(HBO/Cinemax)
When the 2014 television series The Knick made it through two seasons on HBO-owned Cinemax, directed by Steven Soderbergh, it was either dismissed as “period cable-TV drama” too eager to embrace its period, or was hesitantly embraced as a lukewarm hospital drama good enough for your weekend TV break, but not much more.
Watching the show’s two seasons in 2018, it seemed enjoyable mostly as a revolving freak show of how desperately New Yorkers could live on the edge while balancing personal crisis with professional ambition. Not much has changed in that regard.
Watching it today, in the middle of a U.S. administration hell-bent on marginalizing vaccines, intimidating medical journals, promoting dietary fads, and passing budgets predicted to push millions off of Medicaid and ravage rural hospitals, it feels like a barrage of road flares. What The Knick depicts so expertly is the suffering so many endured so that we, in the year 2025, might not have to suffer the same. It is that rare show that entertains and educates, with harrowing examples pulled straight from the gory history of medical research and experiments performed by physicians vying to save lives, but also struggling with personal demons.
The Knick is both an homage to physicians and medical researchers of the past, even those wildly wrong but well-meaning. Above all, it is a portent of what we stand to lose when we cannot, or refuse to, remember all that our modern medical establishment was built on a foundation of trial, error, and incredible suffering and loss of life.
Set in 1900 in Harlem’s Knickerbocker Hospital, a real-life hospital that first opened to serve Union Army soldiers, the drama unfolds at a time when antibiotics were unknown until 1928, cocaine was an accepted part of anesthesia, electricity had yet to dawn, and pregnancy was a coin-toss away from certain death. The series opens with Dr. John Thackery, played by Clive Owen, assisting his surgeon mentor Dr. J.M. Christiansen in a desperate race to save both a mother and child from the threat of placenta praevia, a malady both have researched relentlessly and practiced for a surgical cure on multiple patients. Soon after having failed, Dr. Christiansen commits suicide. Dr. Thackery, the struggling hospital’s brilliant and hard-driving head physician, then assumes Christiansen’s mantle with all the brio of a self-aggrandizing drug addict. Which he in fact is, and continues to be, as he switches throughout the show, among cocaine, opium, and heroin. Thackery is the “functional addict” par excellence, pulling all-nighters of lab experiments and poring over medical papers for cures between paranoid bouts of psychosis, sprinkled with breakthroughs and victories in the operating room.
“We now live in a time of endless possibility,” Dr. Thackery tells all the nascent characters of the show’s cast in a eulogy for Dr. Christiansen. “We cannot conquer the mountains, but our railroads now run through them with ease. We cannot defeat the river but we can bend it for our own will and dam it for our own purposes. … More has been learned about the treatment of the human body in the last five years than was learned in the previous five hundred. Twenty years ago thirty-nine was the number of years a man could expect from his life. Today it is more than forty-seven. Eventually, the train tunnels will crumble. The dams will be overrun. Our patients’ hearts will all stop their beating. But we humans can get in a few good licks in battle before we surrender. … I will not stop pushing forward into a hopeful future. And with every blow I land, every extra year I give to a patient, I will remember my fallen friend.”
The “future” that Thackery speaks of is the one we have now, inherited to preserve for future generations. Is it an inheritance we still care to defend and preserve?
The show’s most bracing scenes unfold in the round, open semi-circles of medical arenas in which the first physicians operated on patients under rudimentary anesthesia, and without the scrubs, face masks, or even surgical gloves of modern hospitals. Blood is pumped out and administered into bodies by hand cranks. Sutures are fashioned from silk or silver wire. Physicians react in shock when patients die, which is often, but really, what they are responding to is the blow to their egos, or being emotionally drowned in questions of how they could have done better to claim the glory of healers to which they aspire. Back then, these scenes were an inspiration to many Americans, most prominently the Philadelphia painter Thomas Eakins, who memorized the medical atmosphere in The Agnew Clinic (1889) and The Gross Clinic (1875).
Much in the vein of how Mad Men appalled at how backward and bigoted people behaved some 50 years ago, The Knick reminds us that Americans behaved even more indifferently, even cruelly, toward others in 1900. The oncoming wave of East European and Irish immigration is referred to by the show’s characters with almost constant fear and derision. The Black physician Dr. Algernon Edwards, played by André Holland, is the hinge upon which we learn how deadly racism could be not just for New York City’s Black population, but also for the city’s White patients who refused to benefit from Dr. Edwards’ talents out of nothing more than bigotry.
Progress against racism, though, is more subjective in measurements of progress and retrenchment. Lives saved, and suffering alleviated, not so much. With all its battles against death in the operating arena, and even its backroom love affairs and personal dramas, The Knick reminds us of the steep price millions before us paid so often, so that we could live longer and better lives with our friends and family, and perhaps live to watch other television shows (The Bear, anyone?) reminding us of how good we have it now, and how valiantly our predecessors struggled in 1900, when they had it very bad indeed.
