The last time Steven Soderbergh dabbled in television was back in 2003 — an HBO series called K Street, a reality/fiction hybrid that mixed real D.C. powerbrokers (Mary Matalin and James Carville played bonkers versions of themselves) with fictional characters. Depending on who you ask, this single-season show was either an engrossing behind-the-beltway drama or an exasperatingly pretentious game of political inside-baseball, but even its detractors (and there were many) admitted the filmmaker's toe-dip into serial small-screen endeavors was wildly ambitious and, in many ways, ahead of its time.
With The Knick, Soderbergh's first post-"retirement" foray into prestige-TV producing, he appears to be taking the opposite approach. This gritty period piece-cum-medical-procedural series, in which a tortured man struggles with the weight of his life choices, follows firmly in the mold of Golden-Age antiheroics kicked off by Tony Soprano's meditations on poolside ducks. Make no mistake, this is a Big Cable Drama: There's full frontal female nudity and a close up of Clive Owen's conflicted genius shooting cocaine between his toes — and that's before the opening credits have rolled.
Whether The Knick will join Mad Men, Breaking Bad et al. at the enviable intersection of artistry and cultural currency, which is what Soderbergh and Cinemax are both betting on, remains to be seen. In the meantime, we're dropped into the halls of the Knickerbocker, a financially strapped New York hospital experimenting with the cutting edge [cough, cough] of modern surgical techniques circa 1900. (Historically, this puts the action somewhere after antiseptics and slavery, and before antibiotics and women getting the vote.) At the "Knick," white men are in charge, white women are seen, if not heard, and African-Americans are not to be seen at all; medicine is still a science, even if the cure is often more gruesome then the disease.
Personifying all of this is the enigmatic Dr. John Thackery (Owen), recently promoted to Chief of Surgery after the death of his boss and mentor, Dr. J.M. "Jules" Christenson (the epically bearded Matt Frewer, suffering another shot through the head so soon after meeting a similar fate in Orphan Black). Dour and drug-addicted, Thackery is wrestling with grief and whatever demons the writer/creators Jack Amiel & Michael Begler are almost certainly holding back from us. And as a period-appropriate causal sexist and active racist, the last thing Thackery needs is progressive in-house administrator Cornelia Robertson (Juliet Rylance) forcing him to hire Dr. Algernon Edwards (Andre Holland), a brilliant black surgeon. You can already sense the lessons on tolerance and cultural changing-of-the-guard tension waiting in the wings.
There is a lot more in this story-stacked first hour (probably too much), but the center of The Knick is the operating room — one that's both a literal and a metaphorical theater. Observers watch from a balcony, as Dr. Thackery and his co-stars perform on a stage below. These operations aren't presented as life-saving; they're pragmatic, pessimistic efforts with a higher scientific purpose, and the action unfolds with sickening tension. Soderbergh's camera lingers on the seeping blood, the puckering incisions and the ungloved hands that violates a patient's body cavity, emphasizing the notion of early 20th-century surgery as a stark ballet of barbarity. Women bear the brunt of the carnage, and a visceral Dead Ringers vibe runs through this hour of television. "If I had to put a percentage on it, I'd say, I was hoping maybe half the people would look away," Soderbergh said in a recent New York Times article. Mission accomplished.
But among the guts and gore, a larger question surfaces regarding the power to decide between life and death. These patients would die without Thackery's intervention — but with surgeries this primitive and brutal, they're probably going to die anyway. It's the good doctor, the one with the cocaine addiction and the dead-eyed stare, who makes this choice, not the patient, ostensibly for the greater good of medicine. But it's also to the determent of whatever meager life these patients have left, and that deep imbalance of power permeates The Knick, as scene after scene presents a stringent caste system between men and women, doctors and nurses, black and white, native-born and immigrants, rich and poor.
Soderbergh has directed, shot and edited every episode of The Knick's first season, and his style is obvious in almost every detail of the pilot. Whether his characters are Vegas heist-pullers or Mexican drug runners, they live in worlds that aren't "cool" so much as highly chilled, and he's dropped The Knick's hospital staffers into a severe, sterile environment of white tiles and dark woods. Outside of the medical institution, muddy Manhattan streets appear grey and de-saturated as if it is always dawn, and even the sumptuous homes of the rich are muted (no lush Downton Abbey spreads here). Add in a sparely used techno score by Cliff Martinez, and the overall effect is a fully formed, if slightly alien, Gothic version of a Gilded-Age Gotham.
If this first hour stumbles at times, it has less to do with the cast or Soderbergh and his restless, prowling cameras then with creators Amiel and Begler. A duo whose resumés includes Disney fare like The Prince and Me and The Shaggy Dog, they still seem to be getting their bearings as they build The Knick's world of cadavers and complicated men; there are times when the dialogue seems to be reaching for the David Milch-like poetry of Deadwood and missing the mark (though the show ably replicates its predecessor's tonsorial fashions). There's an unmistakable sense that the inaugural episode is more interested in checking off Prestige-TV narrative boxes more than fostering subtly or complexity, but there are still nine more installments, and undoubtedly many more botched procedures, to go.
Early on, after a gruesome surgery ends in failure, where Dr. Christenson addresses the gallery: "It seems we are still lacking," he tells them soulfully. "If nothing else, this has been instructive for you all." He could be speaking to the audience. One episode in, The Knick may indeed feel like something key is already missing, or has yet to be revealed. It is, however, nothing if not illuminating.