All words: Vesper Arnett
In Code Black, what starts as a documentary on the daily chaos of Los Angeles County public hospital emergency department quickly becomes a plea for help from doctors bogged down under the weight of the health care crisis. This ER suffers when faced with additional bureaucratic responsibilities put into law under reform mandates and forcing the doctors, including the film’s director and director of photography Ryan McGarry MD, to spend valuable time doing paperwork that could otherwise be spent seeing patients and saving lives. Even though many of these regulations have been in place for years and in some cases, decades, the hospital was not always required to follow the rules due to the way the ER was set up, but after moving to a brand new facility, they were forced to comply.
The first part of the film features the chaos of the County ER’s “C-Booth”, a 20×25’ space in the center of the ER packed with gurneys. Any patient who needed emergency surgery got it right by people with relatively minor injuries, with no sound barriers, blood smeared across the floor, and as many doctors, nurses, and students as could see the patient clamoring for a view, or to help. Many of the shots are overhead: you can see the heads of staffers peering over the walls that are only slightly higher than cubicle height.
Almost all of the doctors featured in the film are residents who have almost completed their programs. They saw the exciting lifestyle of television doctors (funny, considering the film is executive produced by Marti Noxon of Grey’s Anatomy and Private Practice) and are discovering the sobering reality of the future of their chosen profession. It is as dramatic as what you see on television, with slow reveals of the personal histories of several of the residents, shaky handheld camerawork, and plenty of action shots to immerse the audience.
The residents are having difficulty adjusting to the new systems, with complaints about constantly logging in, to the length of time it takes to fill out a series of forms before they can even see a patient, coupled with the volume of patients needing care but not receiving it in a timely manner. It’s a complicated situation: legislation has obstructed the doctors’ ability to do their job of saving lives, versus the visual chaos of C-Booth and the rights of patients. Since it’s a public facility, they cannot turn any patient away, regardless of insurance, or ability to pay. As a result, they are saturated with people in need.
A couple of doctors try to make a compromise in the ER to accommodate more patients and reestablish the intimacy with patients they had in C-Booth, but a nurse objects, with worries about losing their licenses. A guy dies on screen in the footage from the old ER. Dr. McGarry wonders in present day, “If regulations have to be there at all.”
It is frustrating to watch this film and think about the very real results of health care reform. It’s also frustrating for me to review because the doctor who has the most to say, and is the most passionate, is the same guy who filmed and directed this over a four year period. It’s clearly a project of passion, and suffers for it (but not in production value, thanks to that Marti Noxon’s money). It’s a thorough examination of what the director experienced, through his eyes, and is a rallying cry for action.
The bias is bursting from the seams of the film. We don’t get the perspective of anyone who doesn’t work for the hospital, or anyone who works in a private hospital (the majority of hospitals in the country), or any of the actual lawmakers behind the mandates they’re following. However fond the residents’ memories are of C-Booth, it is apparent that most of the older doctors do not get the opportunity to give their ideas on film. Was this an oversight, or did the director simply choose not to include their perspectives?
Code Black is important for L.A., but is it really a microcosm of the greater healthcare crisis, or is it too narrowly focused? It’s not the sort of documentary you like or dislike, especially if you agree with their position, though it’s clearly meant to push an agenda. It is clear that the system is flawed. Maybe the film is best viewed as brief into the working lives of real young L.A. doctors fighting the health care crisis, and not so much as a documentary about the health care crisis itself.
Unfortunately, we are left in a stalemate brought on by bureaucracy, complicated by the public, and featuring a soundtrack with Bon Iver, just like on TV.