Any time a character appears on The Knick who is female, black, Chinese, Jewish, sacrilegious, or poor, a viewer who’s familiar with the show might well start tensing up, waiting for some form of abuse to befall them. More and more, The Knick‘s depiction of the 1900s seems to survey the coalescence of systems of American oppression that still persist, a map of a power structure that spells out collective misery — even for the privileged.What it shows, with brutal repetition, is the havoc these systems wreak on the human body. Ironically, it’s a medical drama — these, of course, usually focus on repairing human bodies. Such is the show’s cyclical brilliance: it exposes a comparably cyclical absurdity to the ways bodies are both broken and fixed by those in control. [The following contains some small spoilers]

In Season 2, which premieres on Cinemax on Friday, it seems more abundantly clear than ever that The Knick has little interest in the episodic, “Will they save a life?” arc typically seen on shows where doctors wear concerned expressions and boast steady hands. More than it’s enamored of the occasional “eureka” moment between its protagonists, Dr. JohnThackery (Clive Owen) and Dr. Algernon Edwards (Andre Holland), it’s often morbidly aware of the stifling conditions surrounding these moments. We skip from contemporary issue to contemporary issue based on each one’s foundations in the past. When the show detours all the way to San Francisco for a mere moment in the first episode of Season 2, it’s a reminder that the policing of non-white bodies isn’t limited to the East Coast. (It briefly touches on the quarantine of all non-whites — approximately 25,000–35,000 people — in San Francisco’s Chinatown due to a bubonic plague scare at the turn of the century.)

But it’s soon back to the Knick, the titular downtown New York hospital at the center of the show. For what better way to stage an indictment of American systems than from within an old hospital — a place fueled by endowments and progressive innovations for helping human bodies — set against a society intent on policing it? This is a place that should be a guaranteed shelter from economic, gendered, and racial prejudice, but all those things are fully entrenched here nonetheless, thanks to the Social Darwinian forces in control of it. Through these doors, people with assorted wounds and ailments inflicted by these very forces are carried and wheeled.

In this setting, within the first three episodes of the second season, we see subplots including: the prosecution of a nun who performs abortions, the lack of proper medical care for sex workers, addiction catalyzed by pharmaceuticals, the physical harmfulness of sexual stigma and religious extremism, white supremacist thought’s imposition on medicine, and the wealth gap’s effect on all of it. Luckily, the show itself doesn’t play like the above list of strung-together hot-button progressive issues, but rather a vital look into a (selectively) telling past of physical abuses — that happens to be seamlessly cohered by Steven Soderbergh’s intelligent stylization and Jack Amiel and Michael Begler’s dextrous writing.

Through Sister Harriet (the impeccable Cara Seymour) — who’d clandestinely been performing abortions for New York women in Season 1, and who’s now in police custody — we’re shown the extent of societal aversions to people breaking both gendered and religious molds. Because the judge overseeing her case thinks she’s besmirched the sacredness of (stifled) womanhood as well as the sacredness of, well, sacredness, he attempts to go extra hard on her. (“I’m surprised the devil allows you to remember any verse [of the Bible],” he tells her in front of the court.) But the abortions she was providing were often the necessary result of pregnancies that wouldn’t have been accepted by society if the children had been born — they often came from rape or, even worse in the eyes of the masses at the time, an interracial union. The centrality of this plot line does not reward viewers with a “look how far we’ve come” mentality — rather, it brings into focus current political attacks on Planned Parenthood.

The show’s critique of the (past and current) state of women’s healthcare in the US doesn’t end there. In another storyline, the proprietor of a brothel seeks gynecological care for the women who work for him. All of the doctors spend their spare time soliciting at brothels, and yet the women they see are medically neglected. Unsurprisingly, the male doctor who’s finally asked to treat them exploits the situation, telling the women that he needs to see them each individually, and that they can use his shoulders — instead of stirrups — to balance their legs.

But the hypocrisies surrounding sexuality, manifested consistently in how the public stifling of sex only leads to more dangerously desperate sex, are perhaps most visible in the continued story of Thackery’s ex, Abigail (Jennifer Ferrin). Last season, Abigail first appeared in a sexy steampunk version of Groucho Marx glasses — and when she removed them, she exposed a hole where her nose once was. Turns out, her adulterous husband had given her syphilis, then abandoned her.

Now, this symbol of sexual shame has eaten through her face. (The likely cause of her husband’s illness: sex workers who hadn’t received medical attention.) Last season, she had reconstructive surgery — her arm was affixed to her face for weeks until a flap of its skin grafted to form her new proboscis. In Season 2, she’s in need of further treatment, as the disease is giving her seizures.

Eleanor Gallinger likewise wears inequality permanently on her face now. As a housewife, her identity was more tied up in parenthood than her working husband’s, and she went mad after their child died. Her psychiatrist has now removed all of her teeth, believing that “all mental disorders stem from disease and infection polluting the brain.” Meanwhile, in an early episode of Season 2, Nurse Lucy Elkins (Eve Hewson) is forced to walk around bearing the bruises of her pastor father’s beatings, which he inflicted when she confessed to losing her virginity.

Then, of course, there’s the intersection of sexual body-policing and racial body-policing, which is where the series grows even more merciless. Dr. Gallinger, who’s envious of Dr. Edwards for wooing the un-wooable Thackery, channels his ire into racist sentiment, and seems ominously taken by a couple of scholars casually espousing a new medical idea: eugenics. He looks as though he’s taking particular comfort in their claim that if people of color “mix in” with white people, “we’ll forfeit potential greatness for mongrelization of our species.”

The introduction of white supremacists’ ideal combination of policing reproduction and race becomes a disturbingly pervasive presence, showing how, in the wrong hands, medicine can be a rather sinister form of control (especially when set against the plot of Dr. Thackery having been prescribed heroin to cure his cocaine addiction). All of this is seen from within the walls of the hospital, which themselves are physically threatened by a system favoring the lucky. The hospital’s imminent closure and move uptown — where fewer working class immigrants reside — reveals even the Knick itself to be a core symbol of American imbalance.

The Knick’s progressivism extends far beyond its balletically handheld digital camerawork, its anachronistic score, and its unflinching focus on the human body. Both its heavy gore and its heavy Soderbergh aesthetics are mere conduits revealing a map of the causal forces, past and thereby present, behind so many forms of bodily harm. “Like the best historical fiction… [The Knick] takes us over a century into the past, and it shows us the future,” James Poniewozik recently wrote in the New York Times.

Obviously none of this is to make the ridiculous claim that The Knick and the now are identical in matters of oppression — to do so would overlook the fact that at least now the forces fighting various forms of discrimination aren’t so marginal. But the fact that all of the sociopolitical issues examined on the show continue, in their own contemporary fashion, to plague American happiness makes The Knick seem far more like an admonishing appraisal of the present than a comparative lauding of it. Because the fact is that when you watch the show, it’s the tools and procedures that all seem the most alien: One is struck by how far rhinoplasty has come. One is struck by how we used to torch patients with equipment just as likely to set doctors aflame. One is not struck by how we no longer police abortion. Or by how America has become a hospitable place for its black population. Or how America generally prizes the safety of non-white bodies, or the health of poor bodies. The backwards science of The Knick is almost otherworldly; the social issues — and the ways they’re made physical — aren’t at all.