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It’s difficult to recall a time when Ryan Murphy didn’t have a year-round presence on television, but that was the case in the early aughts when Nip/Tuck debuted on FX in July of 2003. When it ended 100 episodes later in March of 2010, Murphy’s Glee was already well into its initial season. That overlap was a first for Murphy, but also a sign of what was to come for the now-prolific showrunner, christened by The New Yorker in 2018 as “the most powerful man in TV” and “king of the streaming boom” by Time in 2019.

In 2010, however, Murphy was only on the cusp of his television takeover. Other than Popular (1999–2001), a WB teen dramedy that both satirized and stacked up with the likes of its network contemporary Dawson’s Creek, Murphy’s sole television credit was for an unsold pilot starring Delta Burke and Heather Matarazzo called St. Sass. Glee, a show about a fictional high-school glee club from the Midwest, would go on to become Murphy’s most popular work and arguably the turning point in his career. Its out-of-the-gate success on Fox landed it on several critics’ best of 2009 lists, and earned it the highest finale rating for a new show in the 2009–10 season. After six seasons and 121 episodes, Glee left behind a legacy of impressive onscreen musical numbers featuring show tunes and chart hits, and a distracting offscreen history filled with scandals and tragedies among its young actors, both of which fueled the show’s fandom of “Gleeks,” who made it one of the most-tweeted-about TV shows in history. It’s the obvious candidate for unlocking Murphy’s ascendance to household name.

Nip/Tuck, however, remains his most influential and important show; you can see traces of it and its success in all of his subsequent works, of which there are many. Today, Murphy can lay claim to executive-producing — and in many cases, writing and directing — a dozen more series, including American Horror Story, The New Normal, Scream Queens, American Crime Story, Feud, 9-1-1, Pose, The Politician, 9-1-1: Lone Star, and the upcoming Ratched, Hollywood, and Halston, set to air over the next two years on Netflix; at any given time over the last decade, he’s had no fewer than three shows on the air concurrently. That saturation makes it easy to map out connections within Murphy’s oeuvre, especially given his penchant for frequently casting the same actors, or to find a through line from The Politician back to Glee back to Popular. But Nip/Tuck is the key to understanding what makes a “Ryan Murphy show”: genre-bending television that wraps its social issues in a sheer, shimmering glamour, its true intentions only becoming apparent upon a closer look.

And now thanks to the debut of FX on Hulu this month, viewers can once again take a closer look at all six seasons of Nip/Tuck. While it originally aired on FX as part of the network’s move toward original programming that took risks, pushing the envelope of what could be shown on television, it would later find a home on Netflix in the company’s early days of streaming. In fact, Nip/Tuck was the first off-network syndication deal cut by Netflix. When that ended, however, the show receded into the background as the television landscape changed tremendously to one so overloaded with options that it became difficult to hold onto past gems living outside of streaming platforms. But the series was once so woven into the cultural conversation that a later-season promo that paired high-gloss baroque images with the hip-hop stylings of Kanye West screamed “this is a show with its finger on the pulse of pop culture.”

As that clip suggests, Nip/Tuck is nothing short of fantastical: a serial medical drama that dabbles in elements of crime drama, black comedy, family drama, satire, and psychological thriller, all of which are evident in Murphy’s later works in a more apparent fashion. It is a critique of society’s drive for perfection wrapped in an exterior that’s reference-heavy, oddity-obsessed, superbly soundtracked, and full of steamy sex, shocking violence, and stunt casting. Digging deeper, though, it unearths the true core of Murphy’s oeuvre, which is community. Whether expressed via feel-good moments of misfits banding together or the reality slap of an outsider’s downfall, the exploration of family, whether given or chosen, anchors Murphy’s best work. With Nip/Tuck, it’s a lot of both, as character reveals expand and contract its family tree season by season.

Enter Dr. Sean McNamara (Dylan Walsh) and Dr. Christian Troy (Julian McMahon), protagonists of Nip/Tuck and proprietors of McNamara/Troy, a cutting-edge and controversial plastic-surgery office in Miami that later relocates to Los Angeles, where they begin consultations with the catchphrase, “Tell me what you don’t like about yourself.” That command is as much a driving force for the main characters, as they continually attempt to exorcise their inner demons, as it is an invitation for a revolving door of self-loathing individuals portrayed by some of Murphy’s favorite players to exude some of his favorite oddities.

