Nicolas Cage turns in his most pallid and unhinged performance since Leaving Las Vegas -- or, especially, Vampire's Kiss (he ate a cockroach, remember?) -- as Frank Pierce, an emergency medical services paramedic whose soul is battered nightly on the graveyard shift. Hell's Kitchen (the film is set a few years ago, before Giuliani began polishing the Big Apple) is awash with carnage, and as Frank repeatedly attempts to quit, Capt. Barney (Arthur Nascarella) cajoles: "Go and help the people of New York for me -- go and mop them up." As Frank becomes increasingly strung-out, Barney's kind offer to fire him "tomorrow" becomes less motivating. Drowning in the morbidity and bleak humor of his profession, the guy desperately seeks a rest.
Three nights and two days with Frank and his partners illustrate just why his seams are unraveling. For starters, he is deeply haunted by the face of Rose (Cynthia Roman), a young woman he failed to save. Add in the widespread circulation of a lethal heroin mix called Red Death, raging gang wars, a crumbling state of general health and a hospital filled far beyond its capacity, and reality and nightmare become indistinguishable. Dante Ferretti's design here makes Calcutta look like Bel Air, and, unlike Patrick Swayze's doctor in City of Joy, Frank isn't parlaying philanthropy into a new lease on life. Occasionally, he manages to save someone. More often, he doesn't; thus the title.
While Cage gets to spout some darkly hilarious lines with his trademark wide-eyed goofiness ("Why is everything a cardiac arrest? Come on, people!"), he's most engaging when paired with any of the movie's several excellent co-leads. Ving Rhames steals the show as fellow EMS technician Marcus, flashing loads of humanity through a holy roller/Barry White hybrid that would otherwise collapse into caricature. (It's worth the price of admission to watch him "heal" a smack-addled Goth punk by leading all the other bat-cavers in a prayer circle.) John Goodman (reteamed with Cage for the first time since Raising Arizona) is detached and wary as partner Larry, lending contrast to Frank's psychological spiral. Tom Sizemore brings in a disturbing element of racist violence as Tom, a paramedic who has lost the line between medicine and mauling.
Endlessly cruising through scum and filth, Frank is reminiscent of Robert De Niro's Travis Bickle from Taxi Driver a quarter-century ago, but it's satisfying to note that the comparison is fleeting. Frank is not the violent misanthrope dreamed up by Scorsese and scribe Paul Schrader (who adapts Joe Connelly's first novel here) but, rather, a man struggling, frequently in vain, to bring peace and life to a realm of insanity and death. His sensitivity (or craving for it) is further explored through his tentative relationship with Mary Burke (Patricia Arquette), a mousy former skank whose father was revived by Frank (a miracle via Sinatra) only to hover in a coma throughout the movie. Arquette fills Mary with so much sucker-punched hope that when Frank lets down his fake cheer and admits, "It's been bad lately ... but it's always been bad," we feel it, too. Their chemistry is deceptively simple and one of the most satisfying elements here.
Several other superb players flesh out the ensemble. Not that we need another ER, but a successful TV series could be built around Mary Beth Hurt's Nurse Constance alone. Weary and overburdened, yet razor-sharp, Constance (with Afemo Omilami's steadfastly self-aware security guard, Griss) holds Mercy Hospital together in the face of utter despair. She's like a robust female Wilbur Larch from The Cider House Rules, chopping up pathos with curt admonishment. ("Correct me if I am mistaken, but did we sell you the cocaine? Did we shove it up your nose?") On the other side of the convalescent path is Cy Coates (Cliff Curtis), a minor drug czar whose good intentions (he runs a little pad he calls the "Oasis") get stomped on just like everybody else's. Curtis, proving himself indispensable as an ethnic character actor (Three Kings, Insider), once again works wonders with a small role. It's a shame that his hussy, Kanita (Sonja Sohn), is also denied a larger part. (Their agents probably wouldn't mind the money.) Singer/actor Marc Anthony also pushes buttons as Noel, a dreadlocked (and frequently bloodied) childhood friend of Mary's who single-handedly symbolizes the wretched state of the neighborhood.
Amazingly, these complex turns barely hint at the wealth of material and characterization littered throughout Bringing Out the Dead, so it should be a scintillating entertainment, right? Well ... sort of. Try schizophrenic. Despite moments of gritty greatness that rival Scorsese's best, the movie is severely hampered by please-everyone syndrome, especially in the editing and choice of music. Rather than running with just Elmer Bernstein's score (schmaltzy echoes of '60s cop shows), the producers have decided to bombard us with a ludicrous stream of poorly juxtaposed rock songs. Yes, it is indeed stimulating to hear the Clash's "Janie Jones" and "I'm So Bored with the U.S.A." blasting nonsensically through ambulance montages, but the nonstop parade of hits (the Who, Stevie Wonder, R.E.M., Natalie Merchant and UB40, to name a few) quickly becomes distracting, an invitation to either plug the ears or close the eyes. The pace of the movie is ruined by this fervid multigenerational marketing scheme. Why not just cut out the dull, redundant bits?
Excluding a strange and utterly unnecessary racial slur hurled at a turbaned taxi driver, Bringing Out the Dead is made up of some profoundly compassionate ideas and scenes (note Frank's hallucinations and the guilt theme). It would be nice to gush poetically over it, to say things like: "Graffiti and derelicts hover like a beckoning penance" or "This rumination upon mortality reawakens the soul" or (every payola-critic's standby) "A shattering triumph!" But it's much more accurate to state that this time around, Marty's New York is simply a pretty cool mess. Plenty of soulful blood is splattered, but only about half of it congeals.
Opens Oct. 22.