In the movie “Network” Howard Beale taught the nation that when you’re mad as hell and not going to take it anymore you stick your head out a window and scream. Lot of good that does. The ER doctors who made and star in “Code Black” did something much better — they made a movie.
“Code Black” is a cry for help from the emergency room of LA County Hospital. The health care system in the county, and for that matter the country, is in crisis.
Taking advocacy film journalism to a new level, the medical team behind this doc are on camera for interviews and in action as they treat trauma patients — suffering from gunshot wounds, gasoline burns, dangerous infections and heart attacks.
Its director, Ryan McGarry, is an ER physician at LA County, who spent four years making the film, often with himself on camera struggling to revive a patient. Among its exec producers are several staff members.
So this is very much a bulletin from the front lines of the battle for health care in America. The news isn’t good.
During those four years of production, McGarry and his co-writer/editor Joshua Altman witness a dramatic change in the ER culture at LA County.
Emergency room medicine was virtually invented at LA County. It was in the famous “C-Booth,” a trauma bay thrown together hurriedly in the aging hospital, that ER residents pushed the envelop of medicine.
In its small, cramped quarters, as one ER veteran notes, more human lives were lost than in any other place in America. On the other hand, in that tiny space more lives were saved than anywhere else.
What many residents such as McGarry didn’t realize in 2008, when the movie begins, is that C-Booth’s seeming drawbacks were its greatest strength.
Patients were rushed into quarters with no privacy or room to spare. Paperwork and bureaucracy never invaded the room. Because the facility was so old government regulations were waived.
Comes 2012 and the ER staff moves to a spanking new building. And all those local and federal government regulations, the challenging realities of the modern American health care system, hit the staff like a punch in the face.
Making his rounds one day, McGarry turns to his camera and wryly notes that the crew has been following him for over half an hour and he’s spent maybe two minutes with a patient.
What he and all the other ER doctors and nurses are doing instead is to log on constantly to computer stations in a system designed more as a litigation defense against malpractice suits than patient welfare.
Endless documents and forms eat up valuable time during rotations. Meanwhile ER patients outside wait as long as 12 to 18 hours to see a doctor.
The waiting room is so jammed — Code Black means it’s reached capacity or possibly gone beyond — because local private hospitals discharge or simply kick out patients deemed “unprofitable” since they lack health insurance.
Fed-up with the new bureaucracy, Dr. Danny Cheng challenges a head nurse in a hallway only for her to reply with steely logic that a nurse not following regulations could lose her license and therefore her job.
So Dr. Cheng, Dr. Jamie Eng, Dr. McGarry and other residents put their heads together to create a new patient intake system that skips the forms and BS at least for the most severely ill patients. They enjoy a huge success in reducing the wait time.
The triumph is short lived though.
County officials cut the hospital’s budget, which severely reduces the nursing staff. LA County can no long afford to operate at full capacity. Units get closed but that doesn’t stem the flow of in-coming patents. The waiting room is back to Code Black.
Mind you, this “message” comes to a view osmotically, filtered through scenes of life-or-death salvage efforts on critical trauma patients. Sometimes the attending physician must look up and ask if anyone objects to him “calling” a time of death. Other times a patient recovers.
So there is more gripping drama within “Code Black” than in a dozen TV medical shows. And some of the procedures are graphic, so be warned.
Despite working a sleep-deprecating 24/7 schedule as a doctor in training, McGarry has put together a polished documentary that any film school grad or veteran documentarian would be proud to claim as his own. No doubt he relied heavily on the experience of his producer, Linda Goldstein Knowlton, who has produced many features and docs.
Whatever the case, “Code Black” is a minor miracle of filmmaking that probably could not have happened had not an entire ER staff fully backed the film and made room for a camera crew in its trauma bay.
So this unvarnished look at the reality of American health care is profoundly exciting and moving as it is disquieting. One is immensely impressed with the dedication and sacrifices of all ER personnel. But the system is clearly broken.
I tell you what: Before all congressional hearings on health care, those exercises in political grandstanding that do little more than move hot air around the room, it should be mandatory for the politicias to view “Code Black.”
Yes, there are many ideologically intrenched idiots in Congress who will remain unmoved. But I bet the majority will gasp at many moments in “Code Black.” That might be all it would take.
Opens: June 27, 2014 (Long Shot Factory)
Production companies: C-Booth, LLC
Director: Ryan McGarry
Screenwriters: Ryan McGarry, Joshua Altman
Producer: Linda Goldstein Knowlton
Executive producers: Mark Jonathan Harris, Marti Noxon, Edward Newton, William “Billy” Mallon, Jan Shoenberger, Matthew Damron, Diku Mandavia
Director of photography: Nelson Hume
Music: James Lavino
Editor: Joshua Altman
No rating, 85 minutes