The Waiting Room (International Film Circuit, NR)

film waiting-room_75As one physician notes, the emergency department is no place to manage someone’s health.

 

 

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If you want to understand how the American system of health care delivery works for people without employer-sponsored health insurance, I can think of no better introduction than watching Peter Nicks’ documentary The Waiting Room. It presents a composite day in the waiting room and emergency department of Highland Hospital in Oakland, Calif., created from footage Nicks, who acted as both director and cinematographer, filmed over a five-month period.

The most remarkable aspect of The Waiting Room is the access Nicks obtained to the hospital and its patients, providing insight not only to the medical aspects of emergency care, but also to the difficult administrative and practical decisions that the staff must make on a daily basis. Highland is a public hospital and the emergency department treats about 250 patients per day, many of them uninsured and without any other source of care. Some are “regulars” in the emergency department and have additional problems, such as substance abuse and homelessness, that the hospital must deal with—even though, as one physician notes, the emergency department is no place to manage someone’s health.

Nicks weaves together the stories of five patients and three caregivers against the backdrop of many others. His documentary style blends straight observational filmmaking with voiceovers by some of the patients and caregivers, but his focus remains squarely on the individuality of each of his subjects. The Highland emergency department is part of our social safety net, but rather than presenting more generalized information through graphics or talking heads, Nicks lets you draw your own conclusions about how that safety net is functioning from the individual stories presented.

The star of The Waiting Room is the perpetually upbeat triage nurse Cynthia Y. Johnson, who appears to be holding the whole operation together, as she jokes with one patient to put them at ease, chides another for using bad language, and explains to many how the emergency department works and why they’ve been waiting so long. Physician Douglas White is cheerful and caring, and nurse Liz Lynch struggles with logistics as she tries to find beds for patients. We see other staff members handling difficult situations, as well, including one obstreperous patient who blames the medical staff for the bureaucratic problems he encounters, and then declares that he would rather die than continue to deal with the red tape.

The featured patients are a varied lot: a young man with testicular cancer (he was sent to Highland from another hospital when they learned he had no insurance); a substance abuser and medically noncompliant patient who appears to have used up his last friend; a young girl with a temperature of 104 and a swollen face; a carpet layer with severe pain in his spine; and an elderly woman with diabetes. All are treated with the utmost professionalism, and the hospital staff do their best to connect the uninsured patients with programs to help pay for their care, pointing to one more fact of life in the world of medicine: Everything has to be paid for, and we’ve just chosen perhaps the most bureaucratic and inefficient method possible to get that done. | Sarah Boslaugh

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