Bestselling author Christina McDonald is back with her third suspense novel, DO NO HARM, a tautly plotted, socially informed drama about how far one mother is willing to go to save her son.

Orphaned at a young age, Emma Sweeney is used to being independent and stable. For years her ambition has guided her, and now she is a respected doctor, loving wife to police detective Nate and proud mother of a bright kindergartener. But when Josh starts complaining of exhaustion and flu-like symptoms and comes home from school covered in strange bruises, Emma’s perfect life begins to fall apart. When he is rushed to the ER after a fall, Emma and Nate receive the most horrifying and life-changing news imaginable: their precocious, fun-loving son has cancer, acute myeloid leukemia, and unless they do something fast, the prognosis is not good.

Although Emma knows a bit more about the disease than most parents in similar positions, no amount of education or preparedness can help her when she hears how much the best treatment, CAR T-cell therapy, will cost: a whopping $500,000, only a small portion of which is covered by insurance. In a series of phone calls, emails and research that will be all too familiar to most Americans, Emma is able to find a workaround. However, instead of a clean bill, she learns that the treatment will cost $96,000, and she and Nate will have to acquire the funds within one month, or their son’s life will likely end within the year. Emma is still young in her career and not making anywhere near that kind of money, and though Nate is a second-generation cop, he will need a major promotion to even think about a sum like that. Backed into a corner with few options, Emma can’t help but notice the unlocked, unattended extra prescription pads at her clinic, and she makes an instant decision.

For the past several months, Nate has seen his city ravaged by the opioid epidemic; he and his colleagues are called to overdoses practically every day. But when a police informant is murdered, and his toxicology report indicates the presence of fentanyl, the pressure is on for Nate and his department to figure out why overdoses are spiking and who is bringing fentanyl into their community. Feeling helpless at home, he sees the opportunity to solve the kind of case that will mean an instant promotion --- and enough money to protect his family from nearly anything. Little does he know that this epidemic has close ties to his own family.

With Emma reuniting with shady characters from her past to sell prescriptions for opioids and Nate homing in on the seedy underbelly of his town, their relationship takes on a visceral tension, fueled even further by the stress of their sick child. DO NO HARM takes on the air of a cat-and-mouse thriller, with each character trying to outwit the other and come out on top. Drawing upon the searingly timely topic of the opioid crisis and adding some much-needed context to the severity, classism and racism of the issue, McDonald pens a suspenseful thrill ride that is as socially aware as it is meticulously plotted.

What makes the book stand out is the inclusion of characters from all walks of life. As McDonald illustrates, the idea of the “junkie” is only a small portion of the drug crisis ravaging America, and although she makes no excuses for crime, she highlights the many reasons that people have turned to drugs to solve much larger problems. From patients trying to mitigate symptoms of painful diseases to doctors who are afraid of attracting the attention of the Drug Enforcement Administration and even more stereotypical addicts, she paints a picture of an America that is suffering, and reminds readers that there are many motivations behind those involved with opioids.

While the idea of a doctor wife and a police detective husband with an adorable yet horribly sick child might seem a bit too tidy, McDonald uses this highly specific situation to unpack a world of other, more common ones. At the same time, she uses Emma’s character to frame some poignant questions about motherhood, morality and the idea of ends that justify means.

DO NO HARM is an intensely raw and real thriller, and it is clear that McDonald has done incredible amounts of research into the opioid crisis, medicine and (groan) insurance. But do not let the social commentary fool you; this is not just a close examination of social issues. Instantly gripping and full of gasp-worthy twists, the book is clever, tense and utterly addictive. You won’t stop until you’ve turned the last page.

I think this is the third book I've read by McDonald, and it's probably my least favorite of the three. While I did like it for the most part, and really enjoyed the beginning, I sort of felt like around the middle of the book, things started to falter and break apart. I'll continue to read her works, as she's a great writer. This just wasn't the book for me.



3/5 Stars

The age old question - what lengths would you go to to help/save your child?
What a fantastic thrill ride this book was, my first go with this author and I am going to check out her other material after this one!
A doctor's child is diagnosed with leukemia and the best live saving treatment costs way too much money, so she is force to make a hard decision between breaking the law and her medical code of ethics against saving her child. What ensues is a twisty thrill ride that is at times, heartbreaking and eye opening. We get a glimpse into the world of opioid addiction and usage that is raw and honest.
I really enjoyed this book - recommended for reality thrill fiction. Thankful for the ARC!

