Mark Feuerstein in Royal Pains (Photo: USA)

In 100 Episodes, The A.V. Club examines the shows that made it to that number, considering both how they advanced and reflected the medium and what contributed to their popularity and/or longevity. This entry covers Royal Pains, which is in the middle of its eighth and final season. The show’s 100th episode airs this week.


Hundreds of thousands of words have been written about how The Sopranos kicked off the modern era of prestige television, but it’s really only in the past year or so that TV fans, critics, and showbiz insiders have begun to reckon with what’s been lost during the latest golden age. Early on, the original programming on cable was largely indistinguishable from what was on network TV, aside from the profanity and nudity, but with The Larry Sanders Show, Oz, and The Sopranos, HBO cultivated an audience for sophistication, violence, and vulgarity that the networks soon began to covet. Sacrificed in that chase for “quality?” The kind of mild, modest, family-friendly escapism that TV used to be known for.

For a time, basic cable swooped in to fill that void. TNT and USA—both of which had been doing well with repeats of more old-fashioned genre fare—spent their original programming budgets on new versions of the kinds of shows that neither premium cable nor the major broadcast networks were interested in anymore. Lately, the tide’s been turning back. USA drew a lot of attention last summer for the dark, stylish series Mr. Robot, while the networks recently announced a fall schedule filled with safe throwbacks. But at some point, decades from now, if “watching television” is still a popular pastime, someone’s going to look back with some befuddlement at the early 21st-century proliferation of pleasantly unambitious cable series, many of which ran for years in the shadow of the Mad Mens, Fargos, and Breaking Bads.


Which is to say that sooner or later, some cultural archaeologists will stumble on Royal Pains. And what will they say? Will USA’s medical dramedy be looked at as a small gem that never got its due? Or will the TV watchers of the future be shocked to discover that this show that was never a phenomenon—and was barely acknowledged by critics, recappers, or awards voters—was on the air for eight seasons?

When Royal Pains ends its run later this summer, it will be missed. Even in this era of Peak TV, shows don’t last eight seasons if they don’t have an audience. In Royal Pains’ first two and a half seasons, USA routinely pulled in five million viewers per episode, which began to drop after the midseason hiatus in season three. The series then averaged three to four million viewers for the next few years, which fell to around two million in season six, and about 1.5 for seven and eight. The reasons for the decline have a lot to do with how people find and watch TV shows now, and with how hard it is to sustain interest in something that’s not really part of a larger cultural conversation. The fall can’t really be blamed on an erosion in quality, because Royal Pains is ending its run much as it began: as an enjoyable weekly vacation from the real world.

Royal Pains’ executive producers Andrew Lenchewski and Michael Rauch agreed to answer some questions via email (which they responded to in unison, so the replies can properly be attributed to both of them). In their reflections on the show, Lenchewski and Rauch pinpointed a couple of possible explanations as to why it lasted so long. “To us,” they wrote, “The series was always about family and second chances.” Royal Pains is set in the Hamptons, following the two Lawson brothers—stubbornly conscientious, hyper-capable doctor Hank (Mark Feuerstein) and hustling would-be entrepreneur Evan (Paulo Costanzo)—as they find a place among the super-rich doing “concierge medicine” under the name of HankMed. The two Lawsons start the series estranged and in trouble in their respective careers, but they get closer to each other and make peace with their pasts as they become entrenched in their new home.

Royal Pains’ location played a major part in bringing in an audience. Lenchewski and Rauch noted that USA and Universal Cable Productions provided them with a big enough budget to shoot on Long Island, which gave Royal Pains a look like no other. “Because the show was depicting such a specific and unique world, we all knew we had to show the audience the real thing,” they said. “You can’t duplicate East Hampton on a backlot in Toronto.” Because of the proximity to New York City, the producers had access to theater and indie film stars who could ferry over for an episode or an arc. Royal Pains has boasted guest turns by the likes of Laura Benanti, Frances Conroy, Sonia Braga, Marcia Gay Harden, Emma Caulfield, Shiri Appleby, Amy Sedaris, Donna Murphy, Joanna Gleason, Sutton Foster, Miriam Shor, Carrie Preston… and the list goes on. (And that’s just the women.)

Lenchewski and Rauch also credited their New York home for allowing them to cast Ben Shenkman, who guested in season four as Dr. Jeremiah Sacani—a skilled diagnostician with an autistic spectrum disorder—and fit in so well that he became a regular. From season one on, Royal Pains has built out its cast, starting with Campbell Scott as a mysterious, manipulative European billionaire, and then adding Reshma Shetty as a dedicated physician’s assistant, Brooke D’Orsay as a bubbly socialite, and Henry Winkler as the Lawsons’ wandering con-man father. But Shenkman’s Jeremiah was something different. The producers explained:

All of our core characters had challenges they had to deal with. Some were professional, some romantic, and some medical. But they all interacted with one another with ease and social attunement, and found a way to become a family. We thought it would be interesting to bring a new member into HankMed with complexities in social relatedness, and to see if, and how, they could become a part of the HankMed family, both professionally and emotionally.… It was very important to us that we depict this character with authenticity and respect.… We were very careful in the writers’ room when mapping out Jeremiah’s behavior, and we were very fortunate to land Ben Shenkman, who made Jeremiah real, and portrayed a character with social limitations in a truthful and sometimes aching way, without ever commenting on him.

