Fact-Checking The Knick: Were Doctors Really Deranged and Drugged Out?

Photo: Mary Cybulski/Cinemax

Nurses shooting up doctors…patients bursting into flames on the operating table: The new Cinemax series The Knick paints a shocking picture of medicine in the early 1900s at the fictional Knickerbocker Hospital in New York City. It’s so wild-west that you can’t help but wonder: Is this for real?

To separate fact from fiction on this show about Dr. John Thackery (played by Clive Owen)—loosely based on a real surgeon named William Stewart Halstead—we talked to Lorinda Klein, former archivist for New York’s Bellevue Medical Center and now associate director of media relations at NYU-Langone Medical Center.

The claim: Doctors sterilized their hands by dunking them in barrels.

IT’S POSSIBLE—but it would have been filled with their version of Purell, carbolic acid. “Doctors started using it in 1885 to prevent the blood infection sepsis,” explains Klein. Before then, “no one really understood what caused infection.” In fact, in the mid-1800’s, the mark of a good doctor was how much dried blood from other patients he had on his scrubs. Sterile gloves (made of vulcanized rubber) didn’t come on the scene until around World War I. Halstead evidently invented them because he was in love with his operating room nurse and wanted to protect her hands.

The claim: Surgeons injected cocaine into patients’ spines to numb them.

FACT. As shown on The Knick, Halstead experimented with the drug as a nerve block, first injecting it in his own spine. Whoops, bad idea; he became hopelessly addicted. Amazingly, you can still find cocaine in hospitals, Klein says: “It’s used topically as a spray in throat procedures.”

The claim: Doctors operated on high-risk pregnant women—and timed themselves.

TRUE AND ALSO TRUE. In episode 1, we see The Knick’s surgeons attempt a Cesarean section (badly; both mother and baby die). It seems far-fetched, but C-sections were done as early as the mid-19th century. As for MD’s trying to shave seconds off their operating times, this dates back to the 1800s, Klein notes, when you could tell a top-notch surgeon by “how quickly he could sever a limb.” Given there was NO anesthesia, speed was key.

The claim: The NYC Department of Health (DOH) rounded up Typhoid Fever patients from their homes.

FACT! On the show, the sick are brought to the hospital but in reality, they were quarantined at DOH hospitals and in remote spots like Roosevelt Island. Did you know that—wait for it—you can get rounded up today? “If a patient is considered a risk, he can be detained, even against his will,” Klein says. And don’t think you’re free-and-clear because you live in Boise: the Centers for Disease Control and Prevention has the power to isolate and quarantine anyone at risk of spreading a communicable disease (like, say, Ebola) either between states or overseas.

The claim: Medicine was rough-and-tumble (opium dens! baseball bats! gambling debts!)

PRETTY MUCH. The medical profession was not nearly as exalted in the 19th and early 20th century as it is today. As in, “you could go to medical school with just a grammar school education,” Klein says. OK, so doctors today aren’t perfect—but at least they’ve taken high-school biology!

Lisa Lombardi is the Executive Editor of Health.


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