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Inside the Success of ‘St. Denis Medical’

In today’s world, the need for humor has become increasingly essential. “Laughing is one of the most fundamental, foundational human joys, if not the fundamental foundational joy,” states Eric Ledgin, the showrunner behind NBC’s acclaimed medical mockumentary, St. Denis Medical. Ledgin emphasizes that if a comedy isn’t striving to make audiences laugh, it’s likely not achieving its purpose. “I think that audiences are really feeling the craving for that,” he adds.

Recently, Ledgin participated in a panel discussion titled “Pitch to Screen” at SXSW’s Film & TV Festival, alongside Universal Television’s EVP of comedy development, Jim Donnelly. The panel explored the creative process behind the series, offering insights into the challenges and triumphs of its production.

Creating a successful comedy in the current television landscape is more challenging than ever. Donnelly points out the savvy nature of today’s audiences, noting that they are not only competing against current productions but also against the entirety of television history. “There’s pressure to give a little tweak in the foundation, to not repeat what someone else has done before,” he remarks. As a result, he advises creators to find unique approaches rather than recycling old ideas.

According to Ledgin, the key to the success of St. Denis Medical lies in a combination of serendipity and deliberate effort. “It’s not big setup, big punchline; it’s more about the everyday interactions where humor emerges organically,” he explains. He acknowledges that handling medical scenarios with a comedic touch is a delicate balance, requiring a blend of humor with relatable workplace dynamics. “It felt like a very interesting contradiction for the difference between the stakes of those two experiences,” he adds.

What captivated Donnelly when Ledgin presented the show’s concept was its strong alignment with Universal Television’s comedic style. He likens it to the charm of previous hit single-camera comedies such as The Office and Parks and Rec, while also drawing parallels to classic shows like Friends and Cheers. “It’s a very well-formed ensemble with all these quirky, very specific different characters, but all with mutual respect for each other and a shared goal,” Donnelly states, emphasizing the importance of communal experiences in comedies.

A significant aspect of the show’s development involved a crucial change to the pilot script: introducing a family for Alison Tolman’s character, Alex. Ledgin reflects, “It just made the show better,” underscoring the richness that this addition brought to character development throughout the season.

Ledgin acknowledges the revitalization of the mockumentary format to shows like Abbott Elementary, which have made it fashionable again, alongside reality programs such as Below Deck. He expresses his commitment to maintaining the documentary style’s integrity, noting that the production takes care to ensure the perspective of the cameras remains consistent throughout the show.

Ultimately, both Ledgin and Donnelly agree that the show’s appeal is primarily grounded in its strong cast dynamics. “You can cast the perfect people for the perfect role, but what you don’t know until the thing is on its feet is how they are going to interact,” Donnelly observes. He points to Tolman’s performance as a “home run” and praises Wendi McLendon-Covey for her spontaneous contributions, including an unforgettable cartwheel in heels. Mekki Leeper, known for his role in Jury Duty, often improvises lines that end up making the final cut, much to Ledgin’s delight.

While some episodes reflect real-world headlines—such as the bizarre story of a cat causing an outbreak of the plague in Oregon—the creators aim to maintain a distance from contemporary political matters. Ledgin states, “If anything, I feel like these shows can be a rare respite from that stuff.”

Donnelly shares the aspiration that the themes of St. Denis Medical will resonate with audiences for years to come. “The goal of the show is that it should be something that people 10, 20, or even 50 years down the line can still watch and find relevant,” he explains. The focus remains on universal human stories that capture the essence of life while ensuring that they remain timeless, allowing the narrative to adapt as society evolves.

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