All of which re-raises some questions: Just where did Royal Pains fit into the rocky television landscape of the 2010s, and how will it be seen decades from now? Was it meant to be a serious show about damaged people coping with significant challenges, or a breezy hour, featuring nice-looking super-docs? And if it was just the latter, does that ultimately make Royal Pains too inconsequential?


Back in 2009, NBC Universal Cable Entertainment’s president Bonnie Hammer talked to Entertainment Weekly about the success of USA, which at the time was riding high with Royal Pains, Psych, White Collar, and Burn Notice—the latter of which had just drawn nearly eight million viewers for its season finale. Hammer credited what had become the network’s house style, favoring “aspirational, upbeat characters” and “a blue-skies feel.” In other words: Rather than making brooding action series set in grimy warehouses or nerve-wracking medical dramas set in crumbling city hospitals, USA put wisecracking, hopeful professionals in resort communities, where they could do their work and maybe sip the occasional tropical drink by the beach.

For a time, that approach worked so well that when NBC was tanking in the ratings in the late 2000s, some suggested that Burn Notice should make the jump to the big network. Not only did that not happen, but in February 2010—just a few months after Hammer’s EW interview—NBC’s Saturday Night Live ran a fake game show sketch called “What Is Burn Notice?” that made fun of the ubiquity of the commercials and print ads for a show that none of the contestants had seen or even heard much about.


That sketch was funny. But it also exposed some of the weaknesses in the ways we frame and discuss television now, in this era where online buzz and cultural relevance seems to matter more than actual viewers—or whether a show is good at what it means to do.

In the case of Royal Pains, the goals were simple. Each episode introduced one or two new patients, with diagnosis-defying maladies that often required Hank and company to improvise a life-saving measure out in the field, MacGyver-style. Lenchewski and Rauch noted, “Our writers were amazing at research, and they often brought in the most fascinating cases… somehow we never ceased to terrify ourselves or gross ourselves out.” Meanwhile, Hank would struggle to balance his workload with pursuing satisfying romantic relationships, as his friends, family, and colleagues had their own personal issues that would carry over from week to week. It was formulaic, but like a lot of successful formulas, this particular mix of light serialization and case-of-the-week drama survives because it retains its appeal.

Still, when people talk about the television that “matters,” they tend to talk about novelistic longform narratives. While Royal Pains has told one long story over its eight seasons, it’s been more in the “continuing adventures of” mode, and not at all like Game Of Thrones or The Americans. Even the show’s producers admitted that when the series finale airs, it won’t really be bringing any kind of epic tale to a close. They said, “It was a difficult but crucial moment, when we accepted that we wouldn’t be able to wrap everything up with a bow on it. Our priority was to make sure that all of our main characters—and Hank most of all, obviously—had completed their journeys in a satisfying way. And we wanted our audience to walk away from the series, knowing that in the end, each member of the family had somehow fulfilled his or her second chance in life.”


The flipside to that is that, theoretically, future viewers could drop into any random Royal Pains episode on some retro TV channel and would have no trouble getting absorbed in what’s going on.

“We had two cardinal rules we always tried to honor in the show,” Lenchewski and Rauch explained. “One was that we never specified what anything costs, and the other was that we never specified what year it was. So hopefully, that second rule will buy us a touch of timelessness in the future, by not pegging us to history or world events. But more important, once again, the show was first and foremost about the forming of an unlikely family. And that’s certainly as evergreen a theme as any.… Hopefully, 100 years from now, if someone is watching this show on a virtual reality headset, it will still make them laugh and cry.”

Sometimes we mistake what TV is capable of with what it’s good at. It’s been exciting and rewarding over the past 15 years to see how amazing television can be when shows combine subtle acting, literary writing, and cinematic effects in ways that no other medium really can. It’s easy to see why upstart outlets—namely cable channels and streaming services—want to reach for those heights. The payoff in terms of awards, respect, and fan engagement are worth the big risk that always comes with courting excellence.


But it’s also easy to see why the big networks now seem to be retreating back to providing the TV equivalent of comfort food—and there’s no real reason to knock them for it. Not every show has to be some heavy, adults-only serial that demands close attention and a serious time commitment. The history of television has been dominated more by the Royal Pains: well-crafted, well-acted, likable series that are easy on the eyes. With so much on TV these days, it’s hard to actively recommend something like Royal Pains, which is good but not “The Best Thing You’re Not Watching” or “One Of The 100 Shows You Need To See Before You Die.” But when we’re done with the meaty stuff, shows like this will still be there—like a dessert of aerated cream and finely spun sugar.