The first draft was a 170-page beast that went through events point by point, but it was through collaboration with each other and consultation with producer Judd Apatow that they realized the necessity of alteration.
The break-up not only adds dramatic tension to the narrative while Nanjiani is waiting for Gordon to wake-up and recover, but as he pointed out in the interview, gave the film an important third act conflict for the couple to overcome.
Much in the same way that the movie doesn’t chronicle the extended time Kumail Nanjiani and Emily V. Gordon’s parents (played by Holly Hunter and Ray Romano) spent just sitting in a hospital waiting room, the writing duo understood that The Big Sick couldn’t simply be a completely accurate account of what happened… though that is where the script started.