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THE KNICK, Season 1, Revisited

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images-14If you missed season 1 of the critically acclaimed Cinemax original series The Knick, a fictional rendering of the beginnings of surgery and novel medical procedures at New York’s The Knickerbocker Hospital, you still have plenty of time to catch up on the first season before the premiere of the second.

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Created and written by Academy Award and Emmy winning Steven Soderbergh, the show stars Clive Owen as the egotistical, ego-maniacal, opium- and cocaine-addicted, and personable Head Surgeon Dr. John Thackeray. He’s determined to beat his colleagues — at any other hospital in the world — at discovering and perfecting new medical and surgical techniques in an era when everything was new and untried.

And thus potentially fatal.

To the “guinea pig” patients.

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Forced by the hospital’s über-wealthy benefactor, Captain August Robertson (Grainger Hines, above R) to accept “the finest Negro surgeon” in all New York onto the staff at The Knick, Dr. Thackeray makes no effort to hide his racism against the European-educated and trained Dr. Algernon Edwards (André Holland, above L). cornelia

Robertson, with the help of his daughter, Cornelia (Juliet Rylance), who is actively involved in the hospital’s daily operations, means to make The Knick one of the better hospitals in 1900s New York, despite the fact that most of its clientele, being poor or immigrants or both, cannot pay for their treatment.

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Hampered by a lack of funds, by racism, by sexism, by a corrupt hospital administrator, and by disease outbreaks, the physicians at The Knick battle each other as well as the medical ignorance due to the lack of extensive, documented medical knowledge of the rapidly evolving medical technologies and discoveries, like X-rays.xray

Cinemax and Steven Sonderbergh gave us a compelling medical thriller from the first few moments of the premiere when The Knick aired in 2014.

With an outstanding supporting cast, including Chris Sullivan as ambulance driver Cleary, who literally has to fight for patients, and Cara Seymour as Sr. Harriet, who runs the hospital’s orphanage, The Knick is heart-pounding and intense drama.

images-5Firmly grounded in extensive historical research, the writing of the show is superb. Viewers are treated like intelligent, sophisticated people who’ll get the ironies without getting metaphorically slapped in the face with them (e.g., when medical staff and family “play” with the new X-ray machines as if it were a toy) and surgical procedures are held in a “theatre,” literally, where anyone can watch as the doctors — without gloves, masks, or any other protection — cut open their patients’ bodies and shove their bare hands inside to “fix” things.

images-6You can watch season one of the Golden Globe-nominated The Knick free on Cinemax if you are already a subscriber. If not, you can rent episodes on Amazon — where the show is rated 8.4* out of 10 — for $1.99-2.99 SD/HD, respectively. Amazon also provides a free trailer for season 1, and a free “About The Knick” trailer, featuring the actors, with commentary.

After you watch the shows from season 1, you can read my blog posts, where comments are always “open” and welcome.

The Most Undindest Cut of All:
Cinemax’s Brilliant Series The Knick
(Premiere)

Knick, Knack, Paddy-Whack, Give the Doc a Smack:
Cinemax’s The Knick
(episodes 2-4)

Kudos to The Knick (episodes 5-6)

It was the Best of Times, It was the Worst of Times:
The Knick Season (1) Finale
(episodes 7-10)

Season 1 wasn’t without its flaws, but they were so minor that you might not even notice them if you don’t read my posts where I point out its few weaknesses. Season 2 of The Knick premieres Friday 16 October at 10 p.m. ET. It’s the best thing that’s happened to Friday Nights since popcorn and video-rentals.

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Kudos to THE KNICK

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Warning: Spoilers Throughout

From its opening moments, Cinemax’s new series The Knick, about the advances in surgery and medicine at a (fictional version of) the Knickerbocker Hospital in New York in 1900, has been stunning, disturbing, and realistic. It has also consistently been honest about things like racism, graft, and medical ignorance. Now the show has become downright brave, and deserves kudos for its straightforward portrayal of many historical realities.

