Like a shot of adrenaline to the heart, "The Knick" arrives just in time to save us from the summer doldrums, and as a side bonus, it further enhances Cinemax's status as one of television's most consistently entertaining networks.
Let Cinemax's more ponderous corporate sibling, HBO, make gigantic investments in sprawling affairs like "Game of Thrones" and bet heavily on eat-your-vegetables programming like "The Leftovers." For the most part, HBO does what it is expected to do: It makes deals with A-list talent and up-and-comers with the right industry connections, and it dutifully fills its roster with the kinds of shows its well-heeled audience expects it to have. And of course, some of those shows are very good.
Where Cinemax is concerned, expectations are few, and thus, within certain budgetary and programming limits, it can have fun with friskier and riskier ideas, provided they're wrapped in the right kind of packaging.
In the last few years, Cinemax has unleashed slippery, smart genre gems like "Banshee," "Hunted" and "Strike Back" and quietly begun shedding its reputation as the cheesy Skinemax of yore. You'll still find regular displays of naked human flesh on the channel, but every single one of those shows is a whole lot smarter than it necessarily has to be. This is a canny strategy, because building passion among viewers over the long term is now the smartest play out there, wherever scripted television surfaces. A few years ago, Starz appeared poised to become the go-to source for deceptively smart pay-cable crowd pleasers, but, around the time "Spartacus" came to an end and its audience was casting about for another bloody, lusty adventure tale, the quality of Starz's shows fell off a cliff (the upcoming "Outlander" excepted).
Meanwhile, Cinemax stuck to its B-movie TV template and threw some of its money at Steven Soderbergh, who got Clive Owen and a cast of lesser-known actors to take a stab at the hospital-drama genre. Savvy move. The results of Soderbergh's latest foray into series television are frequently terrific.
"The Knick," which was written by Jack Amiel and Michael Begler and directed in full by Soderbergh, raises the bar even higher for Cinemax, in part by skillfully straddling the line between Prestige TV and the artful execution of one of TV's most stalwart genres. The lead character of "The Knick" is a drug-addicted Difficult Man, cut from anti-hero cloth that's getting ragged around the edges, but Owen is tremendously charismatic in the role of Dr. John Thackery, and "The Knick" isn't so fancy that it disdains the kind of clandestine hookups and babies-in-peril subplots that are the hallmarks of any self-respecting medical drama. Anything you've seen on "Grey's Anatomy" may well turn up in "The Knick," but because the latter show is set in 1900, saws and hand-cranks are more common than fancy diagnostic machines and the medicines we take for granted. It's not difficult to raise the stakes when the doctors regularly root around inside patients' body cavities -- without gloves, of course.
In addition to the artful fusion of procedural chestnuts and Prestige Drama conventions, there's another combination that truly makes "The Knick" a real kick: It unites the cerebral observational powers of Soderbergh with subject matter that is literally visceral (never, ever watch this show while eating). There is always a sense of control in Soderbergh's exacting vision, even when characters and stories are spinning into chaos. The marriage of that rigorous intellectual sensibility to the pulsing, unpredictable life of a big-city hospital makes for a wonderfully lively concoction, one full of insight, curiosity and delightfully rich segues.
But there is a deep undercurrent of anguish that helps power this energetic series: "The Knick" is a piercing look at the discipline it takes to engage in the brutal task of saving lives while reining in one's own emotional reactions. Soderbergh's efficient, inventive camera work and the electronic score by Cliff Martinez work together to leave the viewer feeling slightly jarred much of the time, but that feels entirely intentional. None of what transpires has the sepia-toned sentimentality of a show like "Downton Abbey," and that dedication to palpable, pulsating realism makes the operations and painful dilemmas land with that much more impact. "The Knick" is the first show in a long time that truly reminded me of "Deadwood"; both are scuffed, dusty, lived in and fascinated by what it costs individuals to build a future in the face of endless greed and stupidity.
There's no doubt that Thackery and his staff do good every day, but they're working in a poor neighborhood full of desperate immigrants; disease and death remain overwhelming realities, and the staff's victories are drops in a bloody bucket. Yet turn-of-the-century New York also buzzed with a rich brew of colliding cultures, energies and inventions, all of which thrum through "The Knick" like the (often faulty) new electric wiring in the hospital. Thackery and his fellow doctors are intensely excited by the advances being made in surgery -- some of which they come up with themselves -- but the failure rate for every new procedure is high and disease still takes a terrifying toll, even among the wealthier classes. And yet, driven by a combination of terror and curiosity, the Knick's staff soldiers on.
It's no spoiler to say that Thackery takes refuge in drugs to take the edge off: The very first scene of the show depicts him stumbling out of an opium den at daybreak. Though the sly commentary on our modern medical system is one of the subtler attractions of "The Knick" (patients are, as ever, viewed as profit centers first), it's hard for me not to see the show as a metaphor for the entertainment industry: It's about people who are willing to take risks and perform their craft in front of audiences (most operations are observed by dozens of onloookers), and those who take the biggest risks are constantly beaten down by naysayers, doubters and disbelievers. Also, there's a lot of cocaine around. A lot.
Amist the propulsive energy and fine performances, there are some eye-roll-inducing moments. "The Knick," like so many before it, falls into some anti-hero TV traps: There are woefully underwritten, naked prostitutes wandering around, and a few other female characters don't fare much better. (One frustrated wife actually says, "You always want more!" which must be on Page 1 of the "The Ultimate Guide to Writing Female Characters on Anti-Hero TV Shows.")
But throughout its first seven episodes, "The Knick" -- like "Grey's Anatomy" and "ER" before it -- uses a series of sturdy hospital tropes to delve deeply into the complicated lives of a wide array of characters, and that may be its saving grace: Thackery is its center but not its sole point of view. Sharing extensive screen time with Thackery is Cornelia Robertson (Juliet Rylance), whose father is one of the hospital's chief benefactors and who hates the idea of giving up her beloved work when she eventually marries; Dr. Algernon Edwards (André Holland), an innovative Harvard graduate who faces ferocious racism yet matches Thackery in his dedication to his craft (and in his craftiness); Lucy Elkins (Eve Hewson), a new nurse whose demure facade masks a deep curiosity about urban life; and the Irish immigrant Sister Harriet (Cara Seymour), who runs the Knick's orphanage and sees up close how hard life is for immigrant families -- especially penniless mothers.
It's a world of saturated colors and crowded rooms; the homes of both the rich and poor are cluttered, and, no matter a family's class or status, it feels like the walls are closing in on them. In the wards of the hospital, however, there is wide open space and shining floors; there, the chaos and pain of the world are put into some kind of order. The operating theater itself is almost totally white, like Thackery's shoes. The purity, of course, is a lie: Thackery and his fellow doctors are often covered in blood, ripping and grasping and slicing in urgent attempts to save lives -- and to burnish their own reputations. Thackery never sees those things as mutually exclusive, of course.
The doctors emerge from that white space, where you can always hear the sound of water dripping, covered in blood, empty and spent, even if the procedure was a success. The next discovery, the next performance, may bring even more radically wonderful or harrowing developments.
If not, there's always more cocaine.
"The Knick" premieres 10 p.m. ET Friday, Aug. 8 on Cinemax.