How to shoot a documentary inside a Mexican ambulance

Private ambulances serve much of Mexico City. Midnight Family tells the story of one.

The documentary Midnight Family is set in a place that’s both familiar and strange: an ambulance. The film follows members of the Ochoa family, who live and work in Mexico City, where they operate a private ambulance. The population of Mexico City is roughly 9 million, but the government operates fewer than 45 public ambulances to serve the citizenry, and so the Ochoas — along with many others — have come up with a way to help fill the gap. They spend their nights looking for injuries and accidents, rushing to the scene to get patients to a hospital before some other ambulance company shows up.

But they’re often left in the sticky situation of having to ask sick and injured people for money, and that’s never easy. And thus, the Ochoa family is barely scraping by.

Midnight Family is a compassionate, even funny portrait of a family that genuinely cares about its patients and has to navigate the balance between helping people who need it and being able to pay for its own basic necessities. It’s the first feature film for documentarian Luke Lorentzen, who’s only 26 but managed to nab an award for the film’s cinematography at Sundance this year. (Full disclosure: I was on the jury that awarded it to him.)

I caught up with Luke last June in Sheffield, England, where Midnight Family had its UK premiere. We talked about the long process of making the movie, the difficulty of shooting inside an ambulance, and the challenges and benefits of being an American making a film about a Mexican family.

The following excerpts of our conversation have been lightly edited for length and clarity.

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Alissa Wilkinson

You’re not from Mexico. How did you end up making a film about a Mexican family working and living in Mexico City?

Luke Lorentzen

I was living in Mexico City already. I moved there like a week after graduating from college. I was living with a Mexican friend for four years who grew up there, and it was kind of a spontaneous thing: “Let’s go there and see if I find a film.”

I met the Ochoa family just parked in front of my apartment building, and in a spontaneous moment, [I] asked them if I could ride along for a night, mainly because I was curious about their family’s dynamic. Like, what is a family-run ambulance like? And then, on that first night, I saw the ethical questions, and the adrenaline, and was pretty excited about making a movie about them.

Alissa Wilkinson

Did you know a lot about for-profit ambulances in Mexico before you met the Ochoas?

Luke Lorentzen

I didn’t know anything about it. It’s something very few people know about. If you need an ambulance once in your life, that’s a lot. So, [the lack of public ambulances in Mexico City] has become this egregious example of corruption and government dysfunction, but it hasn’t gotten as much attention as it deserves. And when it has gotten attention, it’s often been mistreated patients making a fuss about private ambulances.

Even just getting the number of government ambulances that are working was really complicated. [The government] reports having two or three times more ambulances than they actually have, and I had to go to every station and count them to find out that what they were reporting was not accurate at all. Or they had that many once, but two-thirds didn’t have engines in them.

Alissa Wilkinson

So you had to do some good old-fashioned shoe-leather reporting.

Luke Lorentzen

Yes. There’s so few ambulances, it took me only a few hours. There’s only two organizations that the government funds for emergencies and health care.

Alissa Wilkinson

How did the Ochoas get into the private ambulance business?

Luke Lorentzen

I spent three years filming, so I slowly got closer and closer to them, and learned more each night that I was there. The Ochoas’ ambulance is an expired ambulance from Oklahoma that was shipped down to Mexico, where they bought it. That’s the story with a lot of these. You see a lot of ambulances that have foreign text on them, often from the US. One of the ambulances that they chase a lot is bright green and comes from the UK.

Alissa Wilkinson

It looks like it’s really close quarters in that ambulance, and you were crammed in there shooting with them for years. That seems really challenging. Were you shooting alone?

Luke Lorentzen

Yeah, it was just me. It started that way because of how the funding was. And it’s how I had done my other films. Then it quickly became clear that that was probably the best way to do it.

I ended up shooting it with two cameras. One was mounted on the hood of the ambulance, and then I had another camera in the back of the ambulance. You really need these conversations that happened between the driver and the people in the back. It was dynamic.

But it was an enormous amount of equipment. I knew that if I could physically get it to the ambulance at the start of the day without an assistant, then I could manage it throughout the night. Figuring out how to juggle all that was a lot. And everyone was wearing a wireless microphone.

Alissa Wilkinson

I know they’re not really equivalent, but it sounds a little bit like the unpredictability and high pressure that goes along with making a reality TV show.

