For Authenticity, TV Show Taps Columbia’s Expertise in Medical Archives

By Joseph Neighbor

“The Knick,” a new drama series that premieres Aug. 8 on cable TV’s Cinemax network, is set in a fictional New York hospital circa 1900, when outbreaks of tuberculosis and cholera were common, surgical techniques were raw, and scientific understanding was scant.

“Medicine was not anywhere near what it is now,” says Jennifer McGillan, archivist in the Health Sciences Library’s Archives & Special Collections. “Doctors didn’t even understand blood types. Washing your hands was a fanciful idea. Going to the hospital back then was like taking your life into your own hands.”

In the interest of historical authenticity, the show’s researcher contacted CUMC’s Archives & Special Collections, a renowned trove of artifacts, documents, and personal papers of prominent Columbia doctors, dentists, and nurses. The archives' holdings range from the late 18th century, when the College of Physicians & Surgeons was founded, to the present day. Though the collection is Columbia-specific—and “The Knick” takes place in a fictional New York hospital—it proved helpful in faithfully rendering the world in which the show takes place. Some of the show’s props are direct replicas of items found in the archives.

“The Knick” is Knickerbocker Hospital in downtown New York. The series focuses on the surgeons, nurses, and staff who reset the boundaries of medicine at a time when mortality rates were high and antibiotics were unavailable. The central figure is Dr. John Thackery, a brilliant surgeon addicted to cocaine. Elements of the character are said to be inspired by William Stewart Halsted, an 1877 P&S graduate who was addicted to cocaine and, later, to morphine. (The drugs were not illegal at the time.) Dr. Halsted was renowned for championing newly discovered anesthetics, the use of gloves during surgery, and radical mastectomy for breast cancer. After serving on the P&S faculty, he moved to Baltimore, where he and three other medical pioneers founded the Johns Hopkins Hospital.

“What the show was looking for wasn’t so much content as form: What did the case books look like, for instance, or floor plans from 1900,” Ms. McGillan says. She is the person who greets visitors to the archives, including students, scholars, authors, and people doing private genealogical research. The first step for any visit is a reference interview to discuss the visitor’s project and how the archives’ holdings might be useful. “I help them find what they need,” she says, “which is often different from what they think they need.”

When the researcher for “The Knick” came by, Ms. McGillan was presented with “an interesting challenge.” She and the researcher spent the next several months sleuthing through “the physical bits and pieces of the 20^th century,” as she describes it. Some of the questions were predictable. What did hospitals look like? How were medical procedures done? What was it like to be sick in 1900? One of Ms. McGillan’s favorite topics concerned ambulances around the turn of the century: How did they work? Automobiles had only recently been invented, after all. Ms. McGillan discovered that instead of bringing patients to the hospital, ambulances were used to bring physicians to the patient.

Some questions were not easily answered. Pictures of nurses from around 1900 show some nurses wearing black gowns, for instance. Why did they wear black? One theory was that it was to hide bloodstains. Another was that it indicated rank within the nursing hierarchy. Ms. McGillan’s idea, though unconfirmed: “There were lots of sick people back then. Consumption was a still a significant and common problem. So some families had private nurses. Perhaps the nurses wore black so they would match the parlor maids. These are some of the things that got lost in time.”

Despite being involved in the show’s research, Ms. McGillan was not given any advance knowledge of the script. “I will watch the premiere like any other viewer,” she says. That is OK with her. “We’re discreet here at the archives,” she said. Her interest is to help anyone doing serious research find the materials they need, regardless of the nature of the project. “We get people working on articles or novels, others with scholarly interests. Lots of people doing genealogical research. We welcome these guests. I love being able to haul out our treasures.”