‘The Knick’ is a new twist on the TV doctor show

Clive Owen plays a medical antihero with a drug problem in Cinemax's "The Knick," his first U.S. television series. (Genaro Molina / Los Angeles Times / August 3, 2014)

At the Knickerbocker Hospital in New York, ambulance drivers get kickbacks for delivering patients, women regularly die from routine pregnancy complications and the chief of surgery's a strung-out cocaine addict who refuses to allow his black deputy to operate on patients. Did we mention there's no electricity or antibiotics?

Thankfully, the people of New York are in no danger — not anymore, that is — of landing at the embattled institution at the center of the series "The Knick," premiering Aug. 8 on Cinemax. Set in 1900 at a time of sweeping change in the city and the world of medicine, the show throws viewers headlong into the seedy underbelly of turn-of-the-last-century Manhattan.

In the pilot's opening minutes, Dr. John Thackery — played by Clive Owen in his first series role for American television — awakens from a stupor in a Chinatown opium den, hops in a horse-drawn cab and injects cocaine in his toes as he winds through the teeming slums of the Lower East Side. Arriving at the Knick, Thackery scrubs in and in a spectacularly gruesome sequence few viewers are likely to forget, attempts to save a pregnant woman with placenta previa, a complication that once spelled certain death for both baby and mother.

Let's just say it doesn't go well.

"It's a bit like, 'Welcome to 1900!'" Owen said recently over cappuccino at the Mercer Hotel in Soho, a few cobblestoned blocks (but a world away) from the imagined home of the Knick in what's now the East Village. Since breaking through stateside in Mike Hodges' sleeper hit "Croupier," released here in 2000, Owen has brought his suave intensity — just don't call him "brooding" — to "Gosford Park," "Children of Men" and the romantic comedy "Words and Pictures."

His role as a "crazy and abrasive and unpleasant and tough" drug addict is likely to do little to distance Owen from the "B" word. "He's dark, and he's complicated. He really is. I'm sure one of the reasons I was excited by him is I've always loved playing somebody who's uncomfortable."

"The Knick" is novel not just for its decidedly unsentimental view of the recent past. In a rarity for series television, the entire 10-episode first season was directed by a single Oscar-winning filmmaker, Steven Soderbergh. And despite its prestigious TV bona fides (charismatic antihero, A-list film-world talent, period setting), it's airing on Cinemax, a cable network more associated with smutty late-night fare and shoot-'em-up action shows than with the Emmy bait regularly seen on HBO, its more sophisticated sister channel. Despite the risks, "The Knick" has already been renewed for a second season, once again to be directed by Soderbergh.

'The doctor show'

In May 2013, just as his Emmy-winning Liberace biopic "Behind the Candelabra" was set to premiere on HBO, Soderbergh declared his retirement from feature films and said he was looking forward to painting lessons.

That's when the script for "The Knick" landed on his desk, courtesy of his manager, Michael Sugar, of Anonymous Content. The project came by way of Jack Amiel and Michael Begler, a screenwriting duo whose family-friendly credits ("The Shaggy Dog," "Big Miracle") hardly suggest the capacity for stomach-churning spectacle.

"I just knew it was going to go fast," Soderbergh said during a conversation in his tidy, compact Tribeca office. "The foundation was the most indestructible genre in television, the doctor show, but I hadn't seen this context before."

The series came about when Begler, amid a personal health crisis in 2012, began researching the history of medicine. "I found myself at times really amazed at what the world had figured out and at some points really frustrated with what we still had to figure out," he recalled. "It just made me start to think about the general question of 'Why do we know what we do?' "

After snatching up vintage medical textbooks on EBay, he and Amiel quickly decided fin de siècle New York would make a rich backdrop for a television series. "It was a society going through changes so fast that people's hair was being blown back," Amiel said.

Following "Mad Men," "Boardwalk Empire," "Manhattan" and "Downton Abbey," "The Knick" is the latest high-brow series to mine the history books for drama. And though a work of fiction, it is rich with real-life influences. Owen's Thackery, an obsessive surgeon helping lead his nascent discipline out of the barber shop and into the realm of science, was partially inspired by William Stewart Halsted, a famed New York surgeon and educator who also happened to be a cocaine addict.

"Thackery is a guy who is always pushing forward and desperately trying not to look back because he's got a load of bodies behind him," Amiel said. "Cocaine gives you courage and stamina, two things that these guys needed at the time."

Drug dependency is merely one of Thackery's shortcomings: He's also verbally abusive to his staff, including a wide-eyed nurse (Eve Hewson) and his black, Harvard-educated deputy chief of surgery (André Holland), and he openly flouts orders from the proto-feminist heiress (Juliet Rylance) who heads the hospital's board of trustees.

The grim financial situation at the Knick doesn't help Thackery's mood. (An actual Knickerbocker Hospital once existed in New York, but this is merely a coincidence, say the series creators.) With the city's elite fleeing uptown, the hospital is left to serve the ever-increasing waves of impoverished immigrants crowding Lower Manhattan.

"It's a great way to look at a very exciting city at a very dangerous time," Owen said, "because you can go into the world of the people who are funding the hospital, or you can go into the slums where diseases are breaking out. New York was pretty wild in those days."

Soderbergh offered the project to Owen, a performer he'd never worked with before but whose "flawless reputation" intrigued him.

Owen, who first made a name for himself in British TV in the con man drama "Chancer" and as a private detective in "Sharman," but hadn't done a series in nearly two decades, was intrigued but wary of the 10-episode commitment — that is, until he read the script. Unlike many other period dramas, he said, "The Knick" "wasn't polite and restrained, it felt very contemporary."