Bloody Hell: Steven Soderbergh Dissects His Modern, 1900s Medical Drama, “The Knick”

Director Steven Soderbergh talks about creating a contemporary feel for the turn-of-the-century medical drama, The Knick, and why he’s having fun with TV.

Bloody Hell: Steven Soderbergh Dissects His Modern, 1900s Medical Drama, “The Knick”
[Images courtesy of Cinemax]

From the jump, The Knick is a shot of pure New York.


In the show’s opening moments, we see a man with stylish shoes wake from a post-bender stupor in a den of vice and head into the early morning streets, grabbing a cab (and arguing with the driver over the preferred route) to head to a high-stress job. He stalls a little to indulge in some liquid fortification on the way.

If the whole thing feels timeless, it’s by design. While the scene is set in 1900, the conveyance is a hansom cab, and the fortification is (legal) liquid cocaine, the feeling–bolstered by a pulsing electronic track–is contemporary. Steven Soderbergh, who directed, shot, and edited all 10 episodes of the new Cinemax series, wanted viewers to be immersed in New York drama, instead of soaking in heavy “period.”

Steve Soderbergh on the set of The Knick

“Strangely enough,” says Soderbergh, “my goal was to, in a way, make you forget that it was a period piece. At least in the sense of of how it sounded, how it felt, how it looked, I wanted to somehow have the viewer feel, oh, their sensation of New York in 1900 is like our sensation of New York now; that’s how it felt to them.”

The Knick, premiering August 8 on Cinemax, revolves around New York’s Knickerbocker hospital, at the dawn of the 20th century. As a buzz-collecting summer drama, and as a new cornerstone series for a channel in transition, it’s got a lot to recommend it. There’s a gorgeous, gritty old New York poised to explode into a new era, Clive Owen, in a role as juicy as a Delmonico steak, an Oscar winning film director, ample blood, grime, and brutality, and hide-your-eyes-graphic cutting and sewing of human bodies in the name of medical progress.

While the show explores the bloody frontiers of medicine in the pre-antibiotic age, the fast-paced narrative is cut through with issues of progress, race, class, and power. Owen is John Thackery, the brilliant and, naturally, troubled new head of surgery at the Knick, who must contend with the dictates of the institution’s wealthy patrons, keeping the lights on (literally–electric lights are among the brand new inventions of the era), a cocaine addiction and, crucially, the integration of the hospital’s first black surgeon, Dr. Algernon Edwards (Andre Holland), all while pushing surgical innovation and coping with the emotional fallout of failure in the operating theater. A range of other memorable characters add dramatic and darkly comic layers. Among the highlights: the ethically unbuttoned ambulance driver Cleary (Chris Sullivan) who gets paid by the body, the badass nun with a deeply unofficial sideline, Sister Harriet (Cara Seymour), and the green nurse, Lucy Elkins (Eve Hewson), who early in the series loses whatever innocence she had in a harrowing encounter with a withdrawl-crazed Thackery.

Soderbergh, who you may remember is meant to be retired, was drawn back to the TV world (his first TV project was 2003’s K Street on HBO) by a script he says he couldn’t pass up. The show was created and written by Jack Amiel and Michael Begler and it’s a drastic departure for a duo whose credits include sitcoms like Empty Nest and The Tony Danza Show and the films Raising Helen and Big Miracle.


For Soderbergh, the dark subject matter is hardly a major zag, but the director pushed into new territory in creating the show’s visual vernacular, and in the process and pace of production.

To create that contemporary tone, Soderbergh shot the vast majority of the show hand held. “I wanted it to feel like it was happening right now,” he says. “I wanted the aesthetic to be participatory. It’s not an approach you identify with a period film.” Soderbergh used RED cameras with the new “Dragon” sensor, which he describes as “super sensitive,” to accommodate working at low light levels–the gore and drama were shot with almost all natural light. Some sets were built with practical light fixtures, but “there wasn’t a lot of augmentation,” he says. “Every once in a while an actor would walk onto the set and say, ‘Are you guys bringing any light in?’” he laughs. “And we’d go, ‘No, that’s it.” All of which led to a strange phenomenon in the editing suite–looking at closeups, Soderbergh said he was plagued by the weird, undefined sensation that . . . something . . . was different, until he figured out he was unused to seeing his actors’ pupils so large.

