A

gainst his better judgment, Steven Soderbergh bought the brain pills.

A filmmaker often described as cerebral and clinical doesn’t seem like an obvious mark for an “all-natural smart pill.” But when he saw an online ad last month promising to boost his brainpower, he couldn’t resist.

The way Soderbergh understands medicine, it made some sort of sense.

advertisement

“Medicine, I think, almost more than any other sort of endeavor or field, really generates a lot of magical thinking,” he said in a lengthy interview with STAT recently. “I’m interested in that collision between hope, science, experimentation, evidence, and magical thinking.”

The Oscar-winning director has returned repeatedly to that muse in recent years. Starting with the 2011 epic pandemic disaster film “Contagion,” followed by the 2013 psychiatric thriller “Side Effects,” and most recently with “The Knick,” a television series about a pioneering surgeon at the start of the 20th century, Soderbergh has devoted more of his focus to medicine and science than perhaps any other A-list filmmaker.

He has also been fixated on authenticity. In collaboration with likeminded screenwriters and teams of technical experts, he has produced some of the most medically conversant works in Hollywood.

“It’s hard for that stuff not to stick on you because it’s interesting,” Soderbergh said, “and when you start to look at it, you realize it touches every layer of society and almost everybody you know.”

His productions aren’t flawless — consulting with unaffiliated scientists makes that clear quickly — but for those who have frequently felt deprived of quality science in mainstream entertainment, they are welcome change.

Soderbergh, who is invariably described by people who’ve worked with him as chronically curious, said he’s obsessed with how “new knowledge is created.” There may be no better lens for exploring that motif than medicine, he said, “because of its proximity to our mortality.”

“Your imminent annihilation is not an abstract idea,” said Soderbergh, 53. “When somebody close to you is sick, that’s not an abstract idea. I think it’s a very primal subject. As a result, people are very engaged by it. We would all like more time, and we would all like the people close to us to have more time.”

But the rationality that drives good science is inseparable, in his view, from the irrationality that leads somebody to buy unproven brain supplements.

Sign up for our Morning Rounds newsletter

Please enter a valid email address.

Scientists save the world in “Contagion,” but not before mass hysteria nearly unravels civilized society. The brilliant physician played by Clive Owen in “The Knick” is a cocaine abuser whose addiction puts his work and life in jeopardy.

It’s perhaps not surprising then that Soderbergh’s father was an academic with whom he said he shared “an appreciation for earned knowledge,” while his mother, who had a “non-linear abstract way of thinking,” once traveled to the Philippines for “psychic surgery.”

For the record, the brain pills didn’t work.

“I don’t think I’m any smarter than I was two weeks ago,” Soderbergh said, though he lamented, “We didn’t do a control test.”

The surgeons of “The Knick” at work in turn-of-the-20th-century New York City. Paul Schiraldi/HBO

‘No more curious person on the planet’

The director colorfully describes this fascination with medicine as “a psychological cicada that’s now emerging.” Looking over his resume, it seems to have been gestating for a long time.

Soderbergh came to prominence with the 1989 independent film “sex, lies, and videotape.” In 1996, he directed “Gray’s Anatomy,” in which the monologist Spalding Gray describes his neuroses and his trials with alternative treatment after being diagnosed with an eye condition. “Erin Brockovich,” released in 2000, centered on the devastating health effects seen in a small town polluted by a nearby factory. “Traffic,” for which he won Best Director at the 2001 Academy Awards, is concerned as much with addiction as the law enforcement side of the drug war.

This recent streak of medical projects was catalyzed by another scientifically minded artist: screenwriter Scott Z. Burns, who wrote the 2009 Soderbergh film, “The Informant!” a dark comedy about a corporate whistleblower that is also a stealthy examination of bipolar disorder.

Both of Burns’s parents were psychologists, and his father was a researcher who worked for a time on the space program. He grew up immersed in science, spending hours looking through his telescope, and said he became attached to the empirical method.

Burns told Soderbergh on a flight that he had always wanted to do a pandemic film and make it “incredibly realistic.”

Soderbergh was sold.

“Almost invariably, the reality of what’s going on is more interesting than anything you could invent,” he said.

Sign up to our Daily Recap newsletter

Please enter a valid email address.

He and “The Knick” creators found the same to be true while bringing to life New York City’s Knickerbocker Hospital in 1900. The Cinemax show debuted in 2014 and has run two 10-part seasons, winning a Peabody Award. Soderbergh directed every episode himself.

