Code Black | Screen | Pittsburgh | Pittsburgh City Paper

Code Black

An inside look from an emergency-room doctor at one of the nation's busiest public hospitals

On the front line of public health: resident doctor Jamie Eng, at L.A. County's emergency facility
On the front line of public health: resident doctor Jamie Eng, at L.A. County's emergency facility

Maybe in the future, there will be feel-good films about America's health-care system, but for now, the best we can hope for are documentaries that temper horror with hope. Such is the case with Code Black, an insider's look at the emergency room of one of the nation's busiest public hospitals.

While a resident at Los Angeles County Hospital, Dr. Ryan McGarry documented the frantic, frustrating and rewarding times that he and other residents experienced over five years. This is a generation of young doctors, Code Black explains, who have been raised in the ongoing throes of the health-care crisis. And for many young doctors, residency is the time when their lofty ideals crash against the rocks of a system that can seem to favor bureaucracy and profit over patient care.

L.A. County Hospital was also the home to "C-Booth," an innovative concept that was the birth of the modern emergency room, and where these residents get their early training. The film depicts scenes there in which doctors, nurses, cops and EMTs work shoulder to shoulder over patients, while orders are barked, monitors attached and bodies vigorously cut open — often next to a second and even third such team. "To an outsider, this looks like total chaos," says one staffer. "But as a doctor, I see unity: There is a team here." (A note for the squeamish: This is an unfiltered look at emergency medicine, with some potentially disturbing surgical footage and on-screen deaths.)

Midway through the film, L.A. County shifts its trauma unit to a newly built emergency facility that complies with current regulations, and the residents face a different set of challenges, namely increased amounts of paperwork and documentation. And perhaps something else is lost, when the managed chaos of C-Room gives way to mandated procedures. It "changed the intimacy with the patients," observes one resident. Now, it's "buckets of paperwork [which] kill the passion of saving someone's life." And then there's the perpetual crisis from which the film draws its title: "Code black" denotes a packed emergency waiting room, in which patients can wait up to 24 hours to be seen.

As awful as that is, at least Los Angeles has a public hospital. It's one of very few cities in the U.S. that still does. Code Black is hardly a comprehensive portrait of modern health care, but it does raise important and provocative issues and concerns, voiced by those on the front lines who are acutely aware of the system's successes and failures.

McGarry, who earned his medical degree at the University of Pittsburgh, is scheduled to attend the Fri., Sept. 19, and Sat., Sept. 20, screenings.

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