codeblack-posterI first saw Ryan McGarry’s riveting documentary Code Black last year at its Los Angeles Film Festival world premiere. The debut film by this working physician won top honors as Best Documentary Feature and went on to captivate viewers at festivals all over the country. In the film, McGarry follows a group of charismatic, young doctors-in-training as they wrestle with their ideals and with the realities of saving lives in a complex and overburdened system. Their training ground and source of inspiration is “C-Booth,” the legendary trauma bay at Los Angeles County Hospital — the very birthplace of Emergency Medicine where “more people have died and more people have been saved than in any other square footage in the United States.” While McGarry was making the film, C-Booth and the historic L.A. County Hospital building closed for good (the old building did not meet new earthquake codes), with everyone moving next door to a brand-new structure. But would the state-of-the-art facilities make up for the increasingly bureaucratic nature of their jobs? Code Black offers a tense, doctor’s-eye view from the very nerve center of the heathcare debate (but mercifully not getting dragged down by the politics of it). I talked to Dr. McGarry at the festival last year but was thrilled to be able to meet with him again just before the film’s current theatrical release in the actual C-Booth in the abandoned hospital building.

Danny Miller: It’s crazy to be talking to you right in the middle of C-Booth. Is there any way you can walk through this place without feeling the ghosts of years past?

mcgarryRyan McGarry: There really isn’t. So much of this place defines my adulthood. I came here as a 23-year-old medical student and now I’m a 32-year-old physician and filmmaker. There’s just no other place that has as much meaning for me.

I have the chills because I remember them mopping up the blood exactly where we’re sitting right now.

Right here, man. And you can see how small this place is. Look at a place like Gettsyburg — a huge battlefield where there are now a few dozen monuments to the people who died there. This little tiny square footage has more casualties than five Gettysburgs! Granted, we saved a lot of lives here, too, obviously, but it’s kind of amazing that in American history  we don’t usually think of these places that have seen so much urban warfare — places that had to deal with violence, mental illness, drug abuse and addiction, and so many other issues.

You can just feel that history in these walls. I hope if they ever figure out a different use for this building that they preserve this space behind Plexiglas! 

You know Parkland Hospital, in Dallas, where John F. Kennedy was sent after he was shot? There was a lot of debate when they renovated that space where they worked on President Kennedy and Governor Connally. They ultimately demolished it, and now all that’s there is a little plaque that says “This is where Trauma 1 used to be.” It’s interesting how we deal with places and memory. In this case, I’m very happy with what they’ve done — C-Booth is now  an active training center. They have these robot “patients” over there attached to computers, and this is where a lot of doctors, nurses, and medics get their emergency room training.

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I know in the film you were all very wistful about C-Booth closing down and having to move to the more modern facility next door. Do you still feel that way?

I think everyone who worked in this place is a little nostalgic for it. There were clearly problems — for example, with patient privacy, and it was probably more physician-central than patient-centric — but interestingly, I would say that that may have still favored the patient in the end. The care here was outstanding.

I understand that some of the doctors from the film are now working elsewhere?

Yeah, it’s pretty common in our profession to leave your first “home.” They like to farm us out but I think some of us will come back. I took an academic job at Cornell in New York but I definitely have ambitions to come back here if I can. And many of my former colleagues are still here.

I really appreciate that you didn’t allow the film to be subsumed by all the debate about the Affordable Healthcare Act — ObamaCare — but I wonder if some of the audiences you’ve shown the film to have questioned you about that.

Oh, sure. I always say that there is definitely room for filmmakers like Michael Moore to make documentaries about that topic and to share their strong opinions about it. Of course, such films are likely to polarize people. In this film, we wanted to disarm all that rhetoric and show what it’s really like. We wanted to provide a point of view that people might really listen to instead of getting lost in the politics.

One of the main points in the film is how the soul-deadening bureaucracy is having an effect on doctors and healthcare in general. Do you have any reason to believe that is getting any better?

To be honest, I think it’s getting worse. One of the reasons I made this film is because I think, at a minimum, that we doctors need more of a voice in this discussion. We need to speak up and talk about how this is really getting in the way of what we’re trying to do. If we’re doing things that haven’t been shown to help patients, we need to ask ourselves and others why we’re doing them. Look, like any job there will always be things that you don’t like, but in this case we’re finding this huge force that is separating us from the patient and that’s really unfortunate.

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It’s so fascinating watching what all of you go through in the film — from your initial idealism to that “oh, shit” moment when you all realize how other factors are impinging on your ability to do your job — and then finding ways to lift yourselves up again. I was impressed by the creative solutions the doctors show in the film as they try to deal with the insane wait times at the L.A. County Emergency Room.

We were lucky here that experimentation was part of the culture. This was an old and powerful emergency room in a big hospital, but I think doctors in many places don’t have that kind of freedom.

I was happy to learn that you’re all still doctors — there were moments when I feared some of you might drop out of the profession.

Remember, a lot of the people profiled in the film came from other industries. That’s something of a newer trend and I think it’s part of the storyline of the film. You’ve got this new generation of doctors who are saying, “We could do something more here.”

What has it been like for your colleagues to see themselves on the big screen?

I think they feel it’s wonderful to be recognized for the hard work that they do. All of us in the film feel like ambassadors for the countless others in our situation.

It’s still mind-boggling to me that you were able to make a feature-length documentary while working as a doctor in an emergency room. Do you hope to keep making movies?

Yes, I would love to. I actually shot a commercial recently which is where directors go between projects! Now I’m looking into creating a TV series based on Code Black.

That would be great! I have to say that compared to all of the doctor shows that are on the air now, it was reassuring to see that you were all thinking about something other than who you were going to have sex with next.

Tell me about it!

Code Black is currently in theaters Click here for more information and to find out if it’s playing near you.