The Knick is not an easy show. 

CinemaxÕs hospital drama, centred on a group of brilliant surgeons working in New YorkÕs Knickerbocker Hospital in 1900, is about to start its second season. 

In preparation, the showÕs actors are talking to the press, but when they speak words like grim, bleak, and exhausting crop up time and time again. Everyone is in agreement that the writers, Jack Amiel and Michael Begler, and the director, the legendary Steven Soderbergh, revel in rendering difficult situations and introducing intractable problems. 

ÒIt wasnÕt easy,Ó says British actor Clive Owen who plays the troubled genius surgeon Dr. John Thackery, based on the real historical surgeon William Stewart Halsted, ÒIt wasnÕt straightforward and I loved the challenge of it.Ó

Loving the challenge could describe the experience of watching the show as much as performing in it. The Knick dons so many television tropes that it can be hard, at first watch, to take seriously. It is a hospital drama, and a period piece, a troubled genius story, and another example of what writer Brett Martin calls the genre of difficult men. The issues it deals with are so fundamental as to seem almost obvious: racism, sexism, science versus religion, vulnerability and the savage reality of the American dream. 

And then thereÕs the way the show deals with its themes. Before you get a feeling for it, the Knick can seem profoundly unsubtle. The dialogue is given in quickly spoken exposition, the acting is often framed in close-ups, all bulging bloodshot eyes and sweating brows, the surgeries are full of oozing blood and theatrical gore. 

Yet, the show is like a whirlpool. You find in time that it is pulling you in more than it is putting you off, that it has, despite an overcrowded surface, discomfiting depths. With all its bombast The Knick is hiding something profound and universal in plain sight, that these characters are all getting sustenance from a wellspring of of existential terror. That they are just like you and me. 

It is a modern television convention that a showÕs second season is a time for radical change: new setting, new characters, a massive plot twist. At The Knick, the setting has shifted. The hospital is being moved uptown, and if physically this means only a handful of city blocks, in reality it is like moving to a different country: from the impoverished, polyglot immigrant part of the American experience, to the richer, whiter, more establishment part. 

The characters have also changed, almost always against their will and in nearly every instance challenged from both sides: clawing their way towards making a future while being forced to deal with their pasts in the form of unexpected visitors or secrets which threaten to come to light.

The style of the show has changed too. The score is still all modern electronic music but it is used much less frequently; silences are allowed to hang and swell across scenes. 

SoderberghÕs camera work, always dynamic, now seems literally unhinged. The camera in season two jogs and swoops, peeking around corners and following characters from behind like itÕs chasing them trying to keep up. The result is a pacing that somehow seems both slower and more frantic; while the conflicts pile up and crises come in torrents, the show takes its time. Perhaps thatÕs what Andre Holland who plays ThackeryÕs foil Dr. Algernon Edwards is talking about when he says: ÒSo much of this season, rather than being broader is just narrower and deeper.Ó

One of the most singular aspects of The Knick is the surgery itself. 

Graphic surgery scenes on television are nothing new. They were pioneered by Nip/Tuck, a show about plastic surgeons which aired in the early 2000Õs. Still, the surgeries on The Knick are in a different realm entirely. Like in Nip/Tuck, medical scenes are designed to titillate, they are well lit, artfully filmed, and scored in a way that makes them, for lack of a better word, alluring. 

Fans of the surgery scenes have a lot to look forward to in season two. ÒLast year the surgeries were really intense but this year makes last year look like a romantic comedy,Ó says Holland, barely concealing his glee, ÒWhen you get to episode 10, believe me, itÕs going to blow your mind.Ó

The surgeries in The Knick are bacchanals of gore. Blood gushes and sprays, puss oozes, bones snap. 

Far from simple shock value, in many ways the surgeries are the point of the show. The Knick at its core tells the story of medical progress, and that progress is played out on the operating table. Also, the proceduresÕ realism elevates them. You feel you know what surgery was like in 1900; the surgeries are thrilling but they are also fascinating.

Ensuring the surgeriesÕ historical accuracy took an enormous amount of work. Especially since Soderbergh insisted on doing them Òfor realÓ; when the doctors on the show are operating they are really using real historic techniques and equipment how they would have been usedÑthe bodies are fake. 

ÒTheyÕre tricky because itÕs like performing a stunt,Ó says Michael Angarano who plays Bertie, ÒIn the sense that so many things have to go right for the surgery scenes to be good.Ó

ÒYouÕre saying these words that IÕve never heard before and you add to that that youÕre actually suturingÓ, says Holland, ÒYouÕre not fake suturing. YouÕre actually doing it with the real instruments, the real cat gutÑthe wire which is like a live organism, itÕs bouncing around like crazyÑand they put the blood on top of that so everything is all slippery and thereÕs a hundred background actors and youÕre addressing them. Your back hurts and your feet hurt from being hunched over all day.Ó

To get everything right the actors spent weeks in research and training, mostly at the Burns Archive in New YorkÑa vast collection of early medical photography. The archiveÕs own Dr. Stanley Burns took Owen and Holland through a two-week version of early 1900Õs medical school and was on set for the shooting of every surgery scene to guide them and answer questions.

