#9 - Ryan McGarry, M.D., Director of CODE BLACK, a Long Shot Factory release 2014A doctor made a movie, and it’s a powerful one. Indiewire calls Code Black one of the “Best Documentaries of 2014 So Far” (see article). Speaking via phone from New York City, where he currently works at Cornell Medical Center at New York-Presbyterian Hospital, 32-year-old Ryan McGarry, M.D., spoke about what inspired him to make this documentary, both cinematically and circumstantially. His ultimate message, however:  Our health care system is super messed up and something needs to change.

Code Black presents a very human portrait of doctors concerned that their passion for patients is being lost in paperwork. The ER doctors McGarry presents are his colleagues, and his intimate access allows for an unfiltered look at these people who clearly seem invested in the human connection between doctor and patient, a luxury that has been compromised by the famed patient privacy laws of HIPAA. The briskly-paced film is far from a lecture piece. It opens with the stark image of doctors and nurses working to save a 21-year-old gunshot victim by cutting him practically in half and digging through his guts to reach his heart in a desperate attempt to revive him. Above this scene, a window allows doctors in training to watch how the group take almost instinctive roles to work as a unit.

McGarry said it was scenes like this, of intimate cooperation, which actually dates back several years, that compelled him to pick up his camera. That trauma bay, known as “C-Booth,” was about to close at L.A. County Hospital, which was actually the birthplace of emergency medicine. “It was now or never,” he said about deciding to make this film and document the last moments of what would become history. “You’re not gonna get a constellation like this again. This is pretty extraordinary.”

The pace of the film is dynamic and McGarry’s influences will not come entirely as a surprise to some. “I love Danny Boyle,” he said. “I think he’s got such a frantic and loud and clangy style that I like.”

Other influences also include the doctor-turned-director and creator of the Mad Max series of films, George Miller and another documentary filmmaker who knows how to respectfully present difficult subject matter. “I think that George Miller, who’s a physician, has done some great work, but for the sake of documentary, I think I’m lucky that Mark Jonathan Harris, who executive produced the film, is someone I really admire.”

#3 - Danny Cheng, M.D., Dave Pomeranz, M.D.,  Ryan McGarry, M.D., Billy Mallon, M.D. at bedside in CODE BLACK, a Long Shot Factory release 2014

His other heroes include his colleagues. While working at C-Booth, he got to know Billy Mallon, a physician with at least two decades of emergency room experience. Mallon is clearly presented as a bit of a maverick who has never lost touch of his humanity in the face of HIPAA laws that require doctors to jump though many hoops while trying to treat patients. The mantra of the film emphasizes the paperwork that takes up valuable time from doctors having to treat patients. “One thing I can say about Billy,” said McGarry, “and this is not the case for all practicing physicians of that many years, is that there is something about him that is not cynical. He’s not dead to everything, and I think it would be easy in private practice to get that way. Ultimately, you worry about the bottom line, and as a sort of a physician/businessman or woman it would be very tough to keep that youthfulness and that rawness too.”

Mallon’s specialty is charity care at one of those rare public hospitals, like L.A. County that takes care of patients regardless of their ability to pay. The equivalent to that hospital in Miami would be Jackson Memorial Hospital. “I think he’s been at a university hospital his whole career, and I think he still feels that it’s very difficult,” McGarry continued. “We all do. One of the benefits of being at a county hospital like that, is that we’re not worried about billing or money. When you’re totally separated from those things, it’s probably mostly conducive to be present with what’s in front of you.”

McGarry, who does not associate himself with a political party and calls himself a “moderate,” emphasized that his film is not political. “I think for a lot of millennials the troubling aspect about American politics is that you have to pick one or the other. That’s bullshit … Ultimately, I think it’s less of a political movie and more of a philosophical one,” he said. “What we’re saying is ultimately the equation is fairly simple:  the providers want to treat people and patients just want to be treated. For that basic exchange there are a heck of a lot of spokes in the wheel that are often not even related to that moment.”

#6 - Dave Pomeranz, M.D., Jamie Eng, M.D., Ryan McGarry, M.D., in CODE BLACK, a Long Shot Factory release 2014

He said he has hope his generation can change things and does not write-off his peers as egotistical and oblivious to the greater good of humanity. “The good news is I think that this generation of doctors, as millennials, can kind of reverse the criticism of the millennials that we’re very entitled. The good news is that we’re all very motivated to fight for an entitled patient-doctor relationship. We think it should be more than just paper pushing or just a 10-minute Medicare moment.”

If the movie does its job right it will make audience members want to do something for the sake of medical care, if not for the doctors or their patients, then for themselves. “I think it wound be good if there were more editorials from patients saying, ‘Look I care about my privacy but what I care about the most is the 20 minutes I get with my doctor,” said McGarry. “‘I don’t want my doctor to be buried in a computer the whole time, and I don’t want to have my nurse have to re-chart something we’ve already charted just because of legal redundancy.'”

