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    Gore and character flaws? We still love TV doctors.

    Clive Owen as Dr. John Thackery in Cinemax’s “The Knick.”
    Mary Cybulski
    Clive Owen as Dr. John Thackery in Cinemax’s “The Knick.”

    Unless you’re a flaming hypochondriac, or a friend of Münchausen, you probably don’t want to spend much time in hospitals or with your doctor. Those experiences are usually the result of something painful, and they often lead to something painful, too — needles and scalpels and those events that have been given the cold euphemism “procedures.”

    But of course that’s exactly why the world of medicine is perfect for TV. Our inevitable dealings with injury and illness usually lead to some of our most dramatic moments, the ones with life-or-death stakes. They’re the gift that keeps on giving for TV writers, who are forever on the make for juicy, tear-filled story lines. From the days of “Dr. Kildare” to the riveting new Cinemax series “The Knick,” medical series have been a TV staple, alongside lawyer and cop shows. They offer viewers both frightening journeys into the chaos and sting of maladies, and then a set of doctors to guide us through them — tension and then release.

    The medical genre has changed a lot — and, in some ways, not changed at all — since the first prime-time medical series, “City Hospital,” in 1951. “The Knick,” which stars Clive Owen as the gruff Dr. John Thackery, is a perfect measure for how MDTV has evolved and yet remained exactly the same. We take our medical dramas with heaps of dark realism these days, of course; that’s true for much of contemporary entertainment. But, by the time the credits roll on these shows, we also still require a good old-fashioned rescue fantasy. We like to keep things real, even scarily so, but we like to keep them comforting, too.


    The realism on MDTV comes in the form of blood and guts in high definition, shown close-up during excruciatingly long takes. Directed with great immediacy by Steven Soderbergh, “The Knick” is filled with such cringingly vivid scenes involving blood and tissue; you sure didn’t see those when Ben Casey was wagging his eyebrows at patients back in the early 1960s in black and white. The show is set in Manhattan’s fictional Knickerbocker Hospital in 1900, a time when the medical world was — as we now say about every industry altered by the Internet — between models. The hospital building has newly installed electricity, but we nonetheless see surgical assistants hand-pumping blood out of patients and into a bucket. The surgery scenes are stunningly crude, with Thackery occasionally sticking an arm almost fully into a body to locate one organ or another.

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    “ER” was among the first of the medical dramas to really show us a variety of viscera, to challenge our sensibilities with the unblocked and unprettified visual reality, to fasten onto medical accuracy. Who can forget the awful sight of Dr. Mark Greene dealing with a pregnancy gone wrong in the Emmy-winning 1995 “ER” episode called “Love’s Labor Lost”? “The Knick” takes that bracing imagery even further, in a way, because what we see is not just bloody; it’s also unsanitary and primitive, far from the slick state-of-the-art surgery of “ER.” In episode three of the show, which airs on Friday nights, Thackery’s ex-girlfriend shows up at his office with a mask on. She removes it to reveal the stomach-turning sight of a nose eaten away by syphilis, a problem later treated with a gruesomely inelegant grafting procedure involving her arm.

    Our taste for realism has also ushered in the popular trend of TV antiheroes, from Tony Soprano on. We prefer the fierce growling of Dr. Gregory House to the gentle purring of Dr. Marcus Welby at this point, because we want to acknowledge that it’s human nature to be ambivalent, to fail sometimes, to not be heroic every moment of every day. We want these doctors to be believable, and so they must be flawed. Owen’s Thackery is a mess of flaws; he’s a testy, arrogant, cocaine- and opium-addicted surgeon with racist tendencies — arguably more of an antihero than the sadistic House. He’s certainly less likable than the plastic surgeons of “Nip/Tuck,” whose emotional spirals were irritating when they weren’t silly, and the doctors of “Grey’s Anatomy,” whose narcissism can be unbearable. He has none of the wounded conscience of Jackie Peyton on “Nurse Jackie,” who is also an addict.

    Paul Drinkwater/NBC/File 1996
    Anthony Edwards in “E.R,” which was among the first of the medical dramas to fasten onto medical accuracy and show a variety of viscera.

    But here’s the thing: No matter how blood-stained our medical dramas may get, no matter how damaged their heroes and heroines may be, the shows remain cultural fantasies of a sort. That really hasn’t changed over the decades. The doctors and nurses may be trouble, personally, but they are nevertheless extremely talented healers. Jackie is as compassionate and skilled with her patients as she is self-destructive. Dr. House was as brilliant a diagnostician as he was dislikable, and so is Dr. Thackery. While Thackery does lose patients on “The Knick,” we know it’s not because of his skills; it’s because of the times, when far fewer patients left hospitals alive. He is a great doctor, a man who, like House, is obsessed with his profession, who spends his off hours dissecting cadavers to find new techniques.

    It’s the last frontier, in a way, when it comes to medical dramas and realism. We lace up our johnnies, sign our consent forms, and hand our bodies over to medical personnel. We simply aren’t ready or willing to follow the trials of doctors and nurses who don’t know what they’re doing once we’re under their control. We don’t want to watch a Paddy Chayefsky-style nightmare week in and week out. The only series that delved into that was a British series called “Bodies,” which detailed an OB-GYN’s botched surgeries; it was deeply disturbing, far exceeding our American tolerance for imperfect doctors and hospital melodrama.


    We aren’t ready for incompetence; we still desire the subliminal comfort of medical virtuosity. We accept the difficult personalities of doctors such as Thackery, even thinking that those failings probably contribute somehow to their medical genius in some way. They may not be able to heal themselves, these tortured health care professionals, but they must be able to heal us.

    Matthew Gilbert can be reached at Follow him on Twitter @MatthewGilbert.