October 22, 1999 | Frank Pierce (Nicolas Cage), the walking-wounded protagonist of Bringing Out the Dead, is a New York City paramedic who works the graveyard shift in Hell’s Kitchen. He has seen and experienced too much, for too long. He is on the brink of exhaustion – physical, mental and spiritual – but yet he cannot sleep. And while he remains awake, he is haunted by the ghosts of those he could not save.
Director Martin Scorsese and screenwriter Paul Schrader want to show us the world through Frank’s bloodshot eyes. And to a remarkable degree, they are stunningly -- and sometimes scarily -- successful. Bringing Out the Dead, based on a novel by former paramedic Joe Connelly, is a highly volatile mix of hard-edged drama, nightmarish fantasia and blood-drenched black comedy. The mood swings are vertiginous as one event follows another, one scene leads to the next, with a randomness more apparent than real. There is something like a conventional narrative structure, much of it supplied by Frank’s tentative relationship with Mary (Patricia Arquette), the ex-junkie daughter of a heart-attack victim Frank barely managed to snatch back from the jaws of death. For the most part, however, the movie sprawls all over the place – here, there and everywhere – as Scorsese and Schrader vividly render the fitful chaos of Frank’s life over two days and three nights.

A few too many scenes play like so much empty padding or ostentatious vamping. But afterwards, when you replay the entire movie in your mind, you realize these are the time-outs between full contacts. It’s almost as if the filmmakers figured, OK, we need to give the folks in the audience a chance to catch their breath now and then. After all, that’s what Frank spends most of the movie looking for.

Whenever it’s up to full speed, Bringing Out the Dead is vibrantly, almost shockingly alive. Paramedics rev up their engines and race through red lights for the adrenaline rush. Radio dispatchers -- including one who sounds suspiciously like Scorsese himself -- pelt the EMS technicians with nonstop reports of life-or-death emergencies. (“A woman says a roach crawled into her ear, giving her cardiac arrest!”) Marcus, a bearish, Bible-quoting paramedic exuberantly played by Ving Rhames, strides into a Goth nightclub and immediately diagnoses a drug overdose. While Frank applies the proper treatment, Marcus demands that the other clubbers join him in group prayer to save the wretched life of the sinning druggie. The treatment works – hallelujah! – so Marcus robustly praises the Lord. And the clubbers add their amens.

Early in Brining Out the Dead, however, Frank bemoans the recent scarcity of miracles in his nightly rounds. “I hadn’t saved anyone in months,” he complains. Later, he imagines “spirits angry at the awkward place death had left them.” (A little bit of this voice-over stuff goes a long way; fortunately, it’s used sparingly.) On almost every street, every night, Frank glimpses the face of an asthmatic girl who died on the street while he vainly attempted to revive her. He would like her to forgive him, even though he can’t forgive himself.

Trouble is, even when he does manage to save somebody, Frank still can’t shake his guilt. Whenever he visits the hospital to check on Mary’s comatose father, he fantasizes that the old man isn’t grateful at all – that, instead, he blames Frank for prolonging his suffering.

Scorsese and Schrader take pains to emphasize that Bringing Out the Dead is set “in the early 1990s” – presumably, long before the renaissance credited to Mayor Rudy Giuliani. The New York City on view here is a Rotten Apple far worse than the urban wasteland the filmmakers charted in their classic Taxi Driver (1976). Neon-lit streets are teeming with garish hookers, half-naked street people and trigger-happy drug dealers. Overcrowded and understaffed hospitals are scarcely more than warehouses for the suffering. The nights crackle with the constant threat of sudden, random violence. (Bleeding profusely from a gunshot wound, a street hood promises that, in the unlikely event of his recovery, “I’m going into the Army, where it’s safe!”) The days aren’t much better. “It’s been bad lately,” Frank tells Mary, speaking of his job and a great deal more. “But it’s always been bad.”

Things are so bad that, try as he might, Frank can’t even get fired: His night-shift captain is so desperate to keep the ambulances rolling – to keep warm bodies in place to deal with the dead and dying – that he’s willing to accept a little craziness, and a lot of grief, from any paramedic under his command. Frank can be chronically late, he can be on the verge of mental meltdown, and it just won’t do him any good. Captain Barney (Arthur Nascarella) will nod sympathetically, and promise to fire him “tomorrow.” But tonight? “Go and help the people of New York for me,” the captain cajoles Frank. “Go and mop them up.”

Later, two paramedics crash their vehicle, priming the audience for some intensely dramatic plot development. But no: The two men emerge from the wreckage relatively intact, grinning and swapping insults, and shrug off the incident.  For a while, you wait for some sort of pay-off – is this enough to get a paramedic fired? – or at least some passing reference to the mishap in a later scene. Only gradually does it become clear that nobody cares, because nobody wants to care – that is, nobody wants to lose a paramedic over a minor thing like a trashed ambulance. Someone has to fill out a form, and that’s that.

Meanwhile, back at Our Lady of Perpetual Mercy Hospital – nicknamed “Misery” by Frank and his more sarcastic partners (John Goodman, Tom Sizemore) – a hard-bitten security guard (Alfemo Omiliani) and a cynical admitting nurse (Mary Beth Hurt) do their best to ignore the despair and decay, and keep things moving through sheer force of will. If these two seem happier and better adjusted than Frank, maybe that’s because they unapologetically distance themselves from their work. Nurse Constance in particular has little sympathy for anyone who causes his own suffering. Faced with a cokehead who survived cardiac arrest, she brusquely requests: “Since you started breathing again, could you do us a favor and stop breathing in another city?”

Much like the movie itself, Cage’s performance is an artful balance of frenetic extremity and ominous stillness. Also like the movie, Cage – perhaps the best and boldest screen actor of his generation -- isn’t afraid to try your patience. There are times when he simply does too much, but only because that is precisely what Frank might be doing at that moment. When Frank frantically pleads with his work partner of the evening to ignore an incoming radio call, or erupts into hysterical laughter in response to something that really isn’t all that funny, Cage goes way, way over the top. But all of it works, because Frank is very close to beyond the pale. Just like the city in which he works.