A THRILLER FROM THE FRONT LINES OF EMERGENCY MEDICINE
What if someone decided your life wasn't worth the drive?
Denver paramedic Oliver Adams can tell which calls will end badly before he even gets there, and he is starting to suspect he isn't the only one who can.
First, Do No Harm is the debut novel by Ryan Herrington
Former Denver paramedic
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10 years on the streets
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Inspired by real 911 calls
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Former Denver paramedic - 10 years on the streets - Inspired by real 911 calls -
Written by a former paramedic.
Inspired by real calls.
I spent ten years on Denver ambulances, which means I spent a good part of my life in other people's kitchens and bathrooms, on the narrow strips of carpet between a bed and the wall, and always working on somebody while their family stood in the doorway trying not to make a sound. It's intimate and close work -and sometimes you can learn about a person's whole life just looking at their nightstand.
What took me longer to understand was how much of these calls were sometimes settled before I ever got the address: what would be authorized, what would be covered, how fast anyone was coming, and for whom. Those decisions belong more and more to systems these days, and those systems have never knelt on a floor beside someone struggling to take their last breath.
That part is real. The rest of this book is mine, and so is the body count.
First, Do No Harm
Sixteen years on Denver ambulances have taught Oliver Adams what a room tells you before anyone in it speaks. He has worked gunshot wounds on stairwell landings, kept a cop breathing long enough to reach the trauma bay, and learned to read a scene the way other people read weather.
Then the calls start coming in wrong. Nothing dramatic -a rig routed the long way around, a delay nobody ordered, a patient who was already behind before Oliver ever knelt down next to him. He notices. Then he keeps noticing, past the point where it would be easier to stop.
The trainee riding beside him is the best young medic he has ever taught. Unhurried, precise, kind to the families. He also knows things about Oliver's sixteen years that were never written down.
I cut the algorithm line entirely. A jacket that names the antagonist in the last sentence has spent its own mystery, and the only variable the system cannot predict puts you back in the arithmetic you told me you don't like. Ending on never written down leaves the reader with the question instead of the answer, and the threat is already in the room — the paragraph just doesn't say what it is.
The Knife & Gun Club was the grim but enduring nickname for the emergency department at Denver General Hospital, now Denver Health. It emerged in the 1980s and early ’90s, when the ER became one of the busiest urban trauma centers in the country. Weekend nights often looked like combat triage: stabbings, gunshots, assaults, overdoses, domestic violence.
It was never meant to be flippant. It was a survival tactic. A hard truth carried with dark humor so it didn’t crush the people who had to live with it.
It’s not that far from the truth. Or our future.
I didn't invent the paranoia in First, Do No Harm. I found it -in dispatch logs, court filings, news articles, and from people who'd only talk if their names stayed out of it.
If you think I'm exaggerating the stakes, the cover-ups, or how far an institution will go to protect itself, read the source material yourself.