Documentaries aren’t required to be objective, but there’s a good reason why it’s rare for a film’s primary talking head to double as its director (with no clear acknowledgment, that is—muckrakers like Michael Moore and Nick Broomfield, who essentially direct on-camera, are a different story). Code Black, which takes an in-depth look at the harried emergency room of the LAC+USC Medical Center, was helmed and partly shot by Ryan McGarry, who was doing his residency there throughout the process (and remains a working ER physician, albeit in New York). This obviously gave him remarkable access, as well as firsthand knowledge of the difficulties and rewards of working at a county hospital, where mobs of uninsured patients with nowhere else to turn are forced to wait as long as 18 to 24 hours just to be seen. However, McGarry’s sheer earnestness, while admirable in principle, often threatens to turn Code Black into a recruitment film, with a self-congratulatory air that’s inimical to keen, persuasive analysis.
There’s a structural problem, too, though it takes a while to become apparent. McGarry began shooting footage in 2008, when the hospital’s emergency room was a tiny, chaotic area known as C-Booth. To the untrained observer, C-Booth looks more like a rugby scrum than a health-care facility, with patients lying on gurneys out in the open, three or four abreast, surrounded by dozens of milling doctors and nurses who practically have to climb over each other to reach them. Privacy and dignity were nonexistent, but everyone who worked there insists that the system maximized efficiency, and they’re all crestfallen when L.A. County, in order to meet earthquake and fire codes, builds a new, state-of-the-art hospital with a more traditional emergency room. Suddenly, the doctors are drowning in paperwork and regulations, and being physically isolated from their patients kills the adrenaline rush on which they rely to keep going. With an hour left to go, it seems as if the film will primarily be about the downside of this transition.
Instead, McGarry notes the upheaval briefly, then proceeds to ignore it for half an hour (of a film that runs just 80 minutes), skipping lightly from one subject to the next. Some of these interludes are interesting for their own sake: We see a first-year resident instructed on how to break bad news to the relatives of a patient who’s not likely to make it, and there’s some sharp discussion of triage procedures (though the latter topic was ably covered by another recent documentary, The Waiting Room). But far too much time is spent on McGarry and his colleagues talking to the camera about how little they’re motivated by money or status and how much they just want to help people. That’s laudable, but it’s not compelling. Only when the film finally returns to the issues caused by the move to the new building does it regain its footing. At one point, McGarry shamefacedly confesses that he’s looking for reasons not to do a necessary procedure because of the mountain of paperwork it’ll require. That candid admission becomes less startling when you discover that he’s the film’s director, and is hence coming clean for the sake of his agenda. But the stark disparity between the recent footage and the C-booth material shot back in 2008 tells its own troubling story.