One of the last entries in Larry Cohen’s long list of B-pictures, The Ambulance was also one of his best, gathering up a whole lot of thriller tropes popular at the cusp of the 90s, and congealing them into a glorious and lurid whole. In essence, it plays as two interrelated movies, the first of which is about a woman, Sandra Malloy (Meaghan Gallagher) who suffers a diabetic attack and is taken away by what appears to be a legitimate ambulance, only to realise that she has been abducted by a gang of rogue scientists intent on selling her on the black market for medical research. The second film revolves around Josh Baker (Eric Roberts), the man who meets her on the street moments before her collapse, and who becomes invested in tracking her down after he realises that the ambulance hasn’t taken her to any of the hospitals in New York, where the film is set. Enlisting Lieutenant Frank Spencer (James Earl Jones) to help him with the case, he sets about trying to track down the phantom ambulance, and to compile a list of all the people who have gone missing in the throes of medical emergences over the previous months. Between Sandra’s story, which plays as surgical horror, and Josh’s story, which plays as police procedural, an awry, genre-bending, code-hopping atmosphere emerges, providing Cohen with a terrific platform for a series of ever more lurid and campy set pieces, all delivered with a wry, acerbic humour.

In other words, this is an amazing B-movie, and often feels like a transition between B-movies designed to be seen in cinemas and B-movies designed to be watched on television, anticipating the Lifetime “Moments of Truth” series in particular. Like that series, there’s a fixation with stalking, peeping and voyeurism – Josh first encounters Sandra after watching her walk down the street – all of which is framed as a cautionary tale, with the critical difference that part of the fun of The Ambulance comes from its refusal to ever really articulate what it is cautioning us against. At first, it plays a bit like a warning about stranger danger – the ultimate fear of the “Moments of Truth” series – and yet it’s only by approaching Sandra, as a stranger, that Josh is able to eventually track her down and rescue her, making for a film that continually and playfully defers any kind of moral message, even or especially as the characters moralise ever more histrionically with each passing scene. Key to that uneasy, slippery tone is Eric Roberts’ performance, since his slightly caricatured, cartoony, facial features mitigated against any residual realism or moral gravity – more attuned, in some ways, to a comic book character than to a conventional heroic protagonist.

It’s no surprise, then, when we find out that Josh actually works as a comic book illustrator for Marvel, where his boss is played by Stan Lee, in his first film cameo. To watch The Ambulance from the vantage point of the 2010s is therefore to realise just how far Marvel has come from its subcultural, underground roots, along with the extent to which it has become synonymous with “quality” blockbusters, since here the Marvel Comic Universe feels completely continuous with the film’s own cheesy, nerdy, B-aesthetic. This isn’t just a flourish either, but a critical part of the plot, since it’s Josh’s’s comic book skills that allow him to draw both the ambulance and Sandra for the police investigators, at which point The Ambulance starts to segue into a strange, distorted riff on the comic book adaptations that became so popular in the wake of Tim Burton’s Batman. Nowhere is that clearer than in the depiction of the ambulance itself – a semi-supernatural, semi-sentient emanation of the cityscape whose bright red exterior and lurid green lighting sets the whole dayglo palette of the film in motion, suffusing Cohen’s mise-en-scenes with a campy pulpiness that embeds it deeper and deeper in the cityscape as the film proceeds – we discover that its resting place is as a prop in a neon-clad nightclub – until it exceeds the agency of any of the evil doctors to become a protagonist and a presence in itself, seeking out Josh for its own private revenge.

That parodically Gothamesque depiction of New York is enhanced by the fact that the majority of the action is shot on and around the Hudson. Presumably, that’s because these decaying riverside lots were one of the cheapest filming locations on Manhattan at the time, but the drabness and banality of the backdrops also serve the subsidiary purpose of rendering the ambulance, and the ambulance’s version of New York, so utterly fantastic that it’s hard to ever take the drama completely seriously. Conversely, when Roberts does spend time in the heart of Manhattan, it’s usually in the service of a haute couture New York that’s just as comically incongruous with the ambulance’s purview, with Sandra managing to inform Josh in the brief moment in which they meet, that her main source of income is –driving a horse and carriage around Central Park. Between New York’s genteel past and the gentrified future awaiting it alongside the Hudson, the central narrative feels as displaced from the city’s actual present as Gotham itself, but with more of a taste for the ridiculous.

This lurching, hallucinatory depiction of the city also ensures that, as with so many comic book panels, the action can get very histrionic very suddenly, and then subside just as rapidly. While that’s clear in both Roberts and Gallagher’s performances, it’s perhaps most evident in James Earl Jones’ appearance, if only because Jones can be quite naturalistic, or quite histrionic, depending on the role, with his more melodramatic style tending to be reserved for his voice acting and his more realistic style tending to be reserved for his live action film roles. Here, as Lieutenant Frank Spencer, he falls somewhere between his on-screen and voice roles, as his delivery continually exceeds and overwhelms his presence in whatever scene he happens to be performing, leading to a series of premature disclosures, hyperbolic pronouncements, and rhetorical flourishes, most memorably his histrionic confessional exchange with Josh about his rocky mental health history ten minutes after meeting him: “I had a nervous breakdown once…after fourteen years on the force. It came upon me without any warning at all.” Before we even find out that the ambulance is targeting diabetics, then, the whole film lurches on the edge of a dangerous sugar high, overcrowded with visual and verbal confections that always feel on the verge of collapsing the entire film around them, and turning its most spectacular tableaux against themselves.

The fact that this never happens probably comes down to Cohen’s deftness in moving quickly from one spectacle to another, never settling on one for enough time for it to turn sickly, or to fully reveal its sicklier underside. Perhaps because the whole plot starts with a fleeting encounter, the film is full of little moments that would form whole set pieces in a more streamlined blockbuster, but which Cohen never fully draws out here, always moving restlessly to the next attraction. For all its exploitative edges, then, and its frank delight in titillating spectacle, there’s something about this kind of B-movie aesthetic that refuses to exploit its ideas as functionally as would occur if they were more contained by Hollywood, or more streamlined to maximise their target audience and crossover appeal. And that refusal to streamline is what allows the film to be so tonally precipitous too, ensuring that Josh’s search for Sandra is nearly always absurd, comic and suspenseful at once – a cocktail that Cohen perfected over the course of his career, and which he pours out here with the supreme confidence of a master at the height of his craft.