Bringing Out the Dead (1999), directed by Martin Scorsese

In the opening scenes of Martin Scorsese's Bringing Out the Dead, the image of an oncoming ambulance is followed instantly by a close-up of driver Frank Pierce (Nicolas Cage), a burned-out veteran of the city's ambulance service. The action, seen through Frank's eyes, takes place over several nights on filthy New York streets populated by drug dealers, addicts, prostitutes, the destitute, the homeless and the hopeless. Beyond the sidewalks lie tenements, abandoned buildings, crack houses—and Our Lady of Misery, an aging, understaffed hospital overwhelmed by the suffering that floods in from the dark streets.

Theological questions lie at the heart of Scorsese's work. How shall we make sense of vocations that call us to the brink of life and death? What does it mean to save? How shall we be forgiven?

Like Travis Bickle in Scorsese's 1976 film Taxi Driver, Frank wonders if violence can free him or give him a sense of meaning. The son of a nurse and a bus driver, he became a paramedic because he was following in his parents' footsteps and wanted to help people. He was good at his job, he tells us, and relished the godlike power he felt when he saved someone's life. But Frank has come to realize that his efforts are futile at least 90 percent of the time. It has been months since he saved anyone. He is unable to sleep and is haunted by the ghosts of the dead. He lives on cigarettes, coffee and whiskey.

Frank feels responsible for the death of Rose, an asthmatic teenager who whispered her name to him before she died on the sidewalk. When Frank had tried to insert a breathing tube into her lungs, he got her stomach instead. Now he sees her face everywhere, asking, "Why did you kill me, Frank?"

He is similarly haunted by Burke, a man who had suffered a cardiac arrest. When Frank and his partner responded to the call, Burke seemed dead, but Frank found a tiny flicker of life and raced Burke to the hospital. Throughout the film, Burke clings to life, unable to speak to his family or doctors but communicating to Frank his desire to be released and allowed to die. Frank seeks forgiveness both for Rose's death and for Burke's death-in-life.

The cardiac paddles that shock people back from the brink of death are one of the film's central images. Burke is shocked back to life 11, then 14, then 17 times. Frank tells Burke's daughter that the technology is meant to "keep the body alive until the brain and the heart are ready to go on their own." But brain and heart are fragile and often traumatized tissue in Frank's world. As long as death is regarded as the enemy and saving someone always means defeating death, Frank cannot resolve his guilt.

The other healing technology central to the film is mouth-to-mouth resuscitation. The paramedics, whose world is filled with bodily fluids, pestilence, disease and dirt, discuss mouth-to-mouth resuscitation with both anxiety and awe. A pathway to Frank's healing and sense of forgiveness is suggested when he bends over Noel, a crazed and bleeding street person who has claimed he wants to die, and gently breathes life back into him.

Scorsese draws us into Frank's frantic and off-kilter world. Stark lights flash in the night, madness and violence burst forth. At times the image jumps 90 degrees and the action seems to be rushing along in a horizontal universe. At other mo­ments the pace slows as Frank reflects on his demons, only to be jerked forward by some fresh explosive intrusion.

Like Jesus in The Last Temptation of Christ, Frank longs to turn from his vocation but cannot free himself from it. By the film's end, he breaks through to renewed hope, understanding more fully something he said during an earlier reflection on his tortured work: "All bodies leave their mark."