Steve McClaren admits he can turn angry if he has to - and this lame performance from England must have tested his temper.
McClaren's team took the first stumble of the Euro 2008 campaign, dropping two points at home to Macedonia.
They remain top of Group E thanks to Israel's draw in Russia but now face a big test away to Croatia on Wednesday.
Gerrard will be suspended from the game in Zagreb after his second yellow card in the qualifiers.
Rio Ferdinand must also be a serious doubt after missing the Old Trafford stalemate with a back injury.
Ferdinand pulled out before the match and was replaced by Ledley King but it was the absence of Owen Hargreaves which was most keenly felt by the team.
Michael Carrick came into midfield and McClaren stuck with his 4-4-2 system but England missed the energy and bite of Hargreaves.
The England boss has some serious thinking to do before Wednesday.
His first three games had gone according to plan with easy wins over Greece and Andorra and a 1-0 win in Macedonia last month.
But the spirited Macedonians hit back at Old Trafford.
England's first half was awful, a reminder of some of their worst performances from the World Cup finals in Germany.
Things improved after the break but a full-house at Old Trafford was not impressed.
It was the biggest crowd for an England home game outside Wembley, at 72,062, but they jeered as the players trooped off.
Srecko Katanec's team from the former Yugoslav republic proved they were no mugs with a gutsy effort in Skopje last month.
They lost only to a Peter Crouch volley which hit the bar and bounced a foot over the line and finished that game strongly.
It clearly did wonders for their self-belief because, after settling into unfamiliar surroundings at Old Trafford, they continued to cause problems for McClaren's team.
Wayne Rooney performed a couple of early tricks to please the crowd but his impact was negligible.
It was his first England appearance since his red card in the World Cup quarter-final and boss McClaren claimed he was ready to "explode''.
He simmered for 75 minutes without making much of an impression and was replaced by Jermain Defoe.
Macedonia gave England an early warning when Goran Pandev jinked into the penalty area and smashed a shot into the side-netting.
Robert Petrov arrived late to meet a right-wing cross from Vlade Lazarevski but fired his volley wide.
Frank Lampard came closest for England, bursting into the penalty box through the centre, but keeper Jane Nikolovski dashed from his line to smother the chance.
Nikolovski produced another top-class save as the game came to life, three minutes after the restart, when John Terry latched onto an inswinging free-kick from Stewart Downing.
Terry's header was firm and arrowed down towards the bottom corner but the Macedonian keeper sprang to his right to tip it round the post.
Gerrard was unlucky to be booked in the 49th minute. He won the ball in a sliding tackle but referee Markus Merk had a different interpretation and showed his yellow card.
The Liverpool skipper was booked in Skopje, three minutes from time, and will miss Wednesday's game in Croatia. He held his head in his hands.
McClaren's team were much more daring in the second half. They lifted the tempo but often looked vulnerable at the back as a result.
Aleksander Mitreski was only inches too high with a header from a corner and King was forced to backtrack quickly to deny sub Aco Stojkov.
Gary Neville, winning his 83rd cap, has never scored for England but a glorious chance fell to him on the hour.
Crouch's diving header forced another good save from Nikolovski but the rebound spilled to Neville on the right.
The angle was tight but the full-back lifted his side-footer too high and it shaved the bar on the way into the Stretford End.
Crouch headed Ashley Cole's cross wide and then the big Liverpool hitman found Rooney with a delightful pass.
Rooney tried to lift his shot over the diving keeper but Nikolovski stuck up an arm to keep it out.
Shaun Wright-Phillips came on with 20 minutes left and made an instant impact with a run and shot which was saved.
Cole cleared from the England goal-line when Nikolce Noveski beat Robinson with a shot.
Lampard and Crouch went close from distance and Gerrard rattled the crossbar with five minutes left.
Nikolovski denied Crouch once again before the final whistle and preserved a precious point for Macedonia.
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