Discrimination

Discrimination was rampant (and still is, though often less blatant) in all arenas of society: whites against blacks, whites against immigrants, immigrants against blacks, men against women, rich against poor, educated against uneducated. The Knick reveals it all without flinching.

  • When Dr. Edwards (André Holland, below) is stitching up a young girl’s arm, the mother asks a white surgeon, “Does [the black Dr] have to touch her so much?”

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  • The wealthy assume that diseases like typhoid, being spread at the time by hired cook “Typhoid” Mary Mallon in their own elite homes and vacation residences, only happened to “those other kind of people,” meaning the immigrants, the poor, blacks, and Jews, who were often forced to live in crowded, unsanitary environments because of their poverty.

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  • When Cornelia (Juliet Rylance, pictured above), whose wealthy father sponsors The Knick, and who herself is actively involved in virtually all aspects of it, reveals, with appropriate pride, that the “detective work” she and the Health Inspector have been doing to track down the typhoid outbreak among the rich has led them to capture the cook who was unknowingly spreading it, Cornelia’s equally wealthy fiancé casually but dismissively says, “My wife will always have the most entertaining stories to tell at Ladies’ Luncheons.” Cornelia’s acute disappointment is obvious to everyone but the men in the scene with her.

The Knick accurately portrays the discrimination that existed (exists?) at every level of society, against every group of individuals, among genders, and among classes, making discrimination an integral examination of the show’s exploration of medical advances, and not just as random, tangential political or social statements.

Violence

Violence is a fact of life, and not just in war-zones, poor neighborhoods, or in times of natural disaster. The Knick often integrates this violence into its sub-plots, and not just by having the doctors treat its victims.

When an Irish policeman mistakes a young, well-dressed black woman for a prostitute and solicits her for a position in a gangster’s whorehouse, the policeman, who is not in uniform, is attacked and stabbed by the lady’s justifiably outraged but “trigger-happy” boyfriend. A riot ensues when the whites then randomly attack any blacks in the streets.

After the Irish policeman dies in surgery, his immigrant family stirs up more violence against the blacks. The policemen, instead of protecting the innocent victims, actively participate in the violence, aiding the mob in attacking the hospital itself.

violence in the streetsThe doctors, including Chief of Surgery Dr. Thackeray (Clive Owen, above), nurses, ambulance drivers, and other members of the hospital staff defend the hospital, try to hide the black patients to protect them, and run into the streets to try to stop the beatings and killings.

trying to protect injured blacksSr. Harriet (Cara Seymour) heads for the church — or the convent — as a place of sanctuary, holding a crucifix in one hand and an injured black man by the other. Ambulance driver Cleary (Chris Sullivan), whose horses have been stolen, pulls the ambulance himself down the street to save the black patients who must be removed from The Knick for their own security.

The Knick is dead-on in its portrayal of random racial violence quickly becoming mob violence that cannot be controlled. The medical staff is forced to deal with its genesis and evolution, not just with its aftermath.

Death

in 1900, medicine was in its infancy. Surgery was probably still in the womb. Death was a fact of daily life, and not just from racist violence, or accidents.babies died

  • Babies died. Even the babies of wealthy people, and of trained doctors and surgeons. In one of the most tragic sub-plots, Dr. Gallinger (Eric Johnson) accidentally infects his own baby daughter with lethal meningitis after unknowingly brushing against the open wound of a hospitalized man bitten by rats (for sport, in a rat-stomping contest at a bar) by not washing his hands after he comes home from the hospital and picks up his baby daughter, Lillian.

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After baby Lillian dies, a photo is taken of the parents holding her, “to remember her by,” which was a common practice.

Babies die. Even educated, wealthy, trained surgeons’ babies with the best care available.

  • Patients regularly died in hospitals. In the first episode, an Eastern European immigrant with TB doesn’t want to go to the hospital because someone else in her building went there when he was sick, and he never returned. The same thing is about to happen to her.

Cornelia (Juliet Rylance) breaks the bad news to the patient — through her daughter since the TB-infected woman cannot speak English — informing her that she will not get better or leave the hospital alive, but that they will do their best to make her comfortable.

