Ambulance cowboys: 'Midnight Family' spotlights industry of pirate paramedics in Mexico City

In Mexico City — a metropolis that is the seventh largest in the world — there are around 100 ambulances.

This is the amount that serves a population of over 10 million.

This is the fact revealed by Marigaby Tamayo, played by Renata Vaca, in the opening episode of the Apple TV+ series “Midnight Family.”

The series airs a new episode on Apple TV+ on Wednesdays through Nov. 20.

Ambulance cowboys: 'Midnight Family' spotlights underground industry of pirate paramedics in Mexico City

It was inspired by Luke Lorentzen’s 2020 documentary of the same name and follows Marigaby Tamayo, an ambitious and gifted medical student by day, who spends her nights saving lives throughout a sprawling, contrasted and fascinating Mexico City aboard her family’s privately owned ambulance.

Along with her father Ramón and her siblings Marcus and Julio, Marigaby serves a population of millions by tackling extreme medical emergencies to make a living.

While the events of “Midnight Family” – produced entirely in Spanish – are fictional, the thrilling concept at its core is compellingly real.

In Mexico City, the hospital system is almost perpetually on the brink of collapse.

That’s why, over the past 25 years, some of the city’s more entrepreneurial residents have established themselves as, essentially, private ambulance cowboys. Listening in on police scanners, these renegade crews speed to the scene of accidents, competing with local rivals in the same game to get to the wounded first.

Once on the scene, they help blue-light their “patients” – for an emergency fee – to one of the city’s many private clinics, who will in turn give the ambulance crew a kick-back for the custom.

This underground industry sprung up around the year 2000 but gained pace during the pandemic, as the need for urgent medical attention exploded and the official system started to buckle under the demand.

Makeshift and sometimes medically untrained, local teams started buying up old, tired equipment from across the U.S. border and began using it to set themselves up as pirate paramedics.

“Before working on this, I didn’t know about this world of private ambulances,” Vaca said. “I would see an ambulance go by and be like, ‘OK, it’s an ambulance.’ I had no idea about the whole universe that it involves and all the crazy things that happen inside them. That’s why this show is such an interesting trip to somewhere you’ve never seen.”

Natalia Beristáin, the series showrunner, was born in Mexico City.

Like Vaca, she’d been previously unaware of the secret life that plays out nightly on its streets.

“As a chilanga (Mexican slang for its natives), the data about these ambulances blew my (mind),” Beristáin said. “The whole idea seemed inconceivable. So, when I was invited to turn this reality into fiction, that seemed like a very rich challenge.”

Beristáin said the documentary was the backbone of the TV series project.

“There was something that attracted me to exploring the different possibilities of a place as gigantic as Mexico City,” Beristáin said. “It’s not a single city but many cities, and the possibility of movement with an ambulance allows you to take small, voyeuristic looks inside all these different urban spaces. I liked the idea of being able to portray a place I love and that I find fascinating, chaotic, ugly and beautiful, all at the same time.”

Filmmakers devised the Tamayos — a family of four who by day each lead their own complicated lives — to come together as a dynamic unit inside the ambulance that has become their second home.

The Tamayos’ father, Ramon, played by Joaquín Cosío, is something of a legend in this world of renegade paramedics, but also struggling with a heart condition he is desperately trying to keep from his children.

Eldest son Marcus, meanwhile, played by Diego Calva, dreams of one day escaping the confines of the ambulance to pursue a career as a rapper; Marigaby (Vaca), is a gifted medical student whose secret double life is seriously jeopardizing her studies; and newcomer Sergio Bautista’s Julio is the youngest of the quartet, skipping school to tag along for the ride, hoping to one day continue the family trade.

“The series is an X-ray of a family involved with the private ambulance business in Mexico City,” Calva said. “Each has their own personal problems, while trying to maintain their love for each other in a vehicle that is falling apart.”