‘St. Denis Medical’ Boss Breaks Down Ron’s Post-Op Confession and Taking Matt and Serena to the Next Level

Note: This story contains spoilers from “St. Denis Medical” Season 2, Episode 18.

“St. Denis Medical” may have just kicked a new will-they, won’t-they dynamic in the final seconds of the Season 2 finale, and not even the NBC comedy’s showrunner knows where things go from here.

Episode 18, titled “We Make Time,” followed as the hospital staff braced for Dr. Ron (David Alan Grier) to undergo a serious heart bypass surgery. The installment followed as hospital executive director Joyce (Wendi McLendon-Covey) and the doctors and nurses came together to give their support before the procedure, while sharing their relief after he got through it.

Things took a turn after the curmudgeonly doctor woke from his anesthesia-induced slumber in the episode’s final moments, only to ask “Where’s my Joyce” before dozing off again — leaving Alex (Allison Tolman) and Bruce (Josh Lawson) in shock.

“There’s always been a special relationship there. I don’t think the show has really defined it,” series co-creator Eric Ledgin told TheWrap. “Their relationship is a little messy. To me this both feels out of nowhere, but also fuels the messiness of their relationship.”

Ron’s confession could be the underlying admission of deeper feelings toward Joyce, as much as it could be a delirious painkiller-ridden Freudian slip. But viewers will have to wait until Season 3 to find out what comes next.

The Season 2 finale brought big feelings as the doctors faced the potential loss of their beloved colleague Ron, who enlisted Ariana Madix’s Dr. Brooke Emerson to perform the surgery. Though initially clashing with her former date night buddy Bruce, the duo ended up potentially rekindling their own romantic flame by episode’s end.

But perhaps the biggest romantic headline came from Matt (Mekki Leeper) and Serena (Kahyun Kim) finally acting on their shared feelings with a kiss and agreeing to start seeing each other after two seasons of courtship.

Below, Ledgin speaks with TheWrap about plotting an emotional ending for Season 2 and his plans for the upcoming third season. This conversation has been edited for length and clarity.

TheWrap: It was great to see a more heartfelt side to the ensemble as they came together as Ron underwent bypass surgery. How did the idea come about for this emotional tone for the finale?

Ledgin: We were headed in a totally different direction, to be honest with you — this is one of those pivot moments. Where we were heading felt good, but didn’t feel quite special enough or something. “What if this was all we get to do? What would I really feel bad about leaving on the table?”

Since the very early conception of the idea, it just felt like any time in my life I’ve seen or heard of doctors having to go under around the people they work with. It’s such a loaded thing, and it’s such a baked in premise of this show, the mix of business and personal. It just felt like, of course we have to do that.

It was so easy and fun to figure out what people’s reactions would be to Ron going through this. Once we knew what the storyline was going to be, it all felt like it flowed from the characters.

Serena and Matt kissed for the first time and ended the season with some more kissing and the beginning of an actual relationship. What made this the right time to pay off this slow burn?

A lot of it is feeling it as you go. I didn’t know if they were going to end up together in Season 1, and we decided to push things in Season 2 in the direction they were already sort of organically going, based on Mekki’s and Kai’s performances of the characters and to see if it felt right. And then at a certain point, we were like, “This does feel right, actually.” I was very happy with the way things came together.

And I mean that from all sides. The directing of that second to last episode and that scene of them kissing, and just like the light was right, it all felt really good. And they played it so well. It felt like validation that this was the right idea.

Ariana Madix made such a fun addition to the ensemble this season, and I’ll admit I loved seeing Brooke and Bruce potentially rekindle their relationship. How much more Ariana would you want for Season 3?

It started as really just something to spark a journey for Bruce — seeing that this woman that was sort of his backup plan was falling through, and it could have really just ended there and that would have been fine.

But again, you wait until something sparks when you see it on camera. And she just had so much confidence that could easily match with Bruce’s, but there was also a vulnerability there that felt a little bit similar to Bruce. They both have a certain something under the surface. It felt right to put them together in this situation and see what comes of it.

And you know, we have some ideas, and we’ll see what happens in Season 3. Ariana has just been wonderful and a great addition to the cast. We just keep getting lucky just finding people that add a whole different dynamic to the show.

There were so many great jokes and gags in this season. Which one stands out as one you’re the most proud of for having successfully brought to life?

I am a sucker for “Person falls and gets hurt,” so I have to say Joyce falling off the stage. But the thing is that it wasn’t just the falling off the stage — which does get me every time I watch it — but it was the way that Wendy played so confidently, needing to keep going afterwards, even with this absurd neck brace and how stiff she was, she just played it so funny for the whole rest of the episode. I was just like, “Wow, this is the gift that keeps on giving.”

I will also just say, because I just saw this, like, quote from this talking head went around a little bit of Matt saying that he’s going to be, he’s going to like, crack someone’s heart open, much like the little girl in the Grinch who cures the Who converts the Grinch to Judaism. I think it was Hunter Toro that wrote that and that just felt so true to me. I was like, “Of course, the Grinch is a metaphor for a Jewish person.” I say that as a Jewish person, but it just felt very real to me. I enjoyed that a lot.

When we talked at the end of Season 1, you talked about expanding the story beyond the hospital walls and deepening the characters’ bond and comedic combinations. What’s the next frontier for you as you look to another season with these characters?

In Season 2, I really did have these goals in mind of wanting to make the show funnier, and I wanted to get out of the hospital a little bit. And now, by the end of Season 2, I feel in the right gear. I want to ride this wave while deepening our look at the characters and their relationships, going even deeper on those relationships and following the threads that we’ve left. So nothing hugely earth shattering.

With Matt and Serena, looking at what happens with them, it’ll be starkly different than watching two people who are kind of pining for each other. That’s just a different relationship. What does it look like for someone like Ron? Who is all of a sudden humbled physically in front of all the people he works with and where he has this certain status. I’m very interested to see the sort of human, messy unfolding of the consequences of all that happened at the end of Season 2.

“St. Denis Medical” Seasons 1-2 are now streaming on Peacock. The show will return for Season 3 during the 2026-27 TV season.

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