01x01 - Method and Madness

[bunniefuu]

(muffled chatter)

(woman giggles)

(woman speaking Chinese)

Woman: Johnny?

Johnny, it's seven and a half.

You said seven and a half?

The Knick. North on Mott, east on 11th.

Bowery is faster, sir.

Won't have a long wait for the trolleys crossing.

I don't want faster. I enjoy waiting.

Mott north across Houston.

Yes, sir.

(music playing)

(kissing noises)

(trolley bell rings)

Please save my baby.

Gentlemen, after two uneventful pregnancies, Mrs. Warren presented in her eighth month with what is assumed to be a case of placenta previa.

The hope had been to delay any procedure for the benefit of the fetus.

But circumstance has forced our hand.

Dr. Thackery and I have rehearsed the newest techniques extensively and feel confident that the speed necessary for success can finally be achieved.

Surgical Kn*fe.

100 seconds.

100 seconds.

100 seconds.

I want the students to take note that Dr. Christiansen is entering on the medial line just above the pubis.

We must be careful to extract the fetus quickly and in such a manner so as not to release pressure on the rupture, thus exacerbating the hemorrhage.

As you can see, there is significant blood in the cavity.

Vacuum, Everett.

Though it's difficult to see, it seems the fetus has migrated through the rupture upward toward the abdomen.

We need to lengthen the incision and get the baby out now.

Jules.

Nurse Monk, Kn*fe. Kn*fe.

Bertie, cauterize.

Monk: Her pulse is weakening.

I have a leg.

Pull the fetus down and out.

It's trapped in the cord.

Forceps clamps, umbilical scissors.

Bertie.

Come on, Thack.

Scissors.

You're free.

Tube it.

More vacuum, Chickering. Put your back into it.

Her pulse has become eccentric.

We still have time. Clamp that artery.

Invert that section, Thack.

There's the bleed.

We can still close the rupture.

Warren's needle and gut.

Dowell's needle and silk.

Good.

Her pulse is faint and fully eccentric.

She's pallid and her lips are blue.

Pedals. One, two, three.

Almost.

Almost. Almost.

There.

The bleeding stopped.

(cranking stops)

(clock ticking)

Nothing.

It seems... it seems we are still lacking.

I hope, if nothing else...

this has been instructive for you all.

We'll solve it.

How many more, Thack?

"And many strokes, though with a little axe, hew down and fell the hardest timbered oak."

Thus spake Thack the Wise.

Jules.

The procedure failed. You didn't.

Thank you, my friend.

♪ Isn't it a knobby one? ♪
♪ It's just the proper style. ♪

(g*n hammer clicks)

f*ck it all.

Thackery: Your god always wins.

It is the longest unbeaten streak in the history of the world.

Yet J.M. Christiansen fearlessly took up arms in that battle to oppose the inevitable.

Throwing himself at an enemy that has never known defeat and, as sure as I'm standing here, never will.

One could not be blamed for wondering if J.M. came to see his life's work as a fool's errand.

A rube... finally realizing that the game he's been playing will be forever rigged against him.

But my dear friend J.M. was a fine man and certainly was no fool or rube.

He and I spent our lives tilting at the very same windmills.

So why have I not lost hope like he did?

Because those windmills at which we tilted were created by men to turn grindstones that transformed the Earth's bounty into flour.

From such humble beginnings grew the astonishing modern world in which we now live.

We cannot conquer the mountains, but our railroads now run through them with ease.

We cannot defeat the river, but we can bend it to our will and dam it for our own purposes.

We now live in a time of endless possibility.

More has been learned about the treatment of the human body in the last five years than was learned in the previous 500.

20 years ago, 39 was the number of years a man could expect from his life.

Today, it is more than 47.

Eventually the train tunnels will crumble.

The dams will be overrun.

Our patients' hearts will all stop their b*ating.

But we humans can get in a few good licks in battle before we surrender.

Catherine.

I will not stop pushing forward into a hopeful future.

And with every blow I land, every extra year I give to a patient...

I will remember my fallen friend Jules Michael Christiansen...

and know that at the very least, something, however temporary... has been won.

(bell tolling)

Lovely eulogy, Dr. Thackery.

Thank you.

If not a bit self-aggrandizing.

