HOLLYWOOD INSIDER: Birthing a Unique Medical Series – Royal Pains Creator and Showrunner Give Us Their Story!

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Last Friday I had the opportunity to take part in a teleconferenced Q&A session with Andrew Lenchewski, creator, and Michael Rauch, showrunner of the new USA series, Royal Pains, which premieres on Thursday, June 4th at 10/9C, following Burn Notice. The series follows Dr, Hank Larson [Mark Feuerstein] as he deals with being fired for doing the right thing and winding up as a concierge doctor to the wealthy and eccentric of The Hamptons.

Joining me in the session were: Beth Ann Henderson, Bags Hooper, Christine Nyholm, Laura Tucker, Sarah Fulghum, Kendra white, Amy Steele, Reg Seeton, Sarah Coughlin and Liz Woolf [no affiliations were given]. Also, series star Mark Feuerstein popped in for about two minutes in the middle…

Hi guys, thanks very much for doing this. This is for both of you. As I watched the pilot, I was really involved and really loved Hank for making the right choices, and then 15 minutes in, I’m thinking, wow, this guy is really wallowing; I really hate this. So how do you find someone to play a role like that where you have to love and hate the guy, and then stay with it as he recovers? What did Mr. Feuerstein bring to the character that persuaded you to cast him?

A. Lenchewski: This is Andrew, and I think we knew from the beginning we needed a guy who could bring the competency of a physician, so we could, see that credibly, and then play the consequences of that decision that you referenced at the top of the pilot, both in terms of the humanity of it, the drama of it, and then the comedy that I think was needed to bounce him back from that rock bottom that he hit when his brother came and scooped him up and took him out to the Hamptons. I think as soon as Mark came in and auditioned for the role, we gave him a few of those critical scenes. The moment of that difficult decision in the yard, the moment of depression in his apartment, and then that first moment out in the Hamptons, and he hit all of those colors brilliantly.

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How did you find the gentleman who plays his brother, whose name escapes me at the moment?

A. Lenchewski: His name is Paulo Costanzo, and he came and auditioned for us here in LA. We saw about 50 or 60 people and he was the third one we saw, and it just didn’t get any better than that. He brought a brilliant comedic take to the character and notably, this character is actually written originally as Hank’s best friend, and as soon as he walked in, we said, well, he can’t be his best friend, he looks too much like his brother. So the next thought was, okay, let’s rewrite the script. And Evan became Hank’s brother.

I wonder if you could describe for us in 20 seconds or less, the show, Royal Pains?

M. Rauch: This is Michael, has the clock started ticking? That’s a lot of pressure. Royal Pains is a show about, basically, a guy, Hank Lawson, who is a doctor, who had some choices he made in his past life have come back to change the direction of where he thought his life was going. Did you see the pilot?

I haven’t yet, no.

M. Rauch: You have not yet, okay. Then let me rephrase that, if you haven’t seen it, because I was referencing off of that. It’s a show about a doctor, that does not take place in a hospital, and his new practice is basically making house calls to both the wealthy and people who do not have as much wealth, in the Hamptons. And it’s a show that deals a lot with medicine, but it’s much more than that, for him as a doctor, in that it’s not just about healing sicknesses, but also helping to heal people. And it’s also a relationship show and because it’s on USA, it’s very strong in character. Andrew, do you want to add anything?

A. Lenchewski: I think that covers it, although I will say I think your shock clock expired at about halfway in, so penalty.

This sounds really great. Where did the idea for Royal Pains come from?

A. Lenchewski: This is Andrew. The idea came, actually, from a friend of mine who was telling me about a concierge doctor that his family had begun to use, and he asked me whether I thought it would be a good idea for a TV show and I said it wouldn’t, I thought it would be the perfect idea for a TV show. And so we, along with two of our other executive producers, Paul Frank and Rich Frank, we went off and pitched it to a few networks, and USA was the one that really, most strongly embraced what it was. And I went off and wrote the script, we shot the pilot last September, got picked up the series in January, and we’ve just begun production within the past couple months and we’re now about to start shooting our fifth episode.

