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‘Midnight Family’: Film Review | Sundance 2019

A family-run ambulance business in Mexico City struggles to stay afloat in Luke Lorentzen’s doc.

A glimpse into the dysfunction of Mexico’s patchwork of public and private health care, Luke Lorentzen’s Midnight Family follows a family of EMTs through Mexico City as they struggle to make a living keeping other citizens alive. Though its micro view limits its usefulness in big discussions of public policy — it’s easy to imagine American partisans using it as evidence both for and against government-run health care — it is a vivid reminder that all such policies are lived out by millions of individuals, who die every day when things aren’t well run.

Opening titles explain that in Mexico City, the government runs 45 public ambulances to serve a sprawled-out population of 9 million. That’s nearly the entirety of what Lorentzen tells us directly in the film. Everything else we observe or infer during ride-alongs with the Ochoa family, who drive one of an unstated number of private ambulances that fill gaping holes in the city’s delivery of health care.

This observational approach gives the film its flavor, especially when it comes to family dynamics, but it makes things frustrating for viewers hoping to actually learn something. Lacking outside comment, we can guess but never be sure when the Ochoas are doing the right thing and when they’re pushing an ethical line, maybe fatally. (Press notes make some things more explicit, but moviegoers don’t get press notes.) Whenever they pick up a patient who needs care they can’t provide, for instance, they have choices to make: Go to a government-run hospital or a private one? Go to the closest facility or a further one that might be more affordable or better equipped? Leave the crowded-looking free hospital in favor of another down the road?

At many junctures, the EMTs inform patients and/or their loved ones of the choices, speaking gently but usually presenting one option as smarter than others. They clearly have more experience than their customers with how the system works. But is their advice sometimes clouded by self-interest? After they’ve brought patients to a private facility in one scene, we see a staffer there hand over cash to the driver. Is this a shady kickback or part of a somehow legitimate transaction? The former seems likely, but we have no way of knowing for sure.

We do, however, get a good sense that the role of police in this ecosystem is morally tainted. Ambulance drivers pay cops bribes in return for tips about accidents; cops hassle drivers, enforcing rules that seem to change arbitrarily.

Questions of law and ethics aside, viewers get a visceral understanding here of the cutthroat nature of this private-ambulance business. Though they suffer through long bouts of boredom, the Ochoas leap into action when they hear reports of an accident: We race through the streets with them, often neck-and-neck with other vans trying to make it to the scene first. Whoever’s riding shotgun mans the PA, shouting at drivers of other cars to heed the sirens and get out of the way.

Juan Ochoa quickly becomes the film’s star. Barely 17, he’s far more professional than the older man we assume is his father. While slow-moving Dad tries to bum cash off his employee-children — he appears to have emptied his pockets for cops — perfectly groomed Juan hustles. He drives the ambulance, helps patients and reports on the night’s frustrations in phone calls to his unseen girlfriend.

He also does much of the undesirable job of asking for payment. Though Lorentzen mostly averts his camera’s gaze when patients are around, he does listen in on some of the conversations about cost. A high-school girl who’s been head-butted by her boyfriend weeps while she bleeds in the back of the van, meekly asking, “Is this expensive?” (And shortly after, “Can you please give me a hug to calm me down?”)

Later on, another woman balks at the 3,800 pesos the Ochoas charge for emergency transport (one of many items on their price list, that’s roughly $200 U.S.). When patients refuse to pay, that’s that; as far as we can see, the EMTs have no recourse. What they do have is a matter-of-fact justification: When no government-provided ambulance arrived at the scene, what was your alternative?

Production company: Hedgehog
Director-director of photography-editor: Luke Lorentzen
Producers: Kellen Quinn, Luke Lorentzen, Daniela Alatorre, Elena Fortes
Composer: Los Shajatos
Venue: Sundance Film Festival (U.S. Documentary Competition)
Sales: Josh Braun, Submarine

In Spanish
80 minutes

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