Black Flies, also known as Asphalt City in some territories, is the latest medical thriller from director Jean-Stéphane Sauvaire (Johnny Mad Dog and A Prayer Before Dawn). Fresh from the world of medical college, rookie paramedic Ollie Cross (Tye Sheridan) finds himself paired with hard-faced veteran Gene Rutkovsky (Sean Penn) as they trawl the streets of New York City helping where they can, despite their own prejudices. But how long can Ollie keep a strong exterior? How long can his mind hold up against the stress?

Now I feel like I should offer a warning ahead of this review for any respective viewer of Black Flies, because if you are in any way squeamish then I would advise taking a bit of caution when watching this one. There’s a lot of naturally gory imagery, with a pregnancy scene late on in the film being particularly gruesome. Needless to say, don’t watch this when eating your dinner.

As for the film itself; well I think it does paint a vivid picture of what the day to day life of a paramedic would look like. There’s never a still moment, with Sauvaire playing in to a frantic and daunting sense of momentum. Our pair of intrepid paramedics never truly get a moment to themselves, Ollie especially begins to suffer as he witnesses his own inability to separate his life inside the ambulance from his life outside it which leads to a quite intense moment with his romantic partner. That central relationship between Ollie and Gene is the real crux of the film, with a strong contrast between the overly attached new comer and wildly detached veteran giving us some hidden tension as the audience is often left to wonder whether Gene will actually put some effort in to saving the lives of drug addicts or petty criminals. Sheridan and Penn have a shockingly good chemistry, with their youth and age respectively adding to their performances and the pair give it their all in trying to sell a sense of perfectly managed chaos.

But a big issue lies in the film’s central nihilism. It doesn’t exactly make the world of the paramedic something of admiration but rather something to aspire to escape. Black Flies’ alliances feel difficult to decipher, because I do think the film ends up following on the side of making people almost demonise the profession. Perhaps demonise is a strong word, but the film does steer clear of any kind of bright side to the profession; making the weight of some scenes just a bit too much for me.

On the whole I enjoyed Black Flies way more than I had anticipated to, because medical dramas really aren’t my thing. But the film’s tight focus on this age gap between its two leads keeps the film from straying in to the exploitative, although the deep nihilism the film adopts when talking directly about the paramedic profession could prove too much for some as there is no sliver lining on show here. Sauvaire certainly has sympathy for those who work in the medical profession, but I’m not quite sure the film ever steps in to empathy.