Code Black's Dr. Ryan McGarry on What Really Goes on in Hospital Emergency Rooms
As an ER physician, Dr. Ryan McGarry is probably the only filmmaker Cultist can forgive for calling in for a scheduled interview five hours late.
From left: Dr. Danny Cheng, Dr. Dave Pomeranz, Dr. Ryan McGarry, and Dr. Billy Mallon in Code Black.
Speaking via phone from New York City, where he moved last year to work at Cornell Medical Center at New York-Presbyterian Hospital, the 32-year-old doctor apologizes for the delay. He says he wanted to make sure a patient he had admitted on his shift two days earlier made his way to the right doctor for treatment around a complicated hip injury. "It's nothing sexy, but it is what it is," he says.
Code Black is McGarry's directorial debut, and the things he captures on camera at L.A. County's trauma bay will illicit great sympathy for this young crusader, his patients and his colleagues, whose greatest adversary nowadays seems to be paperwork.
See also: Review and showtimes for Code Black
Today's doctors have to make the extra effort to ensure their patients get the best care. The maze of paperwork that came with HIPAA laws almost 20 years ago has created many complications for physicians, and as the movie makes clear, it's often why you have to wait so long in waiting rooms before you are tended to. The title of the film comes from the warning status that the ER waiting room is at capacity, and doctors need to prioritize patients for treatment, including some with life-threatening issues.
It's ironic that the film will screen exclusively at the Cosford Cinema at the University of Miami. University President Donna Shalala was one of the architects of HIPPA (the Health Information Portability and Accountability Act). McGarry agrees she, as well as the physicians and med students at the school, should see it, but he also emphasizes that anyone who has ever been a patient should do so as well.
But don't expect a simple lecture on the state of healthcare from a doctor's standpoint. This award-winning documentary made Indiewire's list of Best Documentaries of 2014 So Far. From the intense scenes at L.A. County's "C-Booth," featuring life-or-death cases that are not for the faint of heart, to the emotionally-charged doctors who present desperate cases for patient-doctor relations without bureaucratic duties tying them down, this film is made with passion and driven by it.
Cultist: You don't hold back from the start. Why do the doctors have to cut that 21-year-old man who came in with bullet wounds practically in half to reach inside?
Dr. Ryan McGarry: That's a pretty darn extreme measure. It's something that we do effectively if you arrive just almost without a pulse, and you're hoping sort of to get to the heart as fast as you can to sort of patch up any holes and possibly save it [the heart]. Yeah, it's pretty intense, but it's not gratuitous. What we're trying to show is that there's a sense of teamwork. There's ... this overwhelming sense of what looks like a medical complication, yet that's not actually the hardest part of the job. That's actually doable. We get through that stuff pretty easily. What's really scary is the waiting room.
This is how we get to know C-Booth, the former trauma bay at L.A. County Hospital. A child could be wheeled right next to him in a different situation. Their only divider would be a curtain. There was an advantage to this from a physician's perspective, even though it removed privacy in a way.
I would say it's a tradeoff. It seems to be an imbalance either way. Most patients I know don't really care about their X-ray being protected in the hospital hallway. I mean, who's gonna look at it other than doctors or nurses? What patients want is their pain medicine, what they want is one of us at their bedside. The problem is you can't have this extreme level of privacy protection and huge amount of regulation and at the same time have us right there with you. And it's not even just privacy rights. As physicians, we're totally judged and being monitored on many metrics, and actually some of them make a lot of sense that are actually for the patient's benefit. For example, if you come in with a heart attack you're measured for how quickly you get aspirin or how quickly you get to the cath lab. But what's crazy is that we are asked as doctors to actually be the ones to record that data. It's like watching a Miami Heat game where the players are being asked to do their own stats.