“C-Booth,” the trauma bay at the Los Angeles County Hospital, was the first, the toughest, and the best training ground for ER doctors in the country. In 2008, the County Hospital moved from its historic structure to a modern facility, catapulting the medical staff into an institutional identity crisis. Code Black follows a group of young doctors as they grapple with the divide between their idealistic expectations and the realities of a heavily bureaucratic system. Director Ryan McGarry—a full-time resident doctor at County while making this film—poses the question: can they change the system?
Please describe your film in your own words.
Ryan McGarry: Code Black is intense, loud; your palms sweat. The first 20 minutes we’ve heard are compared to Saving Private Ryan’s level of arresting imagery—it’s a real front seat ride you take with us, young training doctors at the dual front lines of a level 1 trauma center and an embattled public healthcare safety-net.
But then the film becomes quiet, contemplative, literally silent at times, as the young physicians grow into the complexities of the American healthcare system; somewhere in this transition the film becomes disarming with regard to the healthcare debate. This is the best and somewhat accidental reward of the film for me. Audiences seems to leave less polarized… we’re a very different healthcare film.
What inspired you to tell this particular story?
RG: I was frustrated that the healthcare debate is effectively devoid of the physician voice. The government is shut down over this issue right now, and how many times have you heard from doctors—especially new ones, the ones who will inherit the implications of all of this change? Of course I don’t speak for all physicians, but many of my colleagues have arrived in medicine after leaving other careers and industries because we wanted to be a part of improving American healthcare. In the ER, the mentality is this is the one specialty where we are going to roll up our sleeves 24/7 and at the very least let people know we care.
How on earth were you able to juggle the demands of a medical residency while simultaneously making a film about your own workplace?
RG: I think I tried to make the best of sleep deprivation. Keith Richards wrote that he believes in the creative purity of forced insomnia. He might have something going there, but documentary filmmaking is such a function of memory for your footage catalogue—and happily my editor Josh Altman was better equipped for that than me, especially when we cut after I pulled ER nightshifts.
Did you encounter resistance from either your colleagues or the patients? On a very pragmatic level, how did you navigate releases in the heat of the moment?
RG: We released everyone, no exceptions. The key was a team of medical students who did the ground work for this, trailing the camera. Patients were likely to trust them over an external crew, and we were always honest about our motives; only rarely did patients decline.
Ideologically we don’t feel that the ER is a place for filming entertainment, especially with the vulnerable population at a county hospital, but my hospital colleagues in large felt this was an acceptable exception given the message of protecting the safety net.
What do you want audiences to take away from your film?
RG: I hope they agree that it will be hard to ever get healthcare right if profit is the primary factor in the equation.
Do you have one piece of advice for aspiring filmmakers? (I imagine you don’t recommend being a doctor at the same time.) And which is harder: being a doctor or making a movie?
RG: Doctor or filmmaker? I will piss off one group of friends regardless of how I answer! I will say that both are incredibly humbling. And actually my filmmaking advice is to value a voice over what you think are the expectations of a filmmaker. Most of the successful directors I’ve met at the festivals made their films from experiences other than film school / being film fanatics. Unfortunately obtaining a voice from medicine came with a $250K debt price-tag… maybe don’t do that.
What are you most looking forward to at the 2013 Hamptons International Film Festival?
RG: Providing free tick-checks to our audience, obviously! Bring on ’yer medical curbsides.
Ryan McGarry, M.D. is an assistant professor of emergency medicine and filmmaker at The Weill Medical College of Cornell University/New York Presbyterian Medical Center in New York City and director of the feature length documentary Code Black. The film is a first-person reflection of McGarry’s own training at the Los Angeles County General Hospital, one of the birthplaces of emergency room medicine. McGarry spent four years in production on Code Black while simultaneously working the 24/7 schedule of a young doctor in training—an especially sleepless approach to first-time filmmaking. McGarry studied English at The Pennsylvania State University and received his medical degree at The University of Pittsburgh School of Medicine.