With his features Johnny Mad Dog and A Prayer Before Dawn — the former a breakneck, road-to-ruin chronicle of child soldiers in war-torn Liberia and the latter a visceral portrait of a British expat, imprisoned in Thailand on a drug charge and conscripted into a violent kickboxing competition — French-born director  Jean-Stéphane Sauvaire has consistently dropped viewers into extreme, ultra-violent scenarios, employing a mis-en-scene steeped in hyper-graphic realism to compel a one-to-one relationship between his audience and protagonists.

His most recent feature, Asphalt City, is no different. Sauvaire’s first film to shoot in the US, where he has lived for over a decade, it is a relentless, unyielding crash course in the hectic and often brutal world of NYC paramedics. The picture stars Tye Sheridan and Sean Penn, both of whom also produced, and in addition to the captivating work of its two leads features inspired bows from its supporting cast, including Michael Pitt, Raquel Nave, Katherine Waterston, and Mike Tyson]. The film debuted in the main competition at the 2023 Cannes Film Festival under its original title Black Flies, the same as Shannon Burke’s 2008 source novel (adapted here by Ben Mac Brown and Ryan King), which drew on the author’s own experiences as a paramedic working beats in Harlem and Washington Heights. 

Filmmaker spoke to Sauvaire from his home in Bushwick, Brooklyn. Asphalt City opens theatrically on Friday, March 29 from Vertical and Roadside Attractions.

Filmmaker: When did you enter into this project? How did Shannon Burke’s book find you?

Sauvaire: There were two producers — Christopher Kopp, who used to work at Focus with James Schamus, and Lucan Toh — who sent me this book. They had heard about the book from Ryan King, who was an actor, and at one point it was optioned by Darren Aronovsky. The rights were free, I read it and just said, “This is amazing.” It’s based on the reality of Shannon, which I really like, because it’s not bullshit. It’s real and authentic and an interesting portrait of New York. So I said, “I would love to do it, but it’s gonna be tough to finance.” They felt like they could finance it, and we went forward with Ryan writing the first draft.

Filmmaker: But that’s not the draft that got made, or the one that ended up on the Blacklist. What changed?

Sauvaire: The first draft was very faithful to the book and based on the ’90s in Harlem. I knew I couldn’t do a period movie because it was going to be too expensive. I didn’t want the money to have to pay for [period] cars and stuff on the street. The way I like to shoot, to get the reality [of the subject], I thought it just didn’t make sense. So at that point, I said, “Let’s do another pass, and try to readapt Shannon’s book to these modern days.”

Filmmaker: Were you already deep into the research by then?

Sauvaire: That’s really where I got started with my research. You know, I like to have a base, a map. Then, we go into the reality.

Filmmaker: It seems like you shot some of it near where I used to visit you, off the Myrtle-Broadway stop, at your bar, Bizarre.

Sauvaire: I had to close the bar during Covid, but we shot all the stuff with Ollie’s girlfriend [played by Raquel Nave] here, because we couldn’t get the location we wanted at the last minute. And also the scene with the dead body, the woman covered in black flies, in the bathtub, we shot that upstairs too. That was funny because the actor who played the body, she was a SAG actress, and I had [cast] mostly non-professionals. But that day, she wanted to know, “How do you want me to play the woman? Open eyes, closed eyes, makeup?” That was tough because she had to lie there, not breathing, for a long time. We were in the middle of the scene, and the line producer came rushing in and said, “I need to interrupt, we need to have a security meeting, there was a shooting just now on the street outside.”

Filmmaker: Yeah, that’s Brooklyn. Anything goes. So where was your point of access in terms of research?

Sauvaire: My ride alongs were with the Wyckoff Heights Hospital EMS.

Filmmaker: Okay. So, that’s Bushwick, pretty near the same area as your house.

Sauvaire: Yeah, the hospital is not too far from me here, but also, it’s a private hospital, so because of that, I could get the permits. In New York, it’s usually, “Okay, you’re not students, we cannot give you access, you cannot do a ride-along like this…” And they did seem kind of worried about what the film was gonna be, even with Shannon as a part of the project. [When Shannon was working as an EMT], they were [just starting to be] part of the FDNY, at that time. And so the FDNY was kind of worried about what the film is gonna be.

Filmmaker: That makes sense. It’s a rough line of work, and they have a lot of issues with their personnel.

