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It almost seemed like something out of a dream. Somewhere in the middle of the desert, paramedic Carol Thornton found herself standing with a film crew on the set of the multi-million dollar movie, Disney’s The Lone Ranger.

And just like everyone standing with her, Carol had her eyes fixed on actor Johnny Depp and Armie Hammer, who were riding in full costume toward the camera, both perched on their horses who were running at top speed.

Portraying Tonto, the faithful sidekick to Hammer’s Lone Ranger, Depp had become accustomed to riding horses, and this was supposed to be another routine shot. Something Depp had performed several times while shooting this film. However, on this occasion, something was obviously very wrong.

The saddle Depp was riding on had come loose. Carol watched with the rest of the crew as Depp found himself slipping off his horse, still going at full speed. Suddenly, the choreographed illusion of Tonto riding high on his mount had become a crushing reality of Depp falling off his horse, striking the ground hard.  

In a flash the film's director, Gore Verbinski, stunt coordinator and Depp’s security guard all raced toward the injured actor, followed closely by Carol, who, as always, was hoping for the best, but prepared for the worst.

Depp was quickly surrounded by his security and stunt team, all attention focused on him until someone in the crowd shouted, “Make room for the medic!” And then all eyes, including Johnny Depp’s, turned to focus on Carol.

“That was pressure on a whole different level,” says Thornton. “Luckily, Johnny was all right. I saw him immediately after it happened, 30 minutes later, and about 3 hours later when he was finally out of makeup and wardrobe so I could thoroughly check of any trauma or bruising I may have missed earlier.”

A concern was that the horse may have accidently stepped on Depp’s chest after his fall. But according to Thornton, there were no signs or symptoms that she could find to raise alarm.

A 21-year paramedic, Thornton has spent most of her career responding to 9-1-1 calls with Albuquerque Ambulance Service (AAS). In her career, Thornton has treated almost every type of trauma there is: gunshots, stabbings, burns, you name it. However, performing a full trauma assessment on someone as famous as Johnny Depp was relatively new for the veteran paramedic.

“I’m kind of getting used to it,” says Thornton. “You see them on the set almost every day and you realize they’re just like any other person. But if someone as iconic as Depp goes down, the whole movie is impacted. How I perform can affect the entire schedule of this multi-million dollar movie. So yes, pressure on a whole different level.”

Two years ago Thornton decided to retire from her position as a supervisor at AAS and focus on being a set medic. Working on the numerous film projects being produced in New Mexico, Thornton has become just one of a growing number of EMS professionals in the state who are forgoing the “normal” career route of steady employment on an ambulance service or fire department. “It is definitely a feast or famine type of business,” says Thornton. “There can be weeks where you are not called and you have got to take that into consideration. But after 20 years working for AAS, I felt it was time to move on. Working in the film industry seemed like a fun thing to do.”

Hollywood in the Desert

Throughout the years, New Mexico has played host to several films. With diverse, oftentimes isolated scenery and clear blue skies, filmmakers have been able to transform New Mexico into the old west (Young Guns I II, Wyatt Earp, Butch Cassidy and the Sundance Kid), other planets (Ghosts of Mars, The Man Who Fell To Earth) different states, (No Country for Old Men, The Longest Yard) and different countries (Traffic, Transformers I & II). However lately, New Mexico has begun to show a boom in film and television production of all types.

In the past five years alone, several summer blockbusters such as The Avengers, Fright Night, Arnold Schwarzengger’s, The Last Stand, Due Date and Cowboys and Aliens, not to mention television series, Longmire, In Plain Sight and, probably most famous of all, AMC’s Breaking Bad have all been filmed in New Mexico.

Almost certainly the chief reason why New Mexico has become such a hot location to film are the numerous tax incentives and lower expenditures many film producers are offered to bring their project to The Land of Enchantment.

In June 2007, the State of New Mexico began to offer a 25% tax rebate to any film production working in the state. And this is a refund not a credit on the full cost, not just the tax of any item used in the process of making the film. In other words, the expense of an item, including tax is $100, the rebate is $25. And there is no cap on this rebate—effectively cutting the cost of a production shot in New Mexico by ¼.1

And the breaks just seem to keep on coming for the film industry. Earlier this year, New Mexico Governor, Susanna Martinez (R) signed into law the so called “Breaking Bad” bill, which allows qualifying films an additional 5% on tax rebates.

