[2] In an interview with the Orlando Sentinel, McCrane discussed the sequence in which Romano loses his arm in a helicopter accident during the ninth season premiere.

According to The New York Times, it took McCrane just 20 minutes to shoot, but digitally creating and animating the helicopter, the blood, the wind and the Chicago skyline took the Stargate team a full week.

[5] Producer Chris Chulack went on by stating "Even a horrific helicopter accident last season - in which his arm was severed, ending his career as a surgeon - could not curtail his inappropriate, sarcastic remarks.

"[6] After McCrane left the main cast of ER, he went on to direct multiple episodes of the series along with Laura Innes after her departure in Season 13.

He is portrayed as obnoxious and ambitious, and is eager to jump at the job of interim ER Chief to help weasel his way toward the top of the administrative ladder.

Kerry Weaver had originally backed him for the job, backstabbing Mark Greene in the process and earning the permanent ER Chief position, but soon becomes disgusted with him after seeing his diabolical ways which included him suspending her later in the season after she treated a comatose, brain-damaged young woman without HMO approval.

He starts to grow fond of medical student Lucy Knight after she convinces him to do a heart operation on a patient on Christmas Eve.

After Benton impresses Romano by keeping his mouth shut and doing the job, Romano "rewards" him with a raise and benefits but also manipulates him into taking on a new post related to affirmative action at County (but is then outmaneuvered when Benton gets a talented African-American student a previously-denied interview, and the student is then accepted into medical school).

Romano continues to be arrogant and insensitive throughout the season, but surprisingly shows a soft side when Elizabeth has a hard time with Mark Greene's decision to discontinue his brain cancer treatment.

In the first episode of season nine, Romano, Luka Kovac, and Susan Lewis are evacuating the hospital due to a Monkey Pox outbreak.

He shows one of his last moments of kindness on the episode “A Hopeless Wound” when Elizabeth Corday loses her wedding ring down the scrub sink drain and fears it will be lost because maintenance is closed until morning.

In his book Writing for Visual Media, author Anthony Friedmann calls Romano a "mocking, sarcastic, nasty guy.