Workplace sitcoms and medical shows are a dime a dozen in television, but the two genres rarely share any overlap — but with St. Denis Medical, the two are crossing over in a hilarious and refreshing way. From co-creators Justin Spitzer and Eric Ledgin, the new NBC sitcom takes place at the small-town hospital that shares its name with the show, where a crew of dedicated but admittedly overworked nurses and doctors strive to give the best care possible to their patients while struggling to keep their heads on straight. St. Denis Medical boasts an ensemble cast of comedic heavy hitters, including Wendi McLendon-Covey, David Alan Grier, Mekki Leeper, Allison Tolman, Josh Lawson, Kahyun Kim, and Kaliko Kauahi.

Ahead of the series premiere this week, Collider had the opportunity to speak with Ledgin about turning St. Denis Medical from an idea into a reality. Over the course of our conversation, which you can read below, the series co-creator discusses how he and Spitzer landed on the perfect name for the hospital, why Oregon was the right setting for the show, who was easiest to cast, and which jokes are pulled from real-life events. He also reveals why they wanted to make a mockumentary-style sitcom, how often the show plans to lean into comedy versus drama, and more.

You’re a name that people know from the workplace comedy genre — Superstore, American Auto , just to name a couple. What made a hospital the choice of setting for a show?

LEDGIN: I appreciate that. I don’t think many people know my name from anything. [Laughs] I think a lot of people know Justin [Spitzer]’s name for a good reason. But yeah, Always Sunny [in Philadelphia], I would say, is a workplace comedy. I’ve mostly worked in workplace comedies, and I am drawn towards those shows. For obvious reasons, I love these environments where people are just stuck together. Then you can explore every kind of personality and personality conflict, and you never have to ask, “Why don’t these people just break up or just get away from each other?” Well, they can’t because their paychecks depend on it.

The hospital part, in coming up with a workplace comedy, was like, “Why not try to create a show in the most interesting workplace I can think of?” As a kid, I would have said the most interesting workplace I could think of is a movie set or a television set, and then you make that your job, and it’s not that interesting anymore. What was interesting to me is that people in hospitals have that attitude. They’re in this place where people are getting the relief of their life, the worst news of their life, they’re having the craziest stories that they’re going to tell at dinner parties for years, and as that’s happening, several feet from them, there are people who are just rolling their eyes at their jobs or being annoyed because their coworker keeps repeating the same phrase, or someone ate their lunch, and they’re trying to get to the bottom of who it was.

All these conventional workplace tropes are happening in this very high-stakes environment where you’re like, “Oh, so you don’t feel like a hero all the time?” And they’re like, “No, of course not. I’m at my job.” So, I was very interested in that juxtaposition and that dynamic. I should also add, in my experience, I’ve had some hospital experiences that have just been very funny, I think, partially because they’re so filled with tension that the second anyone dares to relieve that tension with an inappropriate joke, it just makes everyone lose it.

In terms of the Oregon setting, it feels like a lot of TV shows just end up going with Portland, but this is a made-up town.

LEDGIN: One thing that I felt strongly about, and Justin agreed — generally when we agree on something strongly, it’s a good sign that that’s the right direction to run in — was that it didn’t feel like a busy city was the right setting for a show like this. For many reasons, one of them being I didn’t want to see as many gunshots and stab wounds — maybe that was part of it — but also, I feel like these are kind of underrepresented areas of the country. My wife is from a very small farm town in western New York, and on my first trip there, I saw someone packing up their truck, and he told my father-in-law, “I’m headed to the big city,” and I was like, “Oh, that’s so cute that they call Buffalo the big city.” And she was like, “Buffalo? He’s talking about Lockport.” Portland is a big metropolis for them, but that’s not necessarily the case if you live in New York or Chicago or whatever.

Early on, I spoke to a real nurse who worked in an ICU in Oregon, and she was not only helpful and very generous with her time, as I harassed her for more information about being a nurse, but she worked in Oregon. Her name was Alex. She was very insistent that I not make the show too much about the doctors and give the nurses some love, and it was truly a great suggestion. It’s a little bit of a hole in the market. Partially as a nod to her, I gravitated towards Oregon, which is a state that I have always honestly loved. I’ve traveled through it a couple of times. It’s so beautiful. There’s such diversity of landscape there and different ideas, when you go from Portland to the countryside aspect of it.

‘St. Denis Medical’ Focuses More on the Nurses Over the Doctors

That’s something that the show does really well, too, calling out how often the nurses are the unsung heroes in healthcare. The sexy medical dramas usually feature doctors and surgeons, so it’s nice to see a show where not only do they play as significant a role, but the nurses outnumber the doctors in the cast, for the most part.

