A doctor’s-eye view of the daily chaos of a major metropolitan hospital proves a major boon and a minor limitation in “Code Black.” Shot during the course of his residency at Los Angeles County General Hospital, physician-filmmaker Ryan McGarry’s documentary offers a bracing, often stomach-churning glimpse inside one of America’s busiest emergency rooms, as well as an inquiry into our broken health-care system — one that might have benefited from a less earnest, more distanced approach. With its combination of verite immediacy and slick packaging, this attention-grabbing companion piece to last year’s “The Waiting Room” should parlay its L.A. Film Festival heat (it won the documentary jury prize) into further fest play and theatrical appointments.
As one of the largest and busiest teaching hospitals in the country, L.A. County General, also known as L.A. County+USC Medical Center, employs more than 1,000 residents at a time. (For the record, a family member of this critic is an LAC+USC medical technologist.) McGarry was one of those residents when he began filming inside the C-Booth, or critical booth, the area of the ER reserved for major trauma patients; as presented here, it’s as tumultuous and blood-spattered a war zone as any seen onscreen in recent memory. The procedures routinely conducted in this 20-square-foot bay — the insertion of a chest tube, treatment of severe burns, etc. — are captured in startling and (for non-medics) often squirm-inducing closeup, conveying the extreme circumstances under which ER physicians go about the business of saving lives.
This graphic handheld footage, joltingly edited by Joshua Altman (who co-wrote with McGarry), feels at once deeply relevant and somewhat calculated to get under the viewer’s skin; certainly it impresses on us the unique fearlessness it takes to operate, with speed, confidence and precision, on the human body. The residents interviewed here speak of their baptism-by-fire experiences in C-Booth with a rush of pride and adrenaline, describing it as a place where they not only proved themselves, but provided the sort of urgent, hands-on patient care that motivated many of them to practice medicine.
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Working with d.p. Nelson Hume, who filmed all but the C-Booth footage, McGarry broadens the film’s perspective to address some of the issues framing the health-care debate, particularly the bureaucratic tedium that has led to a diminished emphasis on doctor-patient interaction. LAC+USC, which in 2008 transitioned from its old stone headquarters to a state-of-the-art $1 billion facility, offers a particularly relevant illustration of these problems in microcosm.
As more than one interviewee notes, doctors and nurses now spend far more time filling out paperwork and logging data than they spend actually seeing patients, exacerbated to some degree by the more sterile, compartmentalized design of the new building and others like it. Yet the problem is also endemic to a system crippled by chronic understaffing, rampant overcrowding and a business-first mentality. As the film’s interviews demonstrate, the patients cramming the waiting rooms at major urban hospitals are often low-income individuals, lacking proper access to medical attention, yet in the direst possible need of it.
The bruised idealism of McGarry and his fellow residents, their determination to speed up the process, reduce wait times and administer treatment to those who cannot afford it, feels genuinely touching and inspiring. This remains true even when the film’s argumentative stance comes off as a trifle simplistic, or when its bright-and-shiny aesthetics — the sight of these fresh-faced young doctors posing around a restaurant table can’t help but suggest a “Grey’s Anatomy” photo shoot — threaten to undercut the seriousness of its message.
A more detached, contemplative perspective, as well as a few more words from the more veteran practitioners briefly interviewed here, may well have yielded a longer, more probing and informative work. Which is not to devalue the film we have before us, courtesy of a doctor clearly gifted with more than one skill set: At 81 minutes, “Code Black” feels like a brisk, vital report from the frontlines of emergency medicine, forged and rooted in the most intense sort of personal and professional experience.