Firstly, because the show is predicated on mysteries of health. The only way to have any kind of actual interaction with the environment is to have a system that keys into that and players who know what the right questions to ask are. Without player knowledge, it just doesn't work. Most every gamer knows basic tactics, basic fantasy plotting and basic mystery solving, but very few gamers know to take a GCS on an unresponsive patient.
The objectors to this suggest either making everything the players do be right, and/or just gloss over it and run it like any TV show. Set up some skill like "Solve This Week's Dilemma" and have different doctors be better at it than others. I believe this is kind of what Prime Time Adventures does and dear GOD do I need to get around to buying that game.
However, thence comes objection number two: even if the players are assumed to be asking the right questions or passing their rolls or whatever, it's not going to FEEL like ER. Because ER thrives on something cultural linguists call "technical discourse". It's dialogue designed not to communicate narrative, or character, or progress the plot. It's dialogue designed to communicate a highly technical setting. And as an audience, we adore it. It's the key to why we watch technical shows like ER, like House, like the legal stuff in Law and Order, like the psych profiling in Criminal Minds, like the silliness of Numbers. Good technical discourse - which is basically defined as something the layman can't see is wrong - makes us feel intelligent. Really good technical discourse can be blended with actual plot and in fact EDUCATE us in the process (see the West WIng for a lot of this brilliance).
You cannot replicate technical discourse in an RPG. Because it relies on prior knowledge of the player. The system cannot provide that.
So was my thinking.
Anyway, so I'm watching Numbers tonight and one of the FBI agents knew a lot about explosives. He made a bunch of cool rolls on his Demolitions skill, and also explained a lot of stuff to his colleagues (and thus to the audience). And I thought, ha, that guy would have the Demolitions skill in Agents Of X. That's exactly what the skill should look like. He should be able to tell (as the character did) that knocking some blasting gel from a bad guy's hand wouldn't make it explode the way knocking nitro to the ground would.
And then I thought, but how would he know that? And how would he know to talk all cool about C4 and C12 and remote charges and blasting gel and how much nitrous sulfate you need to make a home-made bomb? You'd need, like to have all that written down for you. Not necessarily as hints on how to solve the adventure, but if nothing else, the jargon to use to sound cool.
And then it hit me. Like wildfire. Like lightning in my eyes and in my fingers. Like love.
This is an idea in Weapon of the Gods. You could spend points during chargen to have some aspect of your background be realised and as part of that you would get the Loresheet. So for example, if you were an ex-prostitute, you'd get the loresheet on prostitution in the setting. This was a physical way for the GM to introduce the setting to interested players so that if the issue comes up in the game (and it is likely to, since it is part of the PC) the PLAYER can explain it all to his fellows, in character even, having previously read the appropriate setting info.
The espionage genre, the cop genre, the modern day action genre, thrives on skillful people drowning us in technical discourse. Perhaps, then, the best way to do this in Agents of X is for every Advanced Skill (which is most of them) to come with its own LoreSheet. In part, this would be like those excellent D&D tables where they explain exactly what your skill level means and what different DCs let you do. But it would also offer a basic insight into the actual skill itself, in reality and in a cinematic sense, and how to roleplay it, and how to apply it to narratives to create dramatic scenes, solve puzzles and mysteries and move the plot forward.
Of course, it's still not quite the same because much of the info will still be coming from the GM, and in shows like these, it comes from the mouths of characters. But having the player at least know the right questions to ask, and to have him spout the babble in the questions, may go along way to making something awesome.
Of course, GMs (or pre-written adventures) are going to have to know how to answer the questions. Which means they might need their own lore sheets, with different kinds of info on them.
I think this might be a really, really good idea. I also think it's going to be really hard work to implement it. Dammit!