The Knick


Leonard Zwelling

         The Knick is not a new TV show about Walt Frazier. It is
instead a new Cinemax series that began last Friday, August 8, about a hospital
in New York City at the turn of the century. No not 2000. 1900.

         Clive Owen plays the Chief of Surgery, John Thackery and is
a pretty standard Hollywood surgeon–tall, handsome, arrogant, gifted and a
cocaine addict (well, at least he isn’t perfect!)

         Here are some of the script details that make you know it is

1. The transportation is horse-drawn carriages.

2. The hospital is upgrading to electricity from gas for
its lighting. However, the ambulance can be summoned with a telephone.

3. The ambulance drivers fight with one another over who
gets to carry the sick or injured patient to a hospital much as tow truck
drivers vie for wrecks in Houston today. The drivers receive kickbacks for each
paying patient they bring to the Knick. They threaten rival drivers with
baseball bats. It’s an early form of pay for performance with an unusual form
of capitation. The Knick’s ambulance drivers get the patient or they get your

4. There are no masks worn by the surgeons in the
operating room nor do they wear gloves. They do use ether and even a spinal
block is employed for a patient with lungs so compromised by bronchitis that the
spinal block is the only viable anesthesia possible for his life-saving bowel

5. All the suction pumps are operated by hand crank (and
you thought your internship was a grind), but the cautery looks pretty much the
same as the one in use today.

6. The doctors can be rude to the nurses without having
someone call HR.

7. Caesarian sections for placenta previa are fatal.

8. The newly hired surgeon is an African-American from
Harvard who has also trained with the best surgeons in Europe but who is
discriminated against as soon as he shows up at the Knick for an interview. He
gets the job anyway because the hospital’s major patrons are members of a
liberal family wishing to make social history by employing a minority surgeon
on the Knick’s staff.

         But just in case you want to tune in to
laugh at how primitive high-powered medicine used to be consider the following:

1. The Chief of Surgery is tall, handsome, arrogant,
gifted and damaged. (Think about those giants at Methodist and St. Luke’s. OK, ok–it is Hollywood).

2. Without the money from the patron family the
electrical upgrade cannot go forward so the patrons get what they want.  Money talks when it comes to new facilities.

3. Mott Street is a Chinese neighborhood in lower New
York as it is today.

4. Experimental procedures may or may not be done after
consent is obtained. (OK, they weren’t facing the Ebola virus, but bowel
surgery was just as fatal then as tropical diseases are now.)

5. When the leadership of the hospital board needs a new
surgeon, the board hires someone from Harvard.

6. The chief administrator will do anything for the
patron family’s money.

7. The chief administrator is a toady little man with
perfect hair, up-scale grooming and is sartorially perfect if not flashy. He
spends a lot of time doing major sucking up to the money.

other words, the more things have changed, the more they have stayed the same.

consider watching the Knick. If the rest of the episodes hold up it should be
fun (FUN=pleasure+engagement+meaning). It will certainly be a hoot. It’s
somewhat disheartening to see that those physicians and other “providers” who
came before us have to put up with the same nonsense we do today. They never
would have imagined that the same new magical source for lighting would someday
be used for the medical record, which may or may not prove to be truly

most fascinating is the subplot about the African-American, Harvard-trained
surgeon who was about to resign because he was treated so poorly, until he saw
Thackery at work in the OR and decided he still had a lot to learn at the Knick.

that part about the Harvard-trained guy thinking he has something to learn at
an institution south of Boston must be the fictional part.

Leave a Comment

Your email address will not be published. Required fields are marked *