogant and politically calculating, but she cares profoundly about patients, about the hospital and even about the people who resent her. she believes she can make the institution function better largely because she cares so deeply about others, even if she refuses to show it most of the time.
tldr, romano wants authority over people because he is a very insecure man and believes it is proof that he is better than everyone else. kerry wants authority over the decisions that affect people, and sees power as the means to do what needs to be done, even when her own belief that she is the best person for the job becomes its own kind of arrogance
this post is partly building on @johannestevans ’s excellent analysis of romano’s relationship to power, disability and disposability, particularly his comparison between romano’s insecurity and kerry’s confidence in her own competence. my focus here was more specifically on what drives their respective ambitions, and i highly recommend reading his original post as well because it’s so good and insightful
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