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Novelist Joe Connelly, who also acted as technical advisor on the film, spent ten years as a New York City EMS worker. "It can be the greatest job in the world," he says, "but it can also be the worst. There's nothing like saving a life; it's a high like no other. Yet it's a high that fades. I found that watching people die, losing people, being witness to so many tragedies - those stories stay with you and don't leave. They built up in me to a point where I needed to tell them, to get them out. For me, in a sense, writing the book was a new way of saving lives."

Patricia Arquette is Mary Burke, the daughter of a dying man whose life Frank has attempted to save. John Goodman, Ving Rhames and Tom Sizemore are the three partners with whom Frank shares his ambulance runs. Marc Anthony, who recently starred in Paul Simon's Broadway musical "The Capeman," plays a distraught homeless man haunting the Hell's Kitchen neighborhood where Frank works. "I've been lucky," says Martin Scorsese, "that these actors are open and courageous and willing to push the edge somewhat, even if their scenes are emotionally demanding."

"What these paramedics do is extraordinary," says Scorsese. "They're like doctors of the streets. They take care of people nobody else wants to touch. It's as simple as that. The hospital is just a base; the story is really outside on the street, and in Frank's head - the journey that he takes. Maybe the people that he's lost are part of God's plan. And maybe there is no plan. It goes on like that, back and forth through his mind, throughout the picture. He brings people in, and they die, and he goes on to the next job. He takes it like a punch and then moves on like a machine to the next one. That's what's so interesting: How does one handle death in the hospital and on the streets? Also, there is an element of grace that he's finally given, but he has to come through to the other side of the night."

Joe Connelly's novel started a kind of creative chain-reaction even before it was published. Producer Scott Rudin read the book when it was still in galleys. Says Rudin, "I felt there was really only one director who could really do justice to the material, and that was Marty." Rudin brought the book to Scorsese's attention. "When I read the book," says Scorsese, "I thought, 'Who do I know who can get inside this man's spiritual crisis driving through the streets on the West Side of New York at night?' That material is laid out beautifully in the book by Joe Connelly, but the only screenwriter I know who can get inside that man's soul is Paul Schrader. He read the book, said, 'I'll do it,' and he wrote the screenplay in about three weeks."

"My reaction when I first read the book," says Schrader, "was that it was a natural for Marty and me. In fact, I also thought, 'Why haven't I thought of this?' We've both always been drawn to these occupational metaphors, and I'd thought of similar metaphors but not this one. Being a paramedic is a real tricky profession because it can have some real rock-and-roll thrills to it with some wonderful highs - and then it can just blindside you." Inevitably, a parallel to "Taxi Driver" comes to mind. "The 'Taxi Driver' comparison is there; it's unavoidable. We had to take that into consideration in making this feel like a bookend rather than a sequel. There are marked differences. Frank is a different character from Travis Bickle. This is not someone who's cooking in a broth of anger and violence. He's searching for peacefulness. He wants to sleep; to have his reward. But he feels that God has taken his hand off him, and he's become an instrument of death. Also, Travi

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