He said activism to change the laws are a long time coming, and he feels quite passionate about it. “I mean, the trouble with this whole situation is that we are really far into a lot of bad habits, and it’s kind of like how do you backtrack from that? Everyone keeps asking us but what our opinions about Obamacare, and we kind think we’re going, ‘Well, I think there are things about Obamacare that are definitely good when it comes to more access. I think most of us are feeling good about that. But the things that we’re talking about in Code Black are almost pre-Obamacare. These are things that are sort of industry foundations that we kind of feel have become imbalanced around the way, so as a patient, I think there are a few things here that are fair for the picking of what’s just no longer acceptable, but I think it’s just starting a large national discussion about what we are all fighting for, which is that moment when you walk in, you’re not well, and there’s somebody motivated to help you. Well, we have to be protecting that experience and elevating it. Right now it just seems like it’s been slowly eaten away by all these other things that we’re not saying don’t matter but certainly are not as important as they’re made to be.

#2 - C-Booth at LA County Hospital, from CODE BLACK a Long Shot Factory release 2014

“I think like all things in America, when it comes down to these kind of things, it is all about a consumer-based world … I think to ultimately think of patients as customers is bullshit…  The only thing that’s unique about that versus any other aspect of our economy except for education is that you wish it didn’t need to be that way. It sucks that it is sort of locked into profit margins and like a capitalist view and everything else. They’re strange bedfellows. Ideally, you don’t want to think about money and everything else when you’re healing somebody.”

You can read more of my chat with McGarry at the Miami New Times art and culture blog Cultist. He talks about some of his filmmaking choices, including his decision to not hold back from the visceral moments that capture life and death so powerfully in this film. Jump through the blog’s logo below to read more:

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Hans Morgenstern

Code Black opens on Friday, Aug. 1 exclusively at the Bill Cosford Cinema, 5030 Brunson Drive, Coral Gables, FL 33124. (305) 284-4861. Tickets are $9 and $7 for students and seniors. UM Students have free admission.

(Copyright 2014 by Hans Morgenstern. All Rights Reserved. This material may not be published, broadcast, rewritten or redistributed without permission.)

The documentary Side By Side is a film for the cinephiles still trying to come to terms with the end of film cameras and the rise of digital cameras. Maybe 10 years ago the debate would have been more heated, but nowadays it is about coming to terms with the new format. A couple of years ago, I posted about how film lovers simply need to accept this new medium, as everyone from studios to projectionists to general audiences were moving to the new format with little sentimentality for the past (To accept the death of celluloid).

Co-produced and hosted by Keanu Reeves, Side By Side features the actor interviewing some of cinema’s great artists. From cinematographers to editors to colorists, he sits down with them all. These people provide a wide-ranging survey of not only how they make movies but also how the conversion from 35mm to digital has affected their craft. On top of that, everyone seems to have different feelings on the new technology.

Many have knocked Reeves for years as an actor of limited range, but he, with the help of director Christopher Kenneally, offers a nerd-worthy examination at all the moving parts in making a movie while diving into the state of flux in the industry. You cannot help but love him for his affection for the art, which translates to a thorough, easy-to-understand and entertaining documentary on filmmaking with relevance to the moment. No matter that Reeves injects himself in the dialogue; he does not put himself onscreen to upstage the medium itself. He feels cozy to watch as he chats with all these people who have their hands in the details of the medium. With his unkempt beard and his casual dress, Reeves is no movie star, but your disheveled professor, taking you on a tour of filmmaking 101. He introduces the various roles of the people behind the scenes whose names many audience members never seem to notice as they walk out of a movie’s closing credits. In the meantime, he reveals how digital technology has affected all departments from the creative side to the distribution and projection side.

Like any good documentary on cinema, Side By Side, opens with a celebration of iconic films once exclusively distributed in the photochemical film process most filmgoers over the age 20 used to only experience in theaters. It appeals to the nostalgic, sentimental and emotional connection most film lovers have with movies. There are still some youngish film directors who staunchly support 35mm film, though it seems to have become an uphill battle. Director Christopher Nolan says early on, “I’m constantly justifying why I want to shoot a film on film, but I don’t hear anyone asked to justify why they want to shoot a film digitally.” At the age of 42, he may be part of the last generation to care about 35mm.

When I started this blog I thought celebrating film shot and distributed in 35mm and music released on vinyl were the best ways to fully appreciate these arts. Music continues to exist in vinyl fine and dandy, but film is a whole other beast, as digital technology only continues to advance. The costs of making a vinyl record do not compare to producing a 35mm movie. As someone who has both carried vinyl records and canisters of 35mm film, I know. “Film is a 19th century invention,” says Star Wars director George Lucas. “We are at the top of the photochemical process. This is as far as it’s ever gonna go.”

