From lighting to editing, Steven Soderbergh does everything on set, says 'The Knick' star Andre Holland

Set the scene for Algernon at the beginning of the second season…

As the new season begins Algernon is the new acting chief of surgery while Thackery’s away in rehab and getting himself together. Everything in the hospital is going great. There are fewer deaths. They’re making more money. They’re making more scientific advances than they ever have before with Algernon at the head and so he approaches the board and puts himself forward to be considered for the permanent chief of surgery post. And he’s very quickly denied.

Did he think when he went to the board that they would just judge him on his abilities, where previously they’ve always judged him on the colour of his skin?

I don’t think that he expected their hearts necessarily to change but I think he thought that by presenting them with facts he might get somewhere. Take the personal stuff out of it and he thinks,‘I’m actually saving you guys money at the hospital and stuff.’ I think that he did have hope that they would see it his way, even if they didn’t like him or agree with him being the chief. He thought that they would at least understand the bottom line of it.

But they don’t, it’s a flat rebuff.

Flat out, yeah.

What’s his own situation with his eyesight? Is he hiding something?

Yeah. A detached retina is what he discovers he has, and it is gradually deteriorating – in fact swiftly deteriorating, actually.

How quickly does that impinge on his abilities as a surgeon?

Pretty quickly. From the time he notices it I think it takes about an episode or two for it to get quite bad. He starts passing surgeries off to other people and secretly trying to operate on himself at night and then he eventually has to reach out to Thackery for help - and that doesn’t go so well. So it’s getting bad pretty fast.

Algernon is a brilliant man, but he’s also a fighter – sometimes literally. What drives him?

I think what drives him is kind of the same thing that drives Thackery– it is that pursuit of new knowledge. I think he’s extremely ambitious and capable, and he just wants to live up to every ounce of his potential. In terms of the fighting, I think that that comes from frustrated ambition. And then also as a black man living at that time and having done everything the right way - and still finding yourself an island. I think that that creates a rage that has to come out, and unfortunately for Algernon the way it expresses itself is through physical violence.

What sort of things have you learned over the two series of filming that you’ve found exciting or unusual?

So many things. One thing, not medically but historically, that I’ve found interesting is learning about New York. I read a book called Low Life [by Luc Sante] all about New York City at that time and it’s fascinating. Like the way the city developed. For example Soho, which is where I live, I’d never realised used to be called Little Africa. It was the centre of black life in all of New York City. And now I’m probably like one of five brown people who live in that area! And then Canal Street had a canal that ran through it and someone came along and filled it up and paved over it. Then Little Africa was only Little Africa until the Irish came in and pushed the black people further North. And then the Italians come in and pushed the Irish further North and eventually the reason Harlem came to be Harlem is because two brothers who were insurance brokers or whatnot, decided we’re gonna buy some property here, we’re gonna stay here by hook or by crook. And that’s how Harlem became Harlem. So I have just learned so many fascinating things about this city. Medically I’ve learned so much too. Like the fact that they even didn’t wear gloves in surgery until much later. There’s a brain surgery that happens this year, one of the first brain surgeries, and to see those instruments they were using… it’s crazy. Every day it feels like we’re learning something new about it.

What about society at that time? How does it compare with now?

You really see how at that time people were forced to live in such close proximity. So little of Manhattan had been explored or settled (and I hate that word: settled). And then to think about it now when there all this stuff about gentrification that’s happening, and neighbourhoods like Bedford-Stuyvesant and Fort Green: you see the same thing happening again. You see people fighting for their little piece of the city and how people have always been displaced. They just continue to be pushed around. That’s been a real lesson for me.

The surgery scenes look intense but when the camera cuts are people messing about at all? Do you spray blood at each other?

Not really because the way Steven works he’s so intense, and things change so quickly. When we turn up for a surgery everybody has to be 100% focused because he shoots them all differently and he never tells you how he’s going to shoot it until you’re there. So he’ll say,‘All right, let’s rehearse it.’ And when you’re rehearsing it that’s when he’s deciding how he’s going to shoot it. So the rehearsal can’t be like a loose play. You have to be doing it otherwise you might end up not being seen in the shot. First of all, it’s hard enough just to get your mouth around the words and then you have the instruments in your hands, and then there’s blood on the instruments, and then there’s a hundred people in the gallery watching that you also have to be addressing. And then you also have to be in contact with other people who you are playing the scene with. You have to be on your game.

Have you picked up any new skills? Do you think you’ve got better with your hands?

Yeah for sure. We’ve learned some basic things like suturing. We have a medical consultant, Dr Stanley Burns, who has the archive here [Dr Burns is a New York ophthalmologist and historian who has the world’s largest collection of early medical and historical photography]. He’s taken us through his version of medical school where he taught us how to suture and we really are using the actual instruments. So its real forceps and real clamps and catgut, which is what we suture with mostly, which is like the hardest thing to control. And then the prosthetics that they provide us with, they feel and look so real that it really feels like you’re doing the actual thing. So it takes a lot of focus, a lot of focus. But I think if I were to cut my finger or if you were to have a little accident… I reckon I could sew you up.