After enduring a series of childhood traumas, Dr. Emma Sweeney now works as a family physician at a local clinic and is married to Detective Nate Sweeney, a detective in Skamania, a small town outside of Seattle, Washington. Their marriage is a happy one and they have a beautiful 5-year-old son named Josh. And then it all falls apart when Josh is diagnosed with acute myeloid leukemia and needs a very special experimental treatment that Emma and Nate can't afford. While Nate is investigating several drug overdose deaths, Emma decides that she is going to get the money the only way she knows how. She will write prescriptions for opioids and sell them to dealers. Once Emma steps onto this slippery slope, she slides down at an accelerating pace that will involve her in secrets, lies, and murder. But she is doing it all for the sake of saving Josh. NO SPOILERS.

Alas, what a disappointment. In order to suspend disbelief enough to buy into this thriller, one has to like the characters. I couldn't get there despite being told constantly what a good person Emma was and how desperately she loved her son. Do the ends justify the means when involving trafficking in deadly drugs? I found myself increasingly frustrated with Emma and her associations and activities. I also didn't really want to finish but did read to the unsatisfying conclusion anyway. Yes, there is a horrible problem with opioids. Yes, people still need them for intractable pain despite how highly addictive they are. I don't know what the answer is, but Emma didn't solve the problem, she became part of it. Rationalizing that she loved her son so much as the reason for her behavior didn't work for me nor did hearing about that every second sentence (all parents would be desperate in a situation like this - -we know). Anyway, that's how I felt while reading -- just too many irritations about the characters that prevented me from accepting the storyline.

I usually like books with any sort of medical aspect. As an RN and legal nurse consultant, I'm quite aware of the crisis and epidemic related to Oxycontin and fentanyl and I'm not sure that the steps being taken to combat the intense danger are going to ameliorate the many issues. Becoming part of criminal and illegal activity to further your own interests, however, is not the answer. And don't many dealers become their own customers? Definitely people are driven to extremes when they want to save their child and can't afford the expensive or experimental treatments that mean the difference between life and death, but I still can't accept how things worked out for Emma in the end.

Thank you to NetGalley and Gallery Books for this e-book ARC to read and review.

I am still sort of speechless.
While I don't agree per say with Emma, as a mom I can totally see myself in the same position

Talk about pulling on my heart strings and keeping me on the edge of my seat at the same time. Like any mother, Emma will do anything possible to protect her son and get him the care that he needs, even if that means putting her career, marriage, and life on the line. Fantastic writing and left me wanting to scream out in anguish and feeling Emma's pain.

I stumbled across The Night Olivia Fell randomly while strolling through a bookstore (back when we were allowed to do that). I read that book so fast and was hooked from the very beginning. As soon as I was done, I looked up Christina McDonald because I knew I needed everything she had every wrote. I was shocked to find out it was her first adult book. I later read her second book when it came out and was stoked to get approved for an early copy of Do No Harm.

Just like her previous two books, this sucks you in from the very beginning. I read it in two days only because I had to work and sleep at least a little. I fell in love with the character of Emma right from the start and you really feel for her situation and the sketchy decisions she has to make to benefit her family. It really makes you question what you believe is right and wrong when it comes to certain situations. I loved this book and am impatiently waiting for the next book by Christina McDonald.

All I can say about Christina McDonald's newest book, Do No Harm, is WOW! She slayed it with this book! I loved both The Night Olivia Fell and Behind Every Lie, but this book is her best yet! It's a medical thriller/family drama that has you questioning what would you do in Emma's shoes? Just how far would you go to save your son's life?

Somethings are not always morally and ethically absolutes, black and white, but there are millions of shades of gray in between when deciding what is right and wrong, and that's the situation that Emma must face when her young son Josh is diagnosed with a rare and terribly expensive to treat cancer, a treatment that she and her detective husband Nick cannot afford. She's a doctor who took an oath to do no harm, yet what about the harm she would do to her child if she didn't do everything she could to possibly make sure she could save his life? Yet what if saving her son's life meant doing harm to other people because she's selling addictive opioids that can cause a deadly overdose?

My god, this was a riveting read from many perspectives: as a mother who'd do anything for any of my kids, as someone deeply in debt paying off exorbitant amounts of medical bills because the US health insurance system is great-until it isn't, and as someone who lives daily with the chronic pain of Lupus, just like one of the characters in this book, and has struggled in the past with finding Drs to treat my pain without thinking I'm an addict looking for a fix. The healthcare system is just so broken, and Christina really gave an excellent and insightful look at chronic pain patients, drug addiction, the untold stresses of dealing with insurance companies who will pay after you meet this deductible or this copay and make you jump through hoop after hoop.