So with these types of incentives, New Mexico continued to see an unprecedented rise in the number of productions being filmed or planning to be filmed in the state. According to a recent Albuquerque Journal article published on May, 12, 2013, there were more than a dozen major film and television productions being filmed or scheduled to be filmed this year alone in New Mexico, including Johnny Depp’s new sci-fi movie, Transcendence, Mark Walberg’s The Lone Survivor and a western starring Seth McFarland.1

Union Rules

With each production shot in the state, New Mexico film union IATSE Local 480 stipulates at least someone who can administer first aid be present on the set. However, most film sets, construction sites and stunt rehearsals usually have at least one, if not an entire team, of set medics available to respond should something go wrong.

IATSE Local 480 is a chapter of The International Alliance of Theatrical Stage Employees, Moving Picture Technicians, Artists and Allied Crafts. Medical services that work on film production fall under this umbrella of organized labor and are labeled as a craft, like carpenters or lighting technicians. And, you must be a member to be allowed to work. However, the price to play is not free. In order to become a member of Local 480, you must first be nominated by someone who is a member in the union. Next, if selected for induction, you must pay an entry fee of $600 dollars. After that you must pay annual union dues of $300 dollars.

The union also retains a payroll deduction of 4% of all gross wages earned from every IATSE member. “Last year I paid fees in excess of $4,000,” said Brian Lax, a key medic on several productions filmed in New Mexico.

These fees could make a new EMT or paramedic shy away this line of the profession, and possibly with good reason: Entry into the union is absolutely no guarantee of work. There is however, a tremendous upside to joining the union. Higher pay and the amount of work one could potentially make working on a film production make joining very tempting.

Union pay for a medic is normally $27 an hour, usually higher than most ambulance services pay their paramedics.

Also, union rules force employers to pay overtime after 8 hours, and double time after 12 hours even if you only work one day each week. There is also about $80 worth of union-negotiated benefits such as medical, retirement and pension plans, paid tax-free into member accounts for every day worked.

Similar rules apply extra payments for 6th and 7th days worked in a week and even a “meal penalty” of an additional $27/hour when crew are not given a break, sat down and fed a hot catered meal every six hours at work. Added up, these wages are arguably among the best pay EMTs can earn anywhere.

However it’s the EMT’s who could really benefit from getting into this line of work. Especially when considering that Local Film Union guidelines do not use a traditional EMS definition for the word medic. The minimum qualifications needed to apply for a medic position with the union is an EMT Basic certificate and a current CPR card.3

Medic on the Set

Using the term set medic on a film is often a misnomer. Actually, there are three types of medics employed for every film production: set medics, off-production medics and the key medic.

The key medic is often the first medical provider hired for a film production and works as the first aid department head. Hired by one of the film’s producers, the key medic is the person who is ultimately responsible for staffing the medical department with the right crew for the job. It’s a job with tremendous responsibility and usually reserved for people well known in the industry who have displayed on multiple films the ability to handle the job.

One person who has gained a reputation for being able to get the job done is critical care flight paramedic, Brian Lax.

With over 20 years in EMS, Lax understood the potential of “what could be,” with being a set medic. A veteran paramedic who has been involved in EMS since 1990, Lax started working on movie sets early on. In 2007 Lax first worked as a Key Medic on the pilot of the Fox TV show “The Sarah Conner Chronicles”. Since then he’s gone on to be the Key on several well-known films and television series.

In that time Lax has learned that the skills necessary to be a successful Key Medic, are often times the same skills used working on an ambulance or flying in helicopter as a critical care medic.

The way Lax describes the position is very similar to an incident commander at a large scale event. The incident commander will remain above the minutiae and worry about the bigger picture.

“I can’t possibly be everywhere at once, but I have to be available to everyone” said Lax. “We’re filming a movie right now where we have three different shooting locations, and three more construction mills building sets non-stop. All of them spread out across miles and miles. I hire the right people and place them where I’m comfortable they are going to be able to handle what’s going on.”

In addition, scheduling the medics, and knowing where they are at all times, is also a responsibility that falls to the Key Medic.

“All of the medics hired work directly for the production, not the union,” said Lax. “I’ve got to just be able to have the right number of medics, with the right skill sets available when and where I need them.”

