THE KNICK: haunting quality of a fever dream from which you didn’t want to wake
Typhoid Mary and the birth of ‘contact tracing’ – as seen in The Knick Want to know why ‘tracing asymptomatic carriers’ works? Then watch Steven Soderbergh's brilliant, gory historical drama
“ But Thack laid on his back was the perfect fade to grey. The Knick had finished as it started: with the haunting quality of a fever dream from which you didn’t want to wake. “
New York has been paralysed by a wave of deaths, caused by a fast-acting and unrelenting infection. It strikes indiscriminately, targeting the wealthy as ruthlessly as the downtrodden. Scariest of all, this is a hidden killer. By the time you discover you’re sick, it’s often too late. Survival is a roll of the dice.
Such is life as apprehensively lived in Manhattan today, indeed in the rest of the world. Which may explain why we’re all glued to movies such as Contagion and Outbreak, and Netflix’s documentary Pandemic: How to Prevent an Outbreak. But it was also a key plot point from a little-watched television drama that ran in 2014 and 2015. A storyline that was, in turn, based on the real-life case of a lethal outbreak in New York at the turn of the century.
Steven Soderbergh’s The Knick was the prestige-TV equivalent of one of your five-a-day. And it came just three years after he directed Contagion, about a Covid-19-style outbreak. More importantly, it was about the birth of modern medicine: the painful and gory gestation of practices we take for granted now.
Yet the Knick (now available on demand through Sky) explores advances in brain surgery, anaesthetics, infant mortality rates and, most significantly from a 2020 perspective, the battle against infectious diseases such as typhoid and tuberculosis, which we see claim a baby in its cot.
The setting is a baroque New York hospital, The Knickerbocker (based on a real hospital in Harlem which finally closed in 1979). The year was 1900: a time when moustaches were huge, syringes even bigger, and surgery had more to do with lopped-off limbs than hip replacements.
The Knick was a period caper with a very modern pulse. Soderbergh used it as a vehicle to address such eternal themes as addiction, racism and the struggle between head and heart (not to mention the importance of a perfectly maintained ’tache).
It starred Clive Owen, one of the go-to-actors for tortured intensity, as a maverick surgeon with the fantastically old-fashioned name of Dr John “Thack” Thackery. We see him forge ahead in areas such as skin grafting (he grafts skin from a patient’s arm to her nose), placenta previa surgery and hernia repair. He was a pioneer working in a time of unprecedented medical advancement.
As was the real-life surgeon upon whom he was loosely based. William Halsted was the house physician at New York Presbyterian Hospital, where he introduced such innovations as patient charts, and invented the painful-sounding Halsted mosquito forceps – “a ratcheted haemostat to secure and clamp bleeding vessels”. And he married the first nurse ever to wear gloves during an operation. He was, in addition, addicted to cocaine and morphine (then legally available), requiring a minimum cocaine intake of three-grammes daily.
With the cocaine and the clamps and the great facial hair, you can see why he was irresistible to Soderbergh and The Knick’s creators, Jack Amiel and Michael Begler. Their fictional version of Halsted was a classic flawed anti-hero. In a just world, Thack would have joined the ranks of the small screen’s great “difficult men”, alongside Tony Soprano, Walter White and Don Draper.
Thack was portrayed by Owen as charismatic, enigmatic, permanently dishevelled and moderately racist (there are tensions early on over the hiring of African-American doctor Dr. Algernon C. Edwards). He also romped with prostitutes – as was the fashion at the time – and began the day with enough cocaine to floor a camel.
With coronavirus bringing humanity to a stand-still, Thackery is ideal company for an extended binge-watch. The killer infection plot surfaces midway through the first of its two seasons. It doesn’t directly involve Thack. He is otherwise occupied taking drugs and cavorting with nurse Lucy (Eve Hewson, daughter of Bono).