The show was created by Jack Amiel and Michael Begler, and had its genesis in Begler’s own health problem, an unspecified digestive issue that he says has since improved.

“I think what it was: I was so depressed at points,” Begler said in an interview. So he started researching medical history, thinking: “All right, let me make myself feel better. If I lived 100 years ago, I at least wouldn’t be this far in terms of what I can do for myself.”

He shared his insights with his longtime writing partner Amiel and the duo soon bought reams of medical history books off eBay, spending hours studying the material. It was an unexpected turn for writers who had previously worked on sitcoms and romantic comedies.

“That just ignited something that I think we both didn’t realize was inside us,” Begler said. “I love stories about explorers. … There’s something about the life of an explorer that really talks to me. Well, medicine back in the 1900s, these guys were explorers.”

They found a natural partner in Soderbergh. When “The Knick” script landed on his desk, shortly after he had announced a hiatus from directing theatrical films, Soderbergh said it contained everything he was interested in, from medicine and scientific pursuit to race and class divisions. “All the food groups were represented.”

“There may be no more curious person on the planet than Steven. … He is at base someone who is looking to solve problems,” Amiel said. “I think it appeals to this sense of: ‘Wow, there was the giant problem that plagued millions and millions of people. Some humans kept looking and searching and probing and, with the highest of stakes, were trying to solve these problems. And sometimes, they succeeded.’”

Soderbergh seems hooked. He, Amiel, and Begler are developing their pitch for Cinemax on the next seasons of the show. Soderbergh told STAT that he plans to continue directing every episode — a rarity in television. It will be the biggest commitment of his career if the show lasts the planned six seasons.

And though they are both busy with separate projects for now, Burns said that he and Soderbergh talk “all the time” about another science-driven film, what they call “the brain movie.” It would be a comedy based on Dr. Vilayanur S. Ramachandran’s book “The Tell-Tale Brain: A Neuroscientist’s Quest for What Makes Us Human,” which both Burns and Soderbergh have read.

“I think that there’s something really important to be said there,” Burns said. “It’s just fascinating that we can be so gracious and amazing as a species at times and then so primitive at other times. I really want to find the science behind that.”

The CDC’s scientists get a starring role in “Contagion.” Warner Brothers Pictures

‘He told the truth as he saw it’

For many years, Hollywood’s constant bastardizations of science left researchers disgruntled. The 1995 film “Outbreak,” among others, is routinely derided. When it came to “Contagion,” Burns and Soderbergh had to win over skeptical experts to advise them.

Laurie Garrett, the Pulitzer Prize-winning author of “The Coming Plague: Newly Emerging Diseases in a World Out of Balance,” said she walked into a lunch meeting with Soderbergh and other producers with firm demands.

“I went through a whole list. I could see them smiling and grinning,” Garrett said in an interview. “They were very amused.”

When she finished, Soderbergh said: “Hallelujah.”

They needed trained scientists, too. Burns met with Dr. Larry Brilliant, the epidemiologist who helped finish eradicating smallpox decades ago. Brilliant introduced Burns to Dr. Ian Lipkin, an internationally renowned “virus hunter” at Columbia University.

Lipkin had previously been approached by Hollywood — and had declined to work as a consultant because producers wouldn’t give him veto power if the story strayed too far from reality.

“I was not willing to put my name on something that was going to be factually inaccurate and sensational,” Lipkin said. But he believed Burns and Soderbergh when they said they wanted to make something scientifically sound.

Garrett regularly fielded phone calls from Burns as he wrote. Swine flu was international news during the writing process, and she would send him news clips that could serve as inspiration for the screenplay.

Lipkin was on the set almost every day, teaching Gwyneth Paltrow how to act out a realistic seizure and correcting the filmmakers on how the critical vaccine would be injected in its first test — not through the researcher’s pants. He even designed his own virus to be the story’s antagonist.

“I wanted to make sure that movie was irrefutable from a scientific standpoint,” Burns said.

While “Contagion” was in production, the crew was so fastidious about the science that somebody called Dr. Connie Schmaljohn, a senior scientist at the US Army medical research center at Fort Detrick in Maryland, with a strange question. They thought a CDC training video, demonstrating how to take blood samples from an anesthetized monkey, showed the wrong technique.

After checking with the center’s veterinary staff, Schmaljoun found it was true. The production crew had it right.