And another chance for him to trumpet his personal w*r against God.

Good afternoon, Miss Robertson.

Sister.

Mr. Barrow.

It was a lovely funeral.

As these things go.

The minister was very eloquent, Sister.

Protestants have their moments, too.

(chuckles) Yes.

You should come to one of our Sunday services, Sister.

Very God-fearing.

Good day to you both.

The whole event is just completely tragic and quite shocking.

Who would have guessed Dr. Christiansen was so hopelessly lost?

Cornelia: 12 attempts at the same surgery with no survivors would drive any good man mad.

Of course.

His anguish is over, but hers is just beginning.

Though I understand he left her a sizable sum.

Enough to keep a widow warm at night?

And to attract the right type of suitor.

She is still a handsome woman.

Always surprised by your sensitivity.

Thank you.

How were the proceedings?

I'm guessing they chose to go closed casket today.

Yes, Mr. Cleary, the casket was closed today.

Ah, well, the worms will be thankful for the extra holes, though.

Saves them from having to make 'em for themselves.

(chuckles)

Ah, Sister, don't judge me too harsh.

I'm just a poor simple sinner in the eyes of the Lord.

The Lord loves all His children equally.

Though in your case, Mr. Cleary, I'm sure He'll make an exception.

(sighs)

(phone ringing)

Ambulance.

Right.

We got one.

(footsteps approaching)

Good afternoon, gentlemen.

Good afternoon.

Miss Telfer.

My father sends his regrets that he can't be here today, so I'll be sitting in as his proxy.

(men laugh)

Signed by Captain Robertson.

Perhaps we should adjourn, then, till the captain can be here and we're able to do this properly.

Yes.

If you strongly object to my father's wishes, Mr. Habershorn, I will understand if you need to make your apologies and leave.

Then let's get to the business at hand.

I'd like to welcome Dr. Thackery to his first board meeting, seated in place of the late Dr. Christiansen.

My condolences, Dr. Thackery.

Dr. Christiansen's untimely passing has brought added strain to the Knickerbocker.

Aside from the public disaster it presents, it further hampers our efforts at financial solidity.

As you can see, gentlemen, in the published reports in front of you, monthly costs have increased.

This is due in part to the recent renovations in the men's and women's wards.

The hospital is now running at a deficit of nearly $30,000 a year.

Now, in light of this, I've taken the liberty of postponing the much needed repairs in the courtyard.

Now, Dr. Thackery, as you were Dr. Christiansen's Deputy Chief of Surgery, the board would like you to step into his position as Chief.

We'd be grateful if you'd accept.

I will, though with great regret.

Which means you'll be needing a new deputy.

I'm sure we all agree that Dr. Gallinger is the right man for the job.

I'm not sure we all agree on that.

My father and I would like you to consider another candidate.

Based on what? Your surgical expertise?

Based on our faith in the man.

Dr. Algernon Edwards. Mr. Barrow.

He received his medical education at Harvard College, graduating with distinction.

His training was done at Boston Hospital and then Providence.

And he spent the past four years working and instructing at St. Thomas Hospital in London under Sir William MacCormac, President of the Royal College of Surgeons and at the Institut Pasteur in France under Albert Calmette.

He has more knowledge of recent surgical advances in Europe than any man in the country.

And his return to the States provides us with a great opportunity, Thack.

Cornelia and her father have prevailed upon him to travel to New York tomorrow, as we assumed you would want to meet with him.

He seems very qualified.

Then I shall arrange for him to meet with you.

Arrange or insist?

Barrow: I think you can find a few minutes for a candidate of this caliber.

Considering all the Robertsons have done for us, it would be foolish not to respect their opinion and entertain the possibility.

Far be it for me to be foolish, Herman.

I will meet the man, but my choice is firm.

It's Gallinger.

(groaning)

Ah, and a good day to you, Pete.

How you doing there, fella?

(groans)

(laughs) Got a nice little package there for us?

You're not getting this one, Cleary.

(laughs) Oh, Pete.

Can't we be reasonable?

Talk about this like gentlemen?

Now, as to my mind, you can either give us the goods, or youse can all travel to the Knick as patients.

Cleary: Hooked a fine one.

Banker from up 5th Avenue.

Liver problems. Jaundice.

Pissing blood, he says.

