The lurching ambulance filmed in enhanced speed and jagged photography creates visceral involvement. We are with Frank while he is trying to save a good drug pusher impaled on a spike that, although causing him considerable pain and blood loss, is keeping him from plunging to his death. Ultimately, the movie weaves many themes, which are handled well enough by the master director Martin Scorsese. But, how much can we heap on one plate and still keep from choking with indigestion. They are the living, the junkies, pushers, patients, nurses, doctors, and other EMT s who populate this bleak urban world.
Every major character is anesthetized with some drink, drug, neurosis, or insane withdrawal.
Yes, we laughed at some of the black humor. We cringed at the brutality. We wept a bit at the blight. We were hopeful for the lovers, though it would seem their fate was far from anything but a momentary, fragile relief from the sense of loss and doom around them. Perhaps as its greatest achievement, this movie presents insight into the difficulties of dealing with someone who is alive only because he is in a hospital with the resources of modern medicine to constantly jolt him back to physical functioning.