In the series premiere of this medical drama set in a 1900s New York City hospital, accomplished Dr. John W. Thackery is named chief surgeon and is pressured by a major benefactor to hire a black doctor as his top assistant.

Barrow can alleviate a debt if he treats one of Collier's wounded men and also urges Capt. Robertson to buy one of Thomas Edison's new inventions. Meanwhile, Algernon tries a new approach to hernia surgery, the health of Everett and Eleanor's baby worsens, and Sister Harriet and Cleary head to Chinatown.

Refusing to collaborate with Dr. Zinberg on blood-transfusion research, an increasingly paranoid Thackery pushes himself to the limit, and beyond, in an effort to “solve the riddle” and beat his rival. Cornelia and Edwards arrive at a crossroads; Barrow trades one creditor for another; Lucy requests Bertie’s help. With the Knick in the midst of yet another crisis, Robertson calls for a vote.