Over a decade
on the streets
Ryan Herrington / Author
The first time I worked a cardiac arrest, I was a brand-new EMT and was certain that medicine would make sense if I just learned more of it. Ten years later, I knew better. What I'd learned instead was this -the system doesn't fail people dramatically. It fails them quietly in little things like routing decisions, authorization delays, and the distance between what the protocols say to do and what the patient actually needs.
I wrote The Devil's Ledger because I couldn't stop thinking about that distance.
I'm a former paramedic, a product manager, and a writer based in Denver. I've spent my career at the intersection of medicine, technology, and the machinery that decides who gets what. This is the first book I've written where all three of those worlds showed up at once.
Ryan Herrington / Paramedic
There's an unofficial club in the Denver 911 system. There are no financial dues or applications. Membership is conferred at three in the morning, in the back of an ambulance, when you've got someone’s life in your hands. We called it the Knife and Gun Club — and in Denver, we had plenty of members.
I ran calls for over a decade in one of the nation's busiest systems. Gunshot wounds on Friday nights. Stabbings on Saturday nights that started as arguments and ended with subpoenas by Monday.
What nobody tells you about this life is how ordinary it becomes. Not the violence — the violence never becomes ordinary. But the repetition does. The clocking in, the radio traffic, the particular way the rig falls silent after a bad call. You develop a language for it that only other members understand -like shorthand for things that don't have clean words and dark humor that isn't really humor at all.
I wrote this book in that language.