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The gritty dawn of modern surgery
Perspectives
Television The gritty dawn of modern surgery
HBO Enterprises
There’s a moment midway through the first season of the television drama The Knick where lead actor Clive Owen seems to perfectly capture his subject, an elite surgeon in a New York hospital a century ago. His deputy punches another surgeon in the face, and Owen’s character calls him an idiot. “A surgeon needs his hands”, he says. “Next time, kick the man instead.” Owen’s portrayal of the brilliant but unforgiving John Thackery at Knickerbocker Hospital is one of the best things about the series, and it’s not the only one. It’s too early to say whether this is the best American medical drama ever, a genre that includes long-running classics like ER and M*A*S*H. That question will surely rest on how successfully the series runs through future seasons. But so far, there’s a lot to love. Owen’s “Thack” is loosely based on William Stewart Halstead (1852–1922), the tough, gifted father of modern surgery who co-founded Johns Hopkins Hospital and was famous for his innovation and almost inhuman stamina—much of it fuelled in the series by cocaine addiction. Owen seems to relish his role, and he’s not the only one. The scene-stealer is actor Chris Sullivan, who plays Tom Cleary, an Irish bare-knuckle brawler and corrupt ambulance driver. We first meet him as he pulls a club on another driver,
HBO Enterprises
The Knick Directed by Steven Soderbergh, starring Clive Owen. HBO/Cinemax, 2014. http://www.cinemax.com/theknick/
2016
steals his patient, delivers him to the administrator of his own hospital for a prearranged kickback, and declares, “That’s two more bits for Cleary”. It’s an age of mercenary medicine where decisions are based as much on bribery and graft as diagnosis and care. It’s not a show for the faint of heart. There are as many deaths on the operating table as lives saved, and it is at times an extravagance of gore: an arm sawed off; an exposed heart beating in a patient’s chest moments before he bleeds out; a scalpel slicing across a pregnant woman’s belly; a nose lost to flesh-eating bacteria; and more litres of spilled blood than you can count.
“It’s too early to say whether this is the best American medical drama ever…“ Surgery is not the only subject captured in such vivid detail. This is the New York of William Halstead, Margaret Sanger, John D Rockefeller, and Teddy Roosevelt, but it’s also a city of gamblers, murderers, sex workers, pimps, opium dens, back alley abortions, robber barons, race rioters, and raging infectious diseases—all of which figure prominently in the twisting plots. The Knick takes a withering look at segregation and racism through its story lines around Algernon Edwards,
an aspiring and talented black surgeon played with distinction by André Holland. Meanwhile, women’s rights are explored in Juliet Rylance’s character Cornelia Robertson, a philanthropist and hospital board member. As is true of nearly every medical drama, The Knick does not lack for romantic stories. And this is where director Steven Soderbergh shows true mastery. The director broke into Hollywood’s elite on the strength of his 1989 film Sex, Lies and Videotape, and he has gone on to a career spent directing such leading men as George Clooney, Brad Pitt, and Matt Damon. The mesmerising Owen is a welcome addition to that roster. Soderbergh might at first seem an odd choice to direct a television drama, given that he is known for his films, including Ocean’s Eleven, Contagion, The Good German, and Che. Nothing he has ever done is quite like The Knick. Unlike many historical dramas, there are no meticulously recreated period neighbourhoods. Instead, The Knick is filmed mostly inside and has a distinctly modern vibe. The medical cases, room décor, costumes, and authentic period medical equipment are all that exist to throw the audience back in time. This could seem a shortcoming in the hands of some directors, but Soderbergh makes it work. He also takes a fresh approach to surgical cinematography, filming operating room sequences in sharp focus with bright lighting to distinguish them from scenes outside. Those shots are darker, and often muted in tone. Such artistic elements help establish the world Soderbergh has created as both dreamy and dismal: a gritty dawn of modern surgery in a brutal New York City that’s both hard to watch and impossible to turn off.
