HBO: Baghdad ER

Jun 4, 2007  •  Post A Comment

“Baghdad ER” shows where it’s headed from its opening scenes, with the flash of a severed human arm as it is disposed of by medical personnel from the 86th Combat Support Hospital in Iraq.
Produced by HBO and Downtown Community Television and winner of a 2007 duPont Award from Columbia University, “Baghdad ER” was termed by the Peabody judges to be “a horrifying and humbling testament to the dedication of medical personnel confronting the overwhelming brutality of war.”
Told without narration, the film includes moments of reprieve—a saxophone solo on a rooftop, doctors’ cigar night—but mostly, like the hospital itself, it lurches from medical crisis to medical crisis, in unvarnished fashion.
“If you euphemize it, then you’re not telling the true story,” said Sheila Nevins, president, HBO Documentary and Family.
Jon Alpert, who filmed and directed the documentary with Matthew O’Neill, witnessed his first amputation within a few moments of arriving at the hospital.
How much reality viewers could take was the subject of much editing-room debate after the two filmmakers, who traded off shooting in 12-hour shifts, returned from their six weeks on-site.
The film, said Mr. Alpert, “is nowhere near as graphic as the reality” the team filmed, with the constant arrival of helicopters ferrying wounded U.S. personnel from all over Iraq. Editors, he said, “got severely traumatized” in the constant viewing of what he called “violent and scary images,” and many were removed.
“We put in just enough violence so you got the idea of what was truly happening, of the poor kids torn apart, but not enough to push you away or make you change the channel,” Mr. Alpert said.
Ms. Nevins did think some viewers might turn away, and said the team debated whether to open the film with such a gruesome image. “But then we thought it would be really unfair, trying to soft-pedal you into something,” she said. “I don’t like when they lead you in gently.”
The blood and gore, she said, is “the truth of what war is and what these doctors experience.”
The film came about, Ms. Nevins said, as HBO looked at the casualty rates of soldiers in Iraq and noted that while many people seemed to be surviving, “The injuries seemed to be very severe.” She turned to Mr. Alpert, “who of course always wants to go to a war zone.”
Originally, the film was going to be “an encyclopedic look at military medicine,” said Mr. Alpert, following a single medic with a combat unit. But the first stop was the 86th Combat Support Hospital in Baghdad’s fortified Green Zone, and the filmmakers, he said, “knew this was the place we wanted to stay if we were going to give Americans an understanding of the cost of the war, and the heroism of the people we sent over there.” The Army agreed to two extensions of their visit.
The access his team got from the Army “and the support throughout the filming of the program was, I have to confess, quite surprising and also very gratifying,” Mr. Alpert said. “They didn’t try to hide the realities of war. They want the American people to know what happens.”
Nothing was off-limits to the cameras, he said, except the man in the orange jumpsuit, wearing odd goggles, who caught his attention one day. “I zoomed down the hall after this and a nice public affairs officer almost tackled me,” he recalled. Turns out the man was a prisoner of war, and couldn’t be filmed under the Geneva Convention.
The filmmakers themselves decided to digitally obscure the identities of a few patients. Although U.S. privacy laws protect living patients, who must sign release forms for their images to be used, those rights are lost on death.
In an extended emotional scene at the film’s end, the medical team works heroically, and ultimately unsuccessfully, to save a Marine hit by shrapnel. Mr. O’Neill asked the serviceman’s mother if she wanted to see the footage, which she did, and she later thanked the team for filling in missing details of her son’s life. But she also asked that his identity be obscured, which the film does.
“Legally we could have shown a number of soldiers who tragically died while we were filming,” Mr. Alpert said, but in a couple of cases they decided not to, not knowing how to contact the families and not wanting those families to be unpleasantly surprised if they saw the film. “Did this take away the power and drama? Absolutely, but this was the right thing to do.”
HBO plans to air a follow-up film in November, also shot by Mr. Alpert’s team, called “Alive Day.” The film looks at the recovery process for soldiers, who will be interviewed by “The Sopranos” star James Gandolfini. Ms. Nevins gives it the logline: “They’ve saved you; now what’s in store.”



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