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Simply looking at Bringing Out the Dead (1999) is unpleasant. This Manhattan-set movie is shot in color, but the vitality of its hues are dulled — like all its pigments were sucked of life. And light has no warmth: it always has an antisepticness, like you were eternally stuck in a doctor’s office awaiting bad news wherever you go. 

We’re presumably seeing the world as the movie’s protagonist, Frank Pierce (Nicolas Cage), does. This flaming-out, dangerously depressed, and haunted paramedic can’t see anything even resembling hope anywhere and is increasingly struggling to put on a brave face for others. How much longer can he keep covering up the pain that amasses when your job necessitates seeing people, as if they were lined up just for you, die or get close to it? He admits to seeing his job less as about saving lives than bearing witness. He literally begs to be fired, but staffing shortages ensure his pleas strike his boss as little besides white noise. Sleep can’t even provide relief: he can’t bring himself to do it. 

Pierce has been a paramedic for the last five years — and sometime within that period he and his wife divorced — and the movie, director Martin Scorsese’s fourth and so far last collaboration with screenwriter Paul Schrader (1976’s Taxi Driver, 1980’s Raging Bull), captures him getting closer to the personal breaking point whose journey he says began about a year ago. Scorsese and Schrader have repurposed this narrative arc more or less every time they’ve worked together. Bringing Out the Dead chronicles a nightmarish three days in Pierce’s life, where keeping it “together” feels less and less possible. The deepening under-eye purple and worsening sallowness of his skin chart the state of his implosion.

Bringing Out the Dead twines together a series of “episodes” co-starring a given evening’s paramedic partner. Each is played by John Goodman, Ving Rhames, and Tom Sizemore. Their memorable performances are south of hinged; they all could probably star in different versions of this movie. The film, though, continues returning to a man named Burke (Cullen O. Johnson), brought in after a heart attack and whose family stipulates revivification every time it seems they’re losing him. It also comes back to the friendship Pierce forms with Burke’s daughter, Mary (Patricia Arquette), who’s struggling with drug addiction and provides Pierce with his first flickers of optimism in forever. Memories of Rose (Cynthia Roman), a young woman he still feels guilty about being unable to save, are always flaring up, too. Pierce thinks he can see the ghosts of everyone who’s died under his care — certain neighborhoods have a certain number of phantoms per square foot, to his bloodshot eyes — but it’s Rose who appears most. 

You’re never not feeling Bringing Out the Dead’s anguish. Its look and feel expressively conjure the purgatorial monotony ingrained in the job which drives it; it’s one of Scorsese’s most aesthetically distinctive, and assured, movies. But the film elsewhere has an odd asymmetricality that staves off both complete emotional immersion or the ability to appreciate it as the dark comedy it at times announces itself as. Contributing to that is the cartoonish loopiness that sometimes permeates Cage’s performance; that trio of similarly fucked-up paramedics rendered kind of like sitcom fireballs; and many workplace and patient frustrations drawn with the out-of-place levity of that televisual mode. 

With its interruptions of swivel-eyed is-this-really-happening-style comedy, Bringing Out the Dead can sometimes echo Scorsese’s creepy-but-funny After Hours (1985), a movie that has a way of making you think the main character is going to at any point suddenly wake up, revealing all this weird shit has actually just been his unconscious self spitballing bad dreams. The difference with Bringing Out the Dead, though, is that a true emotional resonance seems to be the overarching aim. You particularly see that in Pierce’s gentle, increasingly honest interactions with Mary, and the fate which eventually befalls her father. But Bringing Out the Dead never quite gets to where it wants to go. The moments of comedy are pitched too wackily to be consistent with the emotional naturalism the movie goes for more regularly. Intentions eclipse impact.