Early in the new Cinemax drama "The Knick," Dr. John Thackery boasts of "the astonishing modern world in which we live," insisting that "We now live in a time of endless possibility. More has been learned about the human body in the last five years than in the previous 500."

What is such an astonishing time to him is a very quaint one for us, since "The Knick" (it premieres Friday at 10) takes place in Manhattan in the year 1900. Viewed through a modern lens, Thackery's surgical techniques seem primitive, even barbarous, but in the context of his time — when a procedure we take for granted like an appendectomy is still considered dangerous and experimental — he and his colleagues are miracle workers.

"The Knick" arrives in an era where the possibilities for television drama are as limitless as they were for medicine in 1900. It's a period where a Matthew McConaughey can commit to eight episodes of a "True Detective" and then walk away, but also where an actor like Clive Owen (who plays Thackery) and a director like Steven Soderbergh can commit in the longer term to "The Knick," which was renewed for a second season weeks before the first one was set to debut. (Soderbergh directed all 10 episodes this season — in addition to serving as his own editor and director of photography, under his usual pseudonyms — and has said he will do so again next year.) It's an era of constant surprise and innovation, where the best shows appear in the unlikeliest of places ("Orange Is the New Black" on Netflix, "Rectify" on Sundance, or Amazon's upcoming "Transparent") or in the unlikeliest of forms (FX's "Louie" as a stealth contender for the best drama on television). 

The one drawback to living in an age of miracles is that what once seemed miraculous now can seem more commonplace. John Thackery might be amazed by laparoscopic surgery and modern antibiotics, but he might also feel sad that removing the appendix is now considered such a minor procedure.

Similarly, where "The Knick" might have seemed an indescribable wonder even a few years ago — with Soderbergh's extended hands-on involvement such a contrast to, say, Martin Scorsese directing the "Boardwalk Empire" pilot and then disappearing back to the movie biz — it's now more notable for signaling a change in direction for Cinemax (which until now has focused on well-crafted pulp fiction like "Strike Back" and "Banshee") than it is for the medium as a whole. In a time of abundant greatness, it is very good — and gorgeously shot — but it's not as revolutionary as the men and women whose work it depicts.
 
This is actually Soderbergh's second extended TV series gig. A decade ago, he directed and produced HBO's "K Street," a largely improvised series about Washington lobbyists and politicians, which mixed actors like John Slattery and Mary McCormack with D.C. fixtures like James Carville and Mary Matalin playing themselves. That was a show probably ahead of its time; "The Knick" mostly feels of its time, and in parts feels a few years behind it.

Specifically, John Thackery — a brilliant surgeon plagued by personal demons, fueled by liberal cocaine use and visits to the Chinese prostitutes of a nearby opium den — is such an archetypal cable male anti-hero that he would fall instantly into cliché with a lesser actor than Owen playing him. And with the introduction of Algernon Edwards (André Holland), an African-American surgeon forced on a reluctant Thackery by the hospital's wealthy, progressive benefactors, there are moments where "The Knick" comes across as a more expensive, medically-oriented spin-off of BBC America's 19th century police drama "Copper," which also dealt with the perils of being a black doctor in New York's horse-and-buggy days.
 
But Soderbergh has often been more interested in innovation of form than content. Many of his best films — say, "Out of Sight," or "Erin Brockovich" — have been familiar genre pieces, executed perfectly and in unexpected ways. (For example, the elliptical sense of time in the otherwise conventional revenge story of "The Limey.") Soderbergh and writers Jack Amiel and Michael Begler are essentially showing what "ER" or "Grey's Anatomy" might have looked like had television existed at the dawn of the 20th century(*), but all involved seem to understand how much heavy lifting the setting itself does when it comes to making the old seem new again.

(*) The 7th episode (the last of the batch sent to critics) is simultaneously the most Retro-"ER" of them in the way it has Thack and the other doctors dealing with a major calamity, and the most explicitly Soderbergh-ian in the way he shoots and edits several major character moments.  

So we see the surgeries and other procedures in extremely blunt and graphic detail — when Thack treats a patient who has suffered gruesome complications from syphilis, Soderbergh knows to just leave the camera sitting on the disfigurement, well past the point where it becomes uncomfortable — and we also get matter-of-fact reminders of the many ways the business of medicine has changed in the last 114 years. It is grisly and it is terrifying (and not at all the kind of show you should watch in close proximity to a meal), but to Thack, Edwards and the others, it is simply the state of modern medicine.

One of the show's most memorable characters is Tom Cleary (Chris Sullivan), a hulking Irish ambulance driver who gets a commission for every body — living or otherwise — he brings to  supercilious hospital director Herman Barrow (Jeremy Bobb), and we get to see the variety of extra-legal methods he employs to bump up his numbers. And we get to see how the harsh divisions of race, class and gender govern so many decisions about how the hospital is run and who gets treated. Women are generally second-class citizens, but her family's wealth has put Cornelia Robertson (Juliet Rylance) on the hospital board and in position to influence policy, just as the otherwise arrogant male surgeons take their lead from Sister Harriet (Cara Seymour) on most matters relating to childbirth and infant care. There's pressure to move Knickerbocker Hospital uptown, following the trail of the city's money — one board member even suggests that the poor immigrants of the Bowery and other downtown neighborhoods don't deserve medical care — and Cornelia gets caught up in a mystery where members of the upper class are inexplicably contracting typhoid fever, which at the time was considered a plague only on the impoverished.

The major arc of the season involves Edwards' quest for acceptance by the Knick's white surgeons. The show has to walk a very narrow path between demonstrating the racial realities of the period and making most of the characters seem unbearable from a modern perspective. There's at least a wide spectrum of reasons for Edwards' ostracism — while some of the staffers are vicious racists, Thackery simply feels the hassle of integrating the hospital would distract from his primary work — but the fidelity to history also turns the early portions of the season into a slog at times.

But if the show takes a while to warm up — and seems to hit certain character beats, like Thack's cocaine addiction, or his feelings towards rookie nurse Lucy Elkins (Eve Hewson), over and over again — it builds in the way you would hope a modern cable drama season would, and many of the repetitive earlier scenes wind up laying a foundation for major shifts in the season's second half.

Soderbergh shoots, and edits, all this material together masterfully, and he's cleverly brought in his frequent musical collaborator Cliff Martinez to provide the pulsing, wildly anachronistic electronic score. This is a show that doesn't ask its characters to wink at us about the trappings of the period — these are men and women of 1900, who know no other way — but there are some modern flourishes in the way the stories are presented. Soderbergh doesn't go full Baz Lurhmann or Sofia Coppola with the material, but there are occasionally sequences that wouldn't look out of place on "Breaking Bad," and the synthesizers of Martinez's score are a constant reminder that for men like John Thackery, 1900 wasn't the stodgy past, but the thrilling present.

When I heard Soderbergh was committing so heavily to this project, I had hopes for another new classic from a period (and year) that's already given us so many. "The Knick" isn't that — at least not yet. But just as a medical procedure doesn't have to be cutting-edge to save your life, a modern cable drama can still be awfully satisfying even if it isn't instantly ready for the Hall of Fame.

Alan Sepinwall may be reached at sepinwall@hitfix.com