Patrick Pianezza's 'Love Letter' to EMS

We had the chance to sit down with screenwriter Patrick Pianezza to talk about his upcoming film Code 3, diving into his unconventional path to screenwriting, the collaborative process behind the film, and what it takes to bring authentic stories from page to screen.

InkTip: Congratulations on Code 3! With the film set to be released to the world soon, how has the whole experience been?

Patrick: Each step of the process has been surreal. For so long you’re just writing in a vacuum, nothing’s happening, and then someone finally says, “I like this.” Suddenly things move forward, but it still doesn’t feel real. Even the night before production, you’re thinking, “Is this actually happening?”

Then you show up on set and there are a hundred incredibly talented professionals bringing your words to life. That’s mind-bending – seeing something that lived only on the page suddenly right in front of you. The production wraps, and again there’s this lull. Then you see the finished cut and it blows your mind all over again. 

After we landed distribution, it's felt like we've all been holding our breath until September 12th — which I’m sure will be another unpredictable, crazy experience. But more than anything, it’s exciting to finally share this film with the world.

IT: That sounds like quite the rollercoaster. If I’m not mistaken, your path to screenwriting is pretty unconventional. You don’t have a film school background, so what made you want to tell this story as a screenplay?

P: Very unconventional, yes. My undergrad was actually in Public Relations at the University of South Carolina. That program drilled into us the importance of writing precisely, making an impact with fewer words, and telling a story clearly. It even required us to take a creative writing class, which I hadn’t considered before.

At the time, I wanted to be a Public Information Officer. But in that creative writing class, the professor said something cliché I’d never heard: “If you want to tell a compelling story, write what you know.” I had just come off a brutal 14-hour shift as a paramedic, and half-jokingly thought, “Oh, you want a story?” So I went home and cranked out a 36-page short story. It wasn’t great, but it sparked something.

Years later, I was visiting my brother, Paul Pianezza, who was working as a VFX producer in Santa Monica. He remembered that story and suggested we turn it into a script. I didn’t know the first thing about screenwriting, but we got Final Draft and literally transcribed it into screenplay format. Still pretty bad, but it existed. My brother eventually convinced his coworker, Chris Leone — who would become my co-writer and director — to read it. Chris wasn’t interested at first — no one in L.A. wants to read an unsolicited script — but after losing a bet to my brother, he finally did. His first question was, “What does Patrick know about being a paramedic?” When my brother said, “He’s been one for about ten years,” Chris agreed to give it a shot.

IT: When you transcribed that first short story into a screenplay, did you look at any scripts for reference or inspiration?

P: No — and honestly, I think that was a benefit. I don’t mean that in an insulting way, but I started with a completely blank page. Of course, I’d seen hundreds of movies and done some community theater in college, so I knew the very basics of what a script looked like. But I didn’t study formatting or even realize scripts were publicly available.

That ignorance actually freed me up to be creative. I didn’t know what I “wasn’t supposed to do,” so I just tried things. The first draft was ridiculously detailed — step by step, like “The ambulance opens from this side, the stretcher pulls out this way” — which obviously got cut down. But I learned by doing.

Once Chris came onboard, he gave me scripts to study, which was hugely helpful. But that very first draft came about completely organically.

Filmmaker Christopher Leone alongside the poster for his latest film.

IT: Can you walk me through how your writing process evolved from one draft to the next?

P: Honestly, the first draft was pure stream of consciousness. I just wrote scenes as they came. You could’ve scattered the pages on the floor and each one would stand alone. It was episodic, but not a story.

That’s where Chris was invaluable. He brought a sense of structure I lacked. Together, we started asking: How do we take all these experiences and shape them into a narrative? At first, I resisted. My instinct was that the movie should reflect reality — you show up, work a shift, experience both atrocities and beautiful moments, then go home. No closure, no tidy ending. But as we developed the characters, the story began to demand more, and I had to follow where it led.

IT: Were there any tough “kill your darlings” moments where you had to cut something you loved?

P: Two come to mind right away. The first was actually the very last day of shooting. We had this incredible scene with Seth Green, Lil Rel, Rainn, and Aimee all playing off each other. It was gut-wrenchingly funny — like sitting front row at the best comedy show imaginable. 

But in the edit, no matter how hard we tried, it just didn’t fit. The pacing of the film suffered every time we slotted it in. So the whole scene had to go, and that broke my heart because I thought it was amazing.

The other was a fourth-wall moment with Rainn. Throughout the movie, he occasionally turns to the camera — sometimes for comedy, sometimes to educate. We had this brilliant two-to-three-minute explanation of cardiac arrest that I loved. But since we didn’t have final cut, the studio made the call to cut it. That one hurt the most.

Patrick and his brother Paul "Pizza" Pianezza

IT: Can you elaborate on your relationship with co-writer and director Chris Leone while working on this project? Do you plan to collaborate in the future?

P: Absolutely — Chris is an amazing partner, and I don’t say that lightly. I’ve known him for about 15 years. Even in early drafts, he could pinpoint a problem and break it down so I could improve it. Part of that was helping me grow as a writer, and part was his outsider perspective — he’d never been in an ambulance. Everything we wrote was filtered through: Does this move the story forward? Does it make sense for the characters?

