From its opening shot, a decidedly 21st-century tension drives The Knick: the murky interstice between recorded and unrecorded history. That one of New York’s most prestigious surgeons, John Thackery (Clive Owen), would start his day feet-up in a Chinatown opium den/brothel before heading into work is the first of director Steven Soderbergh’s many blandishments against stepping into his sprawling vision of Manhattan circa 1900 with any preconceptions whatsoever. Soderbergh’s passion is for the stuff that fell through the cracks, details too lurid, contradictory, or, in many cases, un-Christian to survive in history books. With The Knick, his aim seems to be a recreation of the accompanying environment in total, with as little in-retrospect judgment on the characters as the medium allows. By attempting this level of filth-smocked termite-art verisimilitude while also doling out the customary hour’s worth of primetime melodrama, the jump-off is fierce, and nerve-wracking for its high-wire ambition.
But it’s also nerve-wracking because the surgery—to Soderbergh’s credit—is painful to watch. The Knickerbocker Memorial Hospital’s top surgeon, J.M. Christensen (Matt Frewer), commits suicide following a botched c-section that leaves both mother and child dead—the 12th variation on the same doomed procedure. Entering the surgical theater in The Knick’s first five minutes, Soderbergh doesn’t skimp on gruesome details, but the scene feels anything but salacious. The corporeality of then-modern medicine is made unmistakably clear, with Christensen’s team fighting against time while the mother’s seemingly endless rivers of blood collect messily in thick glass jars. As Thackery ascends to Christensen’s position, he delivers a soliloquy for the dead doctor: “Our patients’ hearts will stop beating. But we humans can get in a few good licks in battle before we surrender. I will not stop pushing forward into a hopeful future.”
If the speech rings oddly hollow (given the triple tragedy that’s just taken place), it’s probably safe to assume Soderbergh—alongside the show’s writer-creators, Jon Amiel and Michael Begler—wants it like that. Owen plays Thackery as a figurehead, self-righteously linking the development of medicine and society in a way that can’t help but suggest manifest destiny. But if pompous in his elocution, Thackery is right. And if his motivations are less pure than the eulogy suggests, the rest of “Method and Madness” sees him pressing forward regardless where Christensen no longer could. Owen gives the liquid-cocaine-addicted Thackery’s eyes more hangdog desperation than fits the words coming out of his mouth, and this disparity between outspoken opinions and privately held feelings gives Soderbergh’s entire cast a measure of mystery. If Thackery’s eulogy is his “formal” introduction as a thinker and doctor, the opium den was his actual introduction to the audience.
Thackery’s promotion means the hospital—which, we learn, is $30,000 in debt—needs a new deputy chief of surgery, and his recommendation of Dr. Everett Gallinger (Eric Johnson) is overruled by chief trustee Cornelia Robertson (Juliet Rylance) in favor of Dr. Algernon Edwards (Andre Holland), trained in Paris. The daughter of a shipping magnate, Robertson represents the hospital’s guiding philanthropic vision, but more to the point, the money. Thackery handles his young and fetching boss not just with wariness, but all-but-announced misogyny, assuming he knows what’s best for the Knick at any given time - a problem only made worse when Edwards arrives, and the staff is flabbergasted to discover that the hospital’s new number-two surgeon is black. Dramatically, this is the episode’s crux: The delicate microcosm established in the first half is given a whole new context by the arrival of Edwards, and Thackery demonstrates a remarkably racist streak, telling the new hire that “You can only run away and join the circus if the circus wants you, and I don’t want you in my circus.”
Truth be told, his objections are more pragmatic than ideological (he doesn’t think the already-broke Knickerbocker will benefit from being New York’s first integrated hospital), but Edwards’s reception is chilly at best from all corners, except Robertson’s. The prejudiced callousness of the other doctors—besuited, well-to-do white men, all—folds another inequity onto The Knick’s vision of turn-of-the-century life’s bottomless unfairness, but these structural commentaries are also where the series risks running into trouble. When the script introduces Speight (David Fierro), an unctuous health inspector who goes door to door in search of diseased immigrants, he finds a Polish woman with tuberculosis and sends her to the Knick, putting her building under quarantine. As the crestfallen landlord considers his diminishing options, Speight glibly tells him to “Blame Lister’s microscope and Riis’s camera; the New York City Health Department is just doing its job!” The dialogue’s obviousness makes enough sense here, but it’s hard not to hope that’s a mere tic of the inevitably squeezed introductory episode, and not a strain that’ll dominate future installments.
But when the woman’s tiny daughter translates her dire prognosis back to her mother beneath Robertson’s ever-so-slightly presumptuous patrician gaze, Soderbergh is masterful. Same goes for when the wide-eyed, sheepish Nurse Elkins (Eve Hewson) is dispatched to Thackery’s apartment to summon him in a crisis, and finds the man sobbing in sweat-wracked withdrawal, only to end up injecting cocaine—into his urethra. Thackery strolls into the surgical theater exactly one shot later, fit as a fiddle to save a patient’s life, and it’s these moments—interlacing class tensions, historical detail, and spry glimpses of the characters’ weak spots—that make “Method and Madness” a rich and satisfying opener, even despite Amiel and Begler’s heavy-handedness. Soderbergh’s camera reveals nothing unless one of the characters discovers it themselves, making the hospital’s inner contortions feel less like a dusty starter kit of historical cruelties, and more like the result of very different personalities commingling in the same shared space. Edwards—who, after the being chided by Thackery during his first operation, chooses to stay at the Knick—pretty much sums it up: “I’m not leaving this circus until I learn everything you have to teach.”
For more The Knick recaps, click here.