Sauvaire: Exactly. So I was working with Wyckoff, getting the permits, getting into the back of the ambulance for two years, doing these ride-alongs, seeing all the reality of these neighborhoods.

Filmmaker: Which areas were you working in?

Sauvaire: Mostly Brooklyn, between Bushwick, Bed-Stuy, Brownsville, East New York, and some areas south of there. It was great to do this work with them because it helped us to adapt the script to the reality of these days.

Filmmaker: I want to ask you a couple questions about process, and it might be helpful to set them up in a way that includes your other work. Between Johnny Mad Dog, A Prayer Before Dawn, and, now, Asphalt City, it feels like there’s some connective energy that’s derived from your working methods. There’s a focus on immersive, experiential views of young men who are put into violent, intense, extraordinary situations, and then in one way or another, either have to fight their way out or manage simply to survive. Forgive the preamble, but how did you come to that approach? Was it just an organic conclusion based on your interests or a deliberately designed choice?

Sauvaire: I just think that this is the way I feel more comfortable. I like having the camera as this free thing and trying to capture the reality more than trying to recreate the reality. That’s why we shoot mostly in a 360 axis, with the camera either on their shoulder or on a stabilizer — to be able to go all the way around.

Filmmaker: Johnny Mad Dog’s titular character, Prayer’s Billy Moore, and Ollie in Asphalt City all present as ciphers — people we don’t really learn very much about, except for how they manage these experiences.

Sauvaire: Yes and also I do like the main character to be the one who can sort of introduce us to this kind of world. We’re gonna dig in. I realized that every script that I received where I was attracted [to the material], it was always one where it could become an experience of life for myself as well. It could be a world that I could really dig into and also, I think, one for the actor through the main character. The movie is a way for the audience to get to share the same experience [as the characters]. That’s what I love in movies — trying to share an experience and discover, maybe, a world I didn’t know.

Filmmaker: So it’s the discovery that guides you, the allure or intrigue of it being a somewhat alien life experience or scenario you’re depicting?

Sauvaire: Well, with EMS work, I don’t really know much about it, and not having the cinema as a reference, but more the real life as a reference…

Filmmaker: Much of the time people use films as a reference for these kinds of hardcore, frontline occupations like EMS work.

Sauvaire: Yes, but the reality is sometimes different and more interesting than what films show, and that’s why I do it this way, even with the prisoners in Prayer Before Dawn, you know, to hear their own story, and to have the non-professional actors be able to translate, as well, their own world and their own problems. It was the same with Black Flies / Asphalt City because it’s important for me to have real people, non-professional actors, to tell their own testimony, their own experience of life, their own suffering, their own lives, instead of me having an actor [play them] as a stereotype maybe. And yes, maybe we’re all stereotypes of ourselves, you know? But I like this kind of mix between documentary and fiction, and to be able to get this immersive kind of feeling [for the] audience. I knew when they came to me with the book that I would love to dig into this world because [for an audience], it’s gonna be a great experience to be in the back of the ambulance. And there are not that many movies about paramedics.

Filmmaker: Besides Bringing Out the Dead, which clearly left its mark and sets a high bar, I can only think of Broken Vessels, which I doubt very many people have seen.

Sauvaire: Exactly. And of course, everyone compared us to the Scorsese film.

Filmmaker: It seems like a lazy comparison. But I didn’t get any kind of similar vibe from your movie — it’s much more immersive, and far less plot-oriented than the Scorsese. Did you reference Bringing Out the Dead at all?

Sauvaire: I never tried to. When there’s a strong film like the Scorsese movie I would never try to make a film in reference [to that], because it would have been stupid. I said, “Let me do it the way I feel I can do it, without any reference.” How a French guy could come and make another film [like Bringing Out the Dead], after Bringing Out the Dead?

Filmmaker: You’re definitely putting up on the screen a sort of psychological New York that isn’t so often seen or experienced by many people, either firsthand in their own lives or through films. It really does project the viewer into the experience of being with these EMTs, because essentially, emergency first responders are the only people who get to see some of these places outside of the people who call for help. And especially if NYPD doesn’t respond to the call, EMS might be the only ones there in a lot of these places. I’m referring to the more indigent, desperate housing situations, like the shelters or clinics depicted in the movie.

