As executive producer of the highly popular documentary series, Liane of NYT Television has learned a great deal about trauma medicine and medical journalism. In this question and answer session, she describes how the series is made, what makes trauma medicine special, and what she has learned from making Trauma: Life in the E.R.

Q:		How do you achieve the intimate feel that contributes to the series' realism?
A:		Producers spend an entire month documenting the hospital community to truly understand the process of care, and the lives of those caregivers. On a more practical level, the on-site producers use small, hand-held digital cameras, which allow us incredible access to trauma areas. There's usually just one or two video journalists filming the action — there's no sound person, no boom microphones, no lights. With this approach, we get closer to doctors and patients. This gives a much more honest, human, accurate and real experience than if there were a big production crew.

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Q:		How do you select the trauma centers where the series is filmed?
A:		We try to select level-one trauma centers that are highly respected in the national medical community. We also take into account the hospital setting: does it reflect its community, does the hospital have any medical specialty, or if they have made any medical research advances? We try to represent a cross section of communities and people from rural to the inner city.

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Q:		How do hospitals react to your request to feature their trauma centers on national television?
A:		The response has been overwhelmingly positive. We're proud of the reputation that we've established and the way we've been received from the medical community. Hospitals are excited about the level of medical interest the show has generated as well as the following the show has among viewers. The hospitals that have been featured over the six years we've been producing the show have been quite satisfied with their experiences and with the way the programs document their work.

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Q:		How do you ensure that the team's presence doesn't interfere with the quality of care?
A:		Our production philosophy is to be unobtrusive. Doctors and nurses never let the filming get in the way of their patient care. Since many of the centers are teaching hospitals, it's natural for caregivers to explain what they're doing while they're doing it. The presence of the production crew is welcomed and because of the time, commitment and sensitivity we put into the filming, the crew quickly becomes part of the hospital team.

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Q:		Is it difficult to obtain consent to air a patient case on national television?
A:		We take patient confidentiality very seriously and only feature patients who sign releases. In fact, many featured patients focus on how their personal trauma could benefit their community and the nationwide audience by alerting others, for example, of the importance of wearing seat belts or of child safety tips.

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Q:		What kind of backgrounds do you look for in your video journalists?
A:		We choose caring and compassionate people. In order to capture the intensity, drama, and humor of the daily workings of an E.R., you need to have a certain passion for the job and understanding for those in pain. Crewmembers also exemplify the combination of different visual sensibilities, different styles and different storytelling techniques that we like to bring to the show. On a lighter note, when we hire people, we ask, "How's your stomach? Do you pass out at the sight of blood?"

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Q:		What were the biggest surprises for you?
A:		The volume of traumas these hospitals experience. And more surprisingly, how organized trauma care really is. It looks very chaotic on TV, but there's a real system with a rigid protocol to follow.

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Q:		What were some of the challenges faced while making the series?
A:		One of the biggest challenges is to select which caregivers to feature, because all are so exemplary. The medical professionals we encounter are experts in their field, and narrowing it down to a select few is an arduous process. Also, regarding our more personal challenges, once you film a trauma — once you see what death really means, up close — it changes you as a person. It changes how you view death … and life.

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Q:		How does this program differ from fictional dramas about emergency medicine?
A:		What we show is real — that's the bottom line. Fictional dramas, no matter how realistic, leave viewers wondering if it could really happen. For us, that question is erased. Emotions are pushed to the edge with documentary television because you realize these are real people in real life and death situations.

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