Steven Soderberg, director
Cinemax, studio
2014-2015
Running time: 42–57 minute episodes
According to the Art:
This TV series portrays the health care a New York City hospital provided to its patients in the early 1900s. It shows what were then considered important advances in society, culture, technology, and medicine, many of which were later considered dangerous, unethical, barbaric, inhumane, and racist. The series pointedly asks whether all eras, including the era when it was created are doomed to be seen that way.
Synopsis:
The Knick was inspired by the Knickerbocker Hospital, founded in Harlem in 1862 to serve the poor. In this twenty-part TV series spread out over two seasons, the fictional Knick is somewhere in the lower half of Manhattan around 1900. The time covered during the series is not marked in any distinct way. The characters do not age much, and although fashion and customs remain static during the series, the scope and significance of advancements that come into play were actually adopted over a longer time than the episodes cover.
The series builds on some known history. The central character, the chief surgeon Dr. John Thackery, is modeled on a famous surgeon of the time, Dr. William Halsted, in both his surgical adventurism and in his drug addictions. The character Dr. Algernon Edwards, who is an African-American, Harvard-educated, and European-trained surgeon, is based in part on Dr. Louis T. Wright, who became the first African-American surgeon at Harlem Hospital during the first half of the twenteeth century.
Storylines of human drama and folly run through the series. Among them are medical cases both ordinary and bizarre, heroic successes and catastrophic failures, loves won and lost, gilded lives and wretched existences, honor and corruption, racism and more racism. Within and around these storylines are the scientific, medical, and industrial advances of the period, as well as the social contexts that form fin de siècle hospital care and medical research in New York City.
Some of the industrial advances we see adopted by the hospital include electrification, telephone service, and electric-powered ambulances. We see that transitions to these new technologies are not without risks and catastrophes: patients and hospital staff are electrocuted, and when the ambulance batteries died — a frequent occurrence– many of the patients they carried died, too.
Medical advances integrated into various episodes include x-rays, electric-powered suction devices, and an inflatable balloon for intrauterine compression to stop bleeding. Thackery is a driven researcher taking on some of the big problems of the day, such as making blood transfusions safe, curing syphilis, and discovering the physiologic mechanisms of drug addiction. We see how he learns at the cost of his patients, or rather his subjects. We also glimpse movements directed at population health. For example, epidemiological methods are applied to find the source of a typhoid outbreak, which drew from the actual case of Mary Mallon (aka, Typhoid Mary). Shown juxtaposed to the advances epidemiology was then promising is the concurrent interest that was rising in eugenics and its broad application to control for unwanted groups. Research ethics and regulations were a long way off.
Analysis:
Each era possess its own hubris based on the technological advances and social progress made over those of previous eras, and on the certainty that the mistakes before have not been repeated. In an interview with the New York Times, director Steven Soderbergh noted:
There are so many treatments on the show that make you gasp because they’re so wrong…It just makes you wonder what treatments we’re all taking at face value that 10 or 15 years from now we’re going to be told, ‘Well, that didn’t work, and in fact that makes it worse.’
Early twenty-first-century medical care has benefited from startling advances in molecular biology, medical devices, surgical procedures, data analytics, and epidemiological methods among others. People only participate in experimental protocols with their informed consent, and health care work forces are highly diverse. Impressive indeed, but none that in any way dwarf some of the advances shown during the series, and many that in fact make twenty-first-century medical care possible. And, while The Knick shows how patients were often victims of bad science, bad technique, unproven technology, and malfeasance, The Johns Hopkins University researchers reported that at the time the series was running in 2014–2015, medical errors were the third leading cause of death in the U.S. Thus, we don’t have to wonder whether in ten or fifteen years if we will find out that some early twenty-first-century treatments did not work or made things worse. We already know.
What we do not know is what we will see when we look back at how the new technologies that alter gene expression were applied. At the end of the series, we see one of The Knick doctors leave for Germany to teach doctors there about eugenics. The Nazis eventually put the knowledge they acquired to use in their mission to perfect the Aryan race. The Knick pushes us to consider and to beware of what we may see after ten to fifteen years—or one-hundred years—of experience with genetic manipulation capabilities.
Also:
The Knick began streaming on HBO Max on February 20, 2021
Peabody Award
Six Primetime Emmys
Three Critics Choice Television awards
A version of this review is also posted at the NYU Literature, Arts and Medicine Database.
