This movie (1999) is not as metaphysical or spiritual as are some others. It is really more of a psychological study. Its focus is Frank, an e.m.s driver, and his companion-drivers, who are often eccentric to the point of semisanity.
In fact, "semisanity" might well describe the state of the whole movie. It seems quite surrealistic in places, and it is not at all helped by a soundtrack that can be intrusive, disconcerting, abrasive, and out-of-place.
But if you can follow it, the general story-line is an excellent one. It studies the mind of Frank, as he goes through various stages of speculation about the afterlife, disappointment and guilt about a girl whom he was unable to revive, exhaustion, drug-intoxication (one scene is psychedelic), overstress, anxiety, tenacity, determination, and many other states of mind. This is a "rollercoaster" of a movie-- disjointed, quick-moving, and abrupt. A subtheme of the movie is Patrick Burke--a man who is in the process of dying, and whom Frank finally "lets go," to the relief and gratitude of all-- most of all, Patrick himself and his daughter Mary, with whom Frank has a semipassionate and semiromantic relationship.
This movie is very difficult to place into convenient categories. In this way, it is like real life. It is quite realistic, and so, uses some rather strong language, and that, rather frequently. At one point, Frank is recalling his successes, which make him feel like "God," and his failures, which make him feel like "the god of hellfire." Frank is a very sensitive guy, a specimen of the real but usually unsung heroes who man ambulances, and who keep people alive, including "drunks, whores, and other unworthies."
The film does criticize what people often do to themselves. It takes place in New York, where one must be quite strong to survive. From beginning til the end, Frank is haunted by a young girl named Rose, whom he sees, at times, everywhere.
She appears on the face of Mary, and on several strangers' faces. He explains to her, with deep sincerity, that he was unable to save her, but he did his very best, and seems to find final forgiveness. Despite its absence of many metaphysical or spiritual themes, this film is worth seeing, if for nothing else, then for its revelations of the troubled and stressful minds of ems-drivers.