At the bottom of a lush, green ravine in the upper reaches of Wahiawa, inside a weather-beaten building rising from the mud, Randy Zisk leaned toward a pair of TV screens as they framed the stars of the new ABC doctor drama, "Off the Map."

Zisk, a director and executive producer on the show, watched the scene with a god’s-eye view. If the actors blundered a line or a camera failed to capture the right angle when they nailed their dialog, Zisk would know.

He had six extras in the scene with show regulars Valerie Cruz and Caroline Dhavernas. Everyone had to move without bumping into each other or the crew or the cameras or the sound booms or the lights.

And act.

"It was kind of a ballet," Zisk said when the scene was finished. "That scene was kind of a dance."

He shot the 45-second scene — moving from wide shots to close-ups — more than 20 times. It’s the pace of television but with a wrinkle: "Off the Map" has been shooting since last summer, but the series won’t premiere until Wednesday.

The ensemble cast of eight and the crew of 120 have toiled in this ravine for most of the episodes, hidden from public view on land being used to raise heliconia and ginger. They are just as keen as anyone in TV land to see "Off the Map" on the air.

"It feels like we are all having a baby," Dhavernas said.

On this show, however, Hawaii won’t be showing off its glossy tourist face. Instead, it will serve as a fictional village in South America where the cast members are the doctors in a remote, underfunded medical clinic.

The show is the brainchild of Shonda Rhimes, Betsy Beers and Jenna Bans, who have all been a part of the popular ABC medical shows "Grey’s Anatomy" and "Private Practice." On set, there’s a firm belief the jungle setting they created will sell the show in a unique way.

But that kind of drama is more physically demanding than acting in emergency room scrubs, said Dhavernas, a waifish 32-year-old Montreal native who starred in the acclaimed Canadian film "Passchendaele" as well as the short-lived offbeat Fox series "Wonderfalls." Dhavernas plays an idealistic young doctor named Lily Brenner, a new arrival at the jungle clinic.

"We have scenes in the water," Dhavernas said. "We have scenes where we are running around in the jungle. You have to like that. We are not doing studio work. We are here every day at the clinic in the mud."

THE OUTDOOR settings are familiar turf for Zach Gilford, the actor playing Dr. Tommy Fuller, another newcomer to the clinic. Gilford, a 28-year-old Chicago native and Northwestern University graduate, spent several summers working as a guide for an adventure travel group for teenagers. The job required that he pass a 90-hour medical response course.

"I’ve seen shadows of what I have done in real life," said Gilford, who most recently starred as high school quarterback Matt Saracen in the critically acclaimed TV series "Friday Night Lights."

His guide time included encounters with charging bears and medical problems that ranged from a torn rotator cuff to a near-fatal asthma attack.

"I think there is excitement in this jungle setting, with these way-more-than-ordinary medical things that happen — some weird infection or getting crushed by an anaconda," said Gilford, who in person looks more like a cross-country runner than a quarterback.

Like the characters played by Gilford and Dhavernas, the doctor portrayed by Mamie Gummer — an infectious disease specialist named Mina Minard — is new to the jungle setting.

"It’s a wonderful premise, to explore health care in a Third World country," said the 27-year-old Gummer. "It’s been a ball, a real treat."

Although she’s the daughter of Oscar-winning actress Meryl Streep, Gummer has carved her own identity, appearing on the New York stage and in the films "Evening," "Taking Woodstock," "The Hoax" and "Loss of a Teardrop."

Finding the soul of her character wasn’t too difficult, but it helped that the medical books she read gave her the terms she needed to sound authentic.

"People who follow that path and chose that career obviously have a strong desire to help those in need, and that is easy enough to tap into," she said. "It plays on basic human compassion."

Jason George, the muscular actor who plays tough-talking Dr. Otis Cole, a former Navy medical officer with addiction issues, likens "Off the Map" to a blend of "Romancing the Stone" and "M*A*S*H."

To understand the realities of working in a remote clinic, George spoke to a good friend who works at an orphanage and medical clinic in Africa.

"The dude said he literally was doing amputations with a saw that he got from Home Depot and the batteries ran out midway through," George said. "To me that’s the hard-core version of ‘Off the Map.’"

The 38-year-old George has been in TV since 1996, when he was chosen after a nationwide casting call for the daytime drama "Sunset Beach." His TV credits include "Eli Stone," "Eastwick" and "Grey’s Anatomy," and his film credits include "Barbershop."

HE SAID the creative team of Rhimes and Beers was a big reason he said yes to "Off the Map."

"It’s fantastic for an actor," he said. "It gives you comedy. It gives you drama. Right as you start to get sick of comedy and you wish it would get serious, they hit you with something serious that has you weeping."

As the scene is set for a late-afternoon shooting, the cast, crew and Zisk are aiming for emotion. A thin man with short curly hair and piercing blue eyes, Zisk is once more sitting in front of monitors, only this time in a darkened room.

His doctors are standing over a dying man inside the clinic, and Zisk is again in command of everything, from the 12,000-watt light outside the clinic that will replicate the setting sun to how many takes he’ll need before he lets the patient die for the final time.

A hush falls over the set when the cameras finally roll. The only sounds beyond the dialog are chirping birds and crowing roosters.

And Zisk.

"Cut. That was good. Let’s go again."