Nurse Jackie. 10:30-11 p.m.

Monday. Showtime.

''Do you realize you're the only sane one there?'' an admiring doctor asks Nurse Jackie Peyton during a lunchtime break from the All Saints Hospital emergency room. The smile Jackie flashes in return is as blank and concealing as the surgical mask she wears at the hospital, where her world is in an increasingly wobbly orbit that could crash at any minute.

Her hard-bitten demeanor (''I don't do chatty -- I like quiet; quiet and mean, those are my people'') shrouds an obsessive need to balance moral equations in an uncaring universe: She steals a wad of cash from a rapist to give a pregnant young widow, forges the organ-donor card of a brain-dead patient, tosses a severed ear down the toilet before it can be reattached to the head of a thug.

Between these Dirty Harriet moments, Jackie lives in a dreamy world backlit with the Percocet she mixes with Sweet'N Low, obtained from the hospital pharmacist with whom she frantically couples in a supply room every day at noon. Whether the affair is fueled by love, seedy eroticism or addiction is one equation Jackie leaves unbalanced: ``I know a good buzz when I see one.''

Grimly funny, streaked with sentimentality and malice, Nurse Jackie is the medical miracle of television's summer season, a blue-collar hospital show without a McDreamy in sight. Edie Falco, whose performance as the Faustian mafia princess Carmela in The Sopranos won her three Emmys, is a marvel as the erratic, embattled Jackie. ''Push down and turn,'' she muses as she opens a pill bottle. ``The Jackie Peyton story.''

It's a story peopled with dotty but intriguing characters. Jackie's best friend is Eleanor O'Hara (British stage actress Eve Best), an independently wealthy doctor (asked why she doesn't dry-clean clothes rather than throwing them away, she sniffs, ''I saw it in a movie once; it seems tedious'') who makes no secret of her disdain for patients. Even less stable: Dr. Fitch Cooper (Peter Facinelli, Twilight), a breezy Ivy Leaguer given to drive-by diagnoses and -- when they go wrong -- bipolar mania, including the compulsive grabbing of breasts.

The dysfunction has spread to Jackie's home, where her somber 10-year-old daughter prefers documentaries like Viral Armageddon: Death Knell For Mankind to the Cartoon Network. Jackie accepts it as one more tottering step toward the brink, just as she does when that telltale ear bobs back into her life with misfortune for all concerned.

''The one time I flush a body part, the plumbing backs up?'' she plaintively demands of the universe.

In Nurse Jackie, there's no sign anybody's listening, not even the Percocet.

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