Book 10 of the Extreme Medical Services series opens on a high note that readers of this series know never lasts. Dean Flynn is riding a streak of four consecutive cardiac arrest saves, joking with his partner Leah Casado and getting good-natured skepticism from Lieutenant Brynne Garvey about the odds of keeping it up. That confidence gets tested immediately when Station U is dispatched to Bob, a beloved recurring patient, a werewolf CPA whose diabetes management calls have become a familiar, almost comforting routine over the years.

This time is different. What starts as a low blood sugar call spirals into a full cardiac arrest, and despite Dean and Leah running the code by the book, nothing works. The chapter doesn’t shy away from the emotional weight of losing a patient readers, and Dean, have come to genuinely care about, especially one who was Dean’s very first Unusual patient back when he was a new paramedic.

The real hook comes in the chapter’s final moments, when Dean’s hand brushes Bob’s as they load him for transport. A jolt of blue lightning passes into him, followed by ghostly, half-formed figures at the edges of his vision and a low, wordless crooning sound only he seems to notice. It’s a quietly unsettling ending to an otherwise procedural loss, and it signals that Bob’s death is only the beginning of whatever is about to follow Dean home.

📖 Start Dean’s next case — get The Paramedic’s Siren on Jamie Davis’s site:

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The Paramedic’s Siren — Chapter 1

“These hands can do no wrong,” Dean said with a grin wide enough to punch holes in fate itself. Hopefully, fate wasn’t paying attention.

His partner, Leah Casado, came into the break room behind him. She smiled as she said, “You didn’t save that last call alone, you know.”

“You are one hundred percent correct, Leah. I should call my instructors at the academy and thank them, too.” He nudged her with an elbow and laughed.

Lieutenant Brynne Garvey looked up from her laptop at the desk in the corner. “Let me guess, you got another confirmed cardiac arrest save? Isn’t that two this month?”

“Yes,” Dean replied. “And it gives me four consecutive saves this year.”

“You know it is statistically improbable that you can keep that up. Even the best systems have trouble hitting more than a twenty-five percent save rate for cardiac arrests in the field.”

“Hey, boss lady, don’t rain on my parade here. Let us bask in the afterglow.”

Brynne nodded at Leah. “Don’t let his hubris go to your head, kiddo. This can’t last.”

“I won’t, but seriously, we’ve had everything go right on the last four full codes we’ve run.”

Dean grabbed a Diet Coke from the fridge in the corner and sniffed at the air. “Freddy, what ya cookin’ up over there? It smells delicious.”

“Water nymphs dropped off a half bushel of crabs after last week’s boat rescue. Making Maryland crab soup.”

“Amazing. You are the man, Freddy. Just the kind of victory meal I could use.”

The zombie, who was the resident chef at Station U, returned Dean’s praise with a gap-toothed grin and turned back to his giant pots of soup.

It had been a long day at work, and there were still two hours left until Dean could go home to his wife and three-year-old daughter. He walked back to the locker room and splashed some water on his face to freshen up. He’d covered a double shift, so he was at the end of twenty-four hours instead of the usual twelve. It would be good to get home, share a dinner with his family, and get some much-needed rest. He’d only gotten about two hours of sleep during the night shift.

As he walked back into the break room, the speaker on the wall squawked as the alert tones dropped. “Station U, alert for a diabetic emergency, 568 Elk Neck Circle.”

“Hey, isn’t that Bob’s new place?” Leah asked.

Dean grabbed his jacket off the back of the sofa. “He moved out there when he got remarried. He hasn’t called us in a while.”

Brynne waved from her desk. “Be safe out there.”

Leah led the way into the ambulance bay and headed for the driver’s seat. Dean walked around and climbed in on the passenger side.

“Did I ever tell you Bob was the first Unusual patient I ever treated when I was a brand new probie back in the day?” Dean asked.

Leah started up the ambulance. “You mean when you used to have to walk to the ambulance calls uphill in the snow, both ways?”

Dean laughed. “Okay, okay, I get it. I guess I need to come up with some fresh stories to tell you.”

“It’s been three and a half years. I’ve already heard them all.” Leah put the transmission in gear and pulled out of the industrial park where Station U lay hidden from most of the Elk City community. Very few people knew about the special patients they treated.

It wasn’t far to Bob’s new place, especially with their lights and sirens blaring. They pulled up in front of a small, one-story home and got out to unload their gear.

Dean shouldered the advanced life support bag, while Leah grabbed the heart monitor and oxygen bag to drop atop their stretcher. He set the ALS bag on top with the other gear, and they rolled the ambulance stretcher up to the nondescript suburban home.

“Bob probably took too much insulin again,” he said. “His wife must be traveling for work. Whenever she’s out of town, he messes up his blood sugar and bottoms out.”

Leah turned the cot onto the sidewalk and toward the front door. “Diabetes management is hard, Dean. He’s been able to deal with it most of the time on his own.”

“I get it. Still, we’ll be on our way back to the station in no time.”

The front door popped open. A frantic woman in her fifties stepped out onto the stoop. “Hurry, I don’t think he can breathe.”

That lit a fire under Dean and Leah. They parked the cot by the front door and grabbed their gear before heading inside.

Their patient, a slightly overweight middle-aged man, lay on the floor beside the couch in the house’s front living room. His skin had a pale gray pallor, and he looked way worse than he usually did when they arrived.

Dean knelt down and noted the rapid gasping breaths. He gripped Bob’s wrist. At least they weren’t wrestling the werewolf’s out-of-control shifter form, which happened about half the time they responded to an emergency call at his house.

The rapid, thready pulse worried Dean. “Leah, get vitals—and a twelve-lead.” Dean grabbed the oxygen bag and soon had a non-rebreather oxygen mask on Bob.