I'm sure this one will be in a private with us for a few weeks and be paying his bill in full.

Nice catch.

That's two more bits for Cleary.

(chuckles)

End of the month.

Another beautiful day at the Knick, Nurse Elkins?

Ma'am.

Dr. Gallinger.

This is Mr. Sebastiano Gentile. 40.

On the eighth of this month he was struck by a streetcar, fracturing his pelvis.

Mr. Gentile, don't you know never to quarrel with a streetcar?

I've never known a man to b*at one yet.

I know that now.

Next time, take on one of those horseless carriages.

Much better odds.

Upon arrival, an extensive wound on the lateral side of his thigh was immediately stitched and dressed.

Pulse was 112. Abdomen was tympanitic.

And there was tenderness below the umbilicus.

So he was taken into the operating theater, where we found four puncture wounds from the fractured pelvic bone lacerating the bowel.

And with Dr. Chickering assisting, we immediately sutured the wounds using three catgut sutures on each puncture.

Was there any consideration of removing the damaged section of the bowel?

The difficulty in reconnecting the two new ends of the intestines seemed too great and the danger of post-operative bowel leakage was another complication we discussed.

And I dared not risk a resection.

Any complications thus far?

Mr. Gentile has developed a small case of bronchitis, which is common after such a procedure.

Very good, Doctor.

Clogs.

Which nurse changed the dressings on this man?

I did.

Per Dr. Gallinger's instructions.

Twice in the past 24 hours and I emptied his drains throughout the night.

And did you recently empty that one?

I didn't.

It's tended to have collected very little fluid.

And yet the area where the drain exits the wound is swollen.

Perhaps you might have considered clearing the drainage tube of clogs.

How long have you been here?

Almost three weeks.

Then you should already know, Nurse Elkins, that the goal is to keep the patients alive, not k*ll them with negligence after a surgeon's done his best to save them.

I expect everyone to be well versed in their responsibilities.

I'm sorry.

No, weakness and self-pity have no place on my ward.

If I'm asking too much of you, you can always take the donkey cart back to Kentucky and continue in the fine tradition of curing people with moonshine and angleworm poultices.

Rest up, Mr. Gentile.

You got a lot more trolleys to dodge in your future.

The joke's on Thackery.

He doesn't know you're from West Virginia.

(siren wailing)

(coughing)

Cleary: Jesus, Speight.

You sure it's not you with the f*cking tuberculosis?

Watch your mouth, Cleary.

There's plenty of other stretcher boys I can call for this.

(knocks)

Health Inspector.

Health Inspector. Open the door, please.

(woman coughing)

Hmm.

Mrs. Krawetz?

We're here to take you to the hospital. Do you understand?

Hospital.

Hos... hospital.

She has a disease. She must be taken out of here.

Christ alive, it's the Tower of Babel in these shitholes.

Never the same language twice. Hospital!

My father says he doesn't want you taking my mother.

Well, I'm Officer Sears of the New York Police Department and there is a law that says we have to take her someplace that'll make her well so she doesn't get you sick, too.

(speaking Latvian)

My... my father says they took our neighbor and he never came back.

Oh, she'll be back and fit as a fiddle.

You watch.

No windows, no ventilation, no sunlight inside, no running water.

A breeding ground for disease.

That's why the new laws were passed.

I can compel you to make any and all structural changes to your property I deem necessary to protect the public.

That will cost a fortune.

I'm a businessman.

Blame Lister's microscope and Riis' camera.

The New York City Health Department is just doing its job.

You own two more buildings on this block, don't you?

(sighs)

Perhaps we can come to some other arrangement.

Perhaps we can.

Man: It's the last of the six loads.

Keep your boilers cooking for the next four months.

Barrow: Three cents a pound?

Man: Sounds good.

Barrow: That is excellent, Mr. Corker.

Here is a bank draft from the Knickerbocker for the full amount.

Thank you for choosing Parkhurst.

Mr. Parkhurst is grateful for your business.

And I am grateful for his.

Pardon me, gentlemen.

Where might I find Dr. John Thackery?

Down there.

Let's go, guys.

Come on.

Dr. Thackery?

Yes.

I was told I could find you here.

I'm Algernon Edwards.

Would you prefer for me to wait in your office?

No, this is fine.

