Code Black, the recently released documentary by filmmaker and physician Ryan McGarry, provides a harrowing and enlightening window into the front lines of healthcare. Filmed during McGarry’s residency at Los Angeles County General Hospital, Code Black recounts the history of the C-Booth, the trauma bay at LA County where, arguably, modern emergency medicine was born. The documentary chronicles the experiences of a group of resident physicians as they fight to help patients who have nowhere else to turn, amid the demands of a system that seems more interested in paperwork and profit than people.
As a non-physician, I didn’t know what I’d take away from the film. But when I walked out, I knew I’d look at my next emergency physician differently. Here are five ways Code Black changed my perspective on healthcare, and EM in particular.
1. The safety net is hanging in tatters.
According to the film, the vast majority of our healthcare system is driven by a desire for profit. As a result, the patients who are in the direst need of care are also the ones who have the fewest options for getting it. With the safety net for the entire country consisting of less than 30 government-run facilities that are understaffed and underfunded, our healthcare system is shortchanging the most vulnerable among us…and, as we’ll see in #5, it’s shortchanging itself, and all of us, in the process.
2. Emergency medicine is hell.
In interviews, McGarry has compared the opening shots of Code Black with the opening sequence of Saving Private Ryan. Whether that’s exaggeration or not, the chaos of the C-Booth, in which doctors and staff are in a constant state of triage, does seem to mirror the chaos of a battlefield. Code Black showed me that like war, EM is hell, even if it doesn’t always seem that way in the waiting room. At least the doctors get to go home when their shift is over.
3. Emergency physicians care deeply about their work.
This shouldn’t come as a shock, not even to a non-physician such as myself, but I was surprised by the passion and drive of the doctors interviewed in this film. When I visit the hospital, I’m usually focused on whatever brought me there, not the inner lives of the people treating me. Code Black shows us that there are doctors who are committed not only to helping their patients, but in doing what they can to improve the system…even if what they can do is frustratingly little.
4. EPs are demoralized by an endless torrent of paperwork.
There is a candid moment in Code Black in which McGarry admits to the camera that he needs to help a patient, but is putting it off because he doesn’t want to attend to the mountain of routine paperwork that entails. The film does a good job of showing the demoralizing effects of all the red tape emergency physicians must deal with. In particular, we see how the oppressive burden of paperwork, quotas, and metrics detract from the natural camaraderie of the emergency department. If I find myself in an ED and the staff seems rushed, I’ll have a better understanding of what they’re dealing with.
5. Ignoring small problems now leads to enormous problems later.
There is a patient in Code Black who has diabetes but is unable to afford medication, and is in danger of losing a leg as a result. A resident laments that, had the patient been provided with medication that costs pennies a day, he would not now be in need of emergency treatment that will cost thousands of dollars. This film drives home that the old cliché about an ounce of prevention demands to be reckoned with in dollars and cents, if only for the benefit of those who speak no other language. And those of us who are fortunate enough to be in good health might take this lesson to heart— guarding your health now is better than fixing it later.
Ajai Raj is the Associate Web Editor at EP Monthly.