Set medics are those that are actually assigned to work on set, while filming is being done. They work closely with the stunt coordinators, the onset fire marshal, and usually assistant directors. They attend meetings to see exactly how the days film schedule looks, whether or not there are any potential hazardous stunts being performed, and what the exact plans are should something go wrong.

Usually if the filming is being performed in an urban area, like Albuquerque or Santa Fe, contact has been made with local EMS providers to insure prompt response. If the filming is being performed in a rural area, ambulance service or air transport may have to be coordinated prior to shooting.

“Being able to look at a shooting script and recognizing what kinds of potential dangers are going to be involved then mapping out all of these preparations is what I’m able to do very well.”

For instance, just one stunt filmed for an episode of Breaking Bad involving two experienced stunt men being t-boned at a high rate of speed by another car driven by a third stunt man. This potentially dangerous stunt required several meetings between the set medic and the stunt coordinators. The stunt was deemed dangerous enough that it required not only two set medics to be on hand, but also the series key medic, an ambulance, a fire coordinator and should the need arise, landing zone for a helicopter to land.

One shoot that Lax was on set to personally supervise involved a scene filmed for the vampire film Fright Night, where stunt men were going to be set on fire in a cramped basement.

“I had more than the normal numbers of medics on set that night, because the potential risk was so high,” said Lax. “I mean we were intentionally setting people on fire.

The off production medic is the one who is responsible for watching over the various laborers, carpenters and set designers etc. Basically, anything that goes into the building of the sets used in the filming process. There are usually no cameras or actors around the construction site, and the pace is certainly more laid back and casual.

And while being a construction medic may definitely seem to be the less glamorous of the two, it certainly seems to be the more practical job in terms of steady work and stability.

Off production medics usually work regularly scheduled 12 hour days- the last four paid at an overtime rate. This type of stability attracts a lot of medics who have families or use film work as a second job.

“It’s certainly the job I’d have if I wasn’t doing Key work,” said Lax “Working off production you can still have a fairly normal life. Working on set, you may have a call time of 4 or 5 am and not get off until late, late that night. You just never know.”

Also, off production work is much easier to get. Whereas usually 1 medic is working as set medic, 8 or 10 more medics will be working that same day off production.

And, working off production also may require a lot more of the skills one is accustomed to learning throughout EMT or paramedic school.

“There’s always somebody getting their fingers caught, pinched or cut off, and it’s more than likely going to happen on construction- where they’re constantly working with those heavy saws and drills,” said Lax.

Motion Picture Set Medics

In 2009, Vince Gilligan, the creator of Breaking Bad, approached Lax and asked him if there were AEDs on set as part of the medic kit. “Mr. Gilligan felt that it would be important for them to be available if needed”, recalls Lax, who could not have agreed more, but had to inform Gilligan they were not available.

New Mexico requires medical direction for the use of AEDs and set medics at the time were considered to be providing first aid skills on set without medical direction.

Not one to be happy with an unfulfilled need, Brian contacted the NM EMS Bureau, wrote a 1-page protocol for AED, which got approved. He then hired a medical director and created a registered special event medical rescue service which he named Motion Picture Set Medics (MPSM).

The next year, Brian kept writing until he had a full set of ALS protocols and expanded the capabilities of MPSM to support medics on film in working up to their levels of licensure – something that has not been done anywhere else in North America.

Lax followed that up by assembling a group of medics together who purchased 2 ambulances that would fit serve their needs of providing standby service on larger stunts and remote location work. Their company now owns 4 vehicles, including a 4x4 go anywhere ambulance which was widely used on the Lone Ranger. More information about MPSM can be found at their website,

The Final Word

”It’s a great job, but I can easily see it being a feast or famine type position,” said Thornton. “Right now everyone is looking to New Mexico because of the Governor’s tax breaks, but what if another state, Arizona, offered even bigger tax breaks. We have to be able to offer the best care, the best facilities and the best customer service available when we can and while we can.”

1. New Mexico Film Office-
2. Albuquerque Journal, 5.12.13 section A, page 1
3. Local 480 union website-

Paul Serino, AS, CCEMT-P , is a 10-year medic currently working with Albuquerque Ambulance. He has an associate degree in EMS from Eastern New Mexico University-Roswell and a bachelor’s degree in journalism/communications from the University of New Mexico in Albuquerque.






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