I was just wondering what made you decide on shooting in New York, like a medical-type story? I know there’s a lot of other shows are also doing the New York route for production, like Showtime’s Nurse Jackie.

M. Rauch: I think it was a dual thing. One was the fact that this show does take place in New York, and especially in the Hamptons, and we really wanted to have the authenticity, this is Michael, by the way, we really wanted to have the authenticity of that as opposed to shooting it in Toronto for New York, or even LA for New York, and the environment is such a critical element of the show, and have you seen the pilot?

Yes.

M. Rauch: So you know those locations with the landscape and the ocean and just the really beautiful elegance of the Hamptons, felt like it would be such an important layer to the show itself, and also the tax incentive that New York is giving to television shows and films really helped us get it in regarding the budget and the network approving it, was a big deal as well.

How many episodes are scheduled to be filmed for this first season?

M. Rauch: We’re going to shoot 11 episodes in addition to the pilot that we already shot. So it’s 13 all together, including the pilot. With the pilot counting basically as two episodes because it was ordered as a 2-hour pilot.

My question is for both of you, and in your respective specialties. I always like to find out what kind of advice you would give to young people that want to break into show business, so if you were looking into being, in your specialties or be an actor, what would you advise for a start for people?

M. Rauch: This is Michael. I think it’s many elements, one is an incredible work ethic and working really hard, being passionate and certain that this is the field you want to pursue, because if you don’t have that passion or that certainty, it’s going to make the road very, very difficult. And I think educating yourself in all aspects of, whether it’s film or TV, but if you’re a writer, not just understanding writing but also understanding acting and editing and directing, even cinematography, just to get a sense of all the different elements that collaborate to make a great show.

A. Lenchewski: And luck.

And luck, okay.

A. Lenchewski: The best advice I ever heard, as a struggling writer, was, stop struggling and start writing.

How much do you collaborate between each other when you’re developing a show. Is it a team effort or do you kind of do your own part separately and then try to mesh it together at the end?

M. Rauch: This is Michael, and it’s a lot of both. We have a writer’s room, a fantastic writer’s room, with five other really talented writers, and sometimes someone will come in with an idea and they have a very certain sense of what that idea is, and we’ll all help flush it out. And sometimes we all come up with an idea together and collaborate on building the story, but always when it goes from the outlying stage to script, one writer will take the script and write the script himself or herself.

making the right choice

I love the irony that Hank is fired for not saving the rich guy and now seems to be paying the penance of only treating rich people. How will that play out for him; do you expect to evolve the show for him to begin to understand the rich people more, or begin to resent them even more?

M. Rauch: Do you want that, Andrew?

A. Lenchewski: No, go ahead.

M. Rauch: Hey, this is Michael, Laura. It’s a great question and it is part of the punishment, in a way, and we think that Hank, as both a character and also in terms of the storytelling of the show, is going to treat both the wealthy and also the people in the Hamptons who are not as wealthy, who are really the people who help make the Hamptons run, and they might not get as much attention, but they’re the kind of heart and soul of the Hamptons. So he’s going to be in pretty much every episode having patients who are very well to do and patients who are less well to do. And hopefully, if we do our job, even the wealthiest of these people don’t come across as caricatures but dimensionalized people who might be eccentric or might be privileged, but at the heart of it are human beings as well.

Okay, thanks. Kind of a continuation of that in a way, again, with the character, USA is always so good with creating their shows around these really interesting characters, they’re just always really interesting and they develop the more the show goes. How do you foresee Hank and his brother evolving?

M. Rauch: I think we have a bit of a counterintuitive plan for Hank’s arc, which is that a lot of people wonder how the Hamptons is going to change him, and I think our point of view is more how is Hank going to change the Hamptons. And as far as Evan, I think this is someone who has reached somewhat, exceeds his grasp, and I think he’s finally going to find a forum where he can start to come into his own a little bit and taste of success that he’s always dreamed of, and it’ll be interesting to see how that affects him as a person and how that affects his relationship with his brother.