“When did he get like this?” he asked Bob’s wife.

“He was working out in the front yard for most of the afternoon. I heard him come in, and then he groaned something I couldn’t understand. When I came out of the laundry room, I found him here.”

Leah finished hooking their patient up to the heart monitor. The initial blood pressure was too low, while the heart rate raced too high. With shock setting in, Dean and Leah had little time to stabilize him.

“What’s his blood sugar?”

Leah had started an IV line and dabbed a little drop of the blood she’d drawn on the glucose monitor strip. The screen beeped and revealed the number.

Thirty-two.

“He let his blood sugar drop too low. We’ll get him squared away.” He added the last to reassure himself as well as the patient’s wife. Something about this wasn’t right, but he couldn’t put his finger on what it was.

Leah had already started pushing the D-50 sugar syringe slowly into the IV line.

Dean watched the monitor, waiting for their patient to rally.

Nothing happened.

What was going on here?

“Did you run the twelve-lead?” Dean asked as a triple set of PVCs crossed the monitor. The premature ventricular contractions were cause for alarm.

“No, I was trying to get the IV for the D-50 push. I’ll set it up now.”

“I’ve got it. Get some fluids running into that IV.”

Dean quickly attached the sticky patches across Bob’s chest and connected the cables leading back to the heart monitor. As soon as he was finished, he pressed the button to run the diagnostic electrocardiogram.

His eyes widened as the elevated sections of the wave indicated something he hadn’t expected when they walked in. “Shit, he’s got a STEMI going on.”

“I’ll get the pads in place.” Leah jumped to it, sticking the large pads in place on Bob’s chest in case they had to shock him.

She finished attaching the second pad when Bob’s eyes popped open, and he reached over to grip her arm. His werewolf strength would’ve been a problem for most of the human paramedics at Station U, but Leah Casado was no normal paramedic. Her eyes flashed with a yellow glow as her jaguar shifter powers rose to the surface. She pried Bob’s fingers free from her arm and pressed him back down to the floor.

“Easy, Bob,” she said. “We’re here to help you. Just hold on. We have to give you some meds, and then we’re going to take you to the hospital.”

“It’s too late,” the middle-aged werewolf said. “It’s happening.”

“What’s happening?” Dean asked.

Bob’s eyes rolled up in his head, and he slumped flat to the floor again. The monitor beeped as the heart rhythm changed to rapid waves, indicating ventricular tachycardia. Fast. Deadly.

Dean checked for a pulse.

Nothing.

“Call the code and clear the patient.”

Leah leaned back, taking her hands from Bob’s chest. She pulled up her microphone and spoke into it while Dean dialed up the defibrillator.

Two seconds later, Dean checked to make sure no one was touching Bob. Then he pressed the button and delivered the first shock.

Bob’s body jerked as the jolt transmitted through his skin to his heart. As soon as the electrical energy passed, Leah leaned forward and began chest compressions. Dean went through the automatic checklists in his head as he ran yet another cardiac arrest code.

Twenty minutes and many unsuccessful shocks later, Dean’s confidence had plummeted from its earlier high. Bob’s heart rhythm had deteriorated rapidly into ventricular fibrillation. Nothing, no med Dean had in his tool kit, was working.

The fire department had arrived with more hands ready to help. They’d attached the automated CPR device that could deliver more consistent and regular compressions than any person could.

Nothing they were doing was changing anything. “Let’s get him ready for transport,” Dean said. It was time to get Bob to the hospital where, in all likelihood, the doc would call it.

As he helped lift Bob onto the stretcher, Dean’s hand brushed Bob’s. Painful blue lightning lanced up his arm under his skin. Then something—something entirely alien—slammed into his mind. Voices he couldn’t quite hear. Faces he didn’t recognize. The world tilted.

And then, gone.

“What the hell was that?” Leah asked.

“I’m not sure, but I’m fine. Let’s get him transported.” Even as he said it, ghostly figures with faces Dean couldn’t quite make out stood around the periphery of his vision.

“Dean,” Leah called from the door, bringing him back into the moment. “You coming?”

“Uh, yeah.” He blinked and shook his head. The ghostly figures had faded into amorphous wisps of mist that quickly dissipated.

He loaded up in the back of the unit, with one firefighter coming along to help if Dean needed it. Leah got up front and drove off with the ambulance’s siren call leading the way.

Nothing had changed when they arrived at the hospital ten minutes later. The nurses, techs, and doctors all ran through the motions for a few more minutes while Dean and Leah gave a report of their actions at the house.

After two more unsuccessful shocks, the doc called it. “Time of death, 1749.”

Dean helped Leah roll the stretcher back to the ambulance bay, where they grabbed some sheets from the pile the hospital provided and made it ready for the next patient. He picked up the med bag and zipped the top closed the same way he had years ago, the first time Bob had called. Dean had been fresh out of training then and still believed Unusuals didn’t die on his watch.

“You okay?” Leah asked. “You’re paler than I’ve ever seen you. Maybe we should get you checked out.”

“No, no, I’m fine. I think it’s just that it’s Bob, you know? He was my first ever patient as a paramedic for Station U. He’s been a frequent flyer with our unit for years now. It’s hard to believe that he’s dead, just like that.”

She put her hand on his arm. “You did all you could. There’s nothing about that code I would have done differently. It was textbook from top to bottom, except for that weird jolt of magic that passed into you.”

“I know. I just need to process it. Let’s get back to the station. Our shift is almost over, and we still have some reports to process.”

“After you.” Leah moved to the foot of the stretcher while Dean pulled at the head end. They rolled it back out to their unit. It was time to end this ultra-long day.

📖 Loved Chapter 1? Keep going — get The Paramedic’s Siren on Jamie Davis’s site:

jamiedavisbooks.com/books/the-paramedics-siren/