If you think the health care system is flawed in America, “Midnight Family” provides a stark snapshot of how truly broken things are in Mexico City, where fewer than 45 public ambulances serve a population of 9 million. Luke Lorentzen’s documentary takes up residence alongside the Ochoa family, who earn a living — just barely — by operating one of the metropolis’ numerous privately owned ambulances, ferrying the injured to hospitals in hopes of being monetarily rewarded for their efforts. Portraits of institutional dysfunction don’t come much more urgent, and quietly bleak, than this, which should help the film attract serious attention following its Sundance Film Festival premiere.
Though medically unstable Fer is the nominal head of the Ochoa household, it’s his mature 17-year-old son Juan who — despite his youthful complexion (replete with braces) and habit of hugging a giant stuffed animal during interviews — who’s the clan’s real father figure. Theirs is a tenuous existence in which each night is spent hanging out in the ambulance waiting for a call. When emergency notifications arrive, they ignite harrowing races through Mexico City’s bustling streets, as the Ochoas try to beat rival EMT outfits to the scene and, then, to quickly strap the wounded into stretchers and load them into the back of their van.
Such urgency comes, of course, from their desire to help people survive potentially serious injuries. Yet as Lorentzen’s film makes clear via the Ochoas’ day-to-day ordeal, it’s also driven by a desire to lock citizens into their care — which, ostensibly, will result in payment at the end of the ride. “Midnight Family” illustrates that compensation is rarely in the cards here, as haggling leads to either polite apologies from those unable to pay, or harsher rejections from those simply unwilling to reimburse the paramedics for their trouble. As if that weren’t problematic enough for Juan and Fern, who can only assume their duties if a public ambulance doesn’t show up first, the police are constant impediments, blocking them from accepting patients, citing them for unreasonable (and supposedly made-up) violations, and, at one point, threatening to arrest Juan if they aren’t paid a bribe.
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“Midnight Family” conveys all of this by sticking close to the Ochoas as they navigate an untenable state of affairs that links private ambulances, hospitals and police officers in a web of financial self-interest. Serving as his own cinematographer and editor, director Lorentzen generates intense empathy by following Juan and Fern during a breakneck attempt to get a young girl with a traumatic brain injury to a hospital — yelling at passing cars through a loudspeaker, and giving traffic directions to each other — while the girl’s terrified mother sits beside them in the front seat. At such moments, the film achieves a powerful measure of suspense that’s intricately tied up in its despairing sociological depiction of a system that’s come apart at the seams.
Through it all, Juan counts every penny, spends frugally (on, for example, a dinner of tuna fish and corn), recounts his exploits to his girlfriend on the phone, and cares for his younger brother Josué, who prefers to spend his time ratting around in the back of the ambulance — laughing with friends, eating chips or catching a quick nap — rather than attending school. In his criticisms of his sibling’s delinquency, which come equipped with explanations about why an education is so important, Juan proves himself an everyday hero, trying at home and in the streets as a paramedic, to keep his — and everyone else’s — world together.