'The Knick' Is an Unflinching Look at the Early Days of American Medicine

The second season of the show deals with drug addiction, eugenics, and a lot of blood.
October 16, 2015, 7:00pm

Photo by Dan Winter/courtesy of HBO

Warning: Spoilers ahead.

There's a lot of blood in The Knick. Squirting out of cadavers, smeared onto the uniforms of the doctors and nurses, spilling from the lips of its characters. The award-winning show, whose second season on Cinemax premieres tonight, follows a group of doctors and nurses working to combat the high mortality rates of the time with innovative surgeries at the Knickerbocker Hospital during the early 20th century. Writers Jack Amiel and Michael Begler and director Steven Soderbergh don't deny the fact that "medical advances" have always come at the expense of human life. The cures and operations that we now hail as revolutionary were once barely understood concepts—the experiments of troubled doctors who were grappling with their own ailments and addictions.

In the new season, we see Dr. John Thackery (Clive Owen) delving into an intensive study of addiction. Thackery, who at the end of season one suffered an extreme cocaine-induced breakdown and was committed to rehab, cuts into the corpses of people who succumbed to heroin and alcohol addictions, trying to find common links. Spurred by his own compulsive need for a fix, he proposes this line of study to the board of the Knickerbocker, which is comprised of old, white men who scoff at the idea. "Addiction is a problem of lowly, moral degenerates," huffs one boardmember, startled that Thackery would even propose such a thing.

With this new storyline, the writers are tapping into a contemporary issue. Even today, there's stigma around drug addiction, causing familial embarrassment and personal shame. Addiction is often seen as a pipeline to criminal activity, and substance abuse is met with jail time instead of medical treatment, leading to a dangerous cycle of relapse in many people. In tracing the early threads of that stigma, the show could offer some valuable insight into how we address addiction today.

Meanwhile, the Paris-trained Dr. Algernon Edwards, played beautifully by André Holland, receives some news that threatens his livelihood as a doctor. Last season, we saw him painfully navigate a medical world that saw his exclusion and humiliation as commonplace and necessary, only to see him rise up, create various medical procedures—including one in which he repairs an elderly black man's hernia—and an underground clinic to serve black patients who were refused entry into the Knickerbocker.

Photo by Mary Cybulski/courtesy of HBO

Dr. Algernon inhabits a curious space—he's a better doctor than his white colleagues, but represents a group of people who aren't seen as human.

The show depicts the early world of medicine as an extension of racism, religion, fear, corruption, and ignorance. All of these ills merge with scientific thought, bolstered by the powerful white men who endorse them. They bear some of kind of misguided "truth" that allows groups of people to be deemed unworthy of proper medical attention, including African-Americans, women who need abortions (and must secretly get them done through a fierce nun named Sister Harriet), prostitutes, and immigrants, all of which sounds not so different than today. Here, Dr. Algernon inhabits a curious space—he's a better doctor than his white colleagues, but represents a group of people who aren't seen as human.

This is shown in a scene from season two in which Dr. Everett Gallinger, a strapping, attractive man with a racist streak and jealousy toward Algernon's success as a black surgeon, happens upon a group of white medical colleagues as they extol the virtues of eugenics, proposing sterilization as a way to stop "mongrel" races from procreating and diluting the European bloodline. "Many of the great minds support this new line of study, including Carnegie. I will be teaching a course on it next fall," one of them boasts. Gallinger leans in, intrigued.

The Knick deals with race in stirring, uncomfortable ways. In one of the best episodes of last season, a race riot erupts after a white man harasses a black woman and is stabbed by her black male lover. In sweeping, extended tracking shots and dynamic wide compositions, Soderbergh illustrates the making of a mob, as white residents tear through the town beating, punching, and bludgeoning any black person they see. Dr. Algernon becomes a target of their hatred because he works in the hospital where the white man dies from his stab wounds. Somehow, he's blamed. To save him from the mob, the sympathetic Nurse Lucy Elkins (Eve Hewson) transports him to the local black hospital underneath a rolling hospital bed with a thin white sheet on top. Soderbergh shoots the scene from Algernon's perspective underneath the rolling bed and sheet, and we see the sweat collect on his forehead.

But this is not the only time that Algernon flirts with death in the series. His love affair with Cornelia Robertson, the daughter of the hospital's founder, puts him in an impossible situation. The forbidden nature of their interracial union only make it more satisfying to watch. The show gets the sexual chemistry between characters right, and the result is beautiful televised eroticism. Last season, the relationship between Thackery and Elkins flowered into a scene where Elkins sits on her bed the day after their lovemaking and recounts the moments we didn't see previously. She smiles and giggles with each image, as soft natural light falls on her face. Soderbergh's direction here and throughout the series gives acute such insight into the characters and the locations they inhabit. Characters are often framed in wide shots, amongst elaborate period sets that situate them in the murky New York landscape, while low, high, and skewed camera angles give a sense of a world that's out of whack.

Perhaps what makes the show work so well is that it's not just a period drama, or a medical drama. It's a show about people who come into this hospital with their own complex cultural worlds during a time when those worlds—of addiction, blackness, interracial relationships, and female sexuality—weren't accepted. Thackery, while gifted, is an addict, and he may be forever. The show is not concerned with an easy or neat way to cure his addiction. Nor is it concerned with making Algernon's existence as a black doctor any rosier than it would've been during that time. Elkins, who suffers the end of her affair with Thackery this season, attempts to negotiate her Christian upbringing with the "sins" she committed, only to be chastised and cast out due to her confession. Later, we see her reading a book about gynecology, a field populated by men during that time. The ways these characters interact with the medicine and procedures they perform are all influenced by these complex backstories.

The doctors' forward-thinking approaches to the limited, often accepted medical practices of their times mirrors how certain common medical advances of today may be disproven as harmful in years to come, such as those related to cancer. The Knick shows how far we have come in medicine, and in society, and how far we still have to go. Sometimes it requires a little blood.

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The second season of The Knick premieres tonight at 10 PM on Cinemax.