On the Cutting Edge of Medical Science

I’ve been watching a fair bit of The Pitt lately. The new season has been running, week to week, which prompted my wife and I to go back and watch the first season again (she’d only watched bits and pieces of it the first time around), but that didn’t totally sate our fix. We needed something more, some other drama that could scratch that itch we were looking for. We were in the mood for a medical drama that actually took the subject seriously (and wasn’t just a means for telling soap opera stories, like Grey’s Anatomy or other shows of that ilk). We wanted something good.

Looking in my pile of unwatched DVDs (which is far bigger than I care to admit) I spotted my unopened copies of the two seasons of The Knick, the 2014 period medical drama aired by Cinemax and directed by Steven Soderbergh. Readers of this site will know that I am a fan of Soderbergh, enjoying his directorial style and interesting perspective on filming. I’d heard good things about The Knick when it aired, but as I lacked access to Cinemax programming at the time, all I could do was buy the show when it came to home video, and then after it was cancelled I sat on it, looking for the right time to watch. And I found it.

The Knick follows the doctors of the Kickerbocker Hospital in New York City, circa 1900 AD. The hospital is in one of the lower income areas of the city, but is largely supported in its mission by the powerful and affluent Robertson family, for which patriarch of the family, Captain August Robertson (Grainger Hines), is a vote on the hospital board, which he usually passes to his daughter, Cornelia Robertson (Juliet Rylance), so she can help oversee the place. The hospital has a very skilled and brilliant doctor, John W. "Thack" Thackery (Clive Owen), as its chief of surgery, along with his two well-trained disciples, Dr. Bertram "Bertie" Chickering (Michael Angarano) and Dr. Everett Gallinger (Eric Johnson).

Dissent among the ranks happens when a position comes available at the Knick and, instead of promoting Thack’s first choice, Callinger, the Robertsons step in and suggest their own candidate, Dr. Algernon C. Edwards (André Holland). Edwards is a brilliant surgeon who studied, and worked, under great minds in France, and he would be quite the get for the hospital. There’s only one issue: Edwards is black, and Thack wants nothing to do with a Black man in his hospital. Along with this there are stories of tightening belts, riots over race, tales of abortion, and failed medical experiments. A lot happens at the Knick, with medical science (and strong emotions) riding on the cutting edge.

The Knick has two very strong ingredients going for it. The first is its writing, with the series doing a very solid job of getting you into the lives of these doctors (and the other administrators and staff who work around the hospital) as they have to try and save lives when, at this time in the world, they aren’t always entirely sure what the right thing is to do to save a life. They’re grasping at science they can’t always understand, with a lot of pseudo-science, snack oil, and religious belief getting mixed into it. Medical science had a long way to go, as this show makes clear, and there’s drama to be mined from every mistake the doctors made.

Of course, as with just about any drama (especially those that, unlike The Pitt, don’t occur in real time) there’s a lot of other stories that play out alongside the medical drama. There’s secret loves and drug addiction (although, actually, both of those also come up in The Pitt), gambling debts, illegal procedures, and more. It’s not melodrama, not a soap opera, but it does get us more into the characters, who they are when they’re not cutting people open on operating tables while they grasp at what they can do to try and save a life.

Helping to get us into the characters and their lives is Soderbergh’s filming style. The director (who also acted as cinematographer and editor on the series) went for a cinema vérité style (as he’s often wont to do), getting long takes with the characters as the camera moves around rooms, between and behind objects, and generally makes a living character of itself in the process. It’s not showy, but it does get you into the moment, making you feel more like a part of the proceedings. Soderbergh’s style adds to the vibe of the show, and it makes the era of The Knick come alive even more.

The cast helps as well. The main characters are all deep into their roles, with the standouts, of course, being Clive Owen and André Holland. Owen is loud and bombastic as the headstrong, ego-inflated doctor who feels like he can bend medical science to his will. It’s not a showy performance, and you never think of him as Clive Owen playing Thack. He is the role. Holland is similar as Edwards, getting the subtle nuances of his character down. He’s more controlled than Thack… most of the time, such that when he finally breaks it feels like his own boiling rage matching Thack. These two are the strong leads that guide the show and make it watchable.

With that said, it’s also easy to understand how the ratings of this show struggled, despite great actors and handsome production values all supported by Soderbergh’s direction. For starters, the kinds of programming featured on Cinemax didn’t really align with The Knick. By the channel’s own admission they wanted more action-oriented fare, that’s what their viewers expected, and this show absolutely wasn’t that. The channel was proud of this show (because, damn, it is good) but it didn’t fit their schedule.

But likely low ratings didn’t help, and the biggest contributor was the subject matter. This show is very upfront about the medical science, with the doctors cutting into bodies and all of it looking quite real. It’s gory and disgusting, making even a practiced horror hound like myself turn away at times. The film is unflinching and I have no doubt plenty of the people that tuned in for a stately period medical drama immediately turned the show off after the first fifteen minutes of the first episode. This absolutely wasn’t what they signed up for.

Which is a pity because this show really is solid. From its period setting to its strong acting and the amazing way Soderbergh brings it all together, this should have been a smash hit. But it didn’t find its place, or its audience, in its first season, and it struggled to keep the viewers it had for its second. This first season is a fantastic opening salvo for what could have been, easily, a six season run. Sadly we only have one more to get through after this… which we will soon.