‘Code Black’ Review: Puts a Face to the American Medical System

By  · Published on June 17th, 2014

Editor’s note: Our review of Code Black originally ran during last year’s LAFF, but we’re re-posting it now as the film opens in limited theatrical release this week.

What does Code Black mean? Most people think of codes in hospitals to mean someone is dying with shows like ER and Grey’s Anatomy often having their doctors yell, “He’s coding!” Which is not fictionalized medical jargon, but in this instance, Code Black refers to the volume of patients in a hospital waiting room. And for a doctor, seeing your hospital’s waiting room at Code Black makes you feel as though you have lost the battle to treat as many patients as you can before you even start your shift.

The documentary Code Black from first-time filmmaker Ryan McGarry focuses on the lives of a handful of doctors coming up through the residency program in one of the busiest emergency rooms in the country – that of the Los Angeles County Hospital. The LA County Hospital is considered the birthplace of emergency medicine and was best known for its iconic C-Booth. No one quite knows what the “C” in C-Booth stands for (Central? Critical?), but everyone in the medical community knew this was the place where medical triumphs and near miracles happened. But why? C-Booth was a slightly terrifying and chaotic place with doctors and nurses packed in to a small space trying to help and save as many patients as they could. There was no privacy, no standardized decorum, but this ability to band together and do their job was what made C-Booth so successful, and so well-known.

C-Booth became ground zero for these doctors, giving them a crash course in what it meant to be an emergency room doctor – and they loved it. Each doctor had different reasons for getting into medicine, but they all agreed that when it came to working in the ER, it was the rush, the adrenaline, and the “extreme” environment that appealed to them the most. Code Black starts out almost like a horror film with a distress call that leads to lots of yelling, blood, and slightly jarring images, but in the eyes of the doctor’s there was a very important element shining through the chaos – teamwork.

It takes a certain type of person to become a doctor, but it takes an even more specific type of person to become an ER doctor. Considered the “blue collar” workers of the medical spectrum, these doctors did not strive for status or money; they were simply there to help as many people as they could. But as often happens, the “good old days” never last long and in 2012 the original LA County Hospital was forced to close its doors to move into an updated space and a whole new hospital culture. Gone were the days of doing whatever you needed to do in the moment and in came mountains of paperwork now required to ensure patient safety and privacy.

Doctors who had gotten into the field to interact with and help patients were now spending the majority of their time documenting rather than treating. And the wait times in the waiting room started to reflect this back up. Patients were entered into a computer and categorized, becoming nameless numbers rather than human cases. McGarry and his colleagues decided to challenge this system and find a way to break down the literal walls between them and those in need and by doing so, decreased the wait time in the waiting room and re-energized the staff. But with the nurse staff shrinking and bureaucracy encroaching, the problems they thought they had outsmarted started to encroach once again.

McGarry gives audiences an inside look at what it means to be a doctor in an ER from your first time on the floor to becoming one of the staff’s senior members. If you are losing your faith in the system – how can you teach and inspire a new generation of doctors? What legacy will you leave? Is there any way to change things? Code Black poses these questions, but does not attempt to give answers, instead bringing to light these important issues that should hopefully spark conversations about the American medical system that more of us should be having.

The Upside: Moving, thought-provoking, and memorable; sheds just enough light on a hot button issue to provide awareness and inspire important questions

The Downside: Personal accounts that attempt to fill in the back-story of why some of these doctors got into medicine feel a bit forced and unnecessary, especially when each had a palpable passion when speaking about their work

On the Side: McGarry, who directed the film, is also one of the doctors featured in the documentary.