Sarah Paulson, for example, shows up in season two as Agatha Ripp, a patient purportedly afflicted by stigmata. Paulson would later go on to star in American Horror Story, at one point as a ward of an asylum run by Monsignor Timothy Howard (Joseph Fiennes), who has his own bout of stigmata. Also in season two, Joan Rivers arrives at McNamara/Troy playing none other than herself, hoping to receive several surgeries that will allow her to resemble the woman she would have aged into had she never undergone any cosmetic work to begin with. While Rivers claims the request comes from wanting to show her grandson her true self, she also mentions the publicity possibilities repeatedly — she thinks a before and after that upends the societal expectations will make her famous again. While Rivers’s appearance is a prime example of the sort of stunt casting that would go on to pervade much of the Murphyverse, it’s also a prime example of Nip/Tuck’s ability to balance outrageous circumstance with an exploration of deep human desire.

That balance is best expressed, however, in the duo that gives McNamara/Troy its name. Inspired by the Mike Nichols film Carnal Knowledge, which Murphy called “a love story about two straight men,” a similarly heterosexual love story between Sean and Christian spans the show and reveals how their individual broken pieces fit together like a perfect puzzle. Both have issues with absent and abusive fathers, but work to correct those setbacks in different ways. For Sean, he leans into moral perfection, aiming to be a loving husband, a good father, and an ethical surgeon. Christian, on the other hand, wants physical perfection, something that, when paired with his unending cash flow, steers him toward dastardly deeds. And while these opposite approaches often work to drive a wedge between the two, they inevitably stick together.

Their supporting characters, not so much. Sean never becomes the perfect husband, mostly because his wife Julia (Joely Richardson) is unable to forget about a fling she had with Christian when they were all college coeds. He also fails spectacularly as a parent, with children Matt (John Hensley) and Annie (Kelsey Batelaan) enduring too many bizarre hardships brought on by their inept parents to ever function successfully. And while his profession is where he excels, Christian tends to sully their reputation by systematically ruining every single relationship he has via sex, most notably doing irreparable damage to on-and-off girlfriend Kimber (Kelly Carlson), longtime foe Gina (Jessalyn Gilsig), and co-worker Liz (Roma Maffia).

These personal failures, though entertaining plot points, are also the sort of human realities that thread through the rest of Murphy’s work. Sure, Sean and Christian’s world includes deadly drug lords, sociopathic life coaches, serial killers, murderous madams, sadistic mean girls, and so much incest that one might find it difficult to locate Nip/Tuck’s human center. But it’s there in the impenetrable bond between Sean and Christian, which ebbs and flows the same way a more traditional will-they, won’t-they relationship might, keeping you coming back for more and making Nip/Tuck Murphy’s strongest long-running show from start to finish. It’s a formula he’s replicated elsewhere, sometimes successfully — see the bonds connecting Pose’s characters, so close they’re willing to dispose of a body together (same goes for Sean and Christian in season one) — and sometimes completely fumbling it, as when American Horror Story runs amok, resembling a waiting room full of Nip/Tuck patients with all their most bizarre ailments and no one to care for them.

Perhaps the only show to come out around the same time as Nip/Tuck that mirrored the intensity of its setting and shenanigans was The O.C, which shared Nip/Tuck’s purview of sunny cities with seedy underbellies full of unchecked wealth. But The O.C. was a lot more grounded and a lot less gay. Nip/Tuck has a bevy of queer relationships and a number of trans story lines, some of which have aged well while others admittedly have not. There’s a clear and concentrated attempt at creating a Miami and Los Angeles reflective of the cities’ respective diversity, bolstered by casting actual members of the communities being represented in most, but not all, cases. So although Nip/Tuck may not be a perfect show — if there is such a thing — it was notably progressive for its time. And while both Murphy’s work and television more broadly evolved in many ways over the last decade, the core of his work, the core that’s best illustrated in Nip/Tuck, has always been present.