“The Knick”: Making Old Medical Drama New Again

Review by Nathan Blake

(contains spoilers)

In this post, Nathan Blake reviews season one of Cinemax’s The Knick, an historical medical drama starring Clive Owen and directed by Steven Soderbergh.

“More has been learned about the human body in the last five years than the previous five hundred”, Dr. John Thackery (Clive Owen) says in a eulogy of his former chief, Dr. Christiensen. That knowledge still is not enough to save a woman and her unborn child from a complication of childbirth in the series’ opening scene.

The guilt and frustration over the failed procedure leads Dr. Christiensen to commit suicide in his office, leaving Dr. Thackery to replace him as chief of surgery and take over what is frequently referred to as “the circus.” But the chaos of this medical drama does not include defibrillator paddles, the hum of MRI machines, or the beeping of heart monitors. The year is 1900 and Dr. John Thackery’s “circus” is the operating room at New York’s Knickerbocker hospital.

The show places much of its attention on Thackery’s tireless research and experiments. He is brilliant, dedicated, blunt, and arrogant. He is also a frequent guest of an opium den in Chinatown. His desire to get a few good shots in against death fuels an increasingly severe addiction to cocaine.

This struggle serves as the main arc for season one, but from the first episode, “Methods and Madness”, the show produces a strong ensemble. There is Dr. Algernon Edward’s (Andre Holland), the hospital’s newest surgeon and a controversial hire: he is black. Thackery and others take every opportunity to shut him out of the operating room, but attitudes begin changing later in the season when he develops a revolutionary new procedure to repair inguinal hernias. The series makes issues of racism a focal point during these first ten episodes. Storylines involving police brutality, interracial romance, and segregation are handled in a manner realistic for the time period depicted, but also disturbingly similar to today.

The Knick, both in terms of technique and story, shares similarities with many of the medical dramas of the past twenty-five years. The score by Cliff Martinez is contemporary; electronic and moody. One surgery scene borrows the favored camera movement of NBC’s ER: Circling around the operating table as the procedure unfolds. But everything is shot less frenetically in The Knick. Whereas shows like ER and Grey’s Anatomy rely heavily on quick cuts that showed gruesome imagery but then quickly relieved audiences of the gore, the editing here relies on static shots. Instead of trying to condense long procedures into ninety seconds to ramp up the adrenaline rush, director Steven Soderbergh goes for the opposite by allowing the camera to linger on the cutting, the bleeding, and the gaping wounds for the majority or even entirety of a procedure.

There is plenty of drama outside of the operating room, too. Patients arrive at The Knick courtesy of ambulance drivers who have more in common with truckers and cops (the latter of whom they often clash with) than today’s EMTs. Patients are a commodity. Ambulance driver Tom Cleary (Chris Sullivan) spends just as much time haggling with the hospital over what he is owed for the day’s deliveries as he does transporting patients. When Tom disagrees with the amount he receives for a delivery, he often compensates for it by removing items from deceased patients. He later finds another source of income through a Catholic nun named Sister Harriet (Cara Seymour), who performs after-hours abortions for women of widely varying economic statuses.

That the show tackles, in authentic and unflinching ways, issues such as racism and abortion, is only part of what makes it so riveting. Its greatest strength lies in how every episode reveals a struggle to find cures for ailments such as appendicitis, placenta previa, hernias, meningitis, and typhoid fever – medical issues that have now either been eradicated or can be treated with much higher survival rates. The season finale, “Crutchfield”, finds Dr. Thackery unsuccessfully racing against another doctor to figure out why blood transfusions do not work. The blood types have yet to be discovered!

The viewer is left with a bittersweet view of life, disease, and death. It is depressing that all of these once deadly ailments can now be cured so easily, yet there are still so many other diseases that have no cure. Simultaneously, it stirs up hope that those cures may be coming soon.

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