Life and death in Hell's Kitchen

IF THE vaunted new polish of the Big Apple - the Disney neon, the demise of the murder industry, the retreat of the crack kings - is beginning to wearing you down, share a drink or several with Joe Connelly. Joe will return you in a swig to that old New York when there was mayhem in the night, human despair, filth and gunshots.

Joe has all the good stories. He even has one about the bar we are sitting in, and the vertiginous stairs down to the toilets. Among their victims was a young woman who plummeted their entire length before landing in the basement with a giant gash across her right cheek. She was due to be married the next day.

But after 10 years as an ambulance driver and medic in Hell's Kitchen on the West Side, Joe has much worse to tell. "The stabbings and the shootings, they were the best," he offers with a glint. Mostly, though, there were the drunks who would show up in Emergency three times a night. Then there were the addicts, the abused girlfriends, the gasping cardiacs. And the 15-year-old girl whose death one night in a park he still cannot explain. "Maybe she was meant to die."

You will not have to buy Joe a drink, because he has written it all down. It began as a book about himself, but later became a novel, tracking three nights on the graveyard shift with a nervous paramedic named Frank Pierce. Even the book may not have to detain you - although this reader urges that it should - because it may soon be put on celluloid by director Martin Scorsese and screenwriter Paul Schrader. If they make the film, as at the moment seems likely, it will be their first collaboration since Raging Bull and Taxi Driver.

Bringing Out The Dead is brewing up to be that rare literary phenomenon - a first novel by a total unknown, which, if the gossip is right, is set to become an instant best-seller when it comes out here next month. Knopf has ordered a print run of 50,000 copies, a huge number by any standards; Little, Brown will publish it in Britain in paperback in September.

Hilary Hale, the editor who snared the book for Little, Brown, admits that while the novel is "extraordinary and unique", her "reps might have trouble with it". It is not a thriller, because it is scant in the way of plot. Rather, it is an exhausting and often hilarious spew of all that befalls Frank and his partners on their blood-spattered night rounds in the city. "I wanted to put the readers in the ambulance, and have them experience it for themselves," says Mr Connelly.

It is a ride that takes you 80 miles an hour and then drops you, say, in the tenement top floor where three addicts are trying to reinflate the lungs of an overdosed friend who has a hair-dryer down his throat. Or at Times Square, where mad Noel, a frequent client, will beg you to kill him. (Frank demurs. "It looks bad, you know, medics killing people in the street.")

Before long you realise why Frank is falling apart and why he is haunted by Mr Burke, a cardiac he brought back to a kind of life and probably shouldn't have done, by the boy on the bicycle with a bullet in his side and by the ghost of Rose, the small girl that Frank believes he helped to kill.

Connelly, 34, who took writing courses at Columbia University between shifts, wrote the book in part just to share the stories. "They piled up. I had turned over so many stones," he said. And it was a picture of the emergency services, he thought, that had not been told before. It was not the side shown by 999 on the BBC and Rescue 911, its counterpart here, but the one where things mostly do not go right, "where people don't make it".

And thus, of course, it was also about how he healed himself, how he created a catharsis to chase away the same ghosts that still haunt Frank. "I was saving lives in my head," Mr Connelly says, looking into his beer. "By writing these stories, I'm keeping people alive, keeping them going in some way. All the lost and all the forgotten." It was, he says, his way of "writing my ticket out".

Just how good the ticket would be he can never have known. He quit his job at St Clare's Hospital last year, the very day he got the news of the Scorsese option and the $100,000 (pounds 62,500) it was bringing him. And though he misses the driving - the challenge was to make his riding partner "make a noise and preferably scream" - he will never go back. Nor is he likely to ever need to.

"If it had to happen to someone, I'm really glad it's me," he said.