n New York City in 1900, Dr. John W. Thackery is named Chief of Medicine at the Knickerbocker hospital when his colleague, J.M. Christiansen, commits suicide after a failed attempt at a Caesarian section results in the death of both mother and child. Now a member of the hospital Board, he finds his preferred candidate for deputy chief, Dr. Gallinger, rejected by chairman Cornelia Robertson in favor of an outside candidate, Dr. Algernon Edwards, who has an outstanding resume. To Thackery's surprise, Edwards is an African-American and he wants nothing to do with an integrated hospital. Poverty and unsanitary conditions provide a steady stream of patients for the Knick. Medicine is still in a primitive state with most surgical deaths the result of infection. Thackery has his own demons to deal with however in the form of a cocaine addiction.

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