In my opinion, it is easily the most underrated movie directed by Martin Scorsese. When it was released, it was barely noticed and didn't get much love and even nowadays it is a considered one of Scorsese's minor efforts. Personally, I do think it is actually a very good flick and it features of those great weird performances by Nicolas Cage. You know the Cage rule, right? For every 10 movies, he will make 9 terribly bad flicks and the last one will be great, fortunately this movie is one of the few great ones. I thought there was a great dark mood and it made the whole thing rather spelbinding to watch. Furthermore, I really loved the idea of a paramedic who just starts to losing it because he has some personal issues but also because his work is just terribly depressing. I mean, paramedics are always shown as some kind of perfect righteous heroes (I'm sure many paramedics fit this description though) and I thought it was really refreshing to see one who was a real basket case. To conclude, I really loved this flick, it is totally underrated and definitely worth a look, especially if you are interested in Scorsese's work.