This question is to both of you. Were there any difficulties in getting the script to go from just an idea to a full-fledged series, which is now about to premier?

M. Rauch: Um, yeah, the biggest difficulty was having to sit on the edge of your chair and stare at a phone for two or three months, but to USA’s great credit, I think one of the major reasons for their success, and I think it’s a credit to the cable model in general, is that they’re not doing a volume business. They really very carefully hand pick the ideas that they want to pilot, and the pilots that they want to shoot, and the months that we spent waiting weren’t really just waiting, it was really fine-tuning the script and the characters and the vision for where the series would go. So I think that really was a very encouraging process to go through.

Wow, good to know. This is to either of you. What is the most important factor that makes Royal Pains different from other doctor shows?

A. Lenchewski: I think the way we look at it is that all other medical shows bring the patient to the hospital, and we’re bringing the hospital to the patients.

I haven’t seen the pilot yet, so I’ve pretty much gotten a feel for Hank and his brother as far as the main characters. Are there other important characters that we’re going to get to know throughout the show?

M. Rauch: Okay. Yes, there are multiple other important characters that you’ll get to know on the show, and not in any specific order, there’s Hank’s physician assistant, whose name is Divya, and she is someone who will help Hank run HankMed, which is their concierge doctor service. There’s also the romantic lead with Hank, Jill Casey, who’s the hospital administrator at Hamptons Heritage Hospital, and she’s someone who is part of this hospital system, although she knows it’s flawed whereas Hank is kind of outside of the system now, and also believes it’s flawed. Campbell Scott plays a character named Boris, I’ll let Andrew pronounce his last name. But he is this mysterious man of wealth, power, and a background that no one is quite sure what it is, but has a small sense of omniscience about him, and it is on his estate that Hank and his brother, Evan, live. And then there are also characters that are going to be less frequent in the episodes but very important to the storytelling. Christine Ebersole plays a Hamptonite whose name is Miss Newberg, also known as New Parts Newberg, and then Ezra Miller and Meredith Hagner play a young, teenage couple in love, and they’re kind of wise beyond their years and fantastic in the show.

Also, airing right after Burn Notice, what kind of audience crossover do you think you’re going to get there?

M. Rauch: Hopefully full-out hands cross over. I think that USA is very savvy in pairing us with that show. I think there’s a lot of shared sensibility. I think there’s a lot that the two central characters, the heros, share in common, guys who have sort of, through no choice of their own left their old lives behind and are now working outside the system to help people in beautiful, sunny locations, surrounded by a cast of quirky and fun characters. So hopefully the shows will work really well together and feed off each other.

How much research do you put into this just to keep it authentic medically? What kind of research have you already done, or are you going to do, do you have consultants working on the show, or is that just kind of …?

A. Lenchewski: Yes, we do. This is Andrew, we have a tremendous medical advisor, his name is Dr. Irv Danesh, and he is an ER physician outside of Boston, and he spends time with us out here in the writer’s room in LA, he spends time on the set anytime we’re shooting medical scenes, and he spends a lot of time with the writers by phone and e-mail; and everything that we do medically either comes from him or filters through him and, as Michael touched on earlier, authenticity, both in terms of the location and the medicine, is of tremendous importance to us.

I’m in Boston, so that’s good.

In healthcare it’s definitely a hot topic right now, so are there any healthcare issues or topics that you would like to see covered on any of the shows?

M. Rauch: Yes, there’s a lot of, I think, as you said, healthcare is such a kind of dominant issue right now in our country, and we want to hit it without hitting it too hard, and part of what we’re doing in every episode is having Hank and his company, HankMed, treat both the wealthy and also the less privileged, and oftentimes the story lines that revolve around the less privileged deal with the type of healthcare they’ve been getting, the type of healthcare they’ve been shut out of, so trying to handle it in a way that remains within the tone of the show and the network, but at the same time hoping to deal with it in a way that treats it honestly and with the way that it deserves.

Okay, I’m a writer, also a medical assistant and nursing student.

M. Rauch: Yes, so you know very well.

if god could get in

Yes, because as you guys probably know, some things don’t always go well, so you have to have a backup.