May I ask what it is you're making?

It's an idea for an improvement on an instrument.

(hissing)

A colleague of mine in London was very fond of smelting as well.

In fact, the harelip forceps he modified is now the standard in Europe.

Well, if I find myself on the Continent working on a harelip, I will know who to thank.

I'm beginning to think you were not told everything about me.

You envisioned something different, I take it.

Something lighter.

I did.

And to be frank, Dr. Edwards, I only agreed to this meeting as a courtesy to Miss Robertson, but I am certainly not interested in an integrated hospital staff.

My skin color shouldn't matter.

Well, if it doesn't matter, then why was that information held back from me?

You'll have to ask Miss Robertson.

It's also nowhere to be found on your credentials.

Is your race listed on yours?

There's no need for it to be.

I grant that your background is impressive, and I'm sure there are many n*gro infirmaries that will benefit from your talents, - But this hospital...

You're here.

This is where I'd like to be.

If you would just give me a chance.

In London and in Paris, I was treated as an equal.

And I have no doubt...

This is New York.

This is not London or Paris.

You can only run away and join the circus if the circus wants you.

I don't want you in my circus.

Dr. Edwards.

How was your meeting with Dr. Thackery?

Wonderful if you call being humiliated in front of a 1,000-degree furnace a meeting.

What do you mean?

Thank your father for me.

I'm going to head back to Boston.

Sorry if I wasted your time.

I certainly wasted mine.

Dr. Edwards.

Dr. Edwards.

Algernon.

Miss Robertson.

Dr. Chickering would like to see you.

Inspector Speight.

Mr. Barrow.

How are things on the streets?

Getting worse every day.

The more boatloads they let in, the more pestilence infects the city.

I had three cases of tuberculosis just today.

The poor are just weaker than us.

You'd imagine the mayor would want to think about sending them immigrants elsewhere, but he don't stop 'em.

Shipping companies see to that.

Some of these diseases, they spread so quick, they wipe out whole blocks of people in just a few days.

We have to burn the bodies. We have no place to put them.

That a new one of your kids?

Yes.

Handsome-looking family.

Always wanted to have one of those done of me.

And why haven't you?

Don't think I could sit still that long.

What if I had to use the toilet?

Those frames look like they set you back a bit.

Gold leaf?

Where did you say you sent these tuberculosis patients?

The Knick got one.

City's gonna cover the full freight cost since I put her here.

And you want a finder's fee.

Could have easily sent her to St. Vincent's or Presbyterian.

Next time could be none.

Or it might be all of them.

You know, I like you, Herm.

We're cut from the same cloth.

I like to think not.

(raspy breathing)

Bertie: It's not good.

The tuberculosis is pretty advanced.

Her lungs are completely full of fluid.

Fever of 104. Pulse is erratic.

Her fingers are clubbing.

Are you recommending a sanitarium stay?

She's already on the other side of the hill, I'm afraid.

I honestly don't think she'll make it through the week.

Does she know?

She doesn't speak English.

Her daughter has been interpreting for me.

I see.

Responsibility is to the patient, but there's no rule that says we have to...

Hello.

(coughing)

May I ask your name?

Yetta.

Yetta.

A beautiful name.

Yetta, my name is Miss Robertson.

I'm from the social welfare office of the hospital.

I need your help right now to explain something to your mother.

All right?

Please tell your mother that the doctor says her disease has made her very sick.

(speaking Latvian)

She will not get better.

(speaking Latvian)

She will only get worse.

But the hospital will do all it can to make her as comfortable as possible.

(speaking Latvian)

If there is anything she or your family needs, we are here to help you.

Does she understand?

(speaking Latvian)

She understands.

I'm so sorry.

(speaking Latvian)

My mother wants to know what time it is.

It's 4:30.

(speaking Latvian)

My mother says I should go or else I'll be late for my shift.

Keller Shirtwaist Factory on Delancey.

Be sure she gets there safely, Jesse.

Yes, ma'am. (kissing noises)

(footsteps approaching)

(knocks)

I expected you over an hour ago. What kept you?

Your treatment of Dr. Edwards was indefensible.

No, it was completely defensible.

I'll tell you exactly what I told him.

I'm not interested in leading the charge in mixing the races.

