At its core, Code Black is about the struggle faced by young physicians who want to remain idealistic in the face of our failing health care system.

Code Black, directed by Ryan McGarry. Screening at the Museum of Fine Arts, Boston, MA, August 1 through 9.

“Code Black” director, Ryan McGarry, MD on set at LA County’s USC Medical Center.

By Paul Dervis

Code Black. It’s the code when the emergency room is overflowing.

As the film opens you see a patient wheeled in to the emergency room and cut open like a side of beef. Blood is everywhere. What seems like a dozen people in hospital scrubs are moving around in a seemingly haphazard symphony of frenzied sound and movement. But there’s a method to the madness. They are saving lives… or at least attempting to.

Los Angeles County Hospital. The C-Booth. The emergency room.

We are told more people have died in that square footage than anywhere in United States. And more people have been saved there than anywhere else in the United States. After watching this film it is not hard to believe these stats.

Code Black is a challenging documentary to sit through. There is an amazing amount of blood and gore so it will be difficult for the squeamish among us to watch. But it is remarkably fast paced and kinetic. Doctors and nurses move around like traders on the stock exchange floor. At times you are confronted with a blur of blue uniforms. Visually, it is mind-boggling. And the viewer never gets a breather. (The film won Best Documentary at the Los Angeles Film Festival and the Hamptons International Film Festival; it was the Audience Award Winner at both the Denver Starz Film Festival and Aspen FilmFest.)

At its core, Code Black is about the struggle faced by young physicians who want to remain idealistic in the face of our failing health care system. One junior resident says “I want to be that cool, calm, collected… I want to be that person.” But can she? Another resident claims to spend 45 minutes of paperwork for every 2 to 3 minutes of patient care. Are they fighting a losing battle?

The junior and senior residents, who were given the bulk of the on-camera time, explain why they chose to do their residency in a public hospital. One young man was a student athlete in college. A runner, his times were getting worse and worse. He finally went to his family doctor and found he had lymphoma. He was in critical condition but he survived. Another man was in a automobile accident. He had only minor injuries but his good friend, an undocumented alien, ended up with a severe brain injury. A third, a first-generation Korean, feels pushed to excel by his demanding father. Whenever the emergency room is too much for him, and he wants to take a break, he imagines his father pulling his pants down and spanking him right there in front of his patients and colleagues. All chose their profession to be healers it is why they became physicians. And they all feel that that is not the primary objective driving private health care institutions in the United States.

A few years ago, L A County Hospital’s emergency room moved into a new facility. The facilities were much more spacious, which allowed patients more privacy and, as one doctor puts it, “more dignity.” But at what price? The doctors feared they had lost opportunities to make intimate contact with their patients. So the doctors pulled out beds and put in more waiting room chairs, so they could watch the patients that hadn’t been seen yet. Even though they had fewer examination rooms, the waiting time soon fell. As the connection between the doctors and the people in the waiting room increased, the staff were better able to prioritize those in urgent need.

Success.

Code Black is at times heart wrenching and deeply disturbing. But the film is also filled with hope even as it faces utter hopeless. Filmmaker Ryan McGarry has done a superb balancing act, blending optimism with deep despair. There is a powerful segment, less than a minute long, where he turns off the sound and focuses the lens on patients…people…suffering and waiting. But then the audience is given ‘Ralph,’ a man who appears to be lost to life. Still, the doctors keep working on him, for half an hour, even though it seems that he has died on the gurney. Ralph is introduced a year later to the incoming class of interns.

It’s hokey, but it’s real.

And it’s enough to make you smile…even through all the sadness, it’s enough to make one smile.

Paul Dervis has been teaching drama in Canada at Algonquin College as well as the theatre conservatory Ottawa School of Speech & Drama for the past 15 years. Previously he ran theatre companies in Boston, New York, and Montreal. He has directed over 150 stage productions, receiving two dozen awards for hs work. Paul has also directed six films, the most recent being 2011’s The Righteous Tithe.