This 1923 Season 2 Episode 4 surgery scene had major filming challenges (but 'special effects' did a ton of work)

Talk about intense! The brain surgery scene in 1923 Season 2, Episode 4 wasn't just hard to watch—it was darn near impossible to film. We're not talking about some quickly cutaway or tame medical drama here. This was real deal trepanation, complete with a drill, scalp incisions, and exposed bone. And yes, it was all done through practical effects, not CGI.

Actor Brian Geraghty, who portrays Zane in 1923, spent hours of preparation, including donning a full prosthetic head made especially for the occasion. The whole thing was a monumental technical achievement, and the special effects team, led by Jason Hamer, pretty much bore the brunt of this scene on their backs (and workbenches).

So what exactly was so challenging? Everything. From having to make the prosthetic look like Geraghty's actual face to making the drilling scene look realistically gory, there were no shortcuts.

It was not just a case of slinging blood around the set; it was a case of anatomy, timing, lighting, and emotion. And while the viewers saw only a few minutes of Zane's surgery, the work that went into making those few seconds convincing took days of planning and hours of tough physical filming.

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A challenging scene for everyone involved in 1923

Brian Geraghty did not merely drop in and pretend—he endured an arduous setup procedure that pushed his temperament and patience. The prosthetic head, one with his features accurately copied, took the form of a series of hours spent casting, molding, and tweaking minutiae.

According to TVinsider, Geraghty said,

"It took a full day, maybe a day and a half to film. We had a lot of pieces, and basically we [filmed] me as a practical [effect], and then we switched to the dummy head and they had the procedure. I think they even had a double in there and shaved the hole and added all this stuff. When they did the drain, they had the special effects there with the pump to have it look as authentic as possible.”

Upon being prepared, filming involved his ability to remain fixed in the very same spot with makeup and effect teams walking in circles around him. It was not physically agonizing—it was emotionally taxing. Geraghty explained that the procedure deeply affected him, both due to the violence on screen and what it did for his character's direction.

According to Collider, he said,

"I worked a lot on that scene and tried to really get to the understanding of the emotional relevance of not being able to walk or being able to walk and be cured. It was a two-day process to film the whole sequence, and it was amazing with Darren [Mann] and Harrison. We had a fun time, but once they start rolling the cameras, we all took it down and just tried to get through the scene."

This was not a typical on-screen injury in 1923. It was an intrusive, historically authentic brain surgery, and the emotional stakes were off-the-charts. Geraghty had to access stillness and vulnerability while trusting in the effects team to provide a moment that would look like real-life trauma, without going over into excess.

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Special effects made the scene possible in 1923

Jason Hamer and his special effects team stood at the center of it all, creating a prosthetic head integral to making the surgery appear real. No digital tricks, no CGI enhancements—simply old-fashioned craftsmanship and copious amounts of silicone. The prosthetic included realistic skin colors, hair, and even layers that could be stripped away to replicate the skull being drilled.

According to Esquire, Brian said,

"It is wild. Jason Hamer, the special effects guy, was able to make a whole replica head. It was so weirdly and uncannily me. They matched the exact facial hair, the color, everything."

This wasn't achieved for shock's sake—it was in order to have a feeling of observing an observer to a horrific, but medically correct, operation from the early 20th century. Realism was more important to the feel of the show, and it took a lot of effort from the effects team to maintain that realism across many takes and shots.

As per Screenrant, he also praised the team by saying,

"My hair was a different color from my beard because I was surfing, but they were able to match it so well that when they saw it on set, everyone was like, ‘This is the best special effects I've ever seen.’"

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Accuracy and coordination behind the scenes in 1923

While the prosthetic was the star of 1923, the rest of the production surrounding it was just as critical. Lighting had to be balanced to highlight the surgical procedure without detracting from the illusion.

Camera angles had to be mapped out with utmost care so cuts between Geraghty and the prosthetic head were seamless. The set itself had to be dressed so believability was maximized, but not at the cost of visual overload.

The cooperation between departments—makeup, lighting, camera, costume, and direction—was essential. Every movement had to be rehearsed and choreographed to balance medical realism with cinematic fluidity. Everything had to be gruesomely real, but within control.

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Impact on the viewer of 1923: Realism without gore overload

Regardless of how gruesome the scene was in 1923, it didn't go for gore for gore's sake. Actually, one of the things that made it all the more unsettling was the fact that it didn't do that. The scene was a fine line—it was clinical, not chaotic. The drill, the incision, and the exposed skull were done without stylization, so it felt like something could have happened during that time.

The realism anchored the audience in the barbarism of Zane's circumstances without sensationalizing it. It was restrained but not sanitized, and that made it all the more effective.

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The brain operation set piece in 1923 Season 2, Episode 4 didn't fail due to technologically advanced wizardry—it worked because of craftsmanship, emotional performance, and a sheer round shot of utterly demented attention to detail.

Jason Hamer's team built a prosthetic that was pore for pore with Geraghty. Geraghty provided the emotional weight, and the entire team facilitated a scene requiring virtually flawless delivery from all conceivable angles.

There were no shortcuts taken with special effects in 1923. No post-production gore crutches. Only painstaking realism and a deep respect for the emotional gravity of the moment. That mix—painstaking special effects, grounded performances, and careful filming—made the scene so compelling, which is why it remains memorable in the series.

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