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Thorpe had previously worked on the series as both a cinematographer and director.

Salamunovich was the series unit production manager for the first three seasons and continued to fulfill this role as a co-producer.

Unfortunately, their efforts were in vain, because Chase started using again, eventually crippling him for life.

At the end of the season, Anna's ex-boyfriend comes to the hospital to see if the ER is in need of a pediatrics attending.

Unfortunately, when Morgenstern does come back, he cannot perform surgery like he used to do because he now knows what it is like to be a patient. Robert "Rocket" Romano (played by Paul Mc Crane), but their relationship sours towards the end of the season.

After a surgical accident takes a man's life, Morgenstern decides to permanently step down as head of the ER and he leaves the hospital. Anna Del Amico, played by Maria Bello and a new British surgeon Dr. After she rejects Romano when he asks her out, he decides not to renew her fellowship.

Paul Manning left his supervising producer role but remained involved with the series as an executive consultant.

Long-time crew members Lance Gentile and Neal Baer were promoted to producers for the fourth season.

Manning, Hissrich, and Gentile all left the crew with the close of the season. Baer wrote two episodes while Gentile wrote a single episode and continued to serve as the series medical consultant.

She begins to date a Synergix representative, Ellis West, who advises her to fire a physician's assistant, which happens to be Jeanie Boulet.

Jeanie fights for her job, claiming that she was fired because of her HIV status.

Anna is still in love with him, and faces a decision about her future in the ER.

Original executive producers John Wells and Michael Crichton reprised their roles.

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She is forced to choose whether she moves back to England or stays in America as an intern.

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