A Reflection of Modern Times: An Insider’s Take on The Knick

We’re progressing so fast that the technology of a decade ago seems laughably quaint. We can’t imagine living in the dark ages of 15 years back, and the immediate future is an expanse of exponentially unfolding possibilities so broad that it feels like anything can happen — a great leap in evolution or maybe the end of everything. The steady build of excitement and dread emblematic of our modern age is likely how our forebears felt at the turn of the 20th century, which is why now is the perfect time to revisit 1900, a similar age of ingenuity overdrive.

The Cinemax series The Knick, directed by Steven Soderbergh, explores the achievements, exploits and improprieties in and around a fictionalized version of New York City’s Knickerbocker Hospital at the dawn of the surgical revolution. Dr. John Thackery (Clive Owen) has just taken over as chief surgeon after the suicide of his mentor, Dr. J.M. Christiansen (Matt Frewer), and faces the jarring reality that Dr. Algernon Edwards (André Holland) — a black man with an M.D. from Harvard and European training — will be the new assistant chief surgeon. The show takes the opportunity to investigate this period of great upheaval, when innovation was mushrooming and a move toward racial and gender equality was quietly and slowly beginning.

“We are living through a time of great technological change,” notes Steven Katz, supervising producer and a writer for The Knick, during our recent chat. “Like our ancestors — they didn’t know where X-rays and things like that were going to lead, and we don’t really know where things like the Internet and social media and all these other cutting-edge technologies are going to take us.”

The turn of the century was the heyday of the Wright Brothers and Einstein and saw the invention of the first motion-picture camera. Germ theory had been formally proven by the likes of Louis Pasteur just a few decades earlier, and along with Joseph Lister’s pioneering of antiseptic surgery, it was possible for “an infinite variety of surgeries to take place that were not possible before,” says Katz. “Most people probably thought of a visit to the hospital as a death sentence, but this actually made it possible to do some really radical things. As Thackery says in the pilot, more discoveries were made [during] the turn of the century than in the previous 500 years.”

The Knick, created by Jack Amiel and Michael Begler, begins with a failed experimental placenta previa surgery presented in graphic detail. The subsequent pursuit of perfecting that technique reveals a dark side of the medical progress of the day. Surgeons depended on human subjects with terminal conditions, most of whom died as they provided data for the next attempt. “It does seem like you probably could expect to be treated a little bit like a lab rat when you went into a hospital at the time,” confirms Katz, yet the cold truth was that patients with no hope of survival provided essential learning opportunities.

With Soderbergh’s handheld shots and dimly lit sets instilling a prevailing sense of apprehension, the show takes on racial issues as well. Thackery at first dismisses the idea of accepting Edwards as an equal. He is infuriated upon discovering that Edwards has converted the hospital’s basement into a clinic and operating room for African-Americans who are institutionally denied treatment at the Knick, yet he starts to come around when he sees the groundbreaking work that Edwards is doing — like the development of an electric suction device and a silver-wire suture technique for a new hernia procedure.

“I think [Thackery is] the kind of person who admires talent and brains first and foremost,” Katz suggests. He explains that in the original drafts of the episodes he wrote, Thackery was more of an abjectly racist character, yet “one of the interesting things during the course of the production has been watching Thackery develop, especially under Clive’s interpretation of the character. What you see now is a far more complicated character with definitely racist attitudes — but are they especially virulent, or are they simply a reflection of the times? It’s hard to tell. Clive is a very smart actor and he’s made the character seem so intelligent, and it seems like this is something the character is actually wrestling with as we watch him develop.”

Katz is quick to note the parallels to the current day, pointing out that “the country is still going through it. Turn on the TV. It’s shocking that all these years after the Civil War, we’re still wrestling with these racial issues. The thing that really strikes me about this stuff is that it has so many echoes now — to use [historian and author] Barbara Tuchman’s phrase — it’s like a ‘distant mirror.’ It’s a little bit spooky. One of the things [that happened] at the end of the Gilded Age was everybody felt pretty good about themselves, but there was a lurking fear that something bad was going to happen. And something bad did happen — World War I. I think you get that sense now in the world.”

Having pursued several historical New York City projects through the years, Katz is thrilled to be working on The Knick. “It’s great to see an early 20th-century New York project actually exist,” he enthuses. “I’ve worked on a lot that didn’t come to fruition; it’s not a cheap period to evoke [on screen]. I love this period; I love the city of New York. I’ve lived here 30 years. It’s also an incredible pleasure to be working with Steven Soderbergh and sitting in a room and having script discussions with him, and watching him shoot. I used to play this game whenever we were shooting, to try to predict how he would shoot a scene, and I never got it right. It shows you how unexpected [his work can be] and what an extraordinary visual imagination he has.”

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