LEDGIN: Totally, and that’s definitely by design, because that’s what it feels like. It’s hard to see the doctor when you’re in an emergency room or in a hospital in general. Not only is it hard to see the doctor — it’s not their fault they’re very busy with a lot of paperwork and liability-based stuff, and there’s probably not enough of them — but there are more nurses, and you get more time with them.

I went through an experience in my twenties where I was dating someone who was very sick, and we had to take a lot of trips to the hospital. The attitude of the nurse changed the entire tenor of our day. It meant we were either laughing the whole time we were at the hospital for this very dark reason and laughing all the way home, or it meant that we were all too aware and sober to the purposes of our visit. I think the nurses are what really shape the story of your hospital visit, and I wanted to pay some mind to that with the characters on the show.

The name of the show is the name of the hospital, but I wanted to know about the process behind landing on that name and what inspired it.

LEDGIN: Truly, titles are just not one of my strengths, and Justin Spitzer had this idea. We had talked loosely about the name of the hospital, and he suggested this saint, Saint Denis. As soon as he told me what it was — the patron saint of headaches, and the story behind Saint Denis is that he got his head chopped off and then picked up his head and walked away with it — I was like, “Yes. That’s it.” He showed me the image of the famous statue of Saint Denis in France, and to me, that’s a home run. It’s something that feels real enough that it would be the name, but also funny enough that I get joy out of it.

Why Is ‘St. Denis Medical’ a Mockumentary Sitcom?

One of the things that makes this show distinct isn’t just the comedy aspect, but it embraces mockumentary. What fueled the decision to lean into the format, and what is the in-universe explanation for why these cameras are around at the hospital?

LEDGIN: It’s a good question. For me and Justin, we can’t remember who came up with the idea, who first suggested doing a mockumentary, but we both remember really liking it. Part of it, sure, is to differentiate ourselves from the other few medical comedies, let alone all the medical dramas that there have been, but that’s not really the main reason. The main reason is that we both came up loving documentaries. Justin worked on The Office forever, the British Office was my favorite show of all time, and the first scripted sitcom I worked on was called Comedians; it was this FX comedy that was a mockumentary.

Specifically, there are shows that use it just as a format and cheat it a little bit. Modern Family was a classic example, where you didn’t really buy the reality that this was a camera crew after a while. It was just the format of the show, which is great — that was a great show — but for this show, it was important to me for it to feel like… because I had this fanhood of doctors and nurses and thought of them as celebrities in my mind, it was more like, “What would it be like to get inside the space of the emergency room at a hospital?” Even at a slower one that’s a little more rural would be fascinating to just get to sit there and observe. I tried to do that in preparation for the show because I did a lot of research. You can’t just get into an emergency room and watch what’s happening, so it seemed like something special to me. The more I thought we could make it feel like a real docuseries that would air on PBS or IFC, I felt like we were more well-served to lean into that sort of aesthetic, and feeling like the people making this feel like they’re really trying to observe something.

I had also been watching a lot of Below Deck, and I really like the way that sometimes the person behind the camera, the producer or whoever, holds the feet to the fire of the person they’re talking to, or answers back. We try to incorporate that element into the show and make it feel a little more active.

In terms of specific jokes, is there anything that was pulled from a real-life incident?

LEDGIN: One of them is that halfway through the season, I ended up in the hospital with a staph infection that turned into an abscess that turned into a deeper infection in my bloodstream. It wasn’t very funny as I was going through it, but there was one aspect of it, which is that I was Googling a lot about what to do, and I was texting with my doctor friend, who I really trust, and then struggling with, “How do I tell the doctor what I want them to do without coming off like an asshole?” As I told that story to the writers’ room, it turned into a story that we did in an episode called “Listen to Your Ladybugs,” about a patient who comes in who’s a Googler, and it’s Ron dealing with this obnoxious patient, who knows what he wants and how he wants it.

There are many stories in this that come from a writers’ room or from real life, and just news stories I read about hospitals. That’s my whole feed now is all hospital news. A lot of it’s Oregon news, and there was a patient who had the bubonic plague in Oregon, I think last year, who got it from their cat scratching them. That turned out to be a great launching point for an episode about a patient who’s not able to figure out their symptoms, and it turns out to be something very rare.

[I’m] working with some writers I’ve worked with before, a couple from Superstore, who remember a time when somebody parked close to my car, to the driver’s side door, and I left a kind of obnoxious note on their car because I had to climb around and go over the console as a grown man. Then, when I came into work the next day, another writer was showing this crazy note that they got to the rest of the room, so I had to sheepishly explain that I was the one who wrote the note. So, Ron and Serena have an experience like that in an episode.