Investigating the deaths are two second-string characters, Health Inspector Jacob Speight (David Fierro) and Cornelia Robertson (Julia Rylance), society lady and head of The Knick’s social welfare office. They discover all the households struck down with typhoid , a bacterial fever caused by a pernicious strain of salmonella, have one thing in common: a County Tyrone cook named Mary Mallon worked there.
But how could a cook spread typhoid, which cannot survive the high temperatures associated with preparing food? Eventually they work it out: she’s passing on the fever through her signature room-temperature dish of peach melba. This leads to another question: if she’s knowingly spreading typhoid all over the Upper East Side, why doesn’t she herself show symptoms?
The answer lies in a cutting-edge new theory: that some individuals carry and spread infection whilst themselves not developing symptoms. It’s a condition known as “asymptomatic”. Today, we all know what that entails, but at the time it wasn’t universally accepted within the medical profession.
Certainly, the characters in The Knick struggle to get their heads around it. “She must be a filthy thing and as sick as a cesspool,” Speight says to Robertson as they rush to stop Mary – “Typhoid Mary”, they’ve dubbed her – from serving another dose of lethal peaches.
How did they find her? By tracking down all those who fell ill, and then the people with whom they interacted, and overlaying the data points on a map of Manhattan. In other words, by “contact tracing” – a concept which might have sounded dreary a few months ago, but which today is on everyone’s lips.
In the final confrontation, they head her off at the kitchen, and she’s arrested attempting to flee. (Some might say that the American actress, Melissa McMeekin, should also be in the dock for her dreadful Irish accent, which suggests a heavy viral load of Darby O’Gill and the Little People.) Scientific ignorance, alas, wins the day. Just two episodes later, Typhoid Mary is freed, when the judge refuses to believe that someone could transmit a lethal fever while immune to its symptoms.
These are, more or less, the facts of the real-life case of Typhoid Mary, an immigrant from the Old Country estimated to have fatally spread the fever to more than 50 people (via her delicious ice-cream, however, not peach melba). Yet there was no Hollywood ending for her, despite press baron William Randolph Hearst helping fund her defence at trial. She avoided prison, as she does in The Knick, but the Typhoid Mary name followed her around. And, though she found work under a number of aliases, people continued to die in her vicinity.
Mallon was eventually sent back to North Brother Island in New York’s East River – where we she see her incarcerated in The Knick – and lived out the last 23 years of her life in enforced isolation. After her death from a stroke in 1938 at age 69, an autopsy revealed a gall bladder riddled with typhoid bacteria.
The Knick itself would submit to the inevitable after two seasons and just 20 episodes. And yet despite low ratings, it wasn’t necessarily an obvious candidate for cancellation. The critics loved it, and Soderbergh, one of the most instinctive filmmakers since Spielberg, made it quickly and cheaply for HBO offshoot Cinemax. (Incredibly cheaply, in fact, considering the realism with which he brought to life turn-of-the-century New York.)
He shot each 10-part series in just 73 days – roughly one instalment per week. That’s a decent clip when churning out a 20-minute sitcom. But to produce gorgeous prestige TV in that time-frame was remarkable. The Knick, which was shot on location in New York, looked incredible. While clearly set in the past, there’s something grippingly vivid and urgent about it. It’s the very opposite of starched, stagey period telly such as Downton Abbey and HBO’s own Boardwalk Empire.
That’s because Soderbergh filmed in natural light as far as possible. He was able to do so thanks to cutting-edge RED digital cameras, equipped with new “Dragon” sensors designed to work in low levels of light. Even when it was grim and gloomy outside, he could shoot using natural light. “Every once in a while, an actor would walk onto the set and say, “Are you guys bringing any light in?’” Soderbergh told Fast Company in 2014. “And we’d go, 'No, that’s it'.”This produced the occasional strange side-effect. Looking back over footage, for instance, Soderbergh would suddenly sense something amiss. He’d freeze the frame and zoom in. And there it was: because of the fading light, the actors’ pupils were massively dilated.