While explaining the change over to digital, Side By Side also provides a lesson in the movie camera and establishes just how important the cinematographer, or DP (director of photography), is to the process. Not only do some of the cinematographers interviewed celebrate 35mm film’s natural grain, they also appreciate the natural breaks in action every 10 minutes in order to change the cartridges of film that attach to the camera. Some believe these breaks allow moments of essential reflection to assess work flow. Side By Side also reveals film’s cumbersome nature encourages reflection for film editors as well, as they must handle the physical reels of footage and tape them together in the editing room. Some editors celebrate the sound of such a craft, lamenting the loss of the whir of film to clicks on a keyboard. “It’s a different way of thinking,” says Lawrence of Arabia’s editor, Ann V. Coates.

That is the other level many of those working with the film medium appreciate the format for. As a writer who used to produce first drafts longhand and revised in notebooks before typing a final product out to a professor or editor, I understand how the process in which one creates often contributes to that product’s character. I would go through at least three drafts in my old process. There is something to be said about pausing one’s work that allows to activate moments of reflection by the creative mind. Martin Scorsese laments that something is lost when digital allows you to playback “dailies” right after shooting a scene. With 35mm, filmmakers must wait a day to see what the film captured. Undeveloped film has to be sent to a lab where it is processed and printed. It is then sent back to a screening room the next day. Hence the name dailies. Scorsese believes dailies need to be seen later, so one can concentrate better on shooting a movie while on the set.

As Side By Side continues to chronicle the changes to cameras, including one that produced a “negative” in a cartridge, filmmakers started to evolve with the new cameras. One thing that helped were technological advances in resolution. The better the picture got, the less complaints from filmmakers. The technology began to speak for itself.

Directors were also excited about new advantages like lightweight cameras that allowed for placement and maneuverability unimaginable until now. There was also a healthy sense of competition among camera makers that pushed the quick development of the technology, from functional design to resolution. By the time Danny Boyle won his Best Picture Oscar® and— even more shocking— an Oscar® for cinematography for Slumdog Millionaire, a film mostly shot in with digital cameras, the argument had become moot. Digital had arrived, accepted as one of the tools of the trade.

Side By Side does not hold back on how thoroughly it covers the evolution of digital, as 35mm is almost consistently proven as outmoded. It even goes into the hype of the supposed next generation of theatrical digital projection: 3D. James Cameron talks of his anticipation to shoot in 3D as early as 1999 with digital technology. His Avatar certainly revealed the money studios could make with 3D. Cameron seems proud of himself, noting the successes that followed Avatar, including Tim Burton’s shallow and garish Alice in Wonderland, which nonetheless brought in a record haul at the box office. But director Joel Schumacher warns of abusing the technology, as, he says, there are films made for that technology, like Avatar, and films that are not.

Digital technology and digital effects have grown together, the documentary notes. However, when Scorsese says, “I don’t know if our younger generation is believing anything anymore as real,” and Cameron retorts, “When was it ever real?” in separate interviews, I will hand that round to Scorsese. Even though Scorsese famously followed Cameron into digital effects and 3D with his most recent film, Hugo, which ingeniously paid tribute to cinema’s origins while embracing technological advances, I believe Scorsese is right. The weight, shadow and light interplay on digital characters still have not achieved the same level concreteness as the cheapest, rubbery creature of the B-movies. There is an artificial, almost gimmicky quality of live action characters mixed with what I consider fancy cartoons. This mix of digital and flesh and blood lightens the stakes compared to pure live action, as it calls attention to itself, disturbing the illusion of suspension of disbelief. Side By Side gives Cameron the last word, but for all he created with computers with Avatar, I do not believe he wins his argument.

In the end, Side By Side tries to hand it to celluloid in a token moment, noting it works better for archival purposes. Digital has a tendency to disappear off hard drives, and, with formats constantly moving forward, various methods of archiving also become outdated, leaving files irretrievable. Celluloid actually lasts longer, adds Scorsese. Though most everything seems to point to the advantage of advances in digital filmmaking, this seems to raise some bigger questions, as the documentary ends on a philosophical note tangled in the practicality of archiving. What does saving a film mean, anyway? What ultimately matters to anyone in the future will be saved somehow and even “dug up” when it matters. Ultimately, filmmakers are storytellers, and the value of the story will carry on. It doesn’t matter what sort of medium you use to tell it, be it music, books, film or some new medium that has yet to be perceived.

Hans Morgenstern

Trailer:

Side By Side is not rated (contains no offense material, though) and runs 99 min. It premieres exclusively in South Florida this Friday, Sept. 22 at the Miami Beach Cinematheque. Tribeca Film provided a DVD screener for the purposes of this review. It could already be playing in your city or coming soon. Jump through this link for more locations.

(Copyright 2012 by Hans Morgenstern. All Rights Reserved. This material may not be published, broadcast, rewritten or redistributed without permission.)