Squalor in the streets is the keynote of Martin Scorsese's gruelling, blood-soaked portrait of the work of a paramedic (Nicolas Cage), driven to the edge by his experiences with the hookers, junkies and derelicts in New York's ghettos.

Although it makes ER look tame, that's not a good thing, as Cage drinks to try to forget those he has failed to save.

The black comedy is overwhelmed by the despair that blankets the film.

Cage looks understandably haggard, as this is hardly an advert for the paramedic profession or the streets of America.