And then there are the surgeries themselves, which figure prominently in the show’s narrative and as such, are dealt with in the most direct possible terms. While the operating scenes may prove tough for the squeamish, once you get past the first cut, they’re actually quite interesting–and medically accurate. (In fact maybe the most nauseating thing about the surgeries isn’t the sight of scalpel tracks and blood and the smoke rising off cauterized flesh–it’s thinking how barbaric our own medical practices will seem to people 100 years from today. Ugh. Bring on the Elysium-style cancer-zapping Med-Pod 3000 already).

“I wanted those scenes to be accurate and be graphic enough to be a topic of conversation,” says Soderbergh. “I don’t feel like they’re gratuitous, but they are extremely graphic.” The production team worked with consultant Dr. Stanley Burns of the Burns archive, keeper of the world’s richest textual and photographic record of medical history. “The amount of material we had access to was unbelievable. His five-story brownstone/museum is incredibly comprehensive. We had a bucket of procedures that would suit any story point we needed to make. If we said we need a procedure we can tease out of for this many episodes, or just a one off, we’d call him up and say, ‘What do you have?'”

For Soderbergh, an additional novelty, and challenge, was the pace of production; the team shot at a brisk clip–570 script pages in 73 days. Perhaps because of the on-set rigor for which the director is known, the tight schedule worked, and its constraints yielded beautiful results. And it was fun, which isn’t to be underestimated as a motivator for a guy who ushered in a new era of indie filmmaking in 1989 with, Sex, Lies, and Videotape, and went on to direct commercially and critically successful films nonstop for the next 24 years, before stepping back from a system he feels is broken.

When The Knick script came to him last May, Soderbergh hadn’t been planning on doing a TV show exactly. He was finishing up what would be his last feature film, Behind the Candelabra. He planned to devote his time to painting but then ended up directing a theatrical production, The Library, doing unusual experiments on his site Extension 765 like re-editing infamous films, unspooling a novella on Twitter, working on a multi-year project to bring his liquor brand, Singani, to America (about which more in an upcoming edition of Co.Create) and generally exploring what the next era of storytelling might look like. He’s been vocal about the shortcomings of the studio movie system and has said in a past interview that, frankly, he wasn’t having fun anymore. TV was a return to fun.


And not just the kind of fun that comes with shooting experimental bowel surgery with a handheld camera. “The vibe is better,” he says. “There’s less fear. Fear is not a pleasant sensation to be around when you’re trying to problem solve. There’s, I think, more faith in allowing creative people to solve problems the way they think they should be solved and without a lot of second guessing.”

Pace notwithstanding, however, the process of working on this particular TV show may not have been as much a departure from his film experience as it could have been.

“This was such an atypical experience for TV in that it was budgeted and boarded and shot like a movie. We weren’t delivering episodes serially; we delivered the whole thing. We did lot of restructuring in the first half of the season, moving scenes from one episode to another and playing out throughlines at a different pace and with a different structure than it was written–that was a huge luxury to be able to see the whole thing and make global changes.”

The show is produced out of Anonymous Content, the company behind True Detective, another drama defined by the vision of a single director who set the tone for, and helmed, the entire series. It represents a more holistic approach to TV-making–the production company delivers a more complete creative product to a network, with the involvement of a director throughout. It’s the kind of cohesive production that Soderbergh says is, or should be, the future of TV. “I think you’ll see more of that. It’s a successful paradigm, in terms of creating a totally unified piece. I think you’ll see more situations where you’ll have a director as part of the core creative team.”

With The Knick already renewed for a second season, Soderbergh will continue to slice up traditional notions of retirement. Two more TV projects are going forward with others in development, he says. Starz has ordered a 13-part anthology series based on the director’s 2009 film, The Girlfriend Experience–Soderbergh will executive produce the show, to be written and directed by Lodge Kerrigan and Amy Seimetz. And Soderbergh will work with David Gordon Green (Eastbound and Down, Pineapple Express) on a pilot for Amazon called Red Oaks. Green will direct and Soderbergh will produce the comedy which is set in 1985 at a New Jersey country club.

“It’s fun,” he says of the project.

About the author

Teressa Iezzi is the editor of Co.Create. She was previously the editor of Advertising Age’s Creativity, covering all things creative in the brand world