As it turns out, it’s called the operating theater for a reason. At the turn of the 20th century, when most medicine was still being practiced in barbershops or sold out of the backs of trucks, surgeons plied their burgeoning trade in front of a live audience. Those unlucky enough to be under the knife were both patient and prop. Those daring enough to wield the scalpel were more than doctors: They were actors, carnival barkers, inventors, and showmen. Their failures were just as riveting as their successes — and a great deal more common.

Judging by the opening scenes of The Knick, Cinemax’s riveting new drama premiering this Friday at 10 p.m. ET, the most integral part of this macabre performance wasn’t the bone saw, the sutures, or the copious amounts of cocaine and morphine used to dull the pain inflicted by them. It was the color white. It’s there in the starched aprons of the peacocking surgeons and the lace caps fixed smartly to the heads of the industrious nurses. It’s there in the porcelain washbasins, the gleaming tiled floor; it’s draped over every cart, every chair — even, in the case of that opening scene, the very pregnant woman hemorrhaging atop the table. I’ve never seen a shade quite like it. It’s a white that glows with an almost fanatical brightness; it’s the color of a baptism in a blizzard. Everything in these scenes is so very white and the blood that inevitably stains it is so very, very red that its omnipresence struck me as less a nod to hygiene — the surgeons aren’t wearing gloves, and did I mention the live audience? — and more a shrug toward the blackest of humor. It’s like a man straightening his tie before jumping off a skyscraper. Nothing about what happens next is clean. But at least he’ll look smart before it all goes to hell.

It’s not like me to linger so long on the visual details of a television show, but here we are: The Knick is simply not like other television shows. Instead, it’s a labor of love and a strangely perverse passion project from the brilliant, ostensibly retired filmmaker Steven Soderbergh. Though he has foresworn moviemaking, the restless Soderbergh just can’t seem to put down the camera. Last year, he directed the arch Behind the Candelabra for HBO, and the shift from big screen to small seems to have emboldened him. Within hours of reading the pilot script for The Knick, written by industry yeomen Jack Amiel and Michael Begler, Soderbergh had not only decided to make it himself, he had already started making decisions on how he’d go about doing it. A casual phone call to Clive Owen got him a star. Another got him a meeting with the top brass at HBO. Yet the intrigued suits didn’t provide the quick green light the restive Soderbergh was expecting. Instead, they preached patience. (HBO doesn’t do things quickly. Four years passed between the day Game of Thrones was optioned and the day it premiered.) But Soderbergh — who made eight films between 2009 and 2013 alone — doesn’t brake easily. Rather than wait for space to open up in HBO’s glittery mansion of a schedule, he happily took The Knick to the grotty guesthouse out back.

Until this week, Cinemax’s greatest contribution to historical fiction was most likely Emmanuelle Through Time, just one of the many soft-porny indulgences that kept the network rife with subscribers and helped to get a now-graying generation of teenage boys through puberty. But with the pulpy triumph of Banshee, the network has begun transitioning its programming to a higher-minded type of excess. So while it may seem like an odd fit for an Academy Award–winning director, HBO’s kid brother is a remarkably logical landing place for The Knick. The series isn’t exploitative, but it is extreme, with literal buckets of blood and a surgical fascination with the lurid realities of medicine circa 1900: A skin graft requires sewing a woman’s arm directly onto her face; a complicated pregnancy demands the very delicate insertion of a rubber balloon. Instead of revealing an endless array of breasts, Soderbergh revels in offal. His gaze falls lovingly on a length of diseased intestine, a pumping heart, a swollen appendix. The Knick is visceral in all senses. It will leave you shocked and queasy — both at the treatments on display and the realization that your misbegotten, stuffy-nose-complaining genes somehow survived them all.

But mostly it’ll leave you stunned. One of the reasons I love television is that it’s primarily a writers’ medium. Unlike film, in which directors take the lion’s share of the credit and blame, TV is dictated from the page. Though there are certainly exceptions, there generally isn’t the time or space for a director to establish much of a personal touch on a weekly series; it’s more a matter of getting through the required number of pages and getting out of the way. Even HBO’s True Detective, which was rightly lauded for its uniquely consistent look, is considered to be writer Nic Pizzolatto’s show. He’s the one steering Season 2, while director Cary Joji Fukunaga has been exiled from Carcosa.