The immigrant unemotionally and matter-of-factly then asks the time, and instructs her young (12-year-old?) daughter that she must leave the hospital immediately or she will be late for her shift at the factory.

People in the hospital die, and it’s a well-known fact, even to immigrants who cannot understand or speak a word of English.

  • Patients died more often in surgery than they survived. Thinking that placenta praevia — an obstetric abnormality in which the placenta displaces, preventing the baby from passing through the birth canal and sometimes rupturing the uterus during labor, causing the woman to hemorrhage, killing both mother and child — could be “fixed” by performing a caesarean section delivery faster than 100 seconds, Dr. Christiansen (Matt Frewer) committed suicide in episode 1 after his 12th failed attempt at the procedure, in which both mother and child perished.

patients dieLater in the series, Dr. Thackeray (Clive Owen) attempts to perform the caesarean even faster. Next, he is shown sitting abjectly in the surgical theater with bloodied hands and forearms, asking an equally despondent Dr. Chickering (Michael Angarano), who had assisted him, how long the mother & child had lasted before death (I believe the answer was 72 seconds).

People rarely survive major surgical procedures.

Gruesome and depressing as it may seem, The Knick honestly deals with early medicine’s inability to heal many patients, with the lack of surgical knowledge, and with the high incidence of mortality, despite medical intervention.

Sometimes, because of it.

Segregation

segregation was the normSegregation was the legally enforced norm. After Dr. Edwards (André Holland) sets up a black clinic, surgery, and infirmary in the basement of The Knick to treat the black patients who will not be admitted to the main hospital, he successfully operates on and otherwise treats many of them.

After the “black hospital wing” is accidentally discovered by Dr. Thackeray (Clive Owen), however, he orders it to immediately be shut down. The sick patients are seen forlornly trailing down the street, away from their only hope at medical treatment.

Because Dr. Edwards is black, he has no power to insist that the black patients be treated in the hospital proper, alongside the white patients — though virtually all are poor at The Knick. And he has no power to retain his “black clinic” in the basement.

Dr. Thackeray is not only his superior in the hospital, Thack is white, and in America in 1900, white trumped any other race every time in every arena, including the medical one. Racism and its accompanying legal segregation is an intimate theme in The Knick, and it is handled deftly.

Drug Abuse by Professionals

cocaine between toesOne of the scariest things in the show is the doctors and surgeons using cocaine and opium — both legal — and huge amounts of it, in order to stay awake and alert to do their surgeries. Dr. Thackeray keeps a regular supply at home and in his desk drawer: he injects it between his toes because his veins have collapsed. He offers it to Dr. Chickering when he can’t stay awake and keep up with Thack, as it was offered to Thack by his mentor, Dr. Christiansen, in episode 1.

I noted in an earlier post about The Knick that Dr. Thackeray had too much weight on him to be using as many drugs as was being portrayed, and that he was too functional. In fact, the only time he wasn’t functional, was the time he “quit his post, again,” because the “Negro doctor” had been hired, and Thackeray had gone the night without the cocaine.

professionals and drug useThough he’s still too highly functional, i.e., he’s made no medical or surgical mistakes due to his high drug consumption, the show did finally show him obviously “flying high” on cocaine, calling Dr. Chickering’s home in the middle of the night or extremely early in the morning, and asking him to come down to the hospital to help with some of his placenta praevia research (on two naked Thai prostitutes, who were not pregnant).

When questioned about how long he’d been working without a break, Thack replied, with a sly gin at the nude girls, “Two days, but we’ve had a few breaks.” The prostitutes giggled. Thackery’s rapid speech and quick, jerky movements, along with his lack of sleep for a sustained period, finally accurately portrayed what such high drug use would be doing to him. (And the previews of subsequent shows indicate that the hospital has “run out of cocaine” due to a war, giving hints that when Dr. Thackeray is withdrawing from the drug, he cannot perform as well.)

And he’s the Chief of Surgery at The Knick.

New Medical Equipment
as “Toys”

xrayAs many of the “new” medical advances were made, especially those in  equipment, their dangers were completely unknown. The Knick treats these as commonplace “toys,” with everyone wanting to try them out. Especially the X-ray machine.

