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“Code Black”: New Documentary Depicts Profoundly Broken Healthcare System

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David Ives - published on 09/12/14
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“He then said to him a second time, ‘Simon, son of John, do you love me?’ He said to him, ‘Yes, Lord, you know that I love you.’ He said to him, ‘Tend my sheep.” (John 21:16, NABRE)

It’s one of the fundamentals of Christianity. Yes, we’re supposed to evangelize. Yes, we’re supposed to baptize. But along with those things, Jesus plainly stated that we’re supposed to take care of each other.

Inspired by that humble mandate, the Catholic Church has gone on to become the largest non-government provider of healthcare services in the world. In 2010, it was estimated that the Church manages 26% of the entire world’s health care facilities, including approximately 18,000 clinics, 16,000 homes for the elderly and those with special needs, and 5,500 hospitals. As of 2012, the Catholic Church operates 12.6% of the hospitals located in the United States.

We’re doing what we can.

And in the public healthcare system which the Church helped to build, so are others. At Los Angeles County+USC Medical Center, better known as LA County General, the emergency department alone handles over 150,000 visits per year. It is widely held that the concept of the modern emergency room first came into existence at LA County, where the city’s sickest patients would converge on the hospital’s legendary C-Booth (meaning Critical Booth or Cardiac Booth depending on who you ask) to seek treatment from its team of experienced veterans and residents in training. 

The new documentary from director and ER physician Ryan McGarry, “Code Black,” began as an attempt to record for posterity the daily life and death struggles occurring within C-Booth before its scheduled closing in 2008. What he captured on film is harrowing.

“Code Black” begins with a gunshot victim being wheeled into C-Booth where he (and the audience along with him) is greeted by a sight that to the uninitiated looks like complete madness. In a single bay, bodies on stretchers are scattered about as dozens of physicians and nurses move from patient to patient, often appearing to climb over one another as they go about their work.

The early scenes in C-Booth are not for the squeamish. Chests are cracked wide, hands are thrust into open wounds, feet move through puddles of blood pooling on the floor. Code black is hospital terminology for an overwhelming patient load, and by all appearances, C-Booth stayed in a near constant state of code black.

And yet McGarry assures us that there is unity in the chaos, that the residents are eager to learn and provide help, and that the senior physicians are among the most capable doctors in the country. It may look like a madhouse, but its a finely orchestrated one, with everyone knowing their parts and supporting one another. “Nothing brings people together like struggling for something worthwhile.” we are told. Watching the men and women carry out their duties in C-Booth, it’s hard not to share in McGarry’s admiration.

But an interesting thing happens about halfway through “Code Black.” In 2008, LA County’s emergency facilities were transferred to a brand new state-of-the-art medical facility located adjacent to the old building. Gone were the cluttered hallways, flickering lights and cramped facilities. In their place was a pristine, sterile environment full of computers and modern medical equipment. Oh, and a lot more paperwork.

Jumping to the year 2012, “Code Black” revisits the residents who began their training in C-Booth before being moved over to the new building. Where once they spent most of their time dealing with medical emergencies and establishing relationships with patients, they now must devote 70 to 80 percent of their time to completing the necessary documents required by law. The amount of paperwork becomes so staggering that waiting times for patients in the emergency room creeps upward to 12, 16, even 24 hours for those without life threatening conditions. 

“Code Black” presents a national healthcare system that is profoundly broken. Rather than focusing on the patients, doctors and nurses must now first attend to the whims of investors, lawyers and legislators. The primary emotion expressed by the residents of LA County is one of frustration. They are no less dedicated to their calling, but admit to sometimes considering looking for reasons to bypass minor procedures just to avoid the crippling paperwork. In the end, it is the patients who suffer the most. 

And things are getting worse. In an interview with NPR, McGarry notes, “Even post-Obamacare, we’re seeing, throughout the country, emergency room visits go up, and that might be counter-intuitive. But what we’re finding is that, yes, more people have access, more people are getting insurance cards, but those cards aren’t always premium. And we’re already in a system where a lot of specialists won’t take a sub-premium insurance card, because you’re not seen as profitable enough.” On top of the poor, the immigrants and the uninsured, public emergency rooms are now overflowing with patients who can’t go elsewhere because their insurance doesn’t cover all of their medical costs. 

You would think it would be better at Catholic hospitals, but that’s not necessarily the case. As Dr. Andrew Agwunobi explained in an article for the Huffington Post, as the nuns who used to run Catholic hospitals retired and were replaced by non-religious professionals (there’s just not enough nuns to go around any more), “the leadership culture of Catholic hospitals began to resemble that of non-faith-based hospitals.” As with the state run hospitals, profit has become a greater concern. In effect, a lot of Catholic hospitals just aren’t that Catholic anymore. 

It’s all a mess. Sadly, “Code Black” doesn’t really offer any answers to the problems it shows us, but maybe that’s simply because nobody has really come up with any viable solutions yet. Perhaps it’s enough right now that the documentary got made. “Code Black” reminds us that amongst all the clamour over who should pay what and what reforms should be undertaken, we should never lose sight of the commandment that got this whole healthcare thing rolling in the first place. If we love him, we should tend his sheep. Surely we can find some way to do that properly.

In a world he didn’t create, in a time he didn’t choose, one man looks for signs of God in the world by… watching movies. When he’s not reviewing new releases for Aleteia, David Ives spends his time exploring the intersection of low-budget/cult cinema and Catholicism at The B-Movie Catechism.

 

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