Q&A: 'Station 19' Showrunner Zoanne Clack on Her Journey from the ER to Hollywood
From real-life doctor to the writers' room of 'Grey's Anatomy' and its latest spin-off, the screenwriter found a unique way to marry her two greatest passions - saving lives and storytelling
A mutual friend introduced Zoanne Clack to me seven years ago, and in the years since I’ve known her as a Writers Guild of America West Board member, a doctor, and a writer on and producer of “GREY’S ANATOMY”. As if this weren’t enough, she was also the mother of three beautiful children. In short, I’ve never not been in more than a little awed by her and her accomplishments.
When I asked her to join me for one of my artist-on-artist conversations, I saw it as an opportunity to interrogate how an emergency room doctor became a part of the writers’ room of a hit medical series (a job she held for close to two decades), how such successful TV sausage gets made, and what she learned from the experience that she’s brought with her to her new role as co-showrunner of “STATION 19”. But as our chat began, it quickly became obvious we would be also discussing the role of Zoanne’s mother in her journey from medical professional to professional screenwriter. It’s a deeply moving story of mothers and daughters, intergenerational ambitions, and finding a way to merge an agglomeration of dreams into a single, fulfilling life.
For aspiring and emerging screenwriters, I suggest you pay special attention to the complicated emotional obstacles Zoanne had to navigate to create the life and career she really wanted. I expect her story will make you feel less alone in many ways while simultaneously inspiring you to not give up.
COLE HADDON: Zoanne, I’ve come to think of you as an integral component of the Shondaland machine, but you didn’t start out as a screenwriter. You were a doctor with a focus on public health. Now, I always think of medicine as a calling, rather like writing. Walk me through how you went from trying to save lives to telling stories about the remarkable people who do every day?
ZOANNE CLACK: I was basically groomed to be a doctor. I’m the only child of a single mother and all the hopes and dreams for her life basically rested on my shoulders, and being the good child that I was, that was alright by me. I made good grades in school and was encouraged to either be a doctor or a lawyer, because that was the measure of success, according to my mom. I would get microscopes and chemistry sets for birthday and Christmas gifts. I chose doctor and never looked back - until senior year of high school.
CH: What happened then?
ZC: I started trying to figure out what my major would be, and I wasn’t gung-ho about majoring in sciences. I took an evaluation of my life and realized that I loved writing and I loved TV, and decided maybe I would pursue a radio/tv/film major. Unbeknownst to me, my chosen school of Northwestern University was very competitive in this major. So, I spent my freshman year participating in film projects and taking multidisciplinary classes – trying to get into the program that people had dreamed about getting into for years. And I did it – I got into its School of Speech!
CH: Nice work. But, how did your mother take that?
ZC: I had to look at my mom’s face all that summer. She never said, “Don’t do it,” at least not verbally, but I could tell by the look in her eyes that she was disappointed. I would never amount to anything in that field.
CH: Okay, so you’ve made it into one of Northwestern’s most competitive departments. There’s a glimmer of life as an artist, or at least in media, in your future…but you still ended up a doctor. How?
ZC: Since it had been so difficult to get in, I decided to stay there but change my major to Communication Studies and take all my medical school prerequisites. I had to catch up a bit, so I did some summer school science classes and basically ended up with a minor in neurobiology. At every step I thought about how my medical degree and media could go together, thinking initially that I would try something like being a medical correspondent on news shows. I always knew how important the media was in getting messages out to the masses, I just didn’t know specifically how I would manage it.
CH: I presume you dove right into medical school after you graduated?
ZC: The next ten years were devoted to medicine – medical school, a residency in Emergency Medicine, and a fellowship in Injury Prevention during which I got a master’s in public health. The fellowship came about because, by the second year of residency, I had already burned out and was trying to figure out how to change my life. I considered doing a new residency — quickly aborted that thought because who wants to be an intern again? — different fellowships like sports medicine, and even bench research, which I found extremely boring. But that’s how desperate I was to start a new life.
CH: In the end, you got there. So how did you — get there — to this new life in Hollywood?
