The Thack is back! Clive Owen’s brilliant junkie surgeon Dr. Thackery made a triumphant, historic, quiet and on-the-down-low return to The Knick itself in “The Knick”’s latest episode, having been forced to brave going cold turkey while trapped on a boat. Now he’s a man with a mission, maybe. He’s brought before the hospital board, whose stern killjoy members didn’t seem fully convinced that he’s clean and sober and ready to get back to tearing into live flesh with no gloves. Thack agrees to drug tests and some shadowing (“I thought it was going to be something humiliating”), but he also makes a fiery speech about how he wants to dedicate his considerable powers to defeating a disease that not even he’s been able to tame: drug addiction.

“Addiction isn’t a disease. I’ve never heard of anything so absurd,” goes one of the responses. The board members balk at the idea that being hooked on drugs is anything but a failure of personal restraint. And we can laugh at this and pat ourselves on the back, we looking back on 1900 on a shiny widescreen television from our “Jetsons”-like futurama and finding people to be so stupid back then. Except the savage thing about this scene is that not much has changed. We still blame addiction on addicts; when a prominent celebrity dies from an overdose, your Facebook feed clogs with people chastising the deceased for “throwing it all away.” And then there’s this fun fact: no one has found a cure for addiction. We haven’t even cured nicotine addiction, because Nicorette? It does nothing.

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“The Knick” occasionally indulges in this kind of back-patting, wherein we see how horrible things are back in the day and congratulate ourselves for getting it right now. A scene like this goes the other way. We often say that when a show is set in the past — or in the future, or another sci-fi-like dimension, or, you know, whatever — it’s really taking about us in the here and now. This scene is about then and now, but it lacks the usual smugness. 

More often than not, though, “The Knick” isn’t a historical show that takes a judgmental stand. It’s really agnostic on everything and more about exploring this world, which really can seem like an alternate dimension, with fancy costumes and particularly virulent racism and super-mega-ultra-gross operations done with lots of gaping wounds — all united by a noodly electronic score (by Cliff Martinez) that's so 2015. Speaking of looking at the backwards past, this episode had Tom (Chris Sullivan) dealing with the problems of being an early adopter of motorized ambulances, like when the wheels come off and the engine acts funny. “The Knick” is more interested in what it’s like to be in that early position, not in laughing at Tom for missing his horse-drawn vehicle.

Anyway. When asked by the board how he expects to conquer addiction, Thack doesn’t pause before confessing, in a way that still sounds rock star, “I have no idea.” And he doesn’t. He’s busy trying to find a new way to access his brilliance. In the before-time, he could shoot up, stay up all night and come up with some wacky but genius solution to a problem that had previously eluded humankind, partly because they weren’t super high. Now he can’t even hold his hand straight as he tries to do experimental eye surgery on guinea pig Mr. Holland. (Even though this operation is quickly aborted, the scene is still more hair-raising than last week’s abscess business. Eye surgery is freaky.)

We can never be sure how sincere Thack is being, especially when he's talking to authority figures (or lovers). But he appears to be serious about this game-change. He even rebuffs Nurse Elkins (Eve Hewson), his stalker-turned-lover-turned-gopher, even after she tries to use her knowledge of his drug hiding spots as leverage to get back in the sack. But he’s not having it. And yet sobriety is hard. His groove still not back, he has to fill boring nights with booze and back-alley hookups. And by the end the mere mention of heroin and cocaine is weakening his resolve. But hey, if he backslides, that’s on him, isn’t it?

Token stray observations:
— Sorry this wasn’t a very comprehensive recap, and it’s pretty weird that its director and cinematographer, Steven Soderbergh, didn’t even get a namedrop. A key part of the pleasures derived from “The Knick” are imagining him wielding a camera right into the action, or of setting up impromptu shots, or of blocking the scenes so he can bang out scenes in as few shots as he can. It feels very handmade even as it passes as “invisible” television, where you get involved in the world without being overtly nudged to think of it as created.
— There were few showstopper scenes or set pieces, save the bit where the staff of the opium den — now in cahoots with Knick manager Herman Barrow (Jeremy Bobb) — swing by for their first mass cleansing. It’s awkward at first, and then a thousand times moreso when one of the older doctors jumps right in, even insisting that he doesn’t need stirrups for gynecological exams when the patients can just wrap their legs around his shoulders. Whee!
— The scene where Nurse Elkin’s preacher dad, paying a visit, does some guest preaching at a church is a good example of the film’s agnostic-curious approach. Soderbergh is a pretty big atheist, but he’s not particularly hostile to religion. In fact he finds it pretty fascinating. Here he mostly allows us entree into an old-timey sermon that’s not that different from one that would happen today.

Read our recap of "The Knick"'s first episode of the second season.

Follow Matt Prigge on Twitter @mattprigge