Owen says he still hears the doctorÕs mantra in his head: ÒMore clamps! More blood!Ó

The Knick takes place more than a century ago but it is every inch a modern show. Its period setting is used as a tool, a way to force us into a reckoning with what is happening now. It asks, have we come as far as we think we have?

Nowhere is this clearer than in the showÕs dealings with race. 

The story of Dr. Algernon Edwards, played with a taught smoulder by HollandÑand based at least partially on the historical surgeon Daniel Hale WilliamsÑis one that manages to be both clichŽd and woefully under-told: a person of colour and lavish talent finds their potential squashed at every turn because of their race. 

In the current American cultural climate, hot-button issues, most of all race, seem to inspire treatment with kid gloves. Racism tends to be conveyed in metaphor, in a cameraÕs angle or a shared glance, or it is fodder for think pieces, intellectualised out of the realm of lived-in experiences. Thanks in part to The KnickÕs historical setting, the daily experience of being black in America is not presented as a series of perceived slights, but of shouted slurs. In The KnickÕs world [CL1][CL2][CL3][CL4]racism is a billy club, wielded by a white man, breaking a black manÕs skull. Which, judging from the news coming out of America, is closer to the reality of racism today than more common, subtler depictions.

ThatÕs certainly how Holland sees it: ÒI know itÕs a period piece but I think it speaks to America today É I grew up in Alabama in a very small town. Racism and bigotry is something that IÕve seen firsthand. IÕve seen the effects of it firsthand in my parentsÕ generation and also in my own life.Ó 

To prove his point Holland references a powerful and much-lauded episode from last season chillingly titled Get the Rope.

ÒIn so many aspects of the show, race relations just being one of them, there are direct parallels to whatÕs going on today. Last season we had a man on the street having a misunderstanding with a police officer which turned into a riot on the streets of New York, cut to 2015 six months ago.Ó 

That the score is entirely composed of electronic music and the camera work is so modern seems intended to disorient you, wait, when is this happening? And the obvious and disquieting answer is left hanging: it was happening then and it is happening now.

There is something admirable in the way the show dodges neat solutions and clichŽs. Early in the first season ThackeryÕs oncoming epiphany and transformation into a liberal, colour-blind hero seemed groan-inducingly inevitable.  In the end it took more than six hours of television before Thackery even condescended to perform a surgery with Edwards. Even into season two there is no love lost between them, and ThackeryÕs views on race donÕt seem to have evolved very much.

ÒIn the first season race was one of the most provocative elements and some people were actually shocked,Ó remembers Owen, ÒI had people saying to me Ôhow could you say those lines?Õ but it would have been a complete disservice if I was the one liberal guy that said hey youÕre talented so come in. Life wasnÕt like that. It wouldnÕt be authentic.Ó 

All of which makes it incredibly disappointing to see how the show treats Asian Americans. The only Asian characters on the show are pimps, prostitutes, and opium addicts. Asian women almost always appear naked, even at the hospital. in one particularly odious scene Thackery uses his favourite prostitutes as guinea pigs to test a new vaginal insertion device he is developing. They lounge, naked and dull eyed in the lab, smiling while the doctors discuss, in a language the women show no sign of understanding, literally what to put inside them. It comes as no surprise the showÕs one male Chinese character is revealed to be a martial expert and assassin.

The Knick takes place in a time of radical transformation in America: when new waves of immigrants were landing every day, when tradition was coming into conflict with progress, faith with science. 

The KnickÕs handling of faith is singular in that it often explores faith from a womanÕs perspective. There is Sister Harriet, a nun and midwife played by played by Cara Seymour who is revealed to be a purveyor of illegal abortions. Then there is Nurse Lucy Elkins, arguably the shows major female protagonist played by Eve Hewson.

Her relationship to religion takes centre stage in the second season when she has a crisis of faith and is reunited with her extremely religious father. Her loss of faith is brought on by her growing understanding of science but also by more timeless reasons: heart break, disappointment, and frustration with her place in life. It is inextricably tied up with her experience as a woman in a quickly changing but still rabidly sexist world. 

Hewson says that when she read the script she thought its discussion of faith was its most interesting element, especially that it focused on ÒwomenÕs relationship with god.Ó

In speaking to Hewson you realise, thanks to its feminism, how much of a rarity the show really is. 

Hewson took the role as Nurse Elkins at a vital point in her career. As a daughter of pop super star Bono, Hewson is no stranger to celebrity but her appearance in the Knick marked the first time the spotlight fell so brightly upon her. 

Hewson, who is slated to appear in this yearÕs Steven Spielberg movie Bridge of Spies playing Tom HanksÕ daughter, seems all too aware that her celebrity is about to change her life. Her jokes that sheÕll need to start Òcaring what she looks like before she leaves the houseÓ and Òwashing her hairÓ donÕt go far in masking her apprehension. 