When the Director Barrow (Jeremy Bobb) is negotiating for a used X-ray machine after Cornelia’s father Captain August Robertson (Grainger Hines) has agreed to purchase a new one for The Knick — because another, rival hospital has more than one — the salesman tells Barrow how his own children were playing with it all weekend, so it works just fine.

Barrow then asks if he can try it out himself. He is instructed to hold a photographic X-ray plate in front of his face, which he does, and the salesman turns on the machine — without leaving the room himself. Barrow is instructed to stay in front of the machine, which can be heard humming in the background, until the X-ray of his head is done.

Which will take an hour.

head xrayAfterward, a couple of excited, giggling nurses come into Barrow’s office and ask if they can have a turn with the X-ray machine. Barrow, who likes plenty of women other than his own wife, joyfully obliges them in playing with the newest “toy.”

The danger of the situation isn’t slammed into the viewers’ faces as if we’re stupid. In fact, it’s never even alluded to, in keeping with the knowledge available to the medical establishment at the time period in which the show takes place. The writers and actors all act like the wondrous new X-ray machine, as well as electricity (for surgical cauterization, which catches a patient on fire and electrocutes a nurse the first time it’s used in surgery) are the magical innovations they were considered to be.

They don’t know the dangers of radiation exposure.

We do.

That’s sophisticated writing, and the writers of The Knick — Jack Amiel and Michael Begler, the director — Steven Soderbergh, and all the actors deserve credit for pulling it off so subtly, while not letting it escape the viewers’ horrified notice. That’s dramatic irony at its finest.

Bi-Racial Intimacy

cornelia and edwardsI saw hints of it in early episodes, and was hoping The Knick would be brave enough to enter the territory that Cornelia (Juliet Rylance) and Dr. Algernon Edwards (André Holland), who were childhood playmates, friends, and confidants, have finally entered. Bi-racial intimacy.

Though Cornelia is engaged to the son of another wealthy family (whose father — Hobart Showalter [Gary Simpson]  said and did some creepy, weird stuff to Cornelia in one episode), her fiancé Phillip treats her almost as if she’s his property.

At their own engagement party, Phillip (Tom Lipinski) informs Dr. Edwards that Cornelia and Phillip will be moving to San Francisco — away from her belovèd Knick — after the two of them are married “because Cornelia’s father wants the future son-in-law watching his business interests out there.” It’s the first Cornelia has learned of it, but the only person who notices her dismay, and sympathizes with her about it, is Dr. Edwards.

Later, Edwards teases Cornelia about her new “love interest” — the overweight, crudely mannered Health Inspector (David Fierro) — and she playfully kicks at his foot. In the most recent episode, after Cornelia has saved Edwards from the mob violence  by wheeling him, hidden under a gurney, to the Negro Infirmary, which will take in the black patients, Cornelia and Algernon end up in the basement clinic of The Knick.

There, as they say, one thing leads to another and before the viewer realizes what’s happening (though I was rooting for it), the two were passionately kissing each other and getting intimate on the operating table.

Despite their obvious affection for each other, their shared sympathies, and this recent intimate physical encounter, I doubt that the families — Cornelia’s and her fiancé Phillip’s  — will allow her to break her engagement. Especially not to become openly involved in a love relationship with a “Negro,” even if, according to Cornelia’s father, Edwards is the “finest Negro surgeon” in New York.

Still, it was tremendously brave for the writers to take us to another dangerous reality of the time period: forbidden interracial relationships. And they’re dangerous even if one of the people in the relationship is immensely wealthy and the other is a skilled, highly educated, accomplished surgeon.

images-9The ubiquity of discrimination, violence, and death; legally enforced segregation, legal drug abuse by professionals (even surgeons), ignorance of the dangers of new medical technology, and the taboo of bi-racial relationships and intimacy. These themes and sub-plots are integrally interwoven with the major story of The Knick: the advancement of medical and surgical knowledge and procedures at the turn of the century.

