Don't eat a sandwich before you sit down to watch the documentary "Code Black." In one of the first scenes, we watch a team of doctors and nurses cut into a patient. It's a bloody business, and the camera doesn't turn away. That's because this film is about the brilliant chaos of emergency care, and the people drawn to this work.
For all the debate over health care in America, it's relatively rare to hear from doctors on the front lines, and even more rare to hear from young doctors about a field they've recently chosen to devote their lives to. “Code Black,” a documentary by a doctor when he was a resident at LA County's USC Medical Center, delivers that perspective with punch and passion. It promises a look into "America's busiest ER."
Ryan McGarry is now an assistant professor and physician at The Weill Medical College of Cornell University. Possibly, his penchant for storytelling has something to do with his bachelor's degree in English at Pennsylvania State University. His decision to become a doctor was inspired in part by his experience as a Stage IV cancer patient while an undergraduate. Even though he switched gears professionally, he finds poetry in his new field.
His training ground for emergency medicine is “C-Booth”, a now-closed but legendary trauma bay, where “more people have died and more people have been saved than in any other square footage in the United States,” McGarry tells us in his voice over.
The film is a first-person reflection of McGarry's personal choices: of his respect for the students and teachers around him, of how jazzed he is to be doing emergency medicine, of how anxious he is about the primacy of money and politics over human values in medicine today.
We also hear from McGarry's fellow interns, like Jamie Eng, speaking with an almost dreamy calm about what motivates her to charge into a scene that would send most people running. "When I rotated here as a medical student, I saw how the seniors just commanded the place. And I thought, 'I want to be that person. I want to be that calm. That cool. That collected. That knowledgeable. That confident.'”
That's everything you want to believe about doctors: that smart, soulful, driven people will be doing their darndest to keep you or your loved one alive in that critical moment of need. Whether you can pay or not.
LA County/USC is a public hospital, and it's cheering to see how much the interns care for their patients, no matter how poor. But time marches on. A new hospital was built. It’s clean. It’s quiet. It meets modern codes for earthquake safety. Still, whatever rules the old hospital could be exempted from because it was so old and so small, the doctors have to follow modern rules in the new hospital. Perhaps predictably, they hate them, particularly the bureaucratic documentation required for every last, little thing that happens in the ER.
Eng laments, "I just had a patient with the simplest of complaints. It took me about two minutes to see her. I saw her standing right here in the hallway. I don’t even need a room for her. Basically, it took me four times as long to document as it took me to talk to her and do the exam at the same time."
"I've worked on both coasts now," McGarry says, "and whether it be a primary care office or a busy emergency department, the thing that physicians and other providers are talking the most right now is the disconnection from us and patients." How did it come to be, he wonders, "that insurance companies and administrators and everybody else who isn't as invested, arguably, is sort of running that experience?"