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Verdict: Another deft Scorsese autopsy of New York after dark and the dark night of one man's soul.

Details: Starring Nicolas Cage and Patricia Arquette. Directed by Martin Scorsese. Rated R for gritty violent content, drug use and profanity. 2 hours, 1 minute.

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Review: When a cast list includes credits like "Homeless Suicide" or "Man With Bleeding Foot," you have every right to think you're watching an episode of "ER."

And, in a way, that's what "Bringing Out the Dead" is. Only, as the "South Park" movie bragged, "bigger, longer and uncut." Which, given that the director is Martin Scorsese, translates into grungier, more brutal and a downer. But no one does downers better than Scorsese, and, despite a central narrative flaw, this one's a doozy.

Loosely based on Joe Connelly's semiautobiographical best seller, the picture follows a few days in the life of a New York City paramedic (Nicolas Cage in full "Leaving Las Vegas" mode, so gutter ripe you can almost smell him). Cage's beat is the mean, messy streets of Hell's Kitchen, on the aptly named graveyard shift. He's alcoholic, sleep-deprived and sick of his job. Worse, he's soul-sick, haunted by the ghosts of the people he couldn't save.

He has come to believe "in spirits leaving the body and not wanting to come back," and that his role is "less about saving lives than bearing witness." But that doesn't keep his ghosts at bay. He hasn't saved a life in months, and he's become particularly obsessed with a young woman named Rosa, whose face he sees everywhere.

The script, by longtime Scorsese collaborator Paul Schrader, can't help but echo their most famous film, "Taxi Driver." The same neon nightmare of after-hours Manhattan (though, in the ensuing two decades, Scorsese's camera work has gotten a lot flashier). The same episodic sense of chaos on a cruise from one incident (passenger, victim) to the next.

The difference is that Robert De Niro's Travis Bickle was bonkers; Cage is a burnout case. What they share is what all Scorsese's protagonists have in common: an aching need for absolution. In one epiphany of a scene, Cage pictures his ghosts pulling one another out of the fetid pavement — spirits rescuing other spirits. Yet he can't forgive himself, for Rosa or for all the other Rosas.

Where the movie skids is in its attempt to create a central plot involving a heart attack victim and his repressed, strung-out daughter (Patricia Arquette, who just coincidentally is also Mrs. Nicolas Cage). The father, caught in an endless cycle of tubes and sedatives, becomes emblematic of all those spirits that don't want to be chained to their body. Arquette, meanwhile, is supposed to add a kind of romantic interest or at least an emotional safe harbor of sorts for Cage.

It's hard to say whether the fault is Arquette's acting or her poorly written character (Schrader and Scorsese still sometimes have female trouble). Either way, the scenes focusing on her and Cage feel forced. Like an unwanted interruption of what's really going on: the madness and mess of the paramedics' job.

The movie jumps to life when Cage and his various partners (John Goodman, Ving Rhames, Tom Sizemore, all excellent) go careening through the streets on their emergency calls. And the calls range from the dead serious to the absurd ("a woman says she's been abducted by her cat," reports the unseen dispatcher, voiced by Scorsese). For every gunshot wound to the chest, there's the requisite visit to pick up "our most frequent flier," a smelly old drunk who always passes out on the sidewalk instead of in the privacy of his own place. Plus, watch for singer Marc Anthony as a sympathetic loony and emergency room regular looking like a fugitive from a "Godspell" revival.

The picture's episodic nature can mean something of a rough ride for audiences. Plus, there's no true catharsis. The peace Cage finally finds doesn't have the full emotional resolution it strives for.

Still, Scorsese has delivered a film that's both savage and sorrowing. One that suggests that, sometimes, the life you save may be your own. And that in itself can be enough.

— Eleanor Ringel Gillespie, Cox News Service

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