If you love urban fantasy books where the supernatural world collides with everyday professions, Extreme Medical Services by Jamie Davis opens with exactly the kind of scene that hooks readers for the long haul: a paramedic wrestling a shifting werewolf to administer a glucagon injection.

The book’s prologue does not ease you in. Dean Flynn, a freshly minted paramedic on his very first shift, finds himself in a suburban bedroom helping his veteran partner Brynne Garvey pin down a snarling, half-shifted lycanthrope named Bob — who, once stabilized, turns out to be a CPA and a member of the Chamber of Commerce with a poorly managed diabetic condition.

Why readers who love the “hidden world” trope are obsessed with this opening

The hidden world trope — where a protagonist discovers that monsters, magic, or supernatural beings exist alongside ordinary humans — is one of the most beloved setups in urban fantasy. What makes the prologue of Extreme Medical Services stand out is the speed and specificity of the reveal. Within three pages, readers learn that werewolves prefer to be called “lycans,” that hypoglycemia triggers involuntary shifting, and that the city of Elk City has a dedicated EMS unit for what are called “Unusuals.”

This is not a world where supernatural creatures are rare or alarming to everyone. For Brynne, Bob is a repeat patient. She has his medication history. She knows his estranged wife used to help manage his insulin. The monsters here are neighbors, coworkers, and clients — they just happen to grow claws when their blood sugar drops.

The competent female lead readers are looking for

Brynne Garvey is five-foot-two, ponytailed, and physically restraining a shifting werewolf with one leg while giving calm, gritted-teeth orders. She is the kind of experienced, unflappable female character that paranormal romance and urban fantasy readers specifically seek out — someone defined by her skills and her attitude, not by her relationship to the male protagonist. For readers who search for “strong female lead urban fantasy” or “paranormal series with competent women,” the prologue delivers that promise immediately.

What this book is for readers who love Jim Butcher or Patricia Briggs

Readers who enjoy the Harry Dresden Files, the Mercy Thompson series, or any urban fantasy where the supernatural operates through recognizable institutions will find the world-building of Extreme Medical Services immediately satisfying. It answers the practical question those series often leave open: who takes care of the Unusuals when they get hurt? The answer, in Jamie Davis’s world, is a small, specialized EMS crew working out of a regular firehouse in a mid-sized American city.

The prologue is a master class in genre-specific reader satisfaction. It is action-first, lore-efficient, and funny in exactly the right places. Bob the werewolf eating a peanut butter sandwich and apologizing for the trouble while Brynne has him sign a transport refusal form on a tablet — that single image contains an entire promise about the tone of everything that follows.

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Prologue

Dean couldn’t believe what was happening. He was in a darkened bedroom lit only by a single overhead light and the flashlights of him and his partner. A struggle was taking place on the bed in the corner, accompanied by grunting, growls, and shouts of the two paramedics and their patient. A diminutive dark-haired female was wrestling with a large, snarling, furry creature on the bed.

“Get me the glucagon,” Brynne Garvey said. “Right now!” Brynne is a lot stronger than she looks, Dean thought as he struggled to figure out how to reconstitute the powdered drug in the preloaded syringe. She was only about five foot two inches tall and her long, straight brown hair pulled back in a ponytail made her look younger than her 34 years.

“Probie. I. Need. That. Syringe,” she said through gritted teeth.

“I’m coming, I’m coming. I’ve never used one of these prefab syringes before.” Dean finally got the syringe assembled and handed it to his preceptor. “Here.”

“I can’t do the injection. I’m a little busy here,” she said as she grabbed one of the creature’s flailing arms and pinned it to its body with one leg. She avoided the claws that had spontaneously grown out of the creature’s fingertips. “You do it, Probie! It’s time you stepped up your game and showed me why you got this gig to begin with.” The struggle on the bed intensified as the snarling creature seemed to sprout more body hair and grew even stronger. “Do it! Glucagon! Now!” The last was almost a whisper.

Hesitantly, Dean stepped forward and injected the syringe into the hairy thigh of the creature struggling with his partner.

As the beast continued to struggle, Brynne muttered under her breath. “Humans are much easier to deal with.”

*   *   *

A normal-looking man, wearing the same shorts and t-shirt as the creature Brynne had been wrestling with, was sitting on the edge of the bed eating a peanut butter sandwich.

“I’m sorry, Brynne. I must’ve dozed off after my insulin shot tonight.”