Hewson, at 24, is just beginning to experience the sexism prevalent in Òthe industryÓ, and sheÕll be the first to admit that her role as Nurse Elkins may have set her expectations unreasonably high. 

ÒThe amount of scripts and auditions IÕve done where youÕre just the girl. It can get really tedious,Ó she says, Òand thatÕs why IÕm so lucky to be in this part. ThereÕs a lot of integrity to the womenÕs roles in The Knick. TheyÕre not just there to be fallen in love with.Ó

SheÕs right that The Knick is populated with smart and strong women, whose strength is only emphasised in the face of the visceral sexism of their timeÑagain unless youÕre Asian. But, there is something even more singular going on, especially in the case of nurse Elkins.

Elkins exists internally; she is quiet to the point of introversion and Hewson says she found this aspect of Elkins the most difficult to play: ÒSheÕs really not like me at all,Ó says Hewson, ÒSheÕs very quiet and sheÕs an introvert. IÕm definitely more of an extrovert so she wouldnÕt be a character that I would normally gravitate towards, but I ended up kind of falling in love with her.Ó 

As a television character it is the nurseÕs quietude that makes her so exceptional and Soderbergh uses it to great effect.  When we, and our proxy the camera, interact with her it is mostly through her eyes and micro movements. With all the talk of featuring more intelligent, thinking women on TV, The Knick is one of a very small number of shows that dedicates any time, or art, to actually watching a woman think. 

By presenting Eve as a cerebral presence, it makes her actions, no matter how extreme, seem reasoned. ÒShe is quiet and she does seem like this na•ve little precious thing,Ó says Hewson, Òbut sheÕs made the decision to come to New York. SheÕs made the decision to work in this hospital.Ó So, when for example, she begins an affair with Thackeray and becomes an eager and erotic co-conspirator in his drug use, the potentially facile old story of na•ve nurse falls for brilliant doctor is skewed. 

ÒSheÕs completely put herself into the relationship with Thakerey; heÕs not holding her down,Ó perhaps what Hewson fell in love with is her characterÕs agency, ÒSheÕs sort of attracted to danger and sheÕs looking for this excitement.Ó

 In fact, it is ThackeryÕs vulnerabilityÑwhen she discovers him in the whimpering depths of a drug withdrawalÑnot hers that sparks the relationship. 

Which brings us to the drugs. If questions of race and gender dominated season one, all early signs point to this seasonÕs main story revolving around addiction. 

Season one ended ominously with ThackeryÑa cocaine addict with an opium problemÑbeing treated with a new miracle drug, heroin.  As season two opens, Thackery is still institutionalised and a full-blown junky. Over the course of the episode we see him get clean, and return the The Knickerbocker where he announces he will now dedicate his medical training to eradicating addiction, or as he puts it, treating addiction like a disease.

Here again is an example of how The Knick uses its historical remove to address a modern issue more forthrightly than would otherwise be palatable. Because the nature of addiction, and the behaviour of addicts is so new to the characters on The Knick, we see clearly the confusion that an addict can wreak. How can someone so gifted be laid so low? His colleagues ask these questions earnestly, out loud, and to his face. 

When Lucy is shocked to find ThackeryÕs affection for her didnÕt outlast his drug dependency she is deeply hurt and surprised. As a modern audience with lots of knowledge of addicts behaving shabbily it is tempting to respond with a jaded ÒWell, duh.Ó But LucyÕs reaction, being cast adrift in uncharted waters, will ring true to anyone who has ever been let down by an addicted loved one.

Which is not to say the show doesnÕt treat addiction with nuance. This is where OwenÕs brilliant performance really shines. He has the unenviable role of playing someone who, at least in the first season, is never onscreen sober. Not only that but his demonsÑopiates and stimulantsÑwork at cross-purposes. OwenÕs acting shows a highly tuned awareness of how chemicals are affecting his character

ÒIt was an exhausting character to play in lots of ways because he is so volatile and because is fueled from his drug intake,Ó says Owen, ÒItÕs never just the scene going on, itÕs how high is he? You have to be very focused, very on your game.Ó

In talking about the second season Owen makes it clear that ThackeryÕs recovery will be just as fraught as his evolution on race. ÒIt would be wrong to come back a changed man,Ó he says, Òaddiction is long, hard, difficult. I felt it was really important that we didnÕt take that lightly É the things that fuel his brilliance in the medical world are the same things that make him take drugs and be a crazy man.Ó

As season two premiers, The Knick leaves us where it probably always will, with a host of intractable problems, and a cadre of characters whose better natures seem doomed by their circumstances. More Clamps! More Blood! 







[CL1][CL1]this sounds too much like the current world to be a contrast to todayÕs world instead of a relatable similarity. I agree with what youre saying but considering specifically police brutality has sparked a resurgence of reflection on race it is just too current to be framed as historics

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