Stephan Lee
September 12, 2014 AT 04:00 AM EDT

Okay, so that’s not exactly how it went down. Exec producer Margaret Nagle — who’s written for the period drama Boardwalk Empire and won an Emmy for writing the HBO FDR biopic Warm Springs — was developing a very different pilot for Fox, inspired by the gruesome West Memphis Three murder case. Then she received a DVD copy of Polseres Vermelles, a Spanish drama centered on a gang of unwell but ultimately normal teenagers living in a pediatric wing of a hospital. Fox and Steven Spielberg’s Amblin Entertainment thought of her to adapt this new series for American audiences. Little did they know that the show’s subject matter hit extremely close to home for the writer. ”For some reason, Fox, based on this very muscular pilot I wrote, thought of me for this — having had no idea that I had family who were doctors, had a brother who had been in the hospital, and had worked with kids with cystic fibrosis,” says Nagle.

Narrated by a boy in a coma named Charlie (Griffin Gluck), Red Band Society follows a similar group of teens in L.A.: Leo (Charlie Rowe), who has lost his leg and hair to osteosarcoma, is the veteran member of the wing. Kara (Zoe Levin) is a heartless Candy Crush-ing cheerleader in desperate need of a heart transplant. Dash (The X Factor‘s child rapper Astro) isn’t ashamed to use his cystic fibrosis to get what he wants. Emma (Big Time Rush star Ciara Bravo) waxes wise about Shakespeare while hiding her anorexia under baggy clothes. And joining them is hospital newbie Jordi (Nolan Sotillo), who has to learn the ropes. Among the few adults in the main cast are Oscar winner Octavia Spencer as tough Nurse Jackson and Dave Annable as McDreamy surgeon Dr. McAndrew.

Even with adult supervision, though, these sick teens manage to break plenty of rules. In the pilot, Dash tries to sweet-talk a young nurse (Rebecca Rittenhouse) into taking his virginity before he dies — an incident drawn from Nagle’s actual volunteer experience. ”Kids are kids wherever they are,” she says. ”They’re still doing crazy stuff.”

On set in Atlanta, the teen actors — some young enough to require private tutoring while filming — aren’t quite so rowdy. They’ve formed their own community, which includes taking cooking lessons at Spencer’s house and discussing Wes Anderson films as part of a movie club. ”It feels just like being on a set with a bunch of 30-year-olds,” jokes Spencer, who landed on Red Band after plans for an NBC reboot of Murder, She Wrote fell apart. ”I had a moratorium on nurse roles because I’ve played them so many times. But as I read Nurse Jackson, I realized she wasn’t the typical nurse…. She will always be no-nonsense, and the thing that I love about her is she’s the smartest person in the room.”

About that room: The pediatric wing of the fictional Ocean Park Hospital might look like it was ripped from the pages of a Pottery Barn Teen catalog — from the cute comforter on Charlie’s bed to Emma’s quirky desk lamp — but the bright sets are based on the real-life Mattel Children’s Hospital UCLA and state-of-the-art pediatric wards in the U.K. ”When teens get sick, they’re often in the hospital for a really long time,” says Nagle. ”They have to create environments that are conducive to who they are as people. It’s much more like a boarding school than a hospital, but it’s not a world we know much about.”

Because every day means so much to patients so young, the first season will take place over three weeks, and there will be frequent flashbacks to the characters’ lives on the outside. But on a show revolving around teens with serious illnesses, inevitable questions about their future arise. Rowe, 18, anchors the cast as Leo, the wise-beyond-his-years pack leader who doles out the titular red bracelets to his fellow patients like badges of honor. ”Leo has been through all these painful things in the hospital, and that’s why he loves it so much — it’s a part of him,” he says. ”He’s more afraid of what’s to come rather than what’s happened.”

While Red Band won’t avoid tragedy, Nagle assures us that it won’t reach Fault in Our Stars levels of emotional devastation too often. ”The show we want to make is about that moment when a person that you hardly know becomes the person you can’t live without,” she says. ”The show is about survival — not about death.” Sept. 17

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