Jordana Spiro Jordana Spiro

"What would have happened if Meadow Soprano had gone on to medical school and become a doctor?" That's the question writer-producer Josh Berman said he found himself wondering when Jamie-Lynn Sigler (who played Tony Soprano's brainy daughter on The Sopranos) guest-starred on his show Drop Dead Diva.

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Thus was planted the seed for The Mob Doctor, Berman's new series that stars Jordana Spiro as Dr. Grace Devlin, a surgeon who tries to balance her professional career with a secret side job: providing medical services for the Chicago Mafia in order to pay off a debt owed by her brother (Jesse Lee Soffer).

Berman says that after Sigler's appearance on Drop Dead Diva, he and co-producer Rob Wright started researching real-life Mob doctors. "We were shocked," he said. "It is the underbelly of organized crime — their medical fixers, so to speak. So when we found out that this actually did exist, it became even more compelling and that's the point we decided, 'We have to write this.'"

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Inspired by one nonfiction account in particular, Ron Felber's Il Dottore: The Double Life of a Mafia Doctor, Wright and Berman started developing the character of Grace. Berman says the series will balance the medical drama with Grace's personal life — story lines bookended by her relationships with her boyfriend/colleague (Zach Gilford) and former Mafia boss/family friend Constantine (William Forsythe).

"We have some episodes that take place predominantly in the hospital, and then some that take place predominantly in the field," Berman said. "I like to refer to those cases as the dirty medicine cases, because we get to tell stories without the bureaucracy of a hospital, and to me that's what's so compelling. ... When Grace is in the field, the only thing she needs to do is worry about the patient. And I think she takes that energy and that passion back into the hospital with her, which kind of gives her that 'I don't give a damn' attitude when it comes to placating her bosses. Instead, she puts her patients' interests first."

Spiro, who previously starred in TBS' comedy My Boys, said she was drawn to the role due to the moral dilemmas Grace faces as she tries to extract herself from the Mafia life. (Her father was a minor player in the Mob.) In the pilot episode, for instance, Grace receives a message to kill a patient, an informant who's brought into her hospital."This woman is making choices that are very morally conflicted and yet, at the beginning, it's to save her family," Spiro says. "And so this question becomes, 'How far do you go, and where is that line that you absolutely won't cross? And what happens when that line keeps edging further and further away?'"

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Spiro says that as a surgeon, Grace "[has] this inherent quality of wanting to fix things in a very direct, hands-on way. She wants to cut something open and fix it. And there's a godliness to that. Surgeons cross a line that isn't just physical, it's psychological and spiritual."

Spiro shadowed real-life surgeons and surgical residents to research the role, but Berman had a more personal connection to get input on the medical aspects of the show. "I grew up in a medical family," he says. "My father's a doctor, my mom's a nurse, the siblings on both sides are doctors or nurses or psychiatrists. And yet, after writing on network television for 14 years, it's the one genre I avoided ... because I felt like it had been done to death on TV."

Berman said he even invited his mother to an early table read for input on the medical aspects. "She gave me some good notes on the nursing dialogue. But then she proceeded just to give me general script notes, at which point I kicked her out of the room," he quips.

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Despite the influences inherent even in the title of the show, Spiro says viewers shouldn't be quick to pigeonhole the new series. "I think it's very easy to talk about our show and say it's ER-meets-The Sopranos or something like that," she said. "The risk in that is that it almost sounds like we're just trying to ... marry two formulas to create one new formula. And I think it's different than that. I think this is really about a woman ... who is torn between two worlds that are at odds against each other, but really trying to make good in both of them."

As she does so, Berman promises "twists and turns" for Grace and the surrounding players throughout Season 1. "I have never worked on a show ... where we have so many stories to pick from that it's an embarrassment of riches," he said.

"We have a woman who's a doctor and indebted to the Mob — not something that most people are experiencing in their lives," he admits. "But the themes of what this character goes through, and balancing the pressures of family and work and her brother ... the universality of trying to get through our days today when there are so many pressures on us, I think that's something that viewers can really relate to, especially women, when so much is asked of us in today's world. And so, I hope at the end of the day, people will relate to Jordana's character. Grace is so complex and so interesting. I don't think there's another character like her on television right now, and I hope the viewers fall in love with her as much as I have."

The Mob Doctor premieres Monday at 9/8c on Fox.