M. Rauch: Absolutely, and that’s, both the sad thing about the reality of that and the good thing for us as writers is that there are endless stories about situations like that and it kind of helps us in terms of carving them out.

How prevalent are concierge doctors in real life, given the state of the healthcare system?

A. Lenchewski: I think we’re finding that they’re increasingly common. The trend actually was born in Seattle and it’s extremely prominent in Florida, and they’ve obviously popped up in all the centers of wealth around the country, LA, New York, etc., so it’s interesting; it seems to be a pretty hot button topic and a lot of people seem to know about it, but at the same time it seems like it still has a growth ahead.

Visually, what was the approach to the transition that set the tone of the show, like before Hank was called before the medical board?

M. Rauch: That was a combination of Andrew, who created the show, Jace Alexander who directed it, and the editor, Charles McClelland, to try to find a visual style that felt fun and also organic to the storytelling itself. So that moment that you were referring to, specifically, you mean in terms of the glass?

Yes, right.

M. Rauch: Going from frosted to clear?

Exactly.

M. Rauch: Well, let it be known throughout cyberspace that I actually found the button on the location scout that turned that glass from frosted to clear and back, and if anyone else takes credit for that, you let me know.

M. Feuerstein: No, I’ll take credit for it, because this is Mark Feuerstein …

What’s up, fellows, what’s up?

A. Lenchewski: Hey, Mark.

M. Rauch: We’re talking to — right now, and he was just talking about how much more important the writers are than the actors in the show.

M. Feuerstein: They couldn’t be more true and just to show you how true that is, I’m going to yell in about five seconds because we got the …, which is ten times more important than anything they’re saying.

M. Rauch: Do you have any questions for Mark while you have him?

Yes. Mark, what were some of the challenges for you in bringing Hank to life?

M. Feuerstein: Dealing with these two guys who you’re talking to. No, when you have great writing, honestly, there’s no challenges. You just try to serve the material. It was a beautiful script from the get go in the pilot and then when Rauch joined the team, it only got stronger and deeper with every episode, and the challenges are just trying to live up to the quality of the writing and the work and relax into it and figure out how to say certain words, like xanthochromia.

Just one really quick thing for you guys, is sushi really filled with diamond chunks in the Hamptons, or what?

M. Feuerstein: You’ll have to come and find out for yourself. All right, fellows, I’m going back to work. I just wanted to … your phone across the country.

With each subsequent episode, will the kind of characters or patients, whatever you want to call them, these rich people that Hank gets to deal with, will they be one and done, or will they be stay and the themes that they may bring up be followed throughout subsequent episodes?

M. Rauch: Hey, this is Michael, and that’s a great question. We definitely will have some of these characters be one and done, but there are a bunch that we’ll be bringing back, and for two reasons; one, we really like the actor that we cast in the part and feel like they’re a fun person to bring back, and even more important, part of what Hank does is not just, you know, when he was an ER doctor in Brooklyn, did you see the pilot?

No, I wasn’t able to see the pilot.

M. Rauch: Well, it begins with him as an ER doctor in Brooklyn and part of the life of being an ER doctor is you usually just see a patient once. They come to the ER, you treat them, they go off, you never see them again. And part of what his transformation as a character is in the show is leaving that behind and becoming a doctor who makes house calls and treats people not just once but goes back to make sure they’re okay and continue the treatment. So there’s definitely going to be many opportunities in which we do that.

And then you touched on it a little bit, but in terms of Hank and Evan’s relationship, Evan’s a CPA and … might be dealing with his money, are there issues there or maybe conflict that will arise between the two of them?

M. Rauch: Andrew, do you want to take that?

A. Lenchewski: I think there definitely are, I think that one of Evan’s attitudes about life, is that anyone who says that you can’t mix business and pleasure is just someone who hasn’t figured out how to do it yet. I think as Evan tries to mix these two worlds, he’s going to definitely rub Hank the wrong way and Divya as well, and that will be a source of tension between all of them in HankMed.