Is Algernon based on a particular historical figure? Have you researched him or is that a distraction?

I love doing as much research as I can and I think that they based him on a couple of different people. They started from this photograph that Burns actually gave them of a black doctor in Paris circa 1901, leading a surgery, and from there they jumped from that and they found that there were a number of black doctors who were working in Europe at the time. So he’s not based on any particular person but kind of a mosaic of a few. But for me I’ve read about all of them. I read as much as I can. I love just absorbing all of it and you never know when you might need it. There have been little moments in scenes where something will come up and I’m like,‘Change a line, put something in.’So I’m all about it.

The idea that there’s one black surgeon at that level and we haven’t seen any others in New York – is that credible?

I think it’s likely that he would be the only one at a white hospital. There were other surgeons who were working at black infirmaries. But I think it is likely that, at a hospital like The Knick, this could really be the first black doctor to work at that hospital.

The Knick’s depiction of racial prejudice, and Algernon’s response to it, is nuanced. He’s not always angry; he picks his battles…

…I think that’s what’s great about it and that’s what I really responded to when I read it. I’m from Alabama, myself. From a small town and I know what it’s like to have to choose your moments and swallow down a lot of things. When I read the script I was like,‘That’s exactly what it feels like,’ even down to the fighting. I found myself in those very similar situations. So I think they do a really good job, the writers, of depicting it accurately and not making him just a noble character. He’s arrogant, an arrogant guy, just like Thackery is and he’s angry. Sneaky as well. He has his own vices but he’s brilliant.

What’s at the crux of his and Thack’s relationship do you think?

I think that they’re both brilliant surgeons and I think that they recognise that in each other. Despite their own vices and their own personal problems, they’re both in pursuit of new knowledge. Whether they like each other or not they have to respect each other’s ability. In the first season, Thackery discovered Algernon’s secret hospital in the basement and you could see he admired what he’d done. I think Thackery appreciates that about him and I think that’s part of the reason that Algernon gives him so much leeway in the second season. Algernon knows Thackery is up to some shit and he helps him out with some of that stuff with Abby. They’re both quite subversive and I think they like that about each other.

What about Algernon and Bertie?

Algernon appreciates obviously that Bertie is not like the others – he’s from a younger generation so he’s not innately prejudiced. But I think he also understands that Bertie has a father who was a physician. I don’t know if anyone else will ever get this, but my own thinking is that Algernon sees that Bertie’s got this position and that some people think maybe he got it because of his father. So I think that Algernon sees a bit of insecurity in Bertie. It’s an insecurity that he also recognises in himself. So he takes him under his wing just a little bit more. He gives him a little bit more of his time because of that.

Is there any more of Cornelia and Algernon in this series?

Not a lot. Pretty early on, I think at the end of last season, Algernon closed that door once the abortion happened and once she left. I think that was it. She comes back at the beginning of season two, as you know, and I think she wants that door to be opened again, but it is not possible, at least for now.

How does Steven Soderbergh’s approach differ from other directors you have worked with?

He’s a director who does just about everything. He directs. He’s shooting - literally holding the camera - so he’s right there with the actors. He’s in control of the lighting. He’s editing it on the way home after work. He does so much of the production. So that’s the first thing I would say. But for people who aren’t actors, I would just say it’s so efficient. We were able to cover between seven and ten pages a day and we’re usually done by 3 o’clock in the afternoon. It’s nuts, but it’s all because he’s so efficient. But then he always says,‘Let’s not make anything any more complicated than it has to be.’He just gets down to the bare essentials of every single scene, of every single moment, of every single take. Working with him feels like a dream. I’ve never seen him lose his temper. I’ve never seen him yell at anybody, which is abnormal because usually the director at some point blows up and yells at a grip or somebody, but there’s none of that. It’s just all smooth.

Since you’ve been making this show have you been into a hospital or come across any doctors?

I, fortunately, haven’t been to the hospital but I was out not long ago at the Bowery Hotel having a drink and there was a group of doctors who were out after having been at work. They all came over and they were like,‘Man we love the show, we especially love that you guys do it right.’ They’re like,‘We’ve seen these other shows and they’re just bullshit, but you guys actually do it the right way.’ And they were specifically talking about certain procedures. They were saying,‘The moment when you said so-and-so about such-and-such was just right.’ It felt really good.

And finally, do you have a pair of surgeon’s white boots that you’ve got to keep?

I think Clive started it. He was the first one to rock the white boots. But I think it’s just a matter of time before it catches on. I didn’t get to keep mine, but I might go and get me a pair.

The Knick season 2 airs on HBO Defined every Saturday at 9 pm.