ZC: While looking for this new niche, I remembered my love for TV. I took an acting class in Atlanta and loved it, and decided that maybe I would move to Los Angeles and see if there was a career to be found in entertainment. I had a good day job, I would never be a “starving artist” as it were, so why not go for it? I started preparing for my new life — which I planned like six months in advance because that’s the kind of gal I am — and during this preparation, my friend in L.A. saw an ad at the back of the national emergency medicine magazine that was advertising for an on-set person for the show “ER”. This was an amazing opportunity for me, as I had started my ER residency the same year that the show came out. I remember all of us interns gathering around the TV to witness the glorification of our regular day job, and it was marvelous. In fact, “ER” became such a competitive residency after the show aired that I was glad I had applied the year before!
CH: It’s so true. I actually spent a year determined to become a doctor because of “ER”. I think about the series at least once a day, even now. It’s always there, itching at my creative brain. Anyway, did you apply?
ZC: So, I wrote a letter to the people on the ad and heard…nothing. Now here’s the twist: I never mentioned my real intentions to my medical colleagues because entertainment seemed like such a frivolous endeavor compared to the ability to save lives every day. But for some reason, I mentioned this “ER” job opportunity to one of my mentors at Emory, and he said to mention his name because he had gone to residency with the guy who was hiring for the show. I quickly sent off a letter and got an immediate response for a meeting.
CH: It’s who you know, not what you know, right?
ZC: During the visit, I was able to walk the sets and hear how the sausage was made, and I was giddy with excitement – a feeling I had never felt before for any job interview. I waited two weeks to hear from them and, alas, did not get the job – but they said they would “keep me in mind.” I figured it was just Hollywood talk, so I went about my business, doing ER shifts and taking acting classes because that’s what I thought I wanted to do. Growing up in Houston, all I really knew about entertainment was the people in the box I watched every day, so I thought that was my aspiration. Through the acting classes, I learned that in order to cry, they didn’t just put drops in their eyes and move on. They actually dredged up all the horrible memories of their lives and pulled them up through their eyes. On the one hand, I had a profession that prided itself upon pushing down all of your emotions so that the patients could have theirs, and on the other hand I had these classes that were making me bring them all up.
CH: That sounds brutal.
ZC: So, all these emotions came flooding out and I didn’t know where to put them, so I started writing them down. And then I found writing. And I remembered I loved writing.
CH: Tell me more about that.
ZC: I was an avid reader as a child and at one point had wanted to be the youngest author, but then someone younger than me published something and I let that dream go. This time, I wasn’t letting it go. I started taking writing classes and since I had grown up watching sitcoms, I took a sitcom writing class at UCLA extension. Right in that same time period, one of the EPs from “ER” had a medical show greenlit. Another doctor had already worked on the pilot, but wasn’t sure if she was going to return for the show. “We’ll keep you in mind” became a real thing!
CH: Wait, that never happens.
ZC: The people I had interviewed with recommended me for the show even though the EP didn’t know what she needed at the time. I went into the meeting telling her I would be willing to do anything — be a consultant, work on set — but what I really wanted to do was write, and I shoved literally the first script I had ever written into her hands. Looking back, would I have done that if I had known more? Probably not, but thank god for naïveté because I got hired as a writer on that show two months later. I continued to work in the ER but I had the bug and I loved the writers’ room and the culture so I worked on more scripts — especially once we got canceled — and my next job was “GREY’S ANATOMY”, where I was for two decades
CH: In so many ways, it feels like that voice inside you, the one that had pushed you to creatively express yourself, had finally found a way to live alongside your passion for medicine.
ZC: I basically learned that medicine and the media do go together very well, and they call it entertainment education. My job now is the perfect amalgamation of my communications degree, my medical degree, and my public health degree. It was like I had planned it all along. I take great pride in the ability to educate the masses through entertainment. I always say that if I tell someone about, let’s say, diabetes while working in the ER, they might tell two friends, and they’ll tell two friends - so maybe twenty people will hear the message I’m trying to say. But if I have a story about diabetes on “GREY’S ANATOMY”, twenty million people around the world might hear that same message – and a certain percentage of those people will actually act on that information. It has been a wondrous journey that has resulted in getting exactly what I didn’t know I wanted.