This is a gripping read from start to finish. It's heartbreaking yet thrilling as it touches on all kinds of important issues ranging from motherhood, marriage, chronic pain, ethical issues, betrayal, lies, secrets, right vs. wrong (and what exactly is right under what circumstances?). It's a roller coaster ride of a book that is devastating, emotional, thought-provoking, and one of the best books that I've read so far in 2021. Now I can't wait to see what Christina comes up with next!

Thank you Netgalley and Gallery Books for the DRC. All opinions are my own.

Thank you for the opportunity to read this novel. Unfortunately, I was not able to connect with the character so I wasn't able to finish.

With Do No Harm, Christina McDonald has crafted yet another fast-moving thriller with a mother at the center of the story. This time, however, the female protagonist, Emma, is faced with a moral dilemma. How far will she go to save her child? What is she willing to do to ensure that her five-year-old Josh gets the treatment he needs when he is diagnosed with leukemia? The treatment most likely to cure him is CAR T-cell therapy, a form of immunotherapy in which T cells are collected from the patient and genetically altered in a laboratory before being returned to the patient's body. They serve as fighter cells that attack cancer cells. The treatment is not covered by insurance and carries a $500,000 price tag. And the hospital will not deliver the treatment to Josh until one-fifth of the cost is paid in advance. So Emma is desperate. She and Nate, her detective husband, simply do not have either that much cash or assets they can liquify to raise it. They don't even own their home and Emma is still making student loan payments. There is a possibility that Nate will be promoted in the near future, but that advancement in his career is not assured and will not generate the amount of money needed.

Emma is all too familiar with the opioid crisis because she has encountered patients and would-be patients in search of prescriptions, some of whom have become addicted as a result of chronic, unrelenting pain. Others have been victimized by physicians who did not prescribe medication judiciously in order to prevent addiction. So she knows there is a ready market for prescriptions for Oxycontin, and she begins selling them, issued on prescription pads stolen from the clinic where she works upon which she forges her colleague's names.

If the plot sounds preposterous, consider McDonald's very personal inspiration for the book. Her own brother was addicted to Oxycontin and overdosed. The book is dedicated to him. McDonald notes that the medication to which he became hooked was prescribed to him by a physician and "perfectly legal." For quite some time, she wanted to write a book set against the backdrop of the American opioid crisis, and her strong opinions and emotions are on display in her fictional narrative. One day McDonald happened upon a news story about a podiatrist involved in an opioid ring. "I wondered why he did it: was it money, power, status?" McDonald relates. "What would drive someone to do that? And I thought, what would make me sell opioids amidst a horrific epidemic? The only answer I had was love. My children. And that was the moment I first thought of the story for Do No Harm."

As the story opens, Emma and Nate are happy, still deeply in love after several years of marriage, and fully committed to each other, their marriage, and their son. Both have successful, satisfying careers in the small fictional town of Skamania, Washington, which McDonald fashioned after Snoqualmie. McDonald says it was very important to her that the town be named Skamania because in Cascades Chinook it means "swift waters" and she knows all too well that "circumstances can change very fast once a person becomes addicted." Indeed, she immediately places her characters in some very deep, swiftly running, dramatic waters. Nick is assigned to investigate the homicide of a local informant who was heavily involved in drug trafficking, but warned that he will be removed from the case if the evidence leads back to Emma's brother from whom she has been estranged for years. He has a criminal history and is suspected of being the leader of a drug ring. Only in a little town with a small police force would such a potential conflict of interest be disregarded. But it's the plot device needed to set in motion the series of developments that frenetically propel the story forward.

Because of her own complicated past, Emma knows just who to go to in order to sell the prescriptions. She turns to her old boyfriend, confident that he will be able to sell the prescriptions quickly so that she can get the cash she needs to ensure that Josh receives the first treatment before his condition worsens. After she negotiates the deal, money begins tolling in. But her behavior takes an immediate toll on her and her relationships with her family. Nick begins to suspect that something other than Josh's illness is amiss, and they start drifting apart because Emma knows she will not be able to hid the truth from him indefinitely. Emma is on high alert, edgy, and sneaking around in fear of the severe, life-altering consequences she will endure if she is caught. McDonald credibly and compassionately portrays her singular focus on seeing to it that Josh is provided the best possible chance to survive. Her internal struggle is heartbreakingly believable, especially when she lapses into moments of believing that she is actually providing a service to those who suffering from intractable pain who cannot obtain medication via legitimate means.

