At once both simplistic and harrowing, the surgery scene that happens about halfway through “Start Calling Me Dad” evinces a show firing on all cylinders with what looks like the minimal amount of effort.

In it, Dr. John Thackery (Clive Owen), the liquid cocaine-dependent chief surgeon at the Knickerbocker Hospital, and young Dr. Bertram “Bertie” Chickering (Michael Angarano) try to solve a pressing problem: the hospital’s pregnant patients are bleeding too quickly and die due to the archaic and accepted birthing procedure that involves cutting their stomachs open and removing the child.

Thackery (or “Thack for short), had previously tried developing a new lifesaving procedure with the previous chief surgeon and mentor Dr. J.M. Christiansen before a string of deaths caused the good doctor to commit suicide in the pilot episode. The surgical failure and the subsequent death was the inciting incident of the entire show, and one that cast a pall over Thack’s dealings with himself and his duties… which become increasingly exacerbated by his growing cocaine habit.

The scene in question is sparked by a strung out Thack’s eureka moment while high, this time involving an unsuspecting Chickering stumbling into the lab to see Thack and two naked prostitutes. The only arousing thing that happens is the all-night brainstorming session instigated by Thack’s and Berties contrasting examples of intoxication. One is driven by the very substance that will ruin him, while the other is driven by a dose of ambition for the common good.

If the patients continually bleed out to death, they reason, then why stop them from dying? To effectively let the patients die slower before delivering the baby cleanly and sewing the mother up, the pair devise a way to insert a bladder through the mother’s vagina and into the womb where they inflate it to slow the bleeding. “We’re going to spend the rest of the night in here inserting these into our lady friends and testing all variables,” Thack says. Bertie then chimes in recommending water in order for the bladder to form-fit to the shape of the womb.

It’s a genius idea that leads into what follows: actual testing.

The surgery sequence is a scene of such energy that the audience feels hopped up on the same junk that Thack uses to make it through the night. It’s a kind of cinematic hangover with the camera buzzing as Thack takes us through each step. Soderbergh’s hand-held camera pulls double-duty to both make the vintage New York setting somehow contemporary but also to up the docu-realism of the new procedure.

Bertie works as the doting follower, with Thack as both the father figure and someone who sees in Bertie the kind of unsullied mind that he once had before engineering his own downfall. It’s also the perfect contrasted callback to the opening scene with Christiansen. “The baby is alive. The patient will live to mother it. Gentlemen, I give you the Christiansen-Thackery-Chickering Placental Repair,” an exhausted but fulfilled Thack says.

Through the madness and the sleep-deprived bickering, there are medical and emotional breakthroughs that happen, but at what cost? That is what The Knick is truly about. What will our biggest or most minute decisions do to us, and how will we live with them? In the case of Thack and Bertie, they could give or take life. It’s just another day on the job.

Photos via Facebook /AtTheKnick

Sean is a Brooklyn-based writer with several degrees in English literature. When he’s not digging up culture stories for Inverse, he’s listening to Harry Nilsson and mining obscure movie facts for Mental Floss.