NBC’s ‘ER’ ended its 15-year run April 2 much like it began, with a pulse-quickening symphony of life and death.

The medical drama’s final episode mixed current cast members with old favorites.

The two-hour finale had moments of dark humor – if projectile vomiting and an old man’s penis fracture could be considered funny – and a career-questioning tragedy of a mother of five dying shortly after she gave birth to twin girls.

It ended with a glimmer of hope. Dr. Mark Greene’s daughter Rachel, 22, visits her late father’s place of work and is bitten by the bug to follow him.

Former cast members Eriq La Salle, Laura Innes, Sherry Stringfield and Alex Kingston returned for the finale. So did Noah Wyle, and his character of Dr. John Carter was central to Thursday’s story, as he dedicated a new medical facility for the poor named for his late son and returned to County General for some nostalgic trips to the emergency room.

The series’ biggest star, George Clooney, paid a final visit back to the show three weeks ago.

‘ER’ had begun its run with a two-hour pilot airing on Sept. 19, 1994, and became an instant hit. At its peak, it averaged 32 million viewers every episode, a level unimaginable in today’s television world.

Before the finale began, Wells paid tribute to Michael Crichton, the late series creator. He said the last show ‘is a bit of an homage to what we did in the first episode, in the pilot. I felt as if he wrote it with me.’