THE MISFIT.

The moving images on the camera monitor offered, I thought, a plausible depiction of one of the drawbacks of life in the Old West--an invasive urological procedure conducted without benefit of anesthesia. "A situation involving significant unpleasantness" was how David Milch, the creator of "Deadwood," had described the scene being filmed on a soundstage at Melody Ranch Studios, in Santa Clarita, thirty miles northwest of Los Angeles. One of Milch's inventions, Al Swearengen--or, rather, Milch's conception of the real Al Swearengen, owner of the Gem Saloon, a tavern and bordello in the town of Deadwood, just outside the Dakota Territory, circa 1877--was about to have a metal probe called a Van Buren's sound inserted into his urethra by Doc Cochran, a tormented physician on the verge of a breakdown. If the procedure succeeded, Swearengen would pass a bladder stone and, presumably, resume hatching schemes of byzantine deviousness--a poetically unjust outcome, considering the inventory of murders and casual brutality he was responsible for. If it failed, the next recourse would be surgery, which the doctor dreaded because of its high risk of mortality. That Swearengen, the chief protagonist of "Deadwood," an unlike-any-Western-you've-ever-seen Western that ran for twelve episodes last year on Home Box Office and returns next month with twelve more, might be allowed to die seemed improbable. Yet, ostensibly important characters were not immune from getting shot or having their throats slit or their brains dashed, so who knew? In any event, it turned out that I had only a dim grasp of what I was watching.

Twenty minutes earlier, Milch had instructed the actors Ian McShane (Swearengen), Brad Dourif (Doc Cochran), Paula Malcolmson (Trixie, a prostitute and Swearengen's occasional mistress), and W. Earl Brown and Sean Bridgers (Swearengen's henchmen Dan Dority and Johnny Burns) to approach the scene--five people struggling fiercely so that one of them might properly pee--as if the patient were a woman in labor. Between takes, Dourif wandered over and Milch asked, "How was that?"

"You know, that one seemed to sail pretty goddam good," Dourif said. "It's not just me. It had the whole baby thing in there. If we get the baby thing, we all can make it work together."

"Go get 'em," Milch said.

Then he turned to me and launched into a typical Milchian riff, a garrulous but lucid stream of subtextual information--intellectually daunting, digressive, arcane, wittily profane--a phenomenon familiar to everyone associated with "Deadwood."

"It isn't just about witnessing a woman suffering," he said. "It's about the cohabitation of the spirit--where you've gone out as fully in compassion as one human being can to another. And all you're trying to do is help her through. In any operation, what you have to do is to persuade the patient to grant access to the patient's energy. The purest form of that is when you're trying to help a woman through labor, when you're saying 'Push, push!' and you're rhythmically with the woman. What you see at the beginning of this scene is the doctor--as modern medicine--collapsed into himself. Simply looking at the instruments of his own failure. Left alone, medicine kills. The predicate of modern medicine is 'We invalidate your humanity but we give you immortality, so you have to shut up and listen to us.' That's the bullshit that gets sold to patients, and Cochran knows it. He's already been broken on that wheel. He was a Civil War surgeon and all his patients died."

When Milch speaks, it's with a natural storyteller's alert, legato fluidity. His hands stay busy and he projects a cerebral intensity. He has brown eyes, a wide mouth, a strong nose, dark hair that he refuses to let go gray--he turns sixty this year--and the pale fleshiness of someone who doesn't expose himself much to sunlight. "There's a story by Hawthorne, 'Ethan Brand,' about a man who goes out looking for the unpardonable sin," he continued. "He discovers that it's the violation of the sanctity of another person's heart. To use an instrument to open up another person without a loving, terrified humility is the unpardonable sin. That's what medicine does, and Cochran has done it too much. At the beginning, he falls back on his fear. But then, in apprehending for just a moment the suffering of the others in the room with Swearengen, he's able to go past it and he finds that the minute one person is brave the spirit comes alive. What I'm trying to suggest to the actors is that the modern situation is predicated upon the illusion of the self's isolation--that business of 'I'm alone, you're alone, we can bullshit each other when we're fucking or whatever else, but the truth is we're alone. Right?' Well, I believe that that is fundamentally an illusion."