Do No Harm is a thoroughly riveting thriller, replete with surprising, intricately-constructed plot developments and revelations. There is no imaginable character more empathetic than a mother driven to save her deathly-ill child, no matter the cost to herself, and McDonald capably portrays not just Emma's anguish, but that of Nick and Nick's mother, as well. Josh is a charming little boy who asks questions that no child should ever have to pose to his parents, and the unscrupulous characters with whom Emma becomes entangled are equally believable. McDonald does not shy away from developments in the story that are logical, but heartbreaking, and keeps accelerating the pace right up to the conclusion. At numerous junctures, she offers readers the opportunity to ponder what they would do should they find themselves in similar circumstances, making Do No Harm an excellent choice for book clubs. McDonald acknowledges that her goal was to "get people talking about the opioid epidemic, discussing the driving factors behind it and what we as a society can do to help those who struggle." She has succeeded: the issues she examines provide plenty of material to discuss and debate.

Do No Harm again demonstrates why McDonald is one of today's strongest female novelists, penning breathlessly engrossing thrillers that balance action with emotionally-rich character studies. Do No Harm is sure to be recognized as one of the best thrillers of the year.

Having read past books by Ms. McDonald, I was so excited to receive this advance e-copy. However, this one did not impress me as much as The Night Olivia Fell and Behind Every Lie did. This book presents it’s main character, Emma, with a moral/ethical dilemma when her young son is diagnosed with cancer and she needs to come up with an exorbitant amount of money to pay for his treatment before the final treatment can start. As a doctor in a town suffering through an opioid epidemic, she takes advantage of her access to prescription pads. She uses her brother, a former addict, and an old high school classmate’s ability to obtain the product and their already-established clientele list to get the money she needs for the treatment. However, Emma’s husband is a local cop investigating two overdose deaths and Emma is quickly in over her head.

I had two issues with the main ideas in this book:
Nate, Emma’s husband, and his partner, Kia, become involved in the drug case. Each of them has a significant conflict of interest involving the drug case. I didn’t like that this issue was brushed aside and it was all about Nate receiving a promotion in hopes that he would be able to pay some of the treatment/hospital cost. Kia’s conflict wasn’t really discussed and, as a reader, I felt like I was just supposed to be ok with this. It seemed rushed and unexplained.

My second issue was with the last 2 pages of the book where the reader is given an idea about how Emma’s life will continue post-cancer treatment for her son. I’m going to chalk it up to my moral compass pointing away from what Emma did because I don’t feel like it’s appropriate to take advantage of individuals with drug addictions. Her actions were one-sided and only helped her. I didn’t feel like this was an appropriate solution/suggestion just based on the opioid epidemic we are currently living in. I felt like the characters voice was saying it was ok to take advantage of drug addicts because not enough is currently being done for them and someone may as well benefit from the situation. There was an alternative way this could have been written and the author could have given a voice to ways the character could have helped out her community.

Maybe I was supposed to bond with Emma on a parent level. I really didn’t. I saw her as a mom who didn’t care about the consequences and chose directions that benefitted her. Her decisions were quick and rushed. I saw a small glimpse of her compassion in regards to Julia, but it didn’t seem like she learned anything from that experience.

The writing was good and there was drama. Some parts seem rushed. Definitely book club worthy content if you’re ok with hearing that others may not feel how you do in regards to drug addiction and moral/ethical dilemmas.

I’m hoping that the final published copy contains resources for families with loved ones suffering with drug addiction and resources for families needed financial assistance with medical bills.

TW: drug use/abuse, drug overdose, child illness/cancer, strong ethical/moral dilemmas

2.5 stars
I would like to thank NetGalley and the publishing house, Gallery Books, for providing an advanced e-copy for review. All thoughts and opinions written in this review are my own. My review of Do No Harm can be found on Goodreads, Amazon, Barnes & Noble, my Instagram and Facebook book club page, and my local library website.

This popcorn thriller was one of the most soap opera like books I've every read! Emma the mom is an ER physician who starts selling Oxy to help pay her son's medical bills. Her husband is a cop investigating a case of murders of drug dealers who sold Oxy. Some very outlandish events take place that weren't at all believable, their 5 year old son spoke like a 15 year old, and Emma and her husband were both irritating characters. The ending was over the top and out there.