CH: I’m curious if you can reflect on the role your mother’s voice, her expectations of you, played in this journey to Hollywood. Because it’s far from a linear one, and listening to you, I’ve got the sense you might have been standing in your own way, trying to be practical, trying to pay your bills when others might’ve taken a leap of fate consequences be damned.
ZC: Wow, this is so interesting. If you really want to get into it, it probably has a lot to do with being a child of divorce where my father took off and started another family, not really ever looking back until I united with my half-sisters years later. There was probably a big part of me that wanted or needed to be perfect to try and make amends for that anger and hurt in some way, you know?
CH: That sounds incredibly hard.
ZC: Growing up with a mom who worked two and three jobs to make ends meet did not cast a frivolous net over me. She was a teacher and well-loved by her students and co-workers. She participated in so many school activities and was many people’s favorite teacher. I kind of loved the “notoriety” of being her daughter, but I didn’t love having to watch her work so hard. I never made any kind of pact or anything that I wasn’t going to work that hard but it was likely in the back of my mind at all times.
CH: I can imagine so.
ZC: She used to say this thing when I would watch TV a lot: “They’ve already made their money.” In retrospect, it’s kind of silly, because it was an encouragement for me to do something more substantive like read, but authors had already made their money too, so…? But, basically, it instilled in me that entertainment and entertainment people were not a goal or aspiration that was to be respected or admired, just something to do in the downtime when you weren’t trying to save the world. The goal was to do better than the last generation.
CH: Was that how she was raised, too?
ZC: She had grown up on a farm in East Texas literally picking cotton in the summers to earn extra money and somehow left there, went to college, traveled a bit, and moved to the “big city”. College was never an “if” in my house, it was a “when”. No one would think of not going to elementary school after kindergarten, and I would never have thought of going to high school without following it up with college. I never worried about paying for it, I knew it would happen someway somehow. The harder I worked, the more scholarships and financial aid I would get.
My whole life growing up was about hard work and learning to be independent and not dependent on someone else. I guess I had already kind of lived that “starving artist” life without being an artist, and I didn’t think of it as a real job or a goal. And “consequences be damned” would never be an accurate description of me, even now!
CH: I love that.
ZC: I often say that I don’t recognize the woman who shucked her rise in academic medicine and moved to L.A. to do entertainment. But even that woman had jobs in three different hospitals and took multiple acting, improv, and commercial classes. I looked at some calendars from the year that I moved that were so filled with classes and work that it made my current day head swim. I’m just not a “fly by the seat of your pants” kind of person. I mean, I’ve been on one show for nineteen years! That in and of itself should tell you something. Even in the crazy world of writing for TV, I’ve been practical and held down my job in lieu of trying for other opportunities.
CH: You’re your mother’s daughter, Zoanne. In all the best possible ways.
ZC: I've come to understand that it's partially a cultural thing. My mom was raised in an environment that was all about finding success, holding on to a good job, and being able to support yourself better than the generation before you. Now I'm learning more about generational wealth and making my money work for me instead of me working for it. It's a slow process, but I'm learning.
CH: So, you’ve had a hand in more than 400 episodes of “GREY’S ANATOMY”. Four-hundred-plus hours of TV of any kind would be an accomplishment for any writer, but to do it all with one series boggles the mind. Was it difficult for you to walk away from it, even if it was to a bigger role on another hit series?
ZC: With “GREY’S ANATOMY”, I actually got stuck a bit. I had formed a niche and wasn’t growing as a writer and a leader. The opportunity to re-invent the culture of another show and become co-showrunner was very welcome and came with an exponential growth curve that I actually cherish.
CH: I’d love it if you could reflect upon who you were as a screenwriter in Season 1, and the screenwriter you had become by the time you bid farewell to the writers’ room.
ZC: In Season 1, I knew nothing. I had that one show under my belt that got canceled after eight months. I had learned some things there, but not nearly enough. I did a lot of on-the-job learning. For the first three years, I had to learn to say yes and merge both sides of my brain to work together.