Sauvaire: Yeah, and also, I mean, people don’t understand. Most of my friends, they see it and say, “Oh, that’s just New York.” But it’s not. They don’t understand that if you call 911, it is because you are already in an emergency situation, meaning many people in Bushwick don’t have medical insurance. In France, it’s hard for us to imagine that they are waiting till the last possible moment because they couldn’t go to the hospital before. So when they call, it’s the only possibility they have. And they know they’re gonna have to pay a lot of money. So they don’t want to go to the hospital at all.

Filmmaker: They have no choice.

Sauvaire: Exactly. So you create this kind of conflict all the time with people who want to save lives, the paramedics, and the people [they’re called to help], who don’t want to go to the hospital, and that’s the reality of not only New York City but the whole healthcare system in the US. I hope the movie can give light and show the kind of problem we have in the States right now in the healthcare system. People [who see the film] might say, “Oh, it’s so dark…” But that’s the reality.

Filmmaker: A lot of the patients in the film, they seem at odds with EM, because EMS is naturally associated with FDNY and then therefore associated by second degree with the cops. You show the EMTs constantly having to reiterate to their patients, “We’re not the cops, we’re not the cops.”

Sauvaire: These characters find different ways to be able to survive with this level of violence. And that’s how I think all my movies are in some way the same. [They’re about] how you can survive the violence and fight the violence and find yourself in the world around you. You know the world is pretty violent and difficult. It’s extreme for some people but not that much for a lot of people. It’s a tough city, New York. It’s really expensive, and you have to work to survive. But people don’t see this reality, and me as a French guy coming here in 2009 — even I was surprised to discover this kind of place. It’s something we don’t see much in movies anymore. In the ’70s and ’80s, maybe. Back then you had this kind of cinema, showing this type of reality. Now, not much. But cinema is an illusion and reality [at the same time]. And it’s hard for people when you talk about the reality, because they want to reject it and don’t want to see it. And I think if we don’t, if we want to change this world, we have to try to see the reality as it is.

Filmmaker: A lot of moments in the film — when they’re working on someone in cardiac arrest, or trying to intubate a patient and struggling to get the tube in in time — are excruciating to watch. And then you realize — this is a moment-to-moment, split-second challenge that these EMS workers confront on the regular.

Sauvaire: Someone who saw the film asked me, “Is this really the reality?” And I said yes. Imagine when you are in the ambulance, and the guy you’re taking has passed — he’s dead in front of you, and you can do nothing. And the paramedics, they have to explain to the wife, or whoever it is in the ambulance, that there’s nothing they can do. It’s even worse than that. So it may be difficult for an audience. But imagine it’s not a film. It’s not a movie.

Filmmaker: Did you experience calls like that in your research?

Sauvaire: We did one call, where the guy had died, and the family was there, and they were expecting that we could revive him. This is the woman’s husband. His relatives. And they couldn’t understand that he was dead. The wife, she started to scream, when she finally understood that. And it’s the kind of scream that stays with you because it’s not a movie scream. It’s the pain of real people. In the movie, what I really wanted was to try and see if we can understand how [these EMTs] can deal with this kind of pain in the people they try to help, every day, and how it can become a secondary trauma and their own mental health can be affected. They are between life and death, every day.

Filmmaker: It’s almost as if the film translates that experience of you in the back of the ambulance and passes it onto the audience. It’s possible some of the negative reactions to the movie are reacting to how overbearing that intensity can feel for a viewer.

Sauvaire: Yeah, I agree. But I think sometimes the cinema is here also to make you watch something you don’t want to watch. No one wants to watch the reality of the child soldier in Africa. They don’t care, and they don’t want to see this onscreen. So we exist, but we don’t want to face this kind of reality. We don’t want to be reminded of this kind of New York because that’s not our New York. And I mean — I don’t compare myself to him — but if you look at a Michael Cimino’s movies, his movies show that a lot of the time, the problem is America and the failure of America. And they rejected him because no one wants to see this kind of take on the country. They want to be given an illusion of the US as the best country in the world. But the reality is something different. As far as trying to transfer the experience [of doing ride-alongs] to the viewer, in a sense, it’s because I don’t need for someone to take my hand and tell me a story. There’s a lot of stories. So I think, sometimes, in cinema, we can do maybe something a little bit different and create more an experience than a story. Because if we feel it from inside, maybe then we can really have an opinion about it.