Luke Lorentzen

Yeah. What saved me is that it wasn’t that unpredictable. Once I was set up in the ambulance, I knew that the way in which people would move around it would be almost identical every night. That allowed me to make some really specific visual choices. The movie didn’t look like this for the first 70 percent of the footage — I had to learn how to make a film, and I was saved over and over again by the repetition of their work.

Alissa Wilkinson

The look of the film is noteworthy — it’s cinematic.

Luke Lorentzen

My hope for it, visually, was to create an image-based, scene-based story. … What excited me from the very beginning was that I could make a vérité doc that operated with a high energy level, with excitement, and that could pull people in so many different directions, from humor to tragedy. It was just all there. All I had to do was film it and put it together properly. That’s so rare — you usually need to do so much digging.

Alissa Wilkinson

Did being a white non-Mexican present challenges? Were there any advantages?

Luke Lorentzen

Yeah. At the end of the day, the whole thing rests on my relationship with the Ochoas, making sure we had a real relationship that goes two ways — that they were as connected to me as I was to them. That took three years to happen. We submitted a cut to Sundance in 2017 and didn’t get in, and [we] decided to take an entire additional year [to work on it]. In that year, about 80 percent of the movie as it is now was actually shot.

I think my job when I’m trying to make a film like Midnight Family is to decide, can I connect with people in a meaningful way that’s not just about the movie, but something bigger than that? If I can do that, I start to understand the culture better. They will correct my wrong assumptions. I’ve been in work-for-hire situations where we can’t take the time or there isn’t the willingness to form that connection. That’s when the question of who’s telling whose story really gets more complicated.

Alissa Wilkinson

Right. Because it’s their story, but you’re, in a sense, the author.

Luke Lorentzen

Also, our Mexican producers would probably say that they felt a Mexican journalist [or filmmaker] might have had a harder time connecting with the Ochoas than I did. They were curious about who the hell I was, and got a kick out of me riding around with them as this American guy who made them look cool. I don’t know if that’s totally true — I think, knowing the Ochoas, that they would have let anyone in who was willing to ride along with them. That’s why they’re so special. So the film is about a very specific relationship between me and the Ochoas.

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Alissa Wilkinson

I have to say that when I first started watching it, I figured it would be an exposé on corruption in the medical field or something. But really it’s a movie about a family, and it’s almost a dark comedy at times.

Luke Lorentzen

It’s cool that you saw elements of that. Different people take different stuff from it; the comedy is sometimes harder for people to take in. In Mexico, it works very much as a dark comedy at times. In the US and here in the UK, I think people are quicker to get a little bit deeper into the ethical questions.

Alissa Wilkinson

That’s a bit funny, when you think about it. A lot of American entertainment has centered around characters in medical settings, like Grey’s Anatomy and ER. It feels like people should be primed for both the comedy and drama that happens in the medical world.

Luke Lorentzen

People are especially shocked by how much money plays into the decisions people make about their medical care in the movie. I had a doctor come up to me after a screening in New York who worked in an ER in Baltimore. He was like, “We are making the same financial decisions about people’s lives in our ER every night.” That’s problematic, but it’s happening everywhere in the world where governments are not thinking about the relationship between money and health care.

Alissa Wilkinson

People are going to make decisions about their health care and hospital visits based on what they can afford.

Luke Lorentzen

Yeah. I think about the film as showing two forms of survival: The Ochoas are trying to survive, and the patients are trying to survive. And at each accident scene, those two kinds of survivals bump up against each other in increasingly complicated ways. The Ochoas have two goals: to save people’s lives and to make a living. That can’t be easily done at the same time. Sometimes their patients are victims, but the Ochoas are also victims of the system, trapped and left with this menu of decisions that are shitty.

Alissa Wilkinson

That’s what’s remarkable about the film: You can see the double-edged sword of altruism. They really seem to care about their patients, while also having to ask them for money before treating them.

Luke Lorentzen

That’s what’s so fascinating. When you put good people into a broken system, the things they end up needing to do are really complicated. The Ochoas are good people. They were so generous and warm with me. Then you see them do things in a certain situation that make you nervous [like asking for money before treating an injured patient]. The first time that that happened, I was really conflicted. I didn’t have an edited film to guide me through it, the way audiences do now.

Midnight Family opened in limited theaters on December 6.