Dr. Edwards is as capable as any doctor in this hospital.

Likely more so.

Perhaps.

But just as a shopkeeper would never stock an item on his shelves no customer would buy, I would not employ a surgeon no patient will agree to have operate them.

Then patients must be convinced of his ability.

Are you going to stand there and honestly tell me that the way out of our financial troubles is to hire a n*gro surgeon?

Once people learn that he is an excellent surgeon, they'll change their minds.

We're speaking about a patient's possible mortality.

Is this really a fair time to begin a social crusade?

Yes.

We're an institution in dire condition.

We're not an incubator for some progressive experiment for you and your father's money.

Please, find yourself another hobby.

Got it?

Yeah.

Do you see what you've done?

The Robertsons are pulling their crews.

They're terminating the electrification project.

Oh, so childish.

No, Thack, you're the child.

We need their money. We need to electrify.

I'm not hiring the n*gro.

Do you think I want that dusky co*n roaming these halls?

A man of high rank on our staff who will repel patients?

I need you happy, but right now I need the Robertsons happier.

You know we have no choice.

The man will be hired.

Then I'll resign.

Again?

(whimpering)

I want you to stay like that for 20 minutes, Mrs. Eberhardt.

Nurse Connelly will keep massaging your belly.

Trust an old midwife.

That breech baby will turn around in no time to get away from the cold.

Is this something the doctor prescribed?

He would if he knew what he was doing.

(Cleary laughing)

Oh, I envy that cigarette.

Nice and slow. Nice and slow.

(laughs)

Ah, the poor Lord's got all these ladies married to Him and none will give Him a go.

Hey, do penguins ever just want to go for a good poke?

Oh, we get curious.

But then they show us a photograph of your sorry face and we all run right back into the arms of God.

Your ugly mug's responsible for more girls staying virgins than the chastity belt.

(laughs)

(clock ticking)

(clock chimes)

(footsteps)

How in God's name are you still going?

I have an insatiable desire for fame.

And, of course... my old friend Uncle Parker.

I'd love to have your help for this next part.

Unless, of course, you'd rather go back to sleep.

(clock ticking)

Lucy: His temperature is 105 and his pulse is rapid at 166.

He has vomited three times in the last 90 minutes.

I figured his bronchitis was worsening, so I summoned you.

It's not his bronchitis. It's septicemia.

The swelling of the limbs.

The discoloration has started, too.

My repair didn't hold.

He's leaking his own bowel poisons into his blood.

I should have resected.

It would have happened with any surgeon, Thackery included.

Barrow: Most of our patients will receive their treatment here in the men's ward.

Ah, allow me to introduce you to two of your junior surgeons.

Good morning to you all.

Dr. Everett K. Gallinger and Dr. Bertram Chickering Jr.

This is our new assistant chief surgeon Dr. Algernon Edwards.

Thackery hired him?

Directed me to do it as of late yesterday.

Everyone calls me Bertie.

Feel free yourself.

Welcome to our circus.

It seems we need to head back inside the tent.

Excuse me.

Bertie: Septicemia following a bowel repair.

Mm.

We need to go back in and find the leak right away.

We? He is my patient, Doctor, not yours.

We can't go back in. Bronchitis.

The ether will k*ll him.

Get Dr. Thackery.

I don't believe he's come in yet.

Then find him, please.

Time is precious.

He's dying in front of our eyes.

Surely we can solve this ourselves?

You'll solve nothing.

Doctor.

He needs an immediate resection.

Two slippery pieces of bowel, wet noodles somehow sutured perfectly together while septic fluids leak all over the cavity poisoning the patient.

That is if we are somehow able to bring about surgical sleep without k*lling the man.

Nurse Elkins.

Yes?

Bertie and I will prepare Mr. Gentile for the surgery.

I need you to find Dr. Thackery. Try his home first.

We don't have a minute to spare. Now, excuse me.

Lucy, do you know where he lives?

No.

28 Waverly.

Lucy, do you know where that is?

No.

West, then left on Wooster Street towards Washington Square.

Welcome to the Knick.

(pounding)

Dr. Thackery?

Dr. Thackery?

Dr. Thackery?

Dr. Thackery, you're urgently needed for a procedure.

Good Lord, Dr. Thackery.

Go away.

Please go away.