As someone who cares about story and character above all else, this imbalance has never much bothered me. I’d rather analyze a bravura speech than a tracking shot any day. And yet The Knick is the first series that has made me stop and reconsider my priorities. Soderbergh not only directed every episode of this first season (of which I’ve seen seven), but also operated the camera and edited all 10 hours. The result is a level of visual virtuosity rarely glimpsed on the small screen. It runs far deeper than that hallucinogenic shade of white. It’s in the way the unelectrified darkness lurks just out of every nighttime window, the way the camera lopes into rooms like a ravenous wolf and spins like a drunkard’s bedroom ceiling. The Knick can feel almost improvisatory at times — in one of my favorite scenes, Soderbergh abandons a gaggle of doctors mid-conversation to follow a nurse as she throws open every window shade in the room — but it’s never sloppy. (This alone sets it apart from the lousy K Street, the last time Soderbergh dipped his toe in these sorts of waters.) Instead, it’s exhilarating. The lone constant in Soderbergh’s peripatetic career has been curiosity — what’s up with the drug war? How much can Brad Pitt eat? How many abs are too many? — and his insatiable appetite for the odd, often ugly specificity of the era fuels every frame.

He also has a kindred spirit in Dr. John Thackery, the mustachioed protagonist played with remarkable precision by Owen. Like Soderbergh, Thackery is equal parts cowboy and clinician. High on a toxic combination of liquid cocaine and his own ego, Thackery spends his days at the perpetually underfunded Knickerbocker Hospital improvising radical techniques on live, barely willing subjects, and his nights attempting to sleep it off at a Chinatown opium den. His manners are rough, his bedside manner nonexistent, and his racial politics, at least at first, dreadful. So it’s a credit to Owen’s heavy charisma that Thackery doesn’t come off as cable’s umpteenth antiheroic alpha male. As he barrels across the screen, pausing only to doff his immaculate white shoes in search of a working vein to shoot full of drugs, it’s never clear if Thackery cares more about the life of the patient or the brilliance of the procedure. What I appreciate is that the answer doesn’t much matter. In Thackery, Soderbergh and Owen are giving us a glimpse of the creation of a modern myth, a swaggering archetype that persists to this day on ER and in actual ERs. (As an admiring salesman kvells in a later episode, “inventors, surgeons, and architects” are the new heroes of the 20th century.) Each cut Thackery makes is an opportunity to inscribe his name in history. His rough science isn’t just about saving lives. It’s about saving the world.

Between the two of them, Soderbergh and Owen carry The Knick across its bumpy early hours. Exposition tends to be as broad as the supporting characters are thin. “They call our money new — but it certainly does attract a crowd!” guffaws Grainger Hines as Captain August Robertson, the hospital’s Monopoly Man–like benefactor. His daughter, Knick administrator Cornelia (played with reserve by Juliet Rylance), is a familiar, feisty proto-feminist saddled with a disapproving cardboard fiancé. Eve Hewson — that’s Bono’s daughter to you, MacPhisto! — plays a sweet young nurse who is more object than subject. And while much of the period detail is compelling — ambulances fighting over bodies! 14th Street as a den of iniquity! — some showy historical flourishes fall flat. The first half of the season awkwardly shoehorns in appearances by both Thomas Edison and Typhoid Mary. Neither cameo is as thrilling as the look on Thackery’s face when he rides a bicycle for the first time.

And yet whenever I began to wonder if The Knick wasn’t just the same old doctor drama dressed up in a top hat and tails, Soderbergh’s dazzling camera swooped in to carry me away again. As the season progresses, it’s possible to feel the momentum building, as if the director’s fearlessness were as contagious as the germs that float freely through the dilapidated hospital halls. (A second season has already been ordered; Soderbergh will be back to direct it.) Performances begin to coalesce and stand out: Chris Sullivan as a coarse O.G. EMT, Cara Seymour as a secretive nun, Michael Angarano as a green resident, Jeremy Bobb as a crooked supervisor. As Dr. Algernon Edwards, an African American physician in an era when that was something to be both commented upon and shunned, André Holland burns brighter than the Knick’s newly installed lightbulbs. The series ignites as it sutures his struggle together with the rest of the cast and elevates Holland to co-lead. The racism and classism portrayed in later episodes is horrifying, in many ways worse than the polite savagery of the operating room. Yet Soderbergh’s camera captures both without flinching, not with the prescriptive eye of a doctor but with the tireless inquisitiveness of an artist. It’s enormously exciting. The Knick is the rare TV series that makes you see the world in a different way. Even the parts you’d much rather ignore.