Follow Here To Purchase The First To Say No

Author: Charles C. Anderson

Publisher: Outskirts Press

ISBN: 978-1-4327-9101-8

Prepare to be shocked by the context and details of this thriller set in an urban neighborhood overrun by crime. The main action is around the daily practice and politics of a hospital emergency department struggling for survival in an age when patients’ rights rule. A gang called The Plague has learned to game the health care system to sustain their addictions and justify their killing.

Two women who have had more than enough of this violence and the cowardice of the authorities (including their administrators) decide to take matters into their own hands. They have the knowledge and skills to rid the town of this vermin, so secretly work out a plan. Gradually they are joined by others whose lives have been “plagued” by thugs moving in where the police have been persuaded to be ineffective. Will the vigilantes get away with it? They are being watched.

First To Say No is fantasy, but underlying the fiction is reality, and the author, as an emergency room physician for 38 years, has seen every patient situation he writes about. He also knows that healthcare workers are more likely to get assaulted than are law officers. I won’t describe any atrocities he introduces into this plot. It’s best you stumble into them without warning.

Doctors Elita Romanov and Kate Taylor work in a world where some of their colleagues have died as a result of federally-mandated “good intentions.” You might glean that there are political views woven into this novel, and I won’t deny that I struggled with them. The book presents a heck of a good debate on hot potato topics. Reading FIRST TO SAY NO is quite like being shaken at the shoulders by the hands of a frustrated parent.

The author writes that he is worried there will not be enough people willing to be healthcare workers to serve the “boomer generation.” The book serves as a reality check for those of us who, like the fictional Parkview board of trustees, live decent lives protected by our assumption that criminals can be reformed, or at least they can be understood as victims of their culture. The fact is they live among us and proliferate, and they make our lives hell. There is yet more to concern us: Anderson shows that hospitals cannot respond as we might hope if they have succumbed to the hypocritical oath: First, do no harm to the shareholders.

This is pretty ugly stuff, and probably not good bedtime reading. Yet I can say one of the joys of tackling this novel is that I now know how to poison my enemies. Perhaps Dr. Anderson overstated the efficacy of the method used so as not to be liable for any crimes committed by readers; however, he is fastidious in describing every other procedure, at times dishing out more technical information than I could absorb. What I did absorb is the moral implication of inaction. Doctors and nurses always must act. Most of us would hesitate. In the words of the character Elita, formerly a sniper in Chechnya:

“Killing a human being is an awful thing. In the beginning I thought I was losing a part of my soul with each shot. But there’re things that are worse than killing a human being — like being a coward. If you can’t find the courage to fight back when someone tortures and kills your family and friends, you lose even more of your soul.”

Dr. Anderson appeals to our imaginations by giving us medically trained superheroes. He gives us a piece of the action by inviting us to identify with the more ordinary citizens who feel victimized and are willing to join in war against The Plague. As in the addictive comic book adventures of our formative years, the strength of their convictions is hugely satisfying. Still, I think Anderson wants us to do more than reach for the next story. Legally.