Dr. Gallinger sent me.

A patient is dying.

Which one?

Mr...

Mr. Gentile.

He has septicemia.

Oh, f*cking Gallinger.

What's wrong with you? Are you sick?

I was trying to spend a night without it.

Without what?

(clatters)

Nurse, I need your assistance.

You need to inject me.

I can't do it.

Cocaine?

How much? I don't want to k*ll you.

A touch more than 22.

You've destroyed yourself, Doctor.

You're collapsed everywhere.

Toes.

They're too small.

Not for me. It's fine.

I don't think I can.

Oh, for God's sake.

What are you doing?

You want a bigger vein?

You want me to inject your...

Yes, on the underside.

The urethral.

Nurse.

(sighs)

Do it!

Lord forgive me.

(groans)

Gentlemen, atomizers on.

Everyone scrubbed, washed, cleansed, deloused, purified by God?

Gallinger: All except the last, Thack.

What's he doing here?

You hired him.

I'm here to assist in the surgery.

He's not touching me.

Don't worry, Mr. Gentile.

He won't be. Everett, you'll be assisting me.

Bertie, you'll back up Everett.

Thack, we can't use ether on account of his lungs and we can't operate on a man who's awake.

I know. I was considering this on the way in.

You could try Nirvanin on the abdomen.

There's some success in Germany.

In dental surgery. For something like this, it won't penetrate to the necessary depth.

Nurse Elkins, would you prepare a spinal needle and a hypodermic of 10 of a 2% cocaine solution?

Are you not familiar with the drug?

I am.

Then prepare it. I didn't hire him.

Barrow forced him upon me. He's the new assistant chief.

I was told you had decided to offer me the position.

Well, if Barrow told it to you, you should know there is never likely to be much truth in it.

(men laugh)

I will not stay where I'm not wanted.

Then I'm guessing you don't stay anywhere for very long.

As per my oath, I will remain in the theater until the patient is out of danger.

And then I will resign.

Congratulations, Everett, on your new promotion.

Mr. Gentile, we're going to sit you up.

Everett, Bertie.

Uh, what are we doing?

Sit him up. Arch his back forward.

Nurse Monk, pencil, sponge with antiseptic.

Gentlemen, before you is a patient who is infected with septicemia from his bowel.

Normally, we would induce surgical sleep with ether, but due to a severe case of bronchitis he has developed post-operatively, we cannot.

We must operate, but we cannot do it to a man who can feel pain.

My solution... numb the nerves in the spine between the thoracic vertebrae six and seven so as to stop the brain from learning of the pain.

I intend to inject a 2% cocaine solution directly into Mr. Gentile's spinal canal.

Low enough not to affect the heart and lungs, high enough to dull everything below.

My God, won't that paralyze him?

Not if he makes for the hollow canal in the sub-arachnoid space.

It's been tried once before on a Labrador retriever.

What happened?

There isn't a day goes by where I don't miss that dog.

(coughing)

If you could attempt to suppress your cough.

(clock ticking)

(groans)

Just a few seconds more.

Let's get him back down.

He's a madman.

"Though this is madness, yet there is method in it."

No pain.

Scalpel.

(murmuring)

Gauze.

(sizzles)

Towel.

Gallinger: Here's the location of my repairs.

Your sutures failed in two spots where the obstruction backed up with pressure on them.

You should have resected.

I know that now. I'm sorry.

Dr. Edwards, before you resign and leave us all in tears, would you be kind enough to go to the sterilizer and pass me the metal device contained within?

I'm now removing approximately 12 inches of the patient's intestines to relieve a blockage and some damage.

From this day forth, Mr. Gentile, you will have the honor of evacuating your bowels several seconds faster than any of your friends.

Watch carefully, Bertie.

You're gonna want to tell your father all about this.

(chuckles)

After the bad section of the bowel is removed, each new end of the intestine can be clamped together into this device which allows it to keep its tubular contour and shape.

I now tighten the screw to bring the two new ends together.

And we're in good stead for an easy connection with sutures.

When I finish this, you close, Everett.

Nice knowing you, Doctor.

I'm not leaving this circus until I learn everything you have to teach.

(sighs)

Chinatown.

467 Mott Street.

Yes, sir.

(kissing sounds)

Yah.

(music playing)