A viewer who had been in the emergency room for a non-life-threatening illness wrote to Knowledge Network president and CEO Rudy Buttignol about a show he had seen on the public broadcaster.

The viewer stated that he was grumpy and angry for having had to wait for two or three hours, and thought the experience was terrible.

Then he saw the TV series Emergency Room: Life and Death at VGH.

"He pledged that he would never, ever complain again about having to wait because he got to see what was happening behind closed doors, people who were dealing with truly life-and-death situations, dealing with the drama of life," Buttignol told an audience at Vancity Theatre for an advance screening of an episode from Season 2, which will air on Knowledge Network on Tuesday (April 12) at 9 p.m.

The series takes viewers inside the emergency department at Vancouver General Hospital to show what the realities are of working with life-threatening situations on a daily basis—often in contrast to melodramatic depictions of ER rooms on primetime U.S. TV series.

In an episode from Season 2 (entitled "Full Code", which means all personnel conduct all life-saving measures), a Mandarin-speaking elderly pedestrian is brought in after being struck by a truck while walking a baby in a stroller. While she can't speak English, a bilingual bystander volunteers to accompany her as a translator as she is being treated. Meanwhile, doctors try to quickly determine what is wrong with a man brought in with no discernible pulse. Similarly elsewhere, medical staff members try to figure out what caused a 74-year-old woman to lose consciousness while driving.

And there's humour, both intentional and unintentional, that percolates throughout at unexpected moments, such as a feisty elderly woman who fainted but doesn't want treatment.

"It's the humour, I think, that's important because it helps everybody get through it, including the audience," Buttignol told the Georgia Straight after the screening. "If you're going to deal with such life and death things, you've got to find the humour in it; otherwise, as human beings we'd be lost."

Buttignol knew there were many risks in undertaking a show like this.

Patient confidentiality, the potential for camera crews to interrupt things, reputational risks, and legal issues were all potential problems he said he considered before greenlighting the show.

He added that capturing people on camera "when they're stressed out, when they're at their most vulnerable" meant that he had "to make sure that the approach is ethical".

Similarly, Vancouver Coastal Health president and CEO Mary Ackenhusen had numerous fears as well.

"My concerns going into it [in Season 1] was that the volumes of VGH would skyrocket because if you feel like you know the place and you really respect what you see on the television and how compassionate they are, how skilled they are, what if people all decide to go to Vancouver General but that hasn't happened," she told the Straight at the screening. "I think in some cases, it's actually given more respect to the healthcare system and understand that emergency rooms aren't the first place to go for everything."

The risk, however, paid off. The series premiere turned out to be the biggest documentary series premiere for the Knowledge Network. Over 190,000 viewers watched Season 1's first episode, beating major commercial network shows in its timeslot. Season 1 also drew over 1.2 million online and TV viewers.

Ackenhusen, who said she feels far more confident about Season 2, said her decision to go ahead with the series was "it's the only reason to honour those unsung heroes."

She said she wanted people to understand the stress and challenges that VGH ER staff face in dealing with, for example, 90,578 visits from 2014 to 2015.

In her opening speech before the screening, she also told the audience she wanted the show "to really stimulate the public discussion about what our healthcare system is, how much we value it, and to start those discussions about what it is into the future, which is really my concern often as a CEO. How do we sustain what we have, the good parts, and how do we evolve into what a modern system would expect of us?"

She added that she herself experienced the inner workings of VGH ER as a patient when she broke her back after being bucked off a horse on Saltspring Island and was airlifted to the emergency department.

She was glad that the system was there for her in her moment of dire need. However, she is concerned about would happen if the quality of that healthcare resource is compromised.

"If we can't support staff and physicians and protect them and allow them to do a good job every day, the compassion that we need and that we expect and the skills won't be there when we actually need it," she told the audience. "So that, in one sense, is what this whole series is about too…to keep us thinking about how important something is that we don't always need but we need it very badly when we need it."

Another benefit of the series that Buttignol pointed out is that it helps to bridge gaps in understanding between the public and the healthcare system.

"What we recognized from talking about this to people about this is the fear of unknown," he said. "People don't really know what's going on and that's what they really fear. They imagine it to be something else, and the comments that we got from running these shows is it gives people an idea of what actually happens and when they see the level of professionalism, it helps them calm down a little bit and realize, you know what, if you're in a life-and-death situation, this is the best shot you're going to get."