Published Aug 11, 2015In the pilot episode of Cinemax's medical drama period piece, The Knick, the Chief of Medicine at New York's famed Knickerbocker Hospital commits suicide following a failed attempt to perform a Caesarean section. The year is 1900 and the procedure is an experimental one that routinely results in the death of the mother — and often the infant — from blood loss. As directed by Steven Soderbergh — a decidedly idiosyncratic auteur known for injecting double-meanings into his works — this surgery is bloody, rudimentary and painfully antiquated, which we, an audience with an understanding of contamination and surgical basics, are hyper-aware of.
This suicide places Dr. John Thackery (Clive Owen), a renowned, experimental surgeon known for revolutionizing the field, in the position of Chief of Medicine. Whereas such a creative thinker would normally be championed for his brilliance in a standard narrative, The Knick, with its modernist electronic score and pseudo-gothic vision, posits him as a somewhat unreliable and mercurial dick with a cocaine addiction. And being preoccupied with his research and the new medical techniques popping up around the world, he's understandably annoyed when his preferred candidate for deputy chief of staff is rejected by board chairman Cornelia Robertson (Juliet Rylance) in favour of Dr. Algernon Edwards (Andre Holland), a highly skilled surgeon with an astonishing resume that happens to be black.
Though these issues of drug addiction and the nature of race relations in the early 20th Century do provide logical historical context and an inherent basis for conflict, they're a little on the nose. Thackery's character trajectory throughout the first season is quite obviously destined for downfall, running into a snag only when cocaine shipment disruptions force him to deal with withdrawal. Similarly, while the basic notion that Dr. Edwards is a skilled surgeon at a hospital that won't treat black patients is quite intriguing by sheer merit of what it stands for, the rather preachy and predictable way that the issue is handled throughout the first season doesn't add anything of note to existing dialogue.
Where The Knick transcends these standard tropes is in the many secondary storylines and ideas looming on the periphery of every episode. How abortion is handled pops up, as does the rather grotesque origins of the ambulance industry. Disturbing medical practices, such as one that finds doctors removing the teeth and colons of patients suffering from mental illness, are injected into narratives, as is a storyline involving a "Typhoid Mary" of sorts. But what emerges from each of these dialogues, many of which are described in further detail by the writers in the commentary tracks included with the Blu-ray set, is an underlying preoccupation with social divides. Class distinctions are apparent throughout these ten episodes, as are the thorny divides between people from different racial, religious and professional backgrounds.
Some of this oft-compelling series does concern itself with the generic "greed" angle of the modern narrative, with hospital manager Herman Barrow (Jeremy Bobb) constantly running into problems with loan sharks and bureaucratic nonsense, cutting corners for costs at every turn. But, more often than not, the structure lends itself to modern comparisons (something that's noted by the score and stylization). At the time, these medical professionals were considered revolutionary; these practices were experimental, but there's a certainty and confidence here that doesn't correspond with our current understanding of how archaic these strategies really are. In many ways, as the medical field is constantly changing and improving, we could compare this to modern confidences and certainties, ones that will surely look equally misguided decades from now.
The Knick, much like Cronenberg's rather telling (and misunderstood) biopic about the origins of psychoanalysis, A Dangerous Method, is a work of context. It's looking at the past — at the origins of our present understanding of medical fact — and showing just how much of it stems from trial and error (and ego motivations). Thackery, towards the end of the season, is as motivated by ego as he is by discovery, battling other cutting edge surgeons to ensure he's the first to discover a new methodology.
What we're ultimately left with here is the observation that so much of what we accept as scientific fact was, and is, motivated by professional and financial greed. Yes, there are certainties, insomuch as tactics that don't kill patients and progress made in the world of infection and blood-type identification have ultimately saved lives, but the fundamental message here is that of humbling and admitting that our present day fact may very well be an antiquated absurdity years from now.
Beyond this, The Knick, as a series, does grow increasingly complex and interesting as the first season progresses. The handling of broad political issues is a tad rote and self-righteous initially, but as the characters become more balanced and fleshed out, this starts to fall by the wayside. Season two could very well be an improvement on the first if it continues in the same manner.