What happens when The Office Meets General Hospital? You get St. Denis Medical. Sort of.

Created by Eric Ledgin and Justin Spitzer (American Auto, Superstore), the writers set out to make a work place comedy about an underfunded, understaffed hospital in Oregon and all the ensuing trials and tribulations.

We spoke with Ledgin who makes his showrunning debut. He doesn’t consider St. Denis Medical to be a medical show. It’s the specificity of the characters and the humor that is the “antidote to any expectation of a medical drama.”

“I think about it as a mockumentary. We’re going for grounded realism, feeling like a fly on the wall, observing this group of people who work together in the emergency department of a rural hospital that has high ambitions without necessarily the resources to match those ambitions,” describes Ledgin.

Let’s Make A Mockumentary

Ledgin has been keen to create a workplace comedy set in a hospital for some time.

“I love the idea of very disparate, relatable characters being thrown together in a place where they have to find a way to achieve their common goals, despite whatever conflicts they might have,” he says.

Eric Ledgin. Photo by JSquared Photography/ NBCUniversal

Hospitals inherently trigger core memories that make great stories. Most people have a hospital anecdote they can share at dinner parties. whether it’s a birth, surgery, or a visit to ER. “Some of them are wild, some of them are funny, some of them are dramatic or sad, but they’re all memorable.”

“Imagining the floor of an emergency department where every room has someone that’s experiencing one of those stories, while you have all these nurses and doctors running around trying to do their jobs and deal with all those workplace comedy quirks, struck me as a very interesting juxtaposition,” he adds. It is the TV show’s engine.

St. Denis Medical was always going to be a mockumentary, so the parameters of the comedic tone were set early on. It is different from Bill Lawrence’s Scrubs which is not grounded in realism and often contains fantasy sequences. The show was also never going to be a medical procedural like ER or Grey’s Anatomy. St. Denis Medical focuses on the administrative more than the medical side of hospitals.

As further inspiration, Ledgin mentions HBO’s Getting On. “It was perhaps a more drab version of what we’re going for, because it spoke to some of the funny, laugh out loud, but also harsh realities of a medical setting.”

Eric prefers mockumentaries to straight comedies because they “are made with as much truth in mind as possible and you can make audiences feel they are watching a docu-series.”

In order to capture the “real emotional dynamics of a hospital,” the characters couldn’t be bouncing off the walls. In order to illuminate the comedy, there had to be intense, heartbreaking moments included to balance the emotions.

Challenges Of Writing Mockumentary Characters

The term mockumentary conjures up a barrel of screwball, wild and wacky jokes.

The challenge for Ledgin was to make the jokes feel real. They could never be forced or too zany, to encourage the audience to embark on a journey with characters they care about.

Although this informs the types of jokes appropriate for the show, there’s a wide variety of humor the show pulls from. “The jokes are coming from the characters’ reactions to what’s happening on screen, whether it’s with patients or with their co-workers, where the viewer and the camera become a third person in the room.”

Relying on character-based more than situation-based jokes ensures that the writers can’t rotate a line to another character. The approximately ten writers in the room might focus on one character such as Ron (David Alan Grier), Alex (Allison Tolman) or Bruce (Josh Lawson), and ask if a line is something that would nail a character’s voice.

Even deadpan humor requires moments of levity and silliness to mix things up a bit.

Joyce (Wendi Mclendon Covey) Photo by: Ron Batzdorff/ NBC

Some characters like Joyce (Wendi McLendon-Covey) are a little foolish by trying to look a certain way in front of everyone although it’s clear that’s not who they are.

“I think the nice thing about having an ensemble comedy is that you can have your more grounded characters like Alex and even Ron, who you feel a little more bonded with, and are more reasonable.”

“And then you can have characters like Matt (Mekki Leeper), Bruce and Joyce, who feel a little more fun, more like the people you meet in life.”

Balancing Laughs With Character Growth

After setting the both fun and serious tone, the writers had to balance that with character growth.

A key consideration for Ledgin was not making St. Denis Medical like other shows in terms of pushing the characters to artificially change from season to season.

“I don’t think that’s how I experience life. I think people change very incrementally and slowly, if at all.”

“I also miss some of the sitcoms of my youth where you could rely on the character being the same for a long time and not change too much, even if their situation changed a little bit.” Eric calls it a slow-burn character arc.

There’s Matt and Serena’s (Kahyun Kim) one-sided “will they or won’t they?” romance, Joyce’s desire to take the hospital to the next level, and Alex’s desire to get her promotion. The writers added story beats to these arcs during the season without making them a focal point.

Dr. Ron (David Alan Grier. Photo by Ron Batzdorff/ NBC

Ledgin states that Alex is “the emotional center of the show” despite it having a robust ensemble cast.

“Alex is our way into the pilot. She’s the one that’s speaking to camera the most. Ron and Joyce are certainly main characters in their own right. To me, the three of them occupy that main part of the cast.”

Finding Weekly Stories

St. Denis Medical offers a mix of patient and staff stories. Although the show doesn’t exclusively rely on a medical case of the week, finding a story like a patient who contracts Bubonic plague after his cat scratches him makes for interesting television.

Ledgin gave his writing staff homework assignments to find real cases in the news from ER doctors or documentaries.

“There’s also the gold standard of story source, which is your own life.” This applies to your own ER adventure or workplace experience. Then Ledgin would ask his writers what is interesting or funny about it.

Balancing a writing team of ten writers can pose a logistical issues. The purpose and parameters of the show were defined in the first week. Ledgin wanted St. Denis Medical to speak to people in the medical world and make them feel seen. There are so many usable hospital anecdotes that there wasn’t a need to invent scenarios.

“One of the guiding principles was to pretend this is a documentary series and not do things that break that. Beyond that, it was remembering that we are here to entertain people.”

Final Thoughts On TV Writing & Advice To Writers

“I was probably a lot more indulgent at the beginning of my career about what feels real or interesting to me. Just because it happened to me, that doesn’t make it interesting.”

“Make it very clear what every character wants in every scene and value a surprising turn that will delight the audience. Then add another surprise.”