[27 September 2011]
Filmed over a 28-day period in King’s College Hospital, the 14 episodes of 24 Hours in the ER each follow a single day in one of London’s busiest Accident and Emergency departments. With 70 remote cameras and staff on site 24 hours a day, the “observational documentary” expands beyond the usual selection of fantastic and gruesome medical cases. It also asks some pretty meaningful questions about mortality, aging, faith, and family relationships.
Like other medical documentary shows, 24 Hours in the ER intersperses the treatment scenes with interviews with the doctors, nurses, and patients. These are a means to multiple ends. Patients explain their views of their injuries and care, though most don’t have much to say while in the ER. The show also withholds some patients’ comments, revealing the fates of the most seriously injured only at the very last moments, creating suspense and also aligning the viewer with their confused and frightened families. For some time, you’re left to worry whether Theodore, the Greek college student run over and trapped beneath a double-decker bus, ever walks again or even survives.
The doctors and nurses, as expected, are presented as top-notch professionals, but also personable. Somewhat unusual, at least in comparison to American medical shows like Trauma in the ER, off camera questions are included. Some are mundane (“What do you fear?”), while others are more telling. An ER consultant named Firas reveals, “There are days when the job makes you think about your own mortality, more now because of being married and having a baby.” He contrasts his duties with what he would want as a patient, explaining that though he’s required to try to revive an 85-year-old man in cardiac arrest, it’s nothing he would choose for himself in the situation were reversed: “If a person dies in that circumstance, its not dignified.” Senior Nurse Jen details her own coping mechanism when she prepares the body of a deceased patient with care and sensitivity, speaking to him, unsure if he might be “watching” her.
Firas’ comment connects to a broader point 24 Hours in the ER is making, that for many people, the ER becomes a kind of proving ground. Liz, the ER Chief of Staff, explains that coming through the ER is an experience everyone should have at least once, “because it makes you realize what your priorities are. It’s not the rush, rush, rush, and the money, money, money. It’s the people you love, the fact that one minute they might be there and the next minute they might be gone.”
Confrontations with such frightening possibilities are illustrated time and again: Will crashes his bicycle and is unconscious or confused for upwards of nine hours while his family grows increasingly alarmed; 81-year-old George has come into the ER for the fourth time with “breathing difficulties” and his much younger great-nephew looks on, stressed (and we worry about George too as it becomes clear Jay is using the past tense talking about him in his interview bits). A middle-aged daughter finally realizes that her father is aging after a serious fall (“Dads are not supposed to fall down the stairs or have accidents or die. They are supposed to be there for you forever”), while her father has to face the same reality about himself (“When do you suddenly say, ‘I’m too old to do that?’”). And more than one patient wonders whether “someone” might be looking over him.
Like any emergency room, this one treats less serious injuries that afford a break from the ordeals. Some of these provide an almost comic relief. Scenes showing doctors and nurses working together suggest how their personalities are affected by their profession, like a tendency to underestimate seemingly minor injuries in their own families or the “buzz” they get when a particularly bad accident victim in en route to the hospital (“We’ve got a juicy one coming in”). As if trying to contain the trauma in the telling, Malcolm describes the details of Theodore’s bus accident in all its astonishing detail.
Such moments make the show engaging, to be sure. We are afforded perspectives on staff and patients alike. But, this ER runs almost too smoothly. Anyone who has ever visited an ER will be left wondering how there are no long waits, no disgruntled patients, or impatient medical personnel, and the series offers no criticism of England’s National Health Service (NHS).
We might also consider the timing of 24 Hours in the ER premiere in the U.S., as debates and legal challenges to a national health care system continue. The show refutes the horror stories of abandoned elderly and poor patients that opponents of such a system often evoke. And yet, in excluding anything resembling shortcomings or outright failures in the ER, it leaves us less reassured than skeptical.