‘St. Denis Medical’s Co-Creator Discusses Assembling the Show’s Powerhouse Cast
Image via NBC

When putting together an ensemble like this, which roles or characters were easier to cast, and which ones ended up taking more time in terms of wanting to find the right person?

LEDGIN: The only one that was really easy was Wendi [McLendon-Covey] because we heard that she was available, which wasn’t really public knowledge at the time. We were like, “If we can get her, why would we not?” We just set up a meeting with her.

A lot of the others, partially because — it was a privilege problem to have — it was a slow time in the industry, there were a lot of people available. We were getting good feedback on the pilot, we had a lot of people going out for it, and I wanted to do my due diligence and really see everyone and try to find either the perfect fit for the role or someone who is bringing something totally different to it. That casting process took years off my life. It was extremely stressful. I read with or watched tapes of hundreds of Alex’s and Rons, and ultimately offered them to people who were too big to read for it. Then, during the table read, I had this great sense of relief, of, “Somehow we made the perfect choices for those roles.”

Then, Mekki Leeper was someone who Susie Farris, our casting director, and Ruben Fleischer, the director, had worked with. They were like, “You gotta see this guy.” It wasn’t really the Matt that I or Justin had in mind, but watching him, it was like, “How do you not cast this person if you have the ability to? We’ll shift the character a little bit, and we’ll play to his strengths,” and he’s just turned out to be fantastic.

Kahyun Kim was someone that Susie put in front of us who just had a great audition read. I had never seen her before, but she had so much range and such a great energy about her. Then Josh Lawson and Kaliko [Kauahi] I know from Superstore. We brought Kaliko onto American Auto for an episode, and seeing her on that do something that wasn’t Sandra but was still so funny, I was like, “I think Kaliko can do anything, so let’s just cast her and she’ll be great.” She really is incredible, and Josh just blew the role of Bruce away. I just get so much joy out of watching him. He’s so inhabited it. The process was slow, but it was worth it.

There’s an element of romance brewing, at least within the cast this season, in terms of Matt’s crush on Serena, which at this point is unrequited and very much very one-sided on his end. How open are you to seeing how those types of storylines develop based on things like surprising actor chemistry and putting two people together, versus setting up a dynamic from the beginning and letting that play out?

LEDGIN: I’m very much more interested in the former, in seeing their chemistry and seeing what evolves. With Matt/Serena, I don’t want to spoil anything, but I’ve been calling it a “will I, won’t I,” this one-sided affair. It’s fun to watch Matt pine and to try for that. Without spoiling anything, I don’t think we decide even by the end of the season very firmly what’s happening with that, although it does make progress. But I have to say, there are a couple of scenes between Serena and Bruce where I’m like, “These two should not be into each other at all, but there’s something there.” So, there are some pairings where I’m just like, “This could be interesting.” We didn’t focus on that too much in Season 1 because there were, frankly, just a lot of stories to tell that involved character conflict and different medical stories. But there are some pairings that I think could be very interesting to see something happen with.

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This show definitely falls under a comedy. A lot of times, it’s built up in how stressful the medical profession is, how stressful the healthcare industry can be, how understaffed it is, how resources are stretched thin. Is there ever an intention to lean into those more dramatic or high-tension moments and let those sit for a little while once these characters are a little more established, or do you always want to find the comedy or break the tension?

LEDGIN: It’s somewhat case by case, I would say, as the season goes on. For example, there’s an episode called “You Gotta Have a Plan,” where there is a very real moment that happens in hospitals and is not funny, and I don’t think we try to make a joke out of it because it would be inappropriate, and I want that to be part of the show. At the same time, I don’t want to sell people a bill of goods. If you’re coming into a comedy, I want you to get a comedy and be entertained by it.

In the second episode, when Bruce talks a little bit about his dad and something that happened with his dad, we get that moment, but then there is a joke tacked on at the end, again, because it’s a comedy. I feel like that’s also a little more true to my experience, personally, of life. I tend to go for the joke in a serious moment. I think the show is sometimes a reflection of that, but I also don’t want to bum people out too much. Finding those moments is very crucial if you’re gonna be true to a comedy that takes place in the hospital. I think it’s both fun and of service to the audience to relieve that tension with a joke when it’s possible and appropriate.

St. Denis Medical airs Tuesdays on NBC and can be streamed on Peacock.

At Oregon’s underfunded St. Denis Medical Center, an eclectic team of doctors and nurses tackles chaotic medical challenges with limited resources while striving to keep their sanity intact. Led by the quirky administrator Joyce and a jaded ER doctor Ron, the staff faces both high-stakes patient cases and hilarious workplace antics, bringing a blend of compassion and humor to the mockumentary format reminiscent of The Office and Superstore.Release Date November 12, 2024 Main Genre Comedy Seasons 1

Watch on Peacock