A THRILLER FROM THE FRONT LINES OF EMERGENCY MEDICINE
Some lives cost
too much to save.
Denver paramedic Oliver Adams can tell which calls will end badly before he 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 have spent a good part of my life in other people's kitchens, bathrooms, on the narrow strip of carpet between a bed and the wall , and working on somebody while their family stands in the doorway and tries not to make a sound. It's intimate and close work -you can learn a person's whole life off their nightstand.
What took me longer to understand was how much of that call was 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 to systems now, and the systems have never knelt on anybody's floor.
That much 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.