You could be forgiven for believing that the first twenty-five minutes of Code Black, physician-director Ryan McGarry’s new documentary on the Los Angeles County Hospital’s ER wing, is the spliced-together product of not one but two separate films. Those two films might look something like this:
FILM #1 (potential title: EMERGENCY DOOM): A shaky digital camera hovers in a chaotic and poorly-lit emergency room. In the center of a crowd of robed and screaming physicians is an enormous pale belly of flesh cut open like a rotten pumpkin, with nauseating textures of pink and white made visible inside. Out of a miasma of plastic face masks that look like riot gear, low-ceilinged beige corridors, latex gloves, paper jumpsuits, oxygen tanks, and bloody flooring, clips of frantically-muttered phrases are just audible: “The stab wound to the face is here.” … “All the way in!” … “Can you troubleshoot your tube?” … “Take it out ‘cause he’s gagging…” A faceless patient’s bowels are cut open for anyone to see, and a few seconds later he is reluctantly declared dead by the ER’s exhausted staff.
FILM #2 (potential title: MCGARRY’S EIGHT): A group of young, fit, clear-skinned, attractive doctors are shown drinking at a hip restaurant around a bag of sweet potato fries. “Part of what we’re trying to figure out now is who we are.” A muscled twenty-something dreamboat sits in his clean kitchen and tells the camera crew that all his friends call him “the Epic Guy” because of his love of rock climbing and adventure. “As a young doctor, I have to ask myself — how do I protect the ideals I came here for?” A silver-haired doctor who appears to Kyle Chandler and Anderson Cooper’s lovechild wanders the hospital halls in a crisply-ironed lab coat. “Now, here we are — starting our senior year as ER doctors…” It would be easy to mistake this for the opening credits of a reality TV show about hot young physicians, or a new Grey’s Anatomy spin-off — but no! It’s Code Black’s ready-for-primetime cast of young, on-the-scene ER doctors.
Between the uncomfortable interweaving of these two film worlds, Code Black opens its story, centered around C-Booth (short for “critical booth” or “cardiac booth”), a legendary trauma bay in L.A. County General’s storied ER. According to veteran doctor Billy Mallon (who is genuinely described as “a little rough around the edges, breaking some rules — nobody boxed him in”), more people have died in the square footage of C-Booth than in any other location in the US, though his converse statistic that more people have people have been saved in the same square footage seems a bit more nebulous.
The aforementioned group of hunky young doctors-in-training came to L.A. County General to train in what’s described as “the birthplace of emergency medicine.” However, in 2008, earthquake code violations forced the city to build a new hospital, the sleek and modern New County building located just next door. Accompanying the sterile new establishment is an equally-sterile bureaucratic form of organization that requires 50 to 60 forms per patient visit, 10 to 15 hour waiting room stays, and a corporate climate that limits genuine patient-doctor relations. The remainder of Code Black is devoted to voicing the various physicians’ frustrations that accompany the move to this new environment, as well as a longing for the grittier, more personal working style that C-Booth represented. As one interviewee laments, “The day of the cowboy is gone.”
It is in this second section that the film seeks to make its point, but problematically it is also where Code Black seems to lose its point entirely. Seemingly lacking in a clear agenda or a central argument, the film details the sobering aspects of the ER doctor’s job, vents frustrations with administration and budget limitations, and makes vague references to problems in the American health system at large, all centered around a new working style based around Excel-spreadsheet-bureaucracy and overregulation. The film doesn’t try to further an exact agenda in regards to national health care. It seems instead to settle on airing complaints without establishing a clear path forward, like a doctor at a bar at the end of the day venting to a stranger (or perhaps a bunch of good-looking physicians hanging out at a hip restaurant?).
Doctor-turned-director Ryan McGarry (who is himself one of those TV-ready L.A. County ER doctors we see throughout the film) has stated in interviews that he wanted to add physicians’ voices to the national health care debate. Yet his own admission that he doesn’t know much about that very same debate (“I’m just a young doctor… I don’t know much about politics or the economy.”) seems to muddle both his message and his intentions. Furthermore, McGarry’s starring role in the film and his glorification of his own work and that of his peers makes the film’s repeated critique of private practices as only existing for profit equally dubious and largely self-righteous.
One certainly can’t fault McGarry or his film for having good intentions. But ultimately his stated goal of simply providing an ER doctor’s viewpoint without making a clear case out of that viewpoint leads to an uneven and wandering film. In the end, the only clear point we’re left with is a nostalgia for the bloody but intimate days of C-Booth, before the complicated and bureaucratic New County building came along and, in one doctor’s words, “kill[ed] the passion of saving someone’s life.”