There is none of the uproarious joy or inappropriate Junior Mint-munching of Seinfeld’s operating theater to be found in The Knick. This is a gritty, murky, unanesthetized look at the state of medicine in the early 1900s and the men and women who practiced it in all of its squalid, tubercular glory. From the opening shots of “Method and Madness” to the closing credits, The Knick is meticulously produced, rigorously constructed, and awash in a bloody patina of early 20th century New York City. In an otherwise desolate summer television landscape, it’s exactly what the doctor ordered.

Over the last several years, Cinemax has been undergoing a quiet renaissance. It has transformed itself from a simple tributary where HBO’s television trash-water ran into a respectable, pay-TV channel that showcases top-shelf television. Entering its third season, Banshee has found a small but dedicated following for the twisting, turning Amish murder mystery. The network is confident that The Knick will find its audience too. At this summer’s TCA Tour, HBO revealed that it had already greenlighted a second season, which Soderbergh would again direct.

Retirement may very well be the best thing to happen to Steven Soderbergh. Since leaving the world of feature filmmaking, Soderbergh has carved out a nice niche for himself in the world of premium cable, directing TV movies like HBO’s Behind the Candelabra and now Cinemax’s The Knick, which premieres tonight at 10PM ET. Although Behind the Candelabra was well-produced, well-acted, and generally well done, The Knick is nothing short of spectacular, a feather in Soderbergh’s already well-decorated cap. His aesthetic sensibilities and his signature medical drama soundtrack — cold, pulsing, electronic beats, which he has on display in Contagion, Side Effects, and now The Knick — make an indelible impression on the DNA of The Knick, and make for a tremendous viewing experience.

The thought of yet another medical drama hitting television airwaves initially filled me with trepidation, and though it shares some narrative conventions with other TV medical dramas, showrunners Jack Amiel and Michael Begler’s vision of fictional early 20th century New York City hospital is infinitely more captivating. Aesthetically, it blows the competition out of the water, thanks to Soderbergh’s lingering camera work, sterile framing, and penchant for low angles puts us smack dab in the middle of the operating theater, as well as the muck and the mire of New York’s filthy, typhoid-ridden streets.

Narratively, the pilot feels, for lack of a better term, pilot-y as it introduces us to the hospital’s colorful (and mostly white) cast of characters, doling out exposition all the while. Our ostensible hero is Dr. John Thackery (Clive Owen), a brilliant but flawed surgeon who finds himself in the unenviable position of managing the Knickerbocker Hospital after a colleague’s untimely death. All of this happens in the first ten minutes of the show, which features a particularly gruesome C-section sequence, rendered in excruciating bloody detail in front of a theater of nodding, bearded doctors. (Note: whatever you do, make sure you aren’t eating when sitting down to watch The Knick.) Much like Thackery, we’re reeling with each new development and have visceral reactions to each grim portent. Still, like a car accident on the side of the highway, we cannot look away even if we want to.

Unlike many of his peers, Thackery is willing to try bold, new surgical procedures in an effort to combat Death (“an enemy who has never known defeat”). Necessity is the mother of invention, and Thackery’s drive to provide comfort to his wards means that he is willing to try innovative, untested methods if it gives his patients a sliver of survival or a modicum of relief. Provided he doesn’t have the shakes. Did we mention that he’s addicted to opium and cocaine? Well, he is, and like a racist, drug-addled Dr. House, Thackery needs his fix in order to make it through the day’s labors. And did we mention he’s racist? When ordered to appoint a new Deputy Chief in the form of celebrated African American surgeon Dr. Algernon Edwards (Andre Holland), Thackery objects and makes life difficult for his new colleague. It seems less like a deeply held conviction for Thackery and more of not having the time or energy to deal with taking over a financially ailing hospital while integrating it at the same time, but still it resonates and makes the prickly Dr. Thackery a hero that we’re not necessarily rooting for.

While an anti-hero leading the charge against the status quo is by no means a new trope, especially in a medical drama, it is Owen’s standout performance that elevates The Knick above the rest of the field. His performance of Thackery is poignant, repugnant, addled, and effete, all at once. It’s a thoughtful, well-rounded portrait of a man who, in spite of flashes of brilliance, is exceedingly rough around the edges. The supporting cast, too, is worthy of accolade, especially Andre Holland, who brings a special je ne sais quois to his portrayal of Dr. Algernon Edwards. Despite the tension in the room during every scene Holland is in, he commands your attention and creates a hugely sympathetic figure in Edwards.

What makes The Knick shine like the diamond in the rough that it is, though, is its singularity of vision. Soderbergh expertly executes Amiel and Begler’s concept, transforming what could have been just another period piece into must-watch TV. Anchored by a charismatic, deeply talented cast (Jeremy Bobb, Eve Hewson, and Juliet Rylance, to name a few) and scored by Cliff Martinez’s anachronistic but amazing score, The Knick transports us to a different time. Armed thugs act as ambulance drivers, roughing each other up in order to bring warm bodies to nearby hospitals. Blood sprays from surgical incisions and blood boils between clinical colleagues throughout the Knick’s hallowed halls. Lives are lost and lives are saved, but for the staff of the Knick it’s just another day. And after watching episode one, I cannot wait to see what the next day will bring.

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The Knick airs Friday at 10 PM ET on Cinemax. Have you seen the pilot? Let us know your thoughts in the comment below.

Want more context for how the show went from concept to completion? Read my interview with showrunners Jack Amiel and Michael Begler.