In the midst of a seemingly endless number of docudramas, “reality” series, and “infotainment” programs about emergency medicine, two new remarkable full-length documentaries present a much more accurate and compelling picture of our specialty and work place.
"...side[s] of emergency medicine that EPs have long wanted the public to see..."
The Waiting Room, a 2012 film that aired nationwide on PBS last month (http://www.pbs.org/independentlens/waiting-room/), graphically demonstrates what it is like to spend 24 hours in an overcrowded ED waiting room of a large public hospital in northern California. No alternative care is available to the many patients who must wait hour-after-hour for treatment of their acute conditions and chronic illnesses. None of the patients are particularly odd, flamboyant, or embarrassingly funny, and though the film devotes little time to the dramatic life-threatening trauma and illness that characterize most “ER shows,” its strength lies in how adeptly it captures the oppressive, tedious, and anxiety-producing atmosphere of an overburdened health system—making it easy to understand why even the sickest patients sometimes leave without being seen. Eventually, those who do remain are called inside where most are helped and provided with some form of follow-up care. The Waiting Room presents a side of emergency medicine that EPs have long wanted the public to see—not to scare them away from coming to EDs, but in the hope that our country will find a way to provide the resources needed to end epidemic ED overcrowding and ensure adequate emergency care for all.
At its premier screening at the Los Angeles Film Festival last June, Code Black (2013) (http://codeblackmovie.com/) won the jury award for best full-length documentary and went on to win similar awards at the next two film festivals. It is the compelling story of a group of idealistic emergency medicine residents struggling to learn their craft while saving lives in the overcrowded setting of Los Angeles County General Hospital. The overwhelming numbers of ill patients waiting to be seen, a condition the residents refer to as “code black,” and the cramped surroundings of the old County Hospital ED with its legendary “C-Booth” resuscitation area, present daunting challenges to the residents’ goal of helping all who need care. But these challenges turn out to be nothing compared to the residents’ need, midway through their training, to adapt to a new earthquake-resistant LA County General Hospital. Suddenly their familiar ED and its beloved C-Booth are gone. Pristine and functional, the new hospital replaces visibility with privacy, easy access with confidentiality, and patient contact time with endless paperwork.
Can the residents’ idealism survive 21st-century rules and requirements, inaccessibility of care, and a financially strapped municipality that freezes vacant nursing positions, forcing their brand new ED to close almost half the ED beds? In the words of Ryan McGarry, MD, *director of Code Black and a featured EM resident in the film, “When we started this it seemed so simple. We were going to be doctors. We were going to help people. But what if those ideals can die? What if this hope can fade into the failure of the system?” This movie is not just about emergency medicine; it is also about the timeless struggle between young idealists and the worn out, unsuccessful systems they inherit and must adapt to in order to change them and achieve their goals. It is no wonder that Code Black is resonating so strongly with audiences, and why there is reason to believe that our patients and our specialty will be in very good hands for years to come.
*Ryan McGarry, MD, is currently an EM faculty member at NewYork-Presbyterian Hospital/Weill Cornell Medical Center. During his interview for a position with us last April, he mentioned that he had just completed a documentary about his residency. We hired him anyway.