The ideological makeup of horror movie villains and how they approach their victims has intrigued me since my horror obsession was birthed. You have Freddy Kruger, persistently killing through children’s dreams, slaughtering them while they sleep. You have Pennywise the Clown, building suspense by playing with your personal anxieties and fears and, eventually, making them come to vicious life. Even the masked maniac Jason Vorhees, taking pleasure in ending your life while ending your virginity, catching you, quite literally, with your pants down.
Now, imagine a terrifying fictional enforcer that prefers to approach a victim when they’re at their weakest. Unwell and needing urgent medical assistance, whether it be experiencing a drop in blood sugar or even a sprained ankle. They come by to abduct you in broad daylight, picking you up right off the street in full view of the public. This slasher wouldn’t have the burnt face, hockey mask or still expression of William Shatner. It wouldn’t be human at all. It comes straight to you, approaching on four wheels, with two back doors and an alarming array of red and blue lights on its roof. All those discomforting horrors can be found in Larry Cohen’s healthcare conspiracy thriller, The Ambulance (1990).
To me, Larry Cohen has always been an underseen auteur of the cinema’s finest sub-genre: schlock. Ranging from trashy classics to existential body horror, his films include The Stuff, which examines the nightmares of consumption, and his sweaty, street-level creature noir, Q. Both feature real-world character archetypes, often of the New York variety, being thrust into larger than life horrors, a knack of Cohen’s that he seems to always pull off flawlessly. On all accounts, Cohen lives up to his reputation as a pioneer in midnight cinema, so when I discovered The Ambulance (a neon-lit, wet exterior conspiracy slasher that by the end, feels like a lost Brian De Palma flick), I had a feeling that it was going to be my cup of tea.
The film opens with a barrage of images: public walkways and street corners, occupied by a sea of nameless public, roaming aimlessly, shoulder to shoulder, introducing an obsession with anonymity that pervades the rest of the film. Within the bumper-to-bumper foot traffic is charismatic and mullet-wielding Josh (Eric Roberts), headed to his lunch break when he is caught off guard by the gorgeous yet enigmatic Cheryl (Janine Turner), a woman who is trying her best to blend in with the rest of society. However, her efforts prove futile when Josh woos Cheryl via invitations to lunch dates or even hastily purchasing a walkman off the street to gift her.
Such meet-cute vibes are swept away when Cheryl suddenly collapses, dropping to her knees as her blood-sugar levels fail her. Josh is then forced to rush through their introductions and full names so he can finish his charming, romantic gesture when she’s in a hospital bed. Through this encounter comes our introduction to the titular Ambulance.
From this point forward, Cohen is in suspense machine mode, flexing his genre muscles with a set of thrilling sequences peppered throughout the second and third acts. Moody metropolitan images rub up against the harrowing ambulance attack sequences to make for some of the genre's most niche scares; victims duck and weave in between alleyways and street corners to avoid abduction via ambulance, a scenario that makes for some all-timer visual comedy (intentional and otherwise). Cohen is self-aware enough that when showing an ambulance actively trying to injure a victim, he plays up that delicious irony.
Cohen flirts with the slasher tropes and undertones one comes to expect from this sort of material, but he also allows room to highlight his idiosyncratic brand of sharp, socially tinged, double entendre commentary that sets The Ambulance apart from its genre neighbors. The comedy and the scares alike arise from one of the greatest horrors of all: the American healthcare system.
Within the context of the film, victims fearing the sight of the ambulance is obvious; a large, disheveled vehicle charging towards you is a self-apparently disturbing sight, to say the least. What could be more terrifying than a multi-ton murder machine mowing down innocents? Private healthcare, says Cohen. Sequence after sequence featuring evil paramedics wheeling away kicking and screaming victims can’t help but be understood as Cohen's commentary on the real-life anxieties many people feel in regards to a healthcare system that doesn’t seem to give a shit about, well, health.
As has been proved time and time, Cohen maintains one of the foremost catalogs of sleaze. Many of his films tackle thorny social issue tales and their realistic heroes facing down larger-than-life horrors, and The Ambulance is no different. What begins as something of a romantic mystery mutates into something larger: a slasher, crime epic that brings to light diabolical government conspiracies and the creeping systemic paranoia of an entire nation. By the end, you’re left with the most powerful message that Cohen has ever dealt with as a filmmaker: there is nothing more dangerous than approaching strangers on the street.