“Those are nice shoes,” observes a man waiting on line for the bathroom at the Diggs Hotel. The man with the shoes is Dr. Algernon Edwards (André Holland). The man noting the shoes (“Some kind of fancy leather?”), stands behind Algernon, his face shadowed, his threat obvious. Algernon does his best to look away and also, not to offend.
The Diggs scene is intercut with another set of morning rituals. Where Algernon wakes to the grinding sound of the el and jumps at the sight of a cockroach on his pillow, his benefactor, Cornelia Robertson (Juliet Rylance), is roused by her so she might sit for breakfast with her philanthropist father, Captain August Robertson (Grainger Hines). This sequence at the start of the second episode of The Knick, airing Sundays on Cinemax, sets up two very different sorts of privilege, where her wealth and supportive family provide security at home in 1900s New York City, his relative well-to-do-ness encourages resentment and potential violence (a potential that will be made material by the end of this episode) in the Tenderloin District (where, he says, denizens do “everything that humans would do if no one was looking and God didn’t judge”). Yet they are also related: he’s a black doctor newly installed at the Knickerbocker Hospital, and she’s the person who’s installed him.
That they both endure antipathy at the hospital links their experiences, but hardly makes them the same. Captain Robertson has appointed his daughter the new chair of the hospital’s board of trustees, a position enabled by their money (the hospital is in debt, and in need of this newfangled technology called electricity) and begrudged by the white male doctors. In turn, and at her father’s urging (for reasons that become clear in a couple of episodes), Cornelia has brought in Algernon as the new deputy chief of surgery, redoubling the white doctors’ begrudging.
Among those who voice their objections, chief of surgery John Thackery (Clive Owen) may be the most articulate. “I’m not interested in leading the charge on mixing the races,” he tells Cornelia, who presses her choice nevertheless. John’s dilemma becomes increasingly complex, as he quite plainly understands the financial framework and then slowly comes to comprehend the medical benefits Algernon embodies. Trained at Harvard, as well as at hospitals in Paris and London, he has experience and intuition lacking at the Knick; indeed, John’s initial choice for the deputy chief of surgery, Everett Gallinger (Eric Johnson), is revealed to be a mediocre surgeon, not to mention an especially cruel and vengeful racist. As John comes to appreciate Algernon’s skills—as well as his resilience, which is considerable, and more than a match for John’s own—The Knick shows their disparate but strangely similar trajectories, the losses they suffer and the ambitions they share.
The series underlies that both of these trajectories have to do with bodies and money. Much has been made of the bloody surgery scenes that punctuate John’s experience, the experiments he and his fellows essay and the cut-open, gory corpses they produce, rendered in close-up images, frequently shot as if the camera is a spectator on the floor, peeing between doctors’ figures, peering up at their faces. While you’re invited to worry over the surgical practices —no gloves, shared washing tubs, the spastic use of electrical currents for (amid debates over whether to use copper or tin wires)—you’re also ever aware that the procedures are conducted for another audience, as the operating theater seating is populated by bearded men in suits, doctors and students hoping to witness new and successful techniques.
That most of these shows are not successful makes being a surgeon a difficult emotional job; the series opens with the suicide of John’s mentor, Dr. Christensen (Matt Frewer), following a harrowingly failed C-section, and features John’s various efforts to prove himself sturdy enough, buoyed and burdened by his opium and cocaine addictions. His sense of a fraternity of surgeons is broken when he loses Christensen, yet he persists, as he puts it in the eulogy, “Our patients’ hearts will all stop their beating, but we humans can still get in a few good licks before we surrender,” he says, “I will not stop pushing forward into a hopeful future.”
That desire to keep pushing drives each individual, whether for good or ill, whether that hopeful future is defined by medical breakthroughs, social justice or ego. As tuberculosis begins to take hold in the community, crossing class lines, the health inspector (David Fierro) works with Cornelia to gain entrance into wealthy families’ sitting rooms, looking to track sources or causes. Sister Harriet (the wonderful Cara Seymour) not only looks after the hospital orphanage, but also looks after poor women in the neighborhood, helping them with medical needs the men have no inclination to recognize, let alone relieve. And Algernon decides to set up a separate surgery I the Knick’s basement, in order to serve black patients turned away upstairs.
While the designated flawed hero John espouses an essential grasp of the purpose of medicine and the workings of disease (“Despite what you may believe,” he tells Cornelia, “Sickness isn’t a result of poor character, germs don’t examine your bankbook”), he’s also stymied, by his own prejudices as well as money concerns. That these might take him in different directions suggests the series has some sense of the difficulty of medicine then and still. But even as John comes to see, literally and figuratively, the costs for others shaped by his privilege, he also remains blind to diurnal details. The Knick shows them: again and again, you see nurses and female patients surviving or dying from exceptional duress, traumas delivered by imperious (if hopeful) male doctors. And again and again, you see that Algernon’s predicaments—multiplying even as he tries to tamp them down—are premised on essential traumas, the daily life business of being black in the US. That The Knick makes these traumas visible makes it different, if also related.