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"Code Black" documentary


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I'm surprised this hasn't been posted yet.  There's a documentary coming to theaters this June which centers entirely on USC-LA County's ER- specifically their trauma bay.  It supposedly follows the senior ER residents during their last year, but the scope seems to be highlighting the broken nature of medicine and emergency medicine in general trying to be the safety net.  For those who don't know, LA County is one of the busiest and largest ER's in the entire country, and while their residency certainly gets a lot of well-deserved attention (this is Mel Herbert's and his merry band of misfits' shop), they also at one time featured the gold-standard of PA residencies in the 80's and 90's (some of the founders of SEMPA did residency here back in its heyday- they have amazing stories to tell).  

 

I've never been one for watching medical stuff on TV- I get enough of it at work- but this seems to be different and may be mandatory viewing for ER people.  Who knows if this will get people to start talking about the broken nature of ER care in a real way now- sometimes it takes a piece of pop culture to start that conversation that thousands of articles just can't do.  

 

Trailer:

 

Website:

http://codeblackmovie.com/

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I am currently here for the Navy Trauma Training Course.  Its a pretty stellar ED that gets a lot of significant trauma.  I have learned a ton by working in the ED with the residents and attendings.  Unfortunetly PAs are left to the obs unit and fast track unit and there is no current thoughts of restarting the PA residency according the the department head.  Overall a great experience thus far

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Definitely planning on checking this out - prior to PA school, I was in USC-LAC's "PA Helper" shadowing program for a year or so in addition to my regular job as a peds ED tech for a few years.  "C-Booth" down there is like nothing I've ever seen - I saw my first-ever thoracotomy up in that loft above the main trauma bay.  Saw even more up close and personal as a tech later on, but as a pre-PA that pretty much blew my mind!  When you're standing up there looking out on the whole ED with the main trauma beds under you, other beds squeezed in little cubicles around it and yet still more gurneys jigsawing outwards wherever they can be crammed in with people bleeding & in pain everywhere you look it truly does feel like you're gazing down on the nine circles of hell.  Crazy stuff.  

 

For anyone who has Netflix streaming - "The Waiting Room" mentioned above is up for viewing there.  Got a 100% rating on Rotten Tomatoes, which is hard to come by.  

 

http://www.rottentomatoes.com/m/the_waiting_room_2012/

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back in the day pa residents worked throughout the dept, including running c-booth. it's a shame that they have been relegated to fast track and obs. I work with a grad of the em pa residency program there from the 80s. back then pas did it all....he told me he once spent an entire shift on an ortho rotation reducing complex ankle fractures and dislocations. nothing else for 12 hrs, just because he said he wanted to.

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back in the day pa residents worked throughout the dept, including running c-booth. it's a shame that they have been relegated to fast track and obs. I work with a grad of the em pa residency program there from the 80s. back then pas did it all....he told me he once spent an entire shift on an ortho rotation reducing complex ankle fractures and dislocations. nothing else for 12 hrs, just because he said he wanted to.

 

It's fun talking to those guys about their time at LA County- got to do that with a couple of them this past year at SEMPA.  Ask me, E, sometime about their theory as to why the PA residency was shut down

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It's fun talking to those guys about their time at LA County- got to do that with a couple of them this past year at SEMPA.  Ask me, E, sometime about their theory as to why the PA residency was shut down

I thought it was about $$$.

I had an app. in for the next class the year they closed...

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Do the PAs no longer work in the dedicated Ortho area and that Level 3 type area with the curtained-off cubicle exam rooms that's not C-Booth but is still your garden variety abd pain, chest pain, vag bleeding Level 3 type stuff?  

 

When I was there, they often staffed those two areas and got exposure to tons of Ortho stuff (Bier blocks, FX reductions, setting up stuff for and assisting Ortho with procedures) and at least the Level 3 stuff mentioned above.  It seemed like the MainMain ED (Level 1's, sicksick Level 2's and C-Booth) was the one area they did not staff.  

 

If they've been relegated to FT and Obs Unit alone at this point, that is a bit depressing...

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Heard about this before but never did see the trailer. Interesting, but I am with TA in that its like nails on chalkboard watching medical stuff on TV... even the old (and OK) shows like "Code Blue" and "Trauma Life in the ER." Most of it is absolutely unwatchable. I can't even really say why other than it feels contrived or not real in some way. This looks a little different. I might Netflix it eventually. 

 

As a side note, I thought there was a law against filming patients without their consent, which kinda put the kabosh on the emergent medical documentary?

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  • 2 months later...

back in the day pa residents worked throughout the dept, including running c-booth. it's a shame that they have been relegated to fast track and obs. I work with a grad of the em pa residency program there from the 80s. back then pas did it all....he told me he once spent an entire shift on an ortho rotation reducing complex ankle fractures and dislocations. nothing else for 12 hrs, just because he said he wanted to.

I thought it was one of the best rotations the USC PA program had at the time, that and ortho.

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Going to see this documentary today.

 

**Update:

 

Just got back from Code Black at the local art-house cinema; caution ***spoilers***.

 

Overall it was a good watch. Mainly focused on senior EM residents and their lamentations of modern healthcare. It opened with scenes from 2008 in LA County hospital’s mythical “C-booth” trauma bay (birth place of EM?). It was this functional chaos that seemed to grab the interest of these medical students. Flash forward, “c-booth” is gone, as an entirely new LA County Hospital has been constructed adjacent to the old one. The old hospital wasn’t up to earthquake code and other codes. The residents (whom never get to practice in c-booth) lament the new, sterile, and isolated feel of the modern ED. Packed waiting rooms (“code black”) hold patients waiting for up to 24 hours to be seen, some level 2 acuities still waiting hours. General remarks about the crushing bureaucracy of modern medicine and time spent charting vs. seeing pts, and nurse shortages. It’s also noted that LA County (LAC+USC) is one of only a few handfuls of truly public hospitals remaining in the country.

 

The residents touch on some of their personal expectations of health care and towards the end of the film try to win back some semblance of control by brining patients from the isolated waiting areas into the treatment area. They see people side by side in chairs; akin to the older hospital. They celebrate lowering the avg. waiting times by a few hours with this new (old) practice that offers less privacy, but increases efficiency.

 

I kept my eyes peeled for any sign of PAs. None made it on camera. Most of those interviewed/featured were docs and two were RNs. With about 20 minutes left in the film the dreaded word came up, and not in a flattering light. Young doctor Danny (who argued for having pts. sit in the hallway of treatment areas, much to the displeasure of a charge nurse) is excited about the treatment area they filled with chairs and says something along the lines of (paraphrase) “now patients are back here, instead of being seen by a nurse, or what we call a mid-level provider, they are seen by the doctors”. It didn’t come off as malicious, but seemed unnecessary and undercuts a lot of providers with that sentiment, IMHO.

 

So yeah, worth a watch, especially if one is of the emergency medicine persuasion.

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Looks like it will be pretty great. I also want to see "24/7/365: The Evolution of Emergency Medicine". One of our former residents produced it; it tells the story of EM's development as a specialty.

 

http://www.247365doc.com

 

Finally got to see this yesterday; the producer came back to show it as grand rounds for our residency.  It was very enjoyable, and gave a great overview of how the specialty of EM came to be.  They traveled around the country interviewing some of the monster names of the specialty (e.g. Rosen, Tintanelli, Henry).  I was particularly impressed that Anthony Edwards (aka Dr. Mark Green/Goose) was such a fan of the project that he offered to do the narration for free.  It should be available for free to the general public in October.

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