On set, our collaboration was friendly and collegial. Anything artistic was Chris’s domain, anything medical was mine. I never told an actor, “More sincerity!” — but I’d nudge him if, say, they used the wrong hand for a procedure. Our script supervisor Amy Arter and I became known for yelling, “Gloves!” constantly, because in real life, gloves are always on.

Chris and I never had a power imbalance. He was always open to feedback, and I could say, “No, that wouldn’t happen.” One lunch discussion with the producers and DP involved an ambitious shot idea. They suggested a change, and I was like, “No — the characters would never do that.” Mark Williams, the DP, just laughed and said, “Welp, Patrick says no, so we’ll figure something else out.” 

IT: So you offered a reality check. 

P: Yes. I loved their enthusiasm, though.

IT: It sounds like you were pretty involved on set. Did you work closely with the actors to help provide authenticity in their performances?

P: Yeah, it was a pretty unusual situation. Early on, we agreed I’d be on set since Chris and the cast didn’t really have a medical background. I was there every single day, especially for the medical stuff. Before filming, we even did a full training day at Lifeline Ambulance—six to eight hours where Aimee, Rainn, and Rel learned how to be paramedics from scratch. They all got CPR certified, even “Healthcare Provider” certified, which clinicians need to practice.

We tailored the training to the script—CPR, splinting, airway maneuvers, even how to start IVs—because we wanted it to look right on camera. I still maintain that Aimee could probably pass the EMT test.

On set, the challenge was translating my 12 years of experience into something the actors could use. They’d ask, “Where do my hands go? What do I do next?” and I’d realize they needed it broken down like choreography. That became my lightbulb moment—we treated the medical scenes like dance rehearsals. One producer even wrote down every little step so the actors could rehearse them in sequence.

The cast was always committed. They never pushed back, they wanted to get it right and make it feel real. That level of investment was amazing to see.

Behind the scenes of "Code 3"

IT: How involved were you in post-production, and what was it like seeing the first rough cut?

P: Watching the first rough cut was a watershed moment. While shooting, everything feels hectic — like a job — and I had never been on a movie set before. It was a total crash course in film production. But seeing the rough cut, even with no music or polish, was emotional. I was crying — it was incredible to see something I’d worked on for almost 15 years take on a life of its own.

I wasn’t involved in the day-to-day editing — that was Chris and our editor Jay — but as we neared the final cut, I would watch versions and flag small issues, like a misplaced sound effect that didn’t match reality. These were tiny details most people wouldn’t notice, but it was rewarding to ensure the film felt authentic.

IT: Have you had the chance to experience the final version of the film with an audience yet? What are you looking forward to once it’s released?

P: I didn’t get to attend TIFF, unfortunately, but I did go to three test screenings — one friends-and-family screening and two more formal ones. The last was done by NRG with a truly randomized audience, coming in cold knowing only that it was an ambulance movie. Chris and I sat next to each other, and it felt like seeing it for the first time. Watching a communal audience react — laughing, gasping, or moved by emotional beats — was incredible. I was proud of the response that they had to the movie. We ended up scoring really high, way above where their baseline was.

I haven’t seen it with a paying audience yet [laughs]. I’d say I’m looking forward to two things: first, that it’s entertaining for everyone, giving audiences a ride they feel was worth their ticket while offering insight into a challenging, underappreciated job. Second, that people who actually work in EMS feel seen, heard, and valued — that it resonates as authentic because this has always been my love letter to them.

IT: Do you have anything else in the works that you can share?

P: My brother and I are developing an animated series focused on U.S. healthcare. To quote a smart professor, “write what you know.” Between my corporate and clinical experience, there’s a lot of material for compelling TV. 

IT: If you had no restrictions — any budget, any project — what would your dream film be?

P: I wrote a novel in college, that I’m hoping to get published, that I’d love to turn into a film. It’s an espionage thriller spanning multiple international locations, so the budget would be huge. But if I could do anything, that’s the story I’d want to bring to life.

IT: Studio budgets are high these days, so don’t rule it out.

P: Hey, fingers crossed. Your lips to God’s ears.

IT: You’ve mentioned “write what you know.” Is there any other advice you’d give to screenwriters, especially those just starting out?

P: I’d say: just keep writing. Be determined, but also understand that luck plays a huge role in this business. Talent gets you in the door, but luck often decides what happens next. In my case, the ‘luck’ was having my brother. There is no world where this film exists without him. He was the one who pushed me to write the first draft, brought Chris into the project, and worked relentlessly to see it cross the finish line.

The only way to get good is to practice. Even though I hadn’t done much screenwriting, I’d written for multiple publications — writing in general keeps the craft alive. You can’t just sit down one day and suddenly write Ben-Hur. It’s iterative: you get better, you learn to recognize what isn’t working, and you develop the discipline to “murder your darlings.”

Most importantly: don’t give up. There are amazing writers out there who never got their break. I don’t claim to be Mario Puzo or Francis Ford Coppola — I got lucky. But once you get your shot, dogged determination and giving your best are everything.

Be sure to grab your tickets and catch Code 3 in theaters September 12th!

Hailing from Cleveland, Torey Sinclair spent 6 years studying film and screenwriting at Ohio University and Chapman University, earning his BA and MFA respectively. After spending time in the IP Department and as Social Media Coordinator, Torey currently works as InkTip’s Marketing & Promotions Coordinator. His free time is usually spent either writing, watching indie films, or hoping for a Cleveland Guardians World Series.