How did you decide to set the show in the Hamptons? I mean, for those of us in the New York area, all you have to say is The Hamptons and everyone thinks of the usual stereotypes. Do you find that that’s going to translate nationally, or is it as much a chance to educate people about the stereotype of the Hamptons and how it’s not entirely true as well, going off of an earlier question.

A. Lenchewski: Well, a couple things. When the idea for the show formulated, the second idea that formulated was the only place to set this was in the Hamptons. I just felt that it’s a great world, a beautiful world, one that hasn’t really been seen on TV before, and it also really seemed to fit very organically with this character and his story as a concierge doctor to be, because you’ve got some of the wealthiest people in the world spending a couple of months of their year out there, yet there’s really only one hospital and it’s not a hospital that’s on par with the kinds of institutions where these people are accustomed to being treated, so it felt like there was definitely a niche in the market that Hank would be able to serve. To the second part of your question, I think this is all about Hank and we see the world through his eyes, so I think there are moments of observation where he’ll sort of laugh at the outrageousness and excesses of the world, but at the same time, he’s a doctor and he is helping people; and I think that will allow us to humanize a lot of the characters because at the end of the day, if you’re a 16-year-old kid with hemophilia as Tucker is, the young boy that Michael referenced earlier, the hemophilia doesn’t care how much money you have. So we look at medicine as the great equalizer and we think that the show will help get that across.

i have no dr asst

On another subject, you talked about how the only place to film this was New York, which, having seen the pilot, I completely agree. Is this the first time that you guys have actually filmed in New York and how are you finding it?

M. Rauch: I did a show in New York and I’m from New York, and I would do everything in New York if I could. I love the city. I think that there is an energy and a rhythm to the city that you can only, obviously, capture if you’re shooting in the city, and that includes going anywhere on the Hamptons as well, and we’re shooting a show in the Hamptons. Our stages are in Brooklyn, but we’re shooting the show in the Hamptons as well as other parts of Long Island and Westchester. As we were saying earlier, it just, it gives it an authenticity that you can’t manufacture shooting anyplace else. In a weird way, since New Yorkers seem to just kind of shrug anything off, there’s generally not a lot of problems shooting on location there. And the crews are fantastic.

You said you’re on shooting the fifth episode. I was wondering, were there any favorite moments that you’ve had along the five episodes you’ve produced so far?

M. Rauch: Andrew, do you want to?

A. Lenchewski: I have a couple and I actually don’t think I’m going to tell you what any of them are. I will say there’s one in the second, and definitely one in the third.

M. Rauch: I’ll get more specific. I’ll be less cagey. And less about moments and more about, you know, we had a scene in the third episode that was scripted to be on the water during a sunset. And it was a very romantic scene, and it’s very rare that you actually get the luck and magic to, while you’re shooting it, get the sun to set, and we were able to do that; and it was just over the Atlantic on a beach with the sunset in the background, and it just was beautiful. So we just cut that moment out of the episode.

The opening scene of the pilot had a lot of, like a little subtle humor when they were looking for a way to transport the patient to the hospital. Who is the person who kind of brings the comedy and that subtle humor to the show?

M. Rauch: This is Michael, and that would be all Andrew, who, you know, created the show and wrote the pilot and has a wonderful sense of humor. And pretty much, I’d say that most of those moments came from him and obviously some of the moments come from the actors and the director as well.

A. Lenchewski: And the one thing I’ll add to that is that one of the joys of the collaboration between me and Michael and Mark is that I think we all have extremely similar senses of humor, so from the moment we conceive of an idea or a line or a scene, to it then going to the page, to it then coming out of Mark or Paulo’s mouth, there’s not much distance to travel there. I think we all laugh at the same stuff.

I do have a question about, and now I know you’re following Burn Notice, and Burn Notice is based on this kind of adventurous, fish out of water kind of story where the protagonist is in beautiful sunny Miami, but he doesn’t really like it. I was wondering if you were going to have that same dynamic in your show where the doctor really doesn’t like being in The Hamptons, or will he like it?

