Saturday, July 12, 2014

"Code Black": an emergency room physician makes a film about the work

It’s pretty impressive that an emergency room physician can become filmmaker, but Ryan McGarry accomplishes this directing and writing (with Joshua Altman) his harrowing documentary “Code Black”, presenting life in emergency rooms of several Los Angeles hospitals.

What’s also impressive is McGarry’s presentation of his own battle with lymphoma, which struck suddenly when he had become a track star as a freshman in college and suddenly started failing.  He shows what the chemotherapy did, but he recovered, and “paid back” by becoming a physician. (“The Fault in Our Stars” did not end so well.)

The film starts its narration (in 2008) with the old Los Angeles County hospital, finished in 1932, intended to serve all takers, regardless of ability to pay.  The film focuses on the expanded white monolith in opening sequences, reminding us of the Los Angeles County Courthouse.  There was a specific area (with a catchy nickname, “C-Booth”), small, where the most ill patients were rescued. 

But state law mandated a new earthquake-proof center, next door, which looks smaller.  In the modern facility, bureaucratic rules could be enforced.  HIPAA requires that doctors log in every time they look at a patient record, which slows them down.  (HIPAA was also a source of a lot of mainframe programming jobs in the early 2000’s; I vetted some of them.)

As the film progresses, it explains the difficulty in staffing a large emergency room for all comers, relating in tremendous waits.  It also shows how people fall through the cracks.  A 58 year old woman who used to be an attorney has lost her business to an embezzler can no longer has health insurance.  Such bad “luck” with a criminal sounds unbelievable.  A man is saved with open chest surgery, on camera, when it takes an hour to revive him with internal paddles.  Another middle aged man with diabetes, who couldn’t afford his insulin, shows his feet, on the verge of amputation from gangrene, as well as very bald legs.  The film makes a powerful point about our health care system, that it is cheaper for the public to prevent problems.  Yet, it never gets into the political squabbels over Obamacare.

To become an emergency room physician, you have to live your life into it as a young person.
I didn’t see any coverage of the infection control issue, and how that could impact physicians as well as patients.

The official site is here. he film company is Long Shot Factory.  I saw the film at the Angelika Mosaic in Merrifield VA on a Saturday afternoon before a fairly ample audience.

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