Historical Novels Review | Issue 97 (August 2021)

HISTORY & FILM Blood, Cocaine & Hubris: The Knick

Doubtless much to our readership’s relief, it’s been awhile since I’ve penned a History & Film column. When I came to write this one, I found myself in some difficulty. Lately it’s proved challenging to find something with enough appeal to watch, much less try to blather on about with nominal coherence in written form. I considered Mank, the recent Netflix film about screenwriter Herman Mankiewicz; its plot ostensibly concerns the tribulations that birthed Citizen Kane. Press was positive, with critics calling it a “love letter” to the Golden Age of Hollywood. I dutifully sat through it. Two things: 1. It’s tragic, really, that so many critics have never been the recipient of a love letter; this is the only logical conclusion to draw from their hailing Mank as one. 2. Gary Oldman is exceptional in whatever role he takes on, including this one — a feat near Herculean in a film that requires its 63-year-old British star to convince viewers he’s an alcohol-soaked American screenwriter in his early 30s. I won’t go into what this film actually is, since about halfway through, I realized I had little desire to write a column about it (or even finish watching it, if I’m honest).

I switched gears, really switched them, and settled on The Knick, one of the “best and most influential shows of the prestige TV era…that almost nobody saw.”1 Well, I saw it.

The Knick (two seasons, 2014-2015) is set in New York City in 1900. It stars Clive Owen, was produced and directed by Steven Soderbergh, so there are some heavy hitters here. The Knick of the title is the Knickerbocker Hospital, the name of a real hospital which operated in NYC. Yet it shouldn’t be taken as too literal a model. The real Knickerbocker got its start as the Manhattan Dispensary in the 1860s; it was located on 131st Street and Covent Avenue (presentday Harlem). This is an important distinction from the Knick of the series, because Soderbergh’s hospital is located on the Lower East Side, and there is the constant question of “moving uptown.” The Knick suffers from the location, location, location problem of its real estate — it struggles financially because, though there are notable exceptions, the population it primarily serves is the working poor of the Lower East Side tenements.

The Knick is the domain of Dr. John Thackery (Owen), a volatile and brilliant surgeon whose dapper white shoes are counterbalanced by his unfortunate choice of mustache. He’s also less than judicious in the medication he selects for himself: cocaine, with the occasional opium aperitif. While there’s plenty of relationship drama, one of the show’s more gripping aspects is its portrayal of progress in the medical profession. This time period saw exponential acceleration

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COLUMNS | Issue 97, August 2021

of medical practice and constant innovation. Watching The Knick feels, at times, like the Eakins comparison put into motion. If you’re unfamiliar with Thomas Eakins, he was an American realist painter.

Amongst other things, he treated two subjects (Dr. Samuel D. Gross and Dr. David H. Agnew) hard at work in their operating theatres.

Historians have long compared the two paintings to show exactly how far medicine had come in such a short period of time. The paintings were executed less than 15 years apart (1875 and 1889), and they offer a visual representation of how significantly things had changed, not least of which was the adoption of sterile practice and pervasive use of anesthesia. Thackery personifies this shift in The Knick. He and his small team of doctors race to create new treatments and perfect their understanding of the human body. Often patients benefit, but the word experimental doesn’t even begin to describe Thackery’s approach, and there are plenty of dark inside jokes at ignorance’s expense. As just one example, the sleazeball hospital administrator (Jeremy Bobb), excited to try out the Knick’s first x-ray machine, has its radioactive material trained three inches from his skull…for over an hour.

Thackery seems loosely based on William Stewart Halstead, a pioneering surgeon who focused on aseptic surgery practices and use of anesthesia. Halstead also had a serious drug dependency which included morphine and cocaine, legal and entirely unregulated at the time. Some of Halstead’s innovations, such as inguinal hernia treatment, see screen time through Thackery and his colleagues. Yet Thackery is, like much in the series, a conglomeration, conflation, and vehicle of sorts; he evokes other medical men such as Thomas Dent Mütter, an even earlier 19th century medical pioneer, when he pursues skin grafting for a syphilitic patient, and gets pitted against a colleague of Karl Landsteiner’s in an important plot point regarding the race to demystify blood groups. Thackery’s zeal to find a viable treatment for patients suffering placenta praevia is near obsessive, and there’s also a significant focus on abortion (secretly performed by one of the hospital’s affiliated nuns, no less). These are interesting foci given the fact that, according to the Directory of Social and Health Agencies of New York City for 1914, one of the categories of patients denied admittance to the real Knickerbocker were maternity cases.

Maternity patients weren’t the only ones barred — the show takes pains to highlight the Knickerbocker’s refusal to treat black patients through the character of Dr. Algernon Edwards (André Holland).

Edwards is black, and as a “colored” physician, faces discrimination at most, though not every, turn. There were “colored” physicians in New York City long before 1900; James McCune Smith, who was educated in England and Scotland, is often credited as the first, beginning his US practice in the 1830s. Edwards shares some similarities with this historical man (like Smith, he spends time interning in Paris), but despite sterling competence and a keen mind, he owes his position at the Knick solely to his benefactor, August Robertson (Grainger Hines), a shipping magnate and donor who keeps the Knick financially afloat. Robertson forces Thackery to take Edwards on, and the road to his acceptance by Thackery as a talented physician allowed to preside in the operating theatre takes half the first season. The change of location affects this aspect as well — the real Knick’s stance on not treating “colored people” was even more problematic than that portrayed in the series, especially as time went on, because it was located in the heart of Harlem.

It would be less than accurate to describe this as an ensemble drama. Though there are strong supporting cast members with their