In Manhattan, in New York in the 1990s, we follow ambulance crews attending to a range of tragedies and incidents on the night shift: murders, suicides and attempted suicides, drug overdoses, comatose drunkards, heart attacks, etc. The central character is paramedic Frank Pierce (Nicolas Cage), and the movie is, really, about his difficulties - to say the least - in coping, emotionally and psychologically, with the job. Frank Pierce suffers from depression, made worse by chronic insomnia. He is the classic case of occupational burnout when it reaches its highest point, i.e. Frank is sinking to his lowest point. Frank feels guilty because, in recent months, he has failed to save anyone on his shift, more particularly.
The film follows Frank from one night shift to the next. Nicolas Cage, in my view, is an over-rated actor: his acting is not bad, but it is not phenomenally good. In the film, he sticks to the same pattern, which is to say he looks more and more haggard as the story develops (unshaven, sunken cheeks, wild eyes, etc.). He has 'burn-out' plastered all over his face: it is quite clear he would need medical attention. The incidents, accidents and tragedies accumulate, sometimes graphic and gory, and yet only Frank seems to be desperate. All around him, the others appear to be coping fairly well with the utter, chaotic mess that New York City is (as depicted in the film). In 'Taxi Driver', NYC by night felt dark, atmospheric, threatening, deep, complex and fascinating. Not so in this movie. It is what it is: rushing from one ghastly emergency to the next.
What saves the film, in my opinion, is not N Cage (see above), but the supporting roles, which are among the best you will ever come across on screen, and the sound track, which is remarkably good and inspiring. Regarding the former, I am referring here to the 2nd paramedic that Frank is on shift with (a different one each time). Some of them are, essentially, nutcases. Ving Rhames (as Marcus) is particularly good: that sequence made me scream with laughter, in fact. And there is a lot of humour in the film: a raw New York kind of humour, which makes the film less gloomy and more like real life. The film is a study in larger-than-life characters, essentially, and this does not include Frank, who is a drip more than anything else, but the others: his team mates and the - often strange - people that they come across in the New York night.
The problem I can see is that the film shows things we have seen before: a big city at night, the crime, the violence, the prostitution, the chaos, and so on. This is not new. And Martin Scorsese did it far, far better in 'Taxi Driver'. There are some human-interest stories, but they are not truly earth-shattering. The film focuses on ordinary people trying to cope in extraordinary situations that are, nevertheless, quite common, in a big American city at any rate. The movie will fascinate you if you are highly interested in the work of paramedics, in ambulances, in hospitals, and in medical procedures. Overall, I do not regret seeing this film, but it is not that exceptional and I feel I could have done without. What it lacks, in the last analysis, is that thick, claustrophobic atmosphere that pervades 'Taxi Driver'. But that's a totally different movie, obviously.