Bravura directing was accompanied by powerhouse acting from Owen. As far back as his break-out 1990s hit Croupier, he was always a coiled spring when on screen. All that repressed tension spewed to the surface in his portrayal of Thackery, a brilliant man wrestling perpetually with demons. “It was very, very challenging and very, very demanding, and Steven [is] really fast and very concentrated,” Owen said in a 2014 interview with Indiewire. “We did the 10 hours in just over 70 days, or seven days an episode. There’s some incredibly difficult technical stuff there. All the operation stuff that’s logistically very difficult… Sometimes we’d shoot up to 13 or 14 pages a day."And yet, Soderbergh was supposed to have retired when he made The Knick. In 2012 the director of Out of Sight and Ocean’s Eleven had publicly stepped away from filmmaking. A few months later, he received a pilot script by comedy writers Amiel and Begler. His ambition at the time was to become a painter – a mission he expected to occupy all his free time over the next several years. “I was aware that the 10,000 hours required to become just good would take years of steady, applied focus,” he said. “I was basically ready to do that. I was taking painting lessons from [naturalistic wildlife artist] Walton Ford and having a great time learning things, talking to him and watching him work.”
When he read the screenplay for The Knick, and was riveted from the opening page. “I was the first person to get ahold of the script for The Knick and I just couldn’t let that pass through my fingers. It’s about everything I’m interested in. Everything. I was the first person to see it. And I thought, 'I have to do this'.”
Amiel and Begler had knocked around the industry writing disposable chuckle-fests such as the 2004 Kate Hudson vehicle Raising Helen. The idea for The Knick came when Begler had a turn of poor health. “I was having medical issues. I was researching alternative medicine, and was also frustrated,” he recalled to Indiewire in 2010. “I was thinking: What were my options 100 years ago? I can go online and find out so much different information now. Too much, even.
“But what do you do in 1900? On a whim, Jack and I just bought a couple of medical textbooks from eBay. We opened them and it was just incredible. And yes, it was a horror show. I couldn’t believe the things I was reading: people drinking turpentine to help a perforated intestine.
“My jaw hit the ground. The further we dove into this world, the more crazy s--- we saw. There was too much good stuff here. Once we saw that it was about medicine, then we started to look at what the world of 1900 was like. The world was changing so fast, with so much to play with.”
That “crazy s---” was searingly translated to the screen. The Knick is striking in that it’s set in a world only a few steps removed from ours. Thackery and his colleagues are recognisably modern doctors, not medieval quacks or shamans. Yet their practices also feel like butchery by another name. As antiseptically filmed by Soderbergh, The Knick often has the unflinching quality of an avant-garde horror film.
Thackery injecting cocaine into his genitals (all his other veins having collapsed) and performing a bowel operation using “a revolutionary clamp of his own design” are, for instance, among the highlights of the pilot. Episode four, meanwhile, sees the good doctor trying to save a woman from a botched self-administered abortion. The three-minute sequence contains more gore than all the Saw movies laid end-to-end.
The Knick finished in bravura fashion, too. As season two came to a conclusion, it was unclear if it would be renewed. So Soderbergh gave Thackery a wonderfully ambivalent send off. He recklessly attempts surgery on himself – without an anaesthetic – only for the experiment to go awry. There are a lot of entrails and lots of blood.
“My peripheral vision seems to be going… body temperature has begun to drop,” he says. “This is it… this is all we are.” And then his life flashes before him. Has the most brilliant surgeon of his era expired on his own operating table?
Soderbergh later revealed the plan was to kill off the character and that a third season of The Knick would have time-jumped to the 1940s (he wanted to film it in black-and-white). But Thack laid on his back was the perfect fade to grey. The Knick had finished as it started: with the haunting quality of a fever dream from which you didn’t want to wake.
https://www.telegraph.co.uk/tv/0/typhoid-mary-birth-contact-tracing-seen-knick/
