Film Features Grittiest Side Of ER
Dr. Danny Cheng
Attending physician in the ER at The Queen’s Medical Center
Where did you receive your schooling and training?
I was born and raised here in Hawaii. I went to college at University of California-Irvine. I did my master’s at UCLA and then came back to Hawaii to receive medical school training, and did my specific emergency room physician training at Downtown Los Angeles County Hospital.
How long have you been a practicing physician in the ER field?
It’s been a full year of practice in Hawaii. I am also a clinical professor at University of Hawaii medical school.
What attracted you to working in the ER?
I have to give credit to some really good mentors. One is Dr. Alson Inaba, a 20-year-plus emergency room physician at Kapiolani Medical Center for Women and Children. He was my mentor at med school. Another is now my colleague, Dr. Derek Uemura, who has been an ER attending physician here at Queen’s for more than 10 years.
The ER has become the hub of acute medicine in the world, definitely in America, for a long time now. Going through med school, a lot of our studies were about making the diagnosis. That’s the most fulfilling part of medicine, and making those diagnoses is the bulk of what we do in the emergency room. In addition to being mentally stimulating, the craziness sometimes can be an adrenaline rush.
How did you come to be featured in the documentary Code Black? (The film is showing Sept. 5 and 6 at Kahala Theatres.)
The movie is produced by a friend of mine, Dr. Ryan McGarry. He is an ER physician and we trained together. He also has a minor degree in film. We were both on the same student rotation at Los Angeles County Hospital. It was just crazy there, so he decided to document some of the things that happen in an emergency room in an urban setting. He started filming without any real plans and it grew into a much bigger production, a full-length feature film.
What is Code Black about?
Let me first explain what “code black” means. Different hospitals have terms about the status of wait time or the overall situation regarding how overloaded the system is. They have a color-coded system at Los Angeles County Hospital. Code black refers to when the hospital is so saturated — a combination of every hospital bed being filled, in addition to severe wait times in the emergency rooms of up to 24 hours — that we go into a situation where a series of things happen. An over-surge plan is thrown into production because of this critical mass of patients who are basically waiting for something bad to happen to them. Nursing rooms open, overflow nurses are called in.
Code Black has a three-pronged approach. The movie started out as a showcase, almost like a PBS documentary about Los Angeles County emergency room. The facility is a historic building we call the Stone Mother that was built in the 1920s. It’s this amazing structure of historic proportion, where you would drive by it and have no concept that on a daily basis miracles and insane mayhem are going on inside. We were in it, living it, and we’d see people passing by with no concept of what’s happening inside those doors. A big part of Code Black is an inside view of this place.
The emergency room is in a very busy urban setting, so in the second part of the documentary you get acquainted with it. There’s been a lot of recent focus on ERs through a variety of TV shows and movies, but here it’s a bit more raw. You’re going to see more of the gory truth.
The third part of the movie that grew as it was being created is a political focus on the health-care situation in America. There are the uninsured, the haves and have-nots, in addition to all of the paperwork and barriers that physicians function in while doling out health care.
Are you displayed prominently in the film?
In the narrative of these training physicians ― there are four, myself included ― it follows us equally. There’s a narrative on each person, our background, and then they take choice interactions that they filmed through the years we were there and as it pertains to the themes in the movie.
Do you think the subject is well-represented?
Yes, there are a lot of truisms taken from real contexts. Say there’s a Tuesday and a person who was shot seven times comes in, and the stress that comes with that. Or it’s a random day where wait times are 20 hours and people get frustrated and things boil over. These are not manufactured situations.
This is not just a documentary, but a feature movie with money thrown at it and prominent producers. There’s that aspect of it where they took the cut and said we’d like more of this, so there was some going back and putting in a couple of scenes to give it more of a rounded edge that sometimes documentaries don’t have.
To what extent does the film pertain to Hawaii?
I’m from Hawaii and I realize the good and bad of Hawaii is its insular nature. We like to distance ourselves when we see things on the Mainland or we watch something on TV. We’re, like, “Look at that, L.A. is crazy ― it’s a good thing it’s not like that in Hawaii.” But having come back and working here, people are not getting shot every day in Hawaii, thank goodness. At the same time, this is a great movie for Hawaii residents to see. We have the luxury here of seeing how things play out on the Mainland, the good and bad. We can take that and work with it and predict based on what has happened.
This massive crush on emergency rooms already has been happening on the Mainland for five to 10 years. What happens when health-care systems are overloaded can be seen in this movie. Working in the ER at Queen’s this past year, I can see little red flags on certain days where there’s potential, maybe not for a 20-hour wait, but seeing things we’ve never seen before, like sixto seven-hour wait times, because of the sheer mass of people in Honolulu — sick people. What happens when you don’t have enough hospital beds, enough emergency rooms, enough access to primary care and health insurance? These are all things that have been overwhelming the system in big metropolitan places like L.A. Even Hawaii is vulnerable. It’s a cautionary tale.