The Knick fits well within Steven Soderbergh process-driven filmmaking. It’s a drama about the birth of modern medicine at the dawn of the 20th century, a time when New York City might as well have been the Old West for all the filth and scientific ignorance that ambitious doctors must overcome. A recurring element of the show is the arduous transition of the medical profession from superstition and primitive knowledge to hard science. At one point, the series protagonist, star surgeon John Thackery (Clive Owen), must contend with a snake-oil salesman who wants to capitalize on the doctor’s legitimacy to sell a product and brings up the recent success of Dr. Pepper’s miracle concoction “being enjoyed as much as a beverage as a medicine.” Forced to outpace such pseudoscience, surgeons must also become inventors, working on the front lines of rapid (and unregulated) technical and technological innovation.
The show is at its best when illustrating the gray area between old venality and new idealism and reason. Buried beneath the constant push for new procedures and inventions is the chase for fame and patents, which prompts an investor gold rush and accompanying boom in medical training for those looking to make it rich. This creates such demand for cadavers that bidding wars break out across the city for stiffs, with publicly funded universities regularly leaving privately owned hospitals in the lurch. And forget ambulance chasers; here the ambulance drivers themselves are greedy opportunists, effectively selling patients to hospitals that are in need of live test subjects as much as dead ones.
By foregrounding the relentless drive toward technical improvement, the show pulls attention away from the usual hallmarks of prestige TV—arc development and character showcase—and instead puts the focus primarily on Soderbergh’s direction, cinematography, and editing. Soderbergh is paradoxically one of the most indulgent and most focused of directors, and this capacity for inserting idiosyncrasy into shots that always serve a propulsive motion can be best seen in how the series reflects Thackery’s drug abuse. Soderbergh flips the aesthetic language of drug abuse in filming the doctor’s cocaine addiction, using jittery, fragmented shot patterns when the man is withdrawing, but snapping into intense focus and detailed long takes when the surgeon injects. As such, the moments that capture Thackery’s relief and agitation resonate out to the general tenor around the hospital, as in the way that the wards themselves take on a clammy pallor when the doctor does his rounds in between injections. Likewise, the surgeon’s tendency to operate while high makes for freewheeling scenes that buzz not only with the effects of the drug, but the tension of risking new procedures and the pain and euphoria when the respectively fail or succeed.
But there are more muted aesthetic flourishes as well. Soderbergh loves to frame medium close-ups in the corner of a frame and use the ample background space for contrapuntal composition, and numerous shots use this method to contrast stoic, dignified characters with the vulgarity and poverty that surrounds them. Elsewhere, the director uses long shots to demonstrate subtleties in body language that are normally etched in close-ups, like the way that a doctor’s back stiffens when a rival is spotted, or the nervous gait that gives away the cowardice underneath hospital manager Herman Barrow’s (Jeremy Bobb) officiousness. Even something as innocuous as the way that lamps burn with vivid incandescence in the background has meaning beyond mere prettiness. As flames flicker amid trapped gas and electric lights crackle with possibly ungrounded surges, the lights in every room and hallway say as much about the danger of rushed technology as gory close-ups of faulty equipment in surgery scenes.
The foregrounding of visual tour-de-forces even in functional bridging scenes flips the usual dynamic of television, reducing character arcs from the meat of the narrative to mostly distracting filler. Owen is thrilling when buzzing about an operating theater, boasting about a new technique he’s trying out for the first time in front of a crowd of assembled surgeons, but his private grandstanding about his ambitions is exposed for the padding that it is, along with his amorousness toward sex workers and nurses. Similarly, scenes of Barrow’s antic efforts to relieve both the hospital’s and his own debts wear out their welcome, while a recurring plotline of an abortion-performing nun is so morally on the nose that it undermines Soderbergh’s fittingly clinical tone. The only personal arc that consistently works is that of Algernon Edwards (Andre Holland), the black doctor who must continually face prejudice from patients and peers alike. His struggle for legitimization adds a distinct social contrast to Thackery’s vain quest for glory, calling attention to the glaring flaw of the scientific community struggling to fight external ignorance while unable to address its own. The first season ends on a generally down note, but it’s in the final glimpses of Thackery and Edwards reaching their lowest ebb that the series attains its most affecting drama to date, as well as the greatest indication that the writing might soon be worthy of the direction that enlivens it.
HBO’s Blu-ray looks exemplary, with exceptional textures and stable color fluctuations between the sterile grays and whites of hospital wards, the deep black levels of Edwards’s underlit basement clinic, and the rich amber-red glow of the opium den that Thackery frequents. On rare occasion, the image reveals noise artifacts, but only when Steven Soderbergh pushes his Red camera to its limits to test the boundaries of the constantly evolving technology. The 5.1 DTS-HD Master Audio track, however, lacks even these minor issues. The show’s soundscape is as enveloping as its visual direction, and everything from the sickening sound of siphoned blood pouring into glass jars to the occasional pulses of Cliff Martinez’s eerie synthesizer adds to the horror and dread that hangs over the series.
Three of the episodes—"Method and Madness," "Get the Rope," and "Crutchfield”—come with commentaries tracks featuring showrunners Jack Amiel and Michael Begler, as well as an assortment of supporting actors. Conspicuously absent are Clive Owen and Andre Holland, and especially Soderbergh, whose goofy but technical commentary style would have been welcome amid the general chumminess. The discs also come with "post-ops," two-minute breakdowns aired on Cinemax after each episode that compress soundbite interviews and half-second behind-the-scenes glimpses into baffling packages that offer no information of any kind.
Despite several narrative hiccups, The Knick is one of the most exciting new shows on television, and HBO’s Blu-ray captures its exceptional visual and audio design with near-perfection.