Aug 22, 2014, Anchorage Press
The documentary, Code Black, offers a unique vantage point in the assessment of the current Health Care climate through the dynamics of the Emergency Room (E.R.) at the Los Angeles County General Hospital. The documentary was made by Dr. Ryan McGarry while a resident intern at L.A .County. According to the film, "Code Black" refers to a point of saturation in which the emergency room is operating on all cylinders and maxed out, the pace is unrelenting and patients stream in constantly, waiting for hours and in some cases days to be served.
Code Black uses the Fly on the Wall type of documentary filmmaking to follow McGarry and his cohort through their time at L.A. County and a paradigm shift in how and where services are provided. Through flashbacks to an old E.R., C-Booth, we learn of a much simpler and more effective era in emergency medicine. The transition in locations impacted the dynamics of the E.R. and the physician-patient relationship. The shift from the old L.A. County E.R. facility to the new facility not only brought the E.R. to the current technological era, but also inundated it with a level of bureaucracy that worsened the experience for everyone. The old C-Booth E.R. facility was set up in a way that fostered efficiency through a cacophony of order evoking memories of M.A.S.H. episode triage. Waivers were signed to allow these front-line physicians to effectively treat patients without immediate concern for paperwork. In the new E.R. facility the waivers are no longer in place. A doctor has to fill out more than 50 different forms to get a patient through the registration, treatment and discharge process. The content in the documentary is important to the larger scale of understanding the current state of Health Care in the U.S. However, the delivery style of the content at times undermines the message in Code Black.
Documentaries have come a long way since the early 1900s. Until the mid-1920s this particular genre of filmmaking was known as "actuality" filmmaking because it captured single moments of actual time. As film technology evolved, these moments were sculpted into longer forms of storytelling that documented true-life experiences. In contemporary documentary filmmaking, the nonfiction aspect of a documentary remains mostly intact, but the level of sophistication and possible narratives that deliver the story to viewers varies immensely. The variability is comprised of the multiple types of documentary styles that have emerged and the ease and availability of technology. Anything from smartphones to digital cameras, can capture real time moments that can then be woven into a story by anyone with access to editing software. Anyone can make a film and or a documentary, but it's easier said than done.
As a film, Code Black has some flaws. Among these is the second-rate sound design that overpowers the interviews and distracts from the importance of the content. Apart from a well-timed clip from the Peach Kings, most of the soundtrack fails at effecting mood. As a matter of fact, one of the strongest scenes is a silent rendition of patients in the waiting room. It is in this quiet moment that the viewer connects with the humanity of the patients. Another flaw is the amateur directing. As mentioned earlier, McGarry is a physician, not an auteur; the other protagonists are other resident interns, not actors. Without expert direction, sequences outside of the hospital setting come across as forced and artificial.
In the 78 minutes that Code Black fills the screen with graphic shots of E.R. procedures and subsequent bureaucratic nightmares, the viewer gets a sense that the conditions in health care facilities are overwhelming. McGarry poses fundamental questions and commentaries about the chaotic and detrimental state of U.S. health care policy in the midst of the national debate but doesn't offer any long term or sustainable solutions. To be fair, no one can because the layers and layers of special interests, political and commercial, come at the expense of the only and most valuable unit of measure-the human being in need of help and care.
Code Black shows at Bear Tooth on Monday, August 25 at 7:45 p.m.