CH: Can you explain that?
ZC: When the writers who had no medical boundaries came up with an idea, I had to learn to not say no immediately and open my mind to the possibilities.
CH: You mean writers who had no experience in medicine?
ZC: Yes. I would get on the phone and try to make the ideas work and still be within the realm of medical possibility. I thought for sure I would be fired after that first three-year contract, but I kept holding on. And I held on for each three-year revision of the contract as time went along. So yes, I’d say I was changed enormously from the writer I was in Season 1 - I learned to say yes and to push my boundaries as a storyteller. I used to lament that I was “bad in the room,” but as time went on and I got more help with the medical side of the show, I began to spend more time in the room and found that I had a lot to say.
CH: I’m curious, what is the most common mistake medical shows make in general?
ZC: That’s really hard to say because every medical show is different and takes liberties in its own ways. I always say it’s hard for me to watch other medical shows because I know where I pushed and was denied, but for other shows, I don’t know if they tried to get the correct medicine in and failed, or if they didn’t even try.
One general mistake would be trying to be too preachy. Most shows that are preachy don’t end up making it, but that’s a definite mistake I’ve seen. Also being too specialized. You run out of actual cases your doctors can do, and then they’re doing everything!
CH: I’ve never thought about that, but it seems so obvious now.
ZC: As far as common things we get wrong, it’s definitely who does what and time.
CH: What do you mean by that?
ZC: On “GREY’S”, every doctor has two to three, even up to five specialties so that they can do more. We have no radiologists, so the surgeons are interventional radiologists. We have no internists, so our surgeons do internal medicine. One of our doctors was a pediatric surgeon, neonatologist, pediatrician, fetal surgeon, and an OB/Gyn. She would’ve had to be like twelve when she graduated medical school to have gotten in all of those subspecialties.
CH: [Laughter] Amazing.
ZC: And time is always shortened, for instance - to be able to have more interaction with the patients after surgery. One time, we told a story about a boy getting new ears — I think for Christmas or something — and a surgery that would’ve taken at least six months done in stages we did in a day.
CH: Looking back to when you broke into television or maybe just Day 1 on “GREY’S”, can you think of something you, as a storyteller, had just gotten completely wrong about writing and/or making TV?
ZC: I’d say I had nothing right!
CH: [Laughter] I love the honesty!
ZC: I thought if I just buckled down and did my work that I would also be a good writer, without taking the necessary steps it takes to grow as a writer.
CH: Alright, I need to hear more about that.
ZC: I would basically hibernate in my office taking care of the medical stuff and inputting it into the scripts, and pitching medical stories, and didn’t take advantage of the vast opportunities to be on set, be in editing, and write scenes outside of the ones I was assigned. That’s how I ended up getting stuck. I did my part of the job very well, and once I stuck my head out of my rut, I realized there was so much more to learn that I couldn’t just get through osmosis – and by then I was well into my writing journey. Had it been a show that got canceled somewhere in its run or I had gotten fired and had to take on a new job, I believe these skills would’ve come faster. Initially, I just didn’t know enough to even know what questions to ask. That’s the downside to landing a writing job as quickly as I did after moving to LA. Those that are PAs and assistants get to learn the inner workings much differently, and I respect that entry into this profession so much for that reason.
CH: Before I move on, I want to ask one more question about “GREY’S” that might interest screenwriters at any level. Those 400 episodes I mentioned are both a blessing and a curse to a writers’ room, I imagine. A monumental accomplishment on one hand, but so many stories and cases have been explored during that time. Hell, I feel like by most series’ fourth and fifth seasons, a kind of dreadful fatigue sets in. What kind of challenge did that pose to you and your fellow writers and what strategies did you use to overcome it?
ZC: This is an interesting question. I continued to work in the ER for maybe the first seven seasons or so of “GREY’S”.
CH: Wow, I didn’t know that.
