There is blood, a lot of blood, gushers that turn hospital whites into nightmarish tie-dye. "The Knick" is an astonishing new medical drama that has the potential to be one of the year's best and most talked-about shows, as well as a breakthrough into TV series excellence for its star, Clive Owen, and its director and executive producer, Steven Soderbergh. It could also open up a path to legitimacy for the HBO-owned Cinemax, so easily dismissed as the porn channel for people who like a dab of story line with their action.
But there is blood in this show, which is set at the fictional Knickerbocker Hospital in New York in the year 1900, long before the surgical techniques and antibiotics we now take for granted. Owen plays Dr. John Thackery, who, with his colleagues, often finds himself elbow deep inside a patient, nudging aside organs to find his target, while an assistant manually pumps out blood into a bucket on the floor. If Thackery weren't schooled in medicine, he'd probably be a world-class butcher.
None of the blood is gratuitous, though, lest you take my warning in the wrong way. It's part of the point of "The Knick," which, like "Mad Men" and "Masters of Sex," is to draw a cultural and social compare-and-contrast between now and the not-too-distant past. The primitiveness of the surgical practices, and our revulsion upon seeing them, are all part of the show's significance and power. If you saw and admired the classic 1995 "Love's Labor Lost" episode of "ER," then you understand how gore and drama can be inexorably tied together.
Thackery is the latest of the cable antiheroes, a man who was probably cold to begin with, but who has become even more frigid in a job where failure and death are de rigueur. Like his mentor, played by Matt Frewer in the premiere on Friday at 10 p.m., he appears to have lost much of his humanity in one of the most humane of professions. To get through the days, he shoots cocaine between his toes in the morning and winds up nodding in a Chinatown opium den at night. I'd liken him to Hugh Laurie's Dr. House, but Thackery is far more brutish and less sympathetic, and we quickly learn that he is a racist, too. Owen, Soderbergh, and show creators Jack Amiel and Michael Begler do nothing to sentimentalize the man, to make us soften toward him. The urban poverty recalls Dickens, but the tone of the show certainly doesn't.
Thackery's racism emerges when the hospital's main benefactor forces him to work alongside a gifted black surgeon, Dr. Algernon Edwards (Andre Holland). Along with the other Knick doctors, Thackery treats Edwards with scorn and refuses to let him practice. He doesn't want his life complicated by pushing integration to a resistant public, including people who actually believe that blackness can rub off on them — literally. "He don't need a shoeshine," someone yells when Edwards approaches an ailing man who comes into the ER. "He needs a doctor."
We keep hoping that Edwards's medical brilliance and gentility will win over colleagues and patients, but, in keeping with the grim realism, they don't, at least not in the first few episodes. This is not that kind of show. To fulfill his passion for surgical work, Edwards tries to sneak in charitable doctoring on the sly, an effort that would only succeed in a network environment. Holland is just right as Edwards, as he struggles to find productive ways to channel his barely contained rage. At the hospital he is a pariah whose office is in the basement; at his boarding house, he is considered a snob. Perhaps Edwards and Thackery will eventually find mutual respect, but if they do it will be hard earned.
The world that Soderbergh and company build around these men gets richer and more interesting with each episode of "The Knick." By episode three, I was hooked. Aside from the peppery Sister Harriet (Cara Seymour), the female characters are less interesting, initially, including Cornelia Robertson (Juliet Rylance), the daughter of the main Knick benefactor. Cornelia is a generic philanthropic socialite until episode four, when her story line begins to develop some complexity and distinction. Plots also thicken around a number of characters as the season progresses: the manager who is gambling with the hospital's money, the junior attendant whose father is embarrassed of his work, the opportunistic ambulance driver, the health inspector who seems to smirk at those who may have typhoid. None of the supporting characters is quite as fully drawn as Thackery and Edwards, but their stories, including themes of sexism, abortion, and the collection of laboratory cadavers, are quite compelling.
The look of the show is transporting, from the daylit operating theater in which an audience of men watches the surgeons work, to the dim, stale tenements in which the doctors treat people dying of various infections. It's a world on the verge of change, with automobiles, dependable electricity, and sterility techniques on their way, but still crude and unhealthy. It's a world in which a doctor like Thackery is doomed to fall apart, unless he can remain numb and refuse to look at the person who is lying still underneath his scalpel.