In the heart of Manhattan, Frank Pierce, a paramedic haunted by depression, insomnia, and feelings of failure, grapples with the emotional toll of his job. After a traumatic incident in which he couldn't save a homeless teen named Rose, he begins to see her ghost haunting his thoughts. It is during one tumultuous night that Frank, along with his partner Larry, answers a distress call from the family of Mr. Burke, who is in cardiac arrest. There, he meets Burke’s troubled daughter, Mary, a recovering addict, and learns of her link to Noel, a frequent hospital visitor battling drug addiction.
As their night progresses, Frank and Larry find themselves addressing the grim aftermath of gun violence. It is here that Frank encounters a victim whose sleeve reveals vials of "Red Death" heroin. Before they can reach the hospital, the victim, attempting to make amends for his past as a drug dealer, succumbs to his injuries, further deepening Frank's emotional scars.
The next day, Frank partners with the enthusiastic and deeply religious Marcus. During a club emergency, they discover that a man is actually suffering from a Red Death overdose rather than a cardiac incident. As Frank administers Narcan, Marcus holds a prayer circle, and miraculously, the man regains consciousness amidst the chaos.
On their return trip to the hospital, Frank takes a moment to visit Mary and share good news about her father’s stable condition. However, the day takes a darker turn when they respond to a call involving a mother giving birth to twins. While they succeed in getting the mother and one twin to the hospital, tragedy strikes when the second twin cannot be revived. Overwhelmed, Frank turns to alcohol, leading to a reckless accident in the ambulance, though he and Marcus escape unharmed.
The following morning, Frank again crosses paths with Mary, who leads him to a drug den run by Cy Coates. After learning that Mary has relapsed, Frank is pushed to desperation and, succumbing to temptation, takes drugs himself. This act plunges him further into hallucinations of his deceased patients. After sobering up, he insists on taking Mary out of the den, but soon finds himself tormented by Burke’s voice, urging him to let go of life, yet Frank chooses to revive him.
On another shift, Frank is teamed up with Tom Wolls, a man whose fervor for saving lives is accompanied by a volatile nature. When they respond to a call at Cy’s den, they discover chaos ensuing from a shooting. In a harrowing moment, Frank clings to Cy as emergency services attempt to rescue them both from a perilous situation. Cy survives this, marking the first life saved by Frank in months, but this accomplishment is bittersweet.
Later, Frank's mental state continues to deteriorate as he agrees to assist Tom in confronting Noel, leading to a violent encounter. Just as Tom prepares to unleash his anger, Frank intervenes to protect Noel, illustrating his struggle between moral duty and personal turmoil. After visiting Burke again, ultimately giving in to the relentless whisperings of his conscience, Frank purposefully disconnects Burke's life support.
In the poignant conclusion, Frank informs Mary of her father's passing, culminating in a final vision of his long-lost patient Rose, from whom he seeks forgiveness. With the weight of their shared grief, Mary invites Frank in, where they find a moment of solace as he finally falls asleep beside her.
