The Devil’s Ledger

After a violent call exposes subtle inconsistencies in emergency dispatch data, Denver paramedic Oliver Adams begins to see a pattern no one wants to acknowledge. Certain patients are quietly being deprioritized. Calls are being rerouted without explanation. Outcomes are no longer measured in lives saved, but in efficiency achieved and dollars saved.

As Oliver digs deeper, he uncovers an AI-driven system embedded inside emergency care itself. Built to reduce cost, liability, and so-called inefficiencies, the system makes its calculations long before the sirens sound. It decides, in two hundredths of a second, which patients are worth the resources…and which are not.

The closer Oliver gets to the truth, the harder the system pushes back. Careers unravel. Evidence vanishes. Lines are quietly redrawn. And Oliver realizes he was never supposed to see how the math really works.

The Devil’s Ledger delivers grounded emergency medicine, procedural realism, and high-stakes moral tension rooted in real-world systems already shaping modern healthcare. It’s a fast-moving, near-present conspiracy led by a flawed, human protagonist confronting institutional power.

This is the first novel in a planned series exploring what happens when human judgment is replaced by optimization, and when profit becomes the final factor in healthcare decisions.