“You’ve got to be more careful, Bob,” Brynne said as she zipped up the medication bag. “That’s the third time this month. You’re going to hurt someone one of these days. Here, sign this transport refusal so we can go.” She handed the patient a tablet computer that Bob signed with a finger.

The paramedics picked up their gear and headed out to the ambulance. Dean climbed into the passenger seat staring straight ahead as his new partner and preceptor started the engine. The diesel motor growled to life. “So werewolves are…” Dean started.

“…real,” she finished. “And whenever anything causes a lycan — and they prefer being called lycan — to have altered mental status, they lose control and shape shift. That is the cause of most attacks, by the way. They aren’t that bloodthirsty. Bob’s a CPA and a member of the Chamber of Commerce.”

“And our job is to…” Dean started.

“…treat known or suspected Unusuals who need emergency medical attention.” Brynne glanced over at him. “It’s not all that tough. They’re mostly human, but not. You apply human anatomy and physiology then diagnose the problem based on what you know about the type of Unusual you’re dealing with.”

Dean shook his head. “So I worked my butt off to graduate at the head of my class, aced my NREMT exam on the first try and I get rewarded by getting assigned to be a paramedic for monsters?”

“Unusuals!” Brynne said as she gunned the engine and pulled away from the nondescript suburban home. “Look, Dean, I know this is a bit of a shock to you. Believe me, I didn’t ask to break in a new partner. The job is hard enough without dealing with a brand new paramedic unfamiliar with this type of specialized work. I was hoping to get paired with somebody who had some real street experience — someone who knows what kind of things we’re likely to run into — but it looks like we’re stuck with each other.”

Unusuals… werewolf CPA, lycan… Dean’s mind was trying to put it all in perspective.

She glanced over at him as she drove. She must have seen the shocked look on his face and shook her head.

“Say something. I need to know you’re tracking what I’m telling you.” After a pause, she raised her voice. “Dean, answer me.”

“What do you want me to say?” Dean snapped back. “I finish school and start on what I think is my dream job — saving lives, making a difference — and now I’m… hell, I’m not sure what I’m doing!”

“You are saving lives and making a difference to people who don’t need to be ostracized. You can apply for a transfer from the chief after this shift is done. For now you need to listen carefully to what I have to say or you’re going to end up getting hurt. Worse, you could get me hurt.” Brynne glared at him. “I need you to listen to me like you would any of your academy preceptors. On a call, do what I say, when I say it, without question. A lot of the folks we serve are a bit prickly about how the rest of society views them. We need to tread carefully. For you, that means stay right next to me and keep your mouth shut. When I ask for something from our kit or the back of the unit, you hop to it and get what I need. Got it?”

“Uh, yeah, I guess so,” Dean replied. He looked out the window as the Elk City streetlights went by in the night, the overhead lights forming little pools of light surrounded by what he realized were too many shadows. Shadows that apparently really do have monsters hiding in them. He looked over at Brynne, “Tell me again just what happened back there. Clearly you’ve been to that house before and knew that guy.”

“Bob is an okay guy,” she began. “We didn’t start to get calls to his house until recently. He and his wife are separated, and I think she used to help him treat his diabetes and keep his blood sugar levels even. Since she left we’ve been there a bunch of times to handle what dispatch alerts as an ‘agitated subject’.”

Brynne pulled the ambulance into a strip mall parking lot and stopped in front of the Dollar Store. Putting the vehicle in park, she turned in her seat and looked at Dean. The overhead lights in the parking lot lit up the left side of her face. “Look, Dean, you must have some mad skills or you wouldn’t have been assigned to this unit. You just need to take the stuff you know and apply it to a new situation. Unusuals are people just like us for the most part. Think of the things you know about paramedic medicine and apply it to a new population of patients with some different physiological quirks.”

Dean was starting to calm down a little. “But it’s a whole new world out there, isn’t it? I mean…” He trailed off, unable to get his mind around what he was saying.

“Yes, it is. But you were chosen for this. From what your instructor, Mike Farver, told me, you’re the best he’s ever graduated from that program. I just need you to apply those skills you’ve worked so hard to gain. Can you do that?”

Dean took a deep breath and let it out slowly. He could feel his pulse settling down. “Yeah, I can do that.”

“Good,” she said as she put the vehicle in drive and pulled out of the lot. “Then let’s get back to the station and see what the rest of the night holds for us. And Probie? Next time, have the damn glucagon kit ready before we reach the door.”

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