The film isn’t perfect, though. Upon its release, some outside experts took issue with a few details, particularly how quickly a vaccine to stop the virus is developed, mass-produced, and shipped around the world. Even with its huge cast, characters sometimes were asked to do more than their real-life counterparts likely would. One former CDC epidemiologist told STAT he was shocked Kate Winslet’s character knew how to set up a field hospital.

The death toll eventually reaches 26 million worldwide. Dr. Jeffrey Koplan, a former CDC director, said that almost every variable of the pandemic portrayed in the film gets “turned up to 11.”

“To have them all happen at once is a little beyond our experience, but not inconceivable,” Koplan said, “and I think justifiable if you’re making a movie to scare the bejeezus out of people.”

But the filmmakers have also delivered some decidedly less Hollywood moments. Dr. Sasha Bardey, a forensic psychiatrist, was on the set almost every day while Soderbergh shot “Side Effects,” which was also written by Burns. He helped guide the subdued electroshock therapy portrayed in the film, which is much more subtle than the popular perception.

“I think it’s part of their artistic eye,” Bardey said of Soderbergh and Burns. “They really want to hang drama on a very realistic-looking wall.”

For “The Knick,” Amiel, Begler, and Soderbergh turned to Dr. Stanley Burns, a practicing ophthalmologist with perhaps the most extensive private collection of historical medical photographs in the world, many of them adorning the walls of his New York City brownstone.

Amiel and Begler would send scripts to Burns to make sure the medical details covered in the show — aortic aneurysm repair, the first X-ray, innovative hernia surgery — were accurately rendered. They sorted through his archives, looking for inspiration. The show depicts rhinoplasty necessitated by syphilis, early radiation treatment for cancer, and the emergence of eugenics.

The showrunners were so strict that they would allow medical breakthroughs to be included only if they were achieved within one year of 1900, when the story opens.

But as they went deeper with research, they found such incredible details that they realized they didn’t need to stretch the truth all that much. When Begler read that turpentine was prescribed to treat ulcers, he immediately emailed Amiel. They were astounded to find that cocaine had been used as a localized anesthetic.

“I want the viewer to be like, ‘No [expletive] way,” Begler said. “And then I hope that they then go online and they looked this stuff up. ‘Wait, they really did that?’”

The show has developed such a reputation that its special effects team, the hands behind the show’s visceral surgical scenes, have been hired by Boston Children’s Hospital to build models to help medical residents train.

For Soderbergh, authenticity acts as an ethos.

“When you talk about what role veracity plays in all of these projects, I certainly as a person after I’m gone would like people to say, ‘Whenever he expressed himself about a subject, he told the truth as he saw it,’” he said.

Jude Law’s psychiatrist faces off with a patient and pharmaceuticals in 2013’s “Side Effects.” Endgame Entertainment

Seeing real life in the movies

Ebola and Zika have become real-life analogues to the bureaucratic and scientific challenges covered in “Contagion,” and the film was invoked often as the former gripped the world in 2013 and 2014. “Side Effects” possesses a cynicism about the pharmaceutical industry that seems in tune with the era of Martin Shkreli and Valeant.

“The Knick” covers everything, but its fixation on groundbreaking medical progress evokes the aspirations of Vice President Joe Biden’s cancer moonshot. The second season documents how Owen’s character struggles to treat addiction as a medical disease, greeted with much skepticism, a resonant plot as the opioid epidemic has swept America and changed the public’s opinion of how to stop abuse.

The artists themselves are being treated as experts. Burns was asked to appear on public radio to discuss the Ebola outbreak, a request that he admits baffled him. Amiel and Begler spoke at a medical historical society meeting in San Marino in December. Lipkin said students tell him all the time that “Contagion” inspired them to study microbiology.

The experiences have stuck with Soderbergh, too; he said he follows medical news differently than he did before he became educated in these fields. He is keenly aware of the risks that health workers took when they traveled to West Africa to combat Ebola and the pressures that the CDC is under as Zika fears and misconceptions have deepened this spring in the United States.

It’s even crept into his everyday life.

“Do I wash my hands more? Yeah,” he said. “I am more aware of germs than I was before we starting working on that movie. You can’t help but be.”

“Once you’ve learned what a fomite is, you’re kind of screwed.”

Leave a Comment

Please enter your name.
Please enter a comment.

Recommended Stories

Sign up for our
Daily Recap newsletter

A roundup of STAT’s top stories of the day in science and medicine — delivered straight to your inbox every weekday afternoon.