We pull back the sheet on Cinemax's vivid, visceral medical drama (airing Fridays at 10 p.m.)

Director Steven Soderbergh had one hard-and-fast rule while making The Knick, the Clive Owen-starring period drama about doctors toiling at New York’s Knickerbocker Hospital in the early 20th century. ”He didn’t want it to be nostalgic,” explains production designer Howard Cummings. ”In the first 10 minutes, everybody’s gut reaction is ‘Oh, thank God I didn’t live in 1900.”’ Achieving that level of horrific realism meant a whole lot of research for Cummings and his team — and calling on Stanley Burns, a doctor/historian whose collection of 10,000 turn-of-the-century texts and 80,000 medical photographs would prove an invaluable resource. (”I have a 19-room house,” the doctor says with a laugh when asked where he stores all that stuff.) Here, Cummings and Burns walk us through their bloody good production.

A Dirty Job
Making a modern Manhattan intersection look the way it would have in 1900 takes time (two and a half months of prep work, in fact), lots of canvas awnings (to cover up existing signage), and truckloads of dirt. Different kinds of dirt. ”I got the idea that the Lower East Side and Chinatown have brown, mucky dirt,” Cummings explains. A little farther uptown, there’s ”light gray, dusty-looking” dirt. And finally, on the tony Upper East Side, you’ll find no dirt at all — only cobblestones.

Prop Masters
The Knick‘s authentic-looking props are a mixture of real historical tools and meticulously crafted replicas. The coolest found object: an antique X-ray machine, complete with working electrical wiring. (”We weren’t making real X-ray plates, because that would be a little dangerous,” Cummings assures.) The coolest creation: an animatronic baby that displays symptoms (including opisthotonos, in which the head is dramatically thrown back) of severe meningitis.

A Work of Art
Cummings based the look of The Knick‘s centerpiece set — the operating theater — on The Agnew Clinic, an 1889 oil painting by realist pioneer Thomas Eakins. Its stark aesthetic reflects the director’s original vision for a black-and-white film. Soderbergh and Cummings compromised by keeping the hospital itself mostly achromatic; as Cummings points out, ”The only real color is the blood.”

The High Life
”Nothing looks like Chinatown but Chinatown,” says Cummings — which is why the production was determined to shoot the exterior of Thackery’s (Owen) favored opium den there, despite the multiple headaches the location presented. (Among them: The building they chose is wedged between two busy funeral homes; nearby Chinese merchants balked at taking down their modern signs, because it’s considered bad luck.) Inside, the den’s shabbily opulent trappings hide a secret identity — the same set is used for Dr. Edwards’ (André Holland) basement clinic.

Playing Doctor
Under Burns’ watchful eye, the cast spent two weeks prior to filming learning how to properly hold the equipment, tie surgical knots one-handed (real doctors can do about one tie per second), and sew a variety of sutures. Owen enjoyed the boot camp so much that he came back for two extra lessons. His castmates shared his enthusiasm: ”I don’t remember whether it was Michael [Angarano] or Andréwho said, ‘You know, when the zombie apocalypse comes, I’ll know how to operate,”’ quips Burns.