M. Rauch: Well, Andrew had a, what I found to be a great line earlier when he kind of talked about how this show isn’t about how The Hamptons changes Hank, it’s about how Hank changes The Hamptons? So I think there’s definitely a mixed sense of awe and how crazy this place is when he gets there? And, hopefully, in a very fish out of water way, hopefully we’ll be able to maintain that as he gradually acclimates to this very new and different environment. But I think Jill, I’m sorry, did you see the pilot? I don’t remember.

No, I did not yet.

M. Rauch: Okay, there’s a character named Jill who is the hospital administer of the hospital in the Hamptons that we’re playing, called Hamptons Heritage, and she is a local, and has a much more blue collar upbringing than some of the characters that Hank treats, and in a way she begins the personification for us of the Hamptons and showing that it’s all not just these kind of wealthy, privileged people. I think that’s something that Hank learns, too, and I think we all kind of have this identification when we hear the Hamptons, we just think of glitz and learning that the people who actually make the Hamptons run are people who may have less wealth but are just as important and essential to that environment.

You touched on this earlier, about how people are not as well served and, of course, healthcare is a big issue in the country today, and so you also talked about how people weren’t going to, you also touch on the people that are not as well served by the healthcare industry. In that, are you talking about people who are, say, poverty level, or people that are in the middle class but to have fallen between the cracks as far as medical care, if that makes sense.

M. Rauch: Um, Andy, do you want to?

A. Lenchewski: No, go ahead.

M. Rauch: All of the above. I think we feel that since this is a show about medicine and because of that, healthcare, that it’s incumbent upon us to try to represent the spectrum as realistically as we can, so I don’t think every episode we’ll be dealing with a patient who is impoverished, nor every episode we’ll be dealing with a patient who’s middle class, but we’ll try to fairly represent all the different people in that environment who would suffer from whatever maladies they could.

I’m curious about Hank’s cases. You’re basing the series on the concept of the concierge doctor, so will any of Hank’s cases actually be based on a real cases, and maybe given a little twist, and if so, will it be with one off characters or some of the recurring cast?

A. Lenchewski: I’ll start with the later part. I think, as Michael said earlier, we’ll have both closed-ended story lines and we’ll have recurring characters, and I think that the medical cases will be driven by the characters, in a lot of instances, and sometimes the other way around. And I’m sorry, can you remember the first part of the question?

Will any of Hank’s cases be based on actual cases?

A. Lenchewski: Oh, yes, that’s right. I think as we have one of our senior writers, Carol Flint, was one of the senior writers on ER for the first four seasons of that show and she likes to say there are only so many things that can go wrong with the human body, so I think there’s a lot of overlaps between the world of emergency medicine that Hank used to practice in, and the one that our medical advisor Irv Danesh practices in, and the one that Hank now practices in as a concierge doctor in The Hamptons. Another thing that Irv brings to the table, which has just been a huge asset to the storytelling, is this enormous sense of creativity, we call it the MacGyver aspect of the show, where if you’ve seen the pilot, Hank, when he’s in Tucker’s house, asks for the bottle of vodka and a zip lock bag and a sharp pointy knife; and so I think you’ll be seeing a lot more of that. It’s something that we enjoy writing and from what we can tell so far, the audience will really enjoy seeing, and I think that allows us to really elevate the stakes of the kinds of medical cases we can deal with outside of a hospital and in people’s homes, so I think that’s going to be one of the really fun things to explore.

One last thing, first, kudos on getting Campbell Scott to play Boris.

A. Lenchewski: Oh, thank you. We know how lucky we are, believe me.

How did you get lucky enough to get him for that role?

A. Lenchewski: We sent him the script, he read it, and he agreed to do it. I think that’s another one of the great advantages of filming in New York is that we have access to a completely different talent pool, being so close to the Broadway community and to actors who live in New York and tend to like to and want to work there, and Campbell happens to be one of those guys, and it’s been an enormous thrill to be able to work with him.

M. Rauch: And just to add to that, aside from being an incredible actor, he’s a fantastic guy. He’s just an incredibly positive presence to have on the set.