The writers and director treat its viewers as if we are intelligent and sophisticated. The actors treat us that way, too. It makes The Knick more than interesting: it makes it fascinating and compelling.

Kudos to all involved. You are greatly appreciated.

(Airs Fridays at 10pm ET, with repeats throughout week)

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Knick, Knack, Paddy Whack, Give the Doc a Smack: Cinemax’s THE KNICK

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Cinemax’s newest series The Knick, created by Steven Soderbergh, and starring Clive Owen, began its first episode with a graphic intensity that stunned many viewers. Subsequent episodes have promised many conflicts in the premise of a (fictionalized) privately funded Knickerbocker Hospital, located in one of the poorer neighborhoods of 1900s New York, while its philanthropist sponsors force Chief Surgeon John Thackeray (Clive Owen) to “integrate” the staff by hiring an eminently trained black surgeon Algernon Edwards (André Holland) as his Assistant Chief Surgeon. Though the show still has some weaknesses so far, its strengths make it one of the best dramas in years, setting it right next to the debut season of HBOs True Detective and Showtime’s Penny Dreadful with its writing, acting, and setting.

Warning: Spoilers Abound

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Weaknesses

  • Some of the “injustices” and inequalities suffered by black Assistant Chief Surgeon Dr. Edwards are simply fictionally unbelievable, given the show’s premise. Yes, the show is set only 35 years after the Civil War, and racism is rampant. (That still hasn’t changed in this country.) But to have Dr. Edwards’ office in the windowless basement and not have his egregiously wealthy sponsor’s daughter Cornelia (Juliet Rylance) complain vociferously about it and insist that he be given a proper office is simply not realistic. After all, if the Robertson family stopped installing the electricity when Thackeray didn’t want to hire Edwards in the first place,  she would not allow him to be in the basement with the coal-men without getting angry about it. Seems odd that Dr. Edwards tolerates that arrangement, too.

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  • While several of the other characters, including minor ones, are being developed, the “star” surgeon, Dr. Thackeray remains relatively one-dimensional. Okay, so he had a past love interest. He uses cocaine and opium, both of which were legal at the time. He’s sarcastic and impatient. Other than that, however, he’s one of the least rounded characters in the show, and that’s just downright disappointing. We never see him anywhere except in the hospital and in the opium den, whereas we know more about the Hospital Director Barrow (Jeremy Bobb)’s private life than we do about Dr. Thackeray’s.

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  • Additionally, Dr. Thackeray is so addicted to cocaine that all his veins in his arms, feet, and ankles have collapsed, forcing him to inject the drug between his toes (except for the episode 1 scene where Nurse Elkins (Eve Hewson) injects it, under his instructions, into his urethral artery), and he seems to go to Chinatown to the opium den every night after his shift, yet he’s still highly functional. And he has too much weight on him: an addict using as much cocaine as Thackeray is supposedly using would have no appetite and would lose a noticeable amount of weight. (Even alcoholics lose so much weight that they look like AIDS victims.) Thackeray doesn’t even have dark circles under his eyes. His hair’s never even messed up, though he seems to come directly to work from the opium den, and return there right after work.

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  • Nurse Elkins (Eve Hewson) is even less developed than Thackeray, though episode 4 began foreshadowing her love interest in him (or, rather, in her romanticized vision of him, since he was pretty brutal to her in episode 1). Granted, she’s one of the minor characters thus far, but some of the other minor characters, like Sr. Harriet (Cara Seymour) and ambulance driver Cleary (Chris Sullivan), are being intensely developed. Why not this nurse, who seems to be the only one at the Knick with a name?
  • Some of the contrasts between poor/wealthy, white/black in episode 2 were too heavy-handed. Dr. Edwards living in a tenement or a hotel of some sort where everyone shares the same bathroom, for example, while his own mother and father — servants of the hospital’s sponsor, shipping tycoon Captain August Robertson (Grainger Hines) — live at his mansion was ludicrous. What, they can’t pay this brilliant surgeon trained in the finest European institutes enough of a salary that he could have his own apartment? Setting his morning routine with a bunch of ruffians spoiling for a fight with a black man in “Paris shoes” against Cornelia’s pampered, affluent one was an insult to viewers.

