‘St. Denis Medical’ Creators Wanted to Tackle a ‘Non-Beautiful Grey’s Anatomy’

The world of medical TV shows is typically filled with gorgeous people swooping in to perform dangerous and daring operations as they dart from rare condition to in-office romance. That’s not “St. Denis Medical.” NBC’s latest comedy is more likely to feature two nurses feuding over a candy bar than pulling off a medical miracle.

“Part of the genesis of this show was talking about what is the day-to-day of a non-beautiful ‘Grey’s Anatomy’ or ‘ER?'” executive producer Justin Spitzer told TheWrap during the Television Critics Association’s 2024 summer tour.

For showrunner and EP Eric Ledgin, the true heart of the series made itself known when he was talking to a doctor “friend of a friend.” In the doctor’s hospital, there was a surgeon who was performing bad surgeries and endangering patients. So the staff banded together and worked to get this problematic surgeon fired.

“After that, the head of the hospital came in and was like, ‘OK, well, he was a big earner, so we’re going to have to make up for that somehow.’ It was this moment of like, ‘Oh, yeah, these are businesses,'” Ledgin told TheWrap. “You have these people who are doing this job that may have started as a calling, or something they feel passionately about, but has turned into a job, like all jobs do. They’re still facing the man, or whatever you want to call it, who is at the top trying to run a company.”

That’s the basic premise of “St. Denis Medical,” a mockumentary comedy about workers in an underfunded Oregon hospital. The ensemble largely revolves around the empathetic if not slightly burnt out Alex (Allison Tolman), who constantly butts heads with her cynical mentor Ron (David Alan Grier) and the hospital’s fast-talking executive director Joyce (Wendi McLendon-Covey). Add in cocky trauma surgeon Bruce (Josh Lawson), clueless newbie Matt (Mekki Leeper), self-assured travel nurse with a wild side Serena (Kahyun Kim) and the no-nonsense administrator Val (Kaliko Kauahi) and you have the makings of a classic sitcom.

“Most nurses, especially those who work in the emergency department, will tell you that they are funny people. They have to be; you’re in the trenches. It’s that gallows humor,” Ledgin said. “That’s one thing you miss on a lot of those dramatic medical shows — even though I do like them — that felt ripe for a comedy.”

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Allison Tolman and a patient in “St. Denis Medical.” (Ron Batzdorff/NBC)

Though Ledgin described the casting process as “very fraught,” they knew they found their Alex after Tolman’s audition over Zoom. The two went into the audition as fans of Tolman’s work, especially on “Fargo.” For a period, they even tried to cast her on “Superstore,” which Spitzer created and Ledgin executive produced, but it never worked out. Both EPs noted that Tolman is excellent at both comedy and drama, a balance that’s necessary when making a mockumentary about such weighty topics as death and the worst day of someone’s life.

“She reminds me of America [Ferrera] on ‘Superstore’ a lot of the time,” Spitzer said.

“Especially in a mockumentary, there’s something in her eyes when she looks at the camera that you zoom right in. You’re just in it with her,” Ledgin said. “That’s rare.”

As the series continues, it will follow the familiar beats viewers have come to expect from any self-assured sitcom. Odd couples will crop up. There will be unexpected deep dives into characters’ surprising personal lives and sight gags, albeit with more blood than usual. But as much as the team behind “St. Denis Medical” worked to make their series as sharp and funny as possible, they also strove to make it an accurate reflection of the day-to-day challenges modern healthcare workers face. The team did everything from watching documentaries and reading books about the medical industry to talking to “every person” they knew who had a doctor or a nurse as a friend.

“There were so many people who were generously open with their frustrations, their joys, their stories,” Ledgin said. “Partially because it’s a mockumentary format, we tried to be as real as we can be while still being an entertaining television show.”

St. Denis Medical” airs Tuesdays at 8 p.m. ET/PT on NBC and streams the next day on Peacock.

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