Jason Socrates Bardi [email protected]
www.thelancet.com Vol 384 December 6, 2014
Television The gritty dawn of modern surgery
HBO Enterprises
There’s a moment midway through the first season of the television drama The Knick where lead actor Clive Owen seems to perfectly capture his subject, an elite surgeon in a New York hospital a century ago. His deputy punches another surgeon in the face, and Owen’s character calls him an idiot. “A surgeon needs his hands”, he says. “Next time, kick the man instead.” Owen’s portrayal of the brilliant but unforgiving John Thackery at Knickerbocker Hospital is one of the best things about the series, and it’s not the only one. It’s too early to say whether this is the best American medical drama ever, a genre that includes long-running classics like ER and M*A*S*H. That question will surely rest on how successfully the series runs through future seasons. But so far, there’s a lot to love. Owen’s “Thack” is loosely based on William Stewart Halstead (1852–1922), the tough, gifted father of modern surgery who co-founded Johns Hopkins Hospital and was famous for his innovation and almost inhuman stamina—much of it fuelled in the series by cocaine addiction. Owen seems to relish his role, and he’s not the only one. The scene-stealer is actor Chris Sullivan, who plays Tom Cleary, an Irish bare-knuckle brawler and corrupt ambulance driver. We first meet him as he pulls a club on another driver,
HBO Enterprises
The Knick Directed by Steven Soderbergh, starring Clive Owen. HBO/Cinemax, 2014. http://www.cinemax.com/theknick/
2016
steals his patient, delivers him to the administrator of his own hospital for a prearranged kickback, and declares, “That’s two more bits for Cleary”. It’s an age of mercenary medicine where decisions are based as much on bribery and graft as diagnosis and care. It’s not a show for the faint of heart. There are as many deaths on the operating table as lives saved, and it is at times an extravagance of gore: an arm sawed off; an exposed heart beating in a patient’s chest moments before he bleeds out; a scalpel slicing across a pregnant woman’s belly; a nose lost to flesh-eating bacteria; and more litres of spilled blood than you can count.
“It’s too early to say whether this is the best American medical drama ever…“ Surgery is not the only subject captured in such vivid detail. This is the New York of William Halstead, Margaret Sanger, John D Rockefeller, and Teddy Roosevelt, but it’s also a city of gamblers, murderers, sex workers, pimps, opium dens, back alley abortions, robber barons, race rioters, and raging infectious diseases—all of which figure prominently in the twisting plots. The Knick takes a withering look at segregation and racism through its story lines around Algernon Edwards,
an aspiring and talented black surgeon played with distinction by André Holland. Meanwhile, women’s rights are explored in Juliet Rylance’s character Cornelia Robertson, a philanthropist and hospital board member. As is true of nearly every medical drama, The Knick does not lack for romantic stories. And this is where director Steven Soderbergh shows true mastery. The director broke into Hollywood’s elite on the strength of his 1989 film Sex, Lies and Videotape, and he has gone on to a career spent directing such leading men as George Clooney, Brad Pitt, and Matt Damon. The mesmerising Owen is a welcome addition to that roster. Soderbergh might at first seem an odd choice to direct a television drama, given that he is known for his films, including Ocean’s Eleven, Contagion, The Good German, and Che. Nothing he has ever done is quite like The Knick. Unlike many historical dramas, there are no meticulously recreated period neighbourhoods. Instead, The Knick is filmed mostly inside and has a distinctly modern vibe. The medical cases, room décor, costumes, and authentic period medical equipment are all that exist to throw the audience back in time. This could seem a shortcoming in the hands of some directors, but Soderbergh makes it work. He also takes a fresh approach to surgical cinematography, filming operating room sequences in sharp focus with bright lighting to distinguish them from scenes outside. Those shots are darker, and often muted in tone. Such artistic elements help establish the world Soderbergh has created as both dreamy and dismal: a gritty dawn of modern surgery in a brutal New York City that’s both hard to watch and impossible to turn off.
Jason Socrates Bardi [email protected]
www.thelancet.com Vol 384 December 6, 2014