Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: SATURDAY, February 12, 1994 TAG: 9402120217
SECTION: SPECTATOR PAGE: 1 EDITION: METRO
SOURCE: LYNN ELBER ASSOCIATED PRESS
DATELINE: LOS ANGELES LENGTH: Medium
But Lance Gentile, the physician who co-wrote the movie, doesn't consider the new title an overstatement. The drama, set in a public hospital's emergency room, fairly depicts America's flawed health care, he says.
"The worst problems, the worst deficits, that's where you see them, in inner-city urban hospitals. That's the cutting edge of failure, so to speak," Gentile said.
"State of Emergency" (debuting tonight at 8 on HBO) has a first-rate cast, topped by Joe Mantegna as John Novelli, an emergency room doctor at East End Medical Center in Anytown, U.S.A.
Novelli has spent 12 years tending growing shock waves of the sick and injured as resources have failed to keep pace. As he snaps at nurses and treats patients with coolly efficient disregard, it's clear he's suffering big-time burnout.
Into the ward comes car accident victim Jim Anderson (Paul Dooley), brought to East End because all other emergency facilities were already overflowing. He is alert, but suffering neck and head pain.
The affluent businessman's private health insurance, it soon becomes clear, won't help him here. Patients in various stages of misery, most of them minorities or the elderly, fill the halls.
There is scant time for patients like Anderson, who doesn't appear to have life-threatening injuries. The friendly, uncomplaining man tries to elicit some humanity from the harried staff, and fails miserably.
After all, consider Novelli's state of mind. Following an encounter with a violent patient he tells a nurse: "Sometimes I hate them, just because they're here."
There's worse ahead for the unlucky Anderson. The financially troubled hospital's CAT scan is down - again - and Novelli can't perform tests that might show whether the patient suffered brain damage.
Novelli tells his superiors the E.R. cannot accept head-trauma cases without the machine working, but there's a hitch: A pending merger with a private health-care firm would be endangered if the hospital loses its "level-one trauma" status.
That means it must remain open to all emergency cases, Novelli is told. His frustration grows as Anderson's condition worsens, forcing the doctor to consider lifesaving action that could endanger his career.
Lynn Whitfield ("The Josephine Baker Story") plays a head nurse with heart who tries to bolster Novelli. Melinda Dillon co-stars as Anderson's wife.
Gentile, an 18-year veteran of emergency room medicine, said he wanted to dramatize the health care crisis. But he credits HBO with making the film harder-edged: The cable channel suggested that Gentile and co-author Susan Black strip away a romance that softened the story's politics.
The dark, unsettling tale - which includes some fairly graphic operating room scenes - reflects reality, the doctor insists.
"The whole central event of this story is based on a personal experience of mine," he said. "This can happen. It does happen."
Gentile also wanted to show the impact the system has on health care workers.
"There is a high emotional toll because the nature of your business is people suffering and dying. It's unrelenting. If you let it touch you every time, it eats away at you," he said. "Over time, you back away and build a wall."
The movie's characterization, he says, "is anti-Dr. Welby," referring to the sage, infinitely patient TV doctor of two decades ago.
Doctors today, he said, are squeezed: "Here's diminishing resources on one side and here's patients' expectations and needs on the other, and you're the guy in between."
"Which is why Marcus Welby was the worst thing that could ever happen. He would solve this amazingly complicated medical case, and then he would drive (the patient) to the airport.
"And that's what people expect from their doctors," Gentile said.
Not after watching "State of Emergency." They'll just be hoping for a faint smile and a working CAT scan.
by CNB