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  • Hair and makeup can’t seem to decide if Dr. Thackeray has straight, black hair, or wavy/curly dark brown hair. Maybe this seems really picky, but it’s distracting, and anything that distracts a viewer from the story pulls him out of its fictional world.

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Strengths

  • The show’s handling of racism is mostly spot-on. Except for the heavy-handed scenes mentioned earlier, the racism is subtle and constant. Captain August Robertson tells a guest at Cornelia’s engagement party that Dr. Edwards is the “finest Negro surgeon” in the city. Mrs. Robertson greets Edwards at that party, then asks, “Are you here to see your mother [the Cook]? She’s in the back.” Some characters won’t shake hands with him. Thackeray tolerates — and even jokes about it — when Edwards’ major antagonist, Dr. Gallinger (Eric Johnson) sucker-punches him during a life-and-death surgical procedure. Dr. Gallinger tells his wife that the hospital staff’s “nickname” for Edwards is “Dr. Darkie” and she giggles before saying that it’s not appropriate/professional/nice, her laugh belying her spoken objection. Those subtle presentations of racism are very effective, as are actor André Holland’s facial expressions when they happen.

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  • Thackeray’s constant sarcasm as well as his incredibly high opinion of himself. It seems like such a character should be obnoxious, but Clive Owen pulls it off in every single scene. He even makes the character amusing. Good acting at its best.

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  • The nature, relationship, and conflicts between Sr. Harriet (Cara Seymour) and ambulance driver Cleary (Chris Sullivan) are some of the strongest in the show. These two minor characters are heading for Best Supporting Actor Awards, that’s how powerful their performances are. Humorous, angry, mocking, and suspicious colleagues turned unwilling allies, the two have progressed from a playful teasing relationship to a coercive one involving extortion and dangerous secrets. The first time Cleary addressed Sr. Harriet as “Harry,” I laughed aloud while, at the same time, knowing that something very bad was about to happen.

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  • The special effects. The pigs Dr. Thackeray and others practice surgical procedures on because the Knicks’ Director Barrow is stealing bodies to sell them to other institutions. Beating hearts during open-heart surgery. Patients catching fire after electricity is installed and used during surgery for the first time. Thackeray putting his hands into a woman’s abdomen in an attempt to retrieve her unborn child which has migrated outside the ruptured uterus. Thackeray massaging a dead woman’s heart by putting his bare hands inside her chest cavity, which he has cut open after her death for this express experiment, to test his theory about its causing a pulse. The former lover of Dr. Thackeray who contracted syphilis from her husband and has no nose. All of it is just gory and realistic and gruesome and makes me really grateful I’m not a surgical patient at the Knick in 1900.

  • The research behind the show, which includes actual archival photos of rare and deforming medical conditions (which Cleary is  joking about as the other doctors are breaking-and-entering in order to steal a journal from a surgeon to learn a new procedure rather than ask the black surgeon Edwards about it).

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  • Dr. Edwards finally became a man who stood his ground in episode 4, earning the beginning of Thackeray’s grudging albeit mocking respect, when Dr. Edwards refused to “talk the surgeons through” the next step in a heart aneurysm-repair procedure, which he’d helped pioneer.
  • The original music. Electronic and eerie and compelling.

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  • The set, inside and outside the hospital,  including the rat-baiting scene in the basement of the bar. Very impressive. As good as the show’s special effects.

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  • The doctors’ shoes. Those have to be historically accurate. Otherwise, they’d be too bizarre to be realistic. And Dr. Thackeray mostly wears his without socks, so he can inject the cocaine between his toes more quickly.
  • The hint of an attraction and a possible relationship between wealthy tycoon Captain August Robertson’s daughter Cornelia and the “best Negro doctor” in the city. Oh, please, oh, please, oh, please… Let’s be really brave.

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If you aren’t watching Cinemax’s The Knick (new episodes Fridays 8p.m. ET, with reruns all week long), you’re missing one of the finest and most compelling dramas since HBOs Deadwood.

And that show can’t be beat.

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