ZC: So, I continuously had fodder to draw on from my own personal/professional life and, of course, our researchers would keep us abreast of all of the significant medical happenings. Once we became a hit, it was easy to access most experts around the world who wanted their issues broadcast to millions of people around the world. As one of our researchers put it, the stupidity of humanity also kept us deep in stories.
CH: [Laughter] Thank the gods for good ole human ignorance.
ZC: But truly, it does start to feel old after a while and medical cases began to recirculate. Around Season 9 or 10, I started what we call a “Medical Communications Fellowship”, where we target surgical residents that are doing their research year to come to the show for about three months. I truly think having their input about what’s going on in their own residencies plus cases that they’ve seen themselves has really helped infuse the show with new and fresh ideas that come from the source. We’ve had general surgeons, neurosurgeons, ENT surgeons, plastic surgeons, and trauma surgeons to name a few. It’s for people like me who always had a creative side that they let go of in order to train for and practice medicine. Two of these fellows have stayed on with the show and are now full-time employees - part of what we call “Team Medical”.
CH: Last year, you were named Head Writer of “GREY’S” spin-off “STATION 19”. Eight months later, you were named co-showrunner of a series that’s quickly hurtling toward its 100th episode. Sounds like someone’s killing it at her job, my friend. Tell me, how has the adjustment been from staff writer and producer to head writer to, now, the big chair?
ZC: It has been really amazing, to tell you the truth. Going to “STATION 19” has been a refreshing change and an opportunity to lead in a way that I feel is fair and just. I have learned so much through my decades at “GREY’S”, and now have been able to put all of those learned tactics to the test. The “STATION” room is full of a fairly young staff and very diverse voices and to be able to guide these voices to be heard and tell stories that are culturally and socially respectful and relevant has been a dream for someone who is grounded in entertainment education and responsible storytelling. The opportunities are endless in the stories we get to tell, and I am here for it!
CH: Our conversation is almost over, sadly. I have two more questions. The first is, do you miss working in the ER at all?
ZC: I miss the people, I miss the healing, I miss the interactions, but I in zero way miss the bureaucracy and business of medicine. The constant “robbing Peter to pay Paul” mentality, the constant threat of being sued and wondering if I missed a diagnosis, the constant and all-consuming paperwork to cover your ass all the time. Part of the reason I stopped practicing was that I wasn’t practicing enough to become really familiar with the computer systems as they changed, so I couldn’t quickly do my paperwork in-between patients. I would literally spend hours after my shifts catching up on paperwork for the patients that I had seen that day. I went into Emergency Medicine because I didn’t have to worry about what insurance they had in order to treat people. It was mandated by law that we treated every person who walked through the door. But I couldn’t get away from insurance. To make any referral, you had to know their insurance. Before you wrote prescriptions, it was important to know their insurance. To figure out who to admit them to, yep - insurance. The system is broken. And I was able to find another way to provide help.
CH: It makes me happy you’ve reached this point, someplace where you are happy and making a real difference. Okay, final question. We started this conversation with you talking about your mother’s expectations for your career, to such a degree that it sometimes has sounded like you were making decisions more to make her happy than yourself. After this journey that has finally helped you realize the real you, how does your mom feel about where you’ve ended up?
ZC: The biggest truth is my mom now has Alzheimer’s so says nothing about it, so that doesn’t really help you out.
CH: Oh god, Zoanne, I had no idea. I’m so sorry, for both of you.
ZC: Yeah, it's been hard being part of the sandwich generation with small kids and a mom living with dementia. I feel like she did all the things they say to do to keep your mind fresh - puzzles, word games, kept herself busy with lots of volunteer work after retiring, continued working with adolescents. But it still hit her, and fairly early, too. She's just eighty this year. But up until she couldn't anymore, she never stopped asking me if I still had my license. I would show her my name on the show. I would take her to fancy parties and awards shows. I would have her meet famous people. I would show her my paycheck — making much more than I would’ve as a doctor — and still, she would constantly ask if I still had my license. She’s proud, yes, but mostly because of the external perks. The fact that other people thought what I was doing was cool. But she could always still say her daughter is a doctor, and I’m sure that’s what made her proudest of all.
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