This is one of those stories that truly begs the question, just how far would you go to save your child? If you’re a parent, your number one responsibility is to do everything you can to keep your child(ren) safe, right? So, when Dr. Emma Sweeney’s perfect family with husband, Nate, and son, Josh, gets turned upside down, she was faced with a dilemma that I can’t imagine any human being would ever want to face.

Emma was a very good doctor, and that being the case, why was it she was unable to diagnose her son’s medical condition? Perhaps that was a blessing, but to Emma it was her worse nightmare. Her son was dying of Leukemia. How did she not detect this? She and her husband, Nate, were so distraught and each angry with themselves for not having figured this out. But now the issue became, how do we as parents pay for our sick child’s medical bills? Was Josh’s life worth going to the ends of the earth for?

At the end of the day, Emma made a quick decision. She was fighting for her son’s life come hell or high water, and when I tell you that Emma did everything she needed to do to save her child, is truly an understatement. As I continued to read this fast-paced thriller, I kept asking myself would I do all of what this woman is doing to pay for the cost of her son’s treatments? I would like to think I’d make different decisions, but a parent’s love is like no other. My God, this novel was amazing!

I have to admit, I was not a fan of the ending. In fact, I absolutely hated the ending! If you think you know how this ends you couldn’t be more wrong! This story was explosive on so many levels—I couldn’t tear my eyes away from it. To better explain my opinion, just think about something so horrible you’ve witnessed and even though you know it’s painful to look at, for some strange reason you can’t bring yourself to stop staring. That’s the best way to describe this story. With each swipe of the Kindle page, I could not get enough, even though I was terrified beyond belief of what was going to unfold. And jeez oh man when the story was revealed, my jaw dropped. McDonald wrote the hell out of this book. If you do not find your mind questioning your own motives as to how you would have dealt with this situation, you couldn’t possibly be human. It was a constant struggle with thinking seriously if I would have done what Emma did?

In Do No Harm, McDonald has given us a taut, tense thriller which asks us to decide whether the end ever justifies the means, and how far outside our moral boundaries are we willing to go to save someone we love.

Emma and Nate Sweeney have a close marriage, a five-year-old son, Josh, and jobs which deeply satisfy them. Emma is a doctor at a nearby hospital, and Nate is a detective on the local police force. All is perfect until Josh is diagnosed with an aggressive and deadly cancer. The only hope of saving him is a new treatment that their medical insurance won't pay for. Emma decides to risk everything by selling opiod prescriptions to people in the drug world. Her eye is on the money to save Josh, but the underworld is dirty, and she finds herself caught up in unexpected and dangerous circumstances that she can't escape.

Nate has been asked to join a DEA task force after one of their local confidential informants is murdered. Nate begins investigating the murder, never dreaming that his wife will be among those involved in what he uncovers.

An engrossing, fast-paced read with very well defined characters, a good plot and plenty of twists and surprises. You'll want to say "YES" to this one!

My thanks to NetGalley and Gallery Books who allowed me to read an e-copy of this book. All opinions stated here are my own.

I loved this! McDonald is a new writer to me, but with razor-sharp prose and page-turning action, I couldn't put this down. Amazing!

Another emotionally gripping novel by Christina McDonald. Do No Harm brings us a mother desperate to save her child with cancer, needing a very expensive treatment to save his life. Danger, the opioid crisis, a friend with Lupus, murders. This book has it all. I read it in one sitting and absolutely loved it. I will read any book McDonals writes.

I love Christina McDonald's work. But, This was not my favorite of her work sadly. I found it to far fetched.

The story centers around Emma (who is a doctor) and her family, 1 son and a husband who is a police officer. Her young son recently was diagnosed with Leukemia. With the mounting debt of her degree and her husbands lower income as a police officer, They are struggling to figure out how to make ends meet with her son's treatment. Without her husbands consent, Emma, Contacts an old fling who was once a drug dealer. She eventually steals her workplaces prescription note pads and writes out prescriptions for ladies to fill. Once the ladies fill the prescription, She and her past fling then distribute the drugs to "those in need" in order to collect enough funds to pay for her son's treatment. All while her husband is investigating this occurrence and has no idea that it leads back to his wife.

I found this book interesting but once I started it, I quickly found it boring and a bit anti climatic. This should not discourage you from reading this author as I LOVED "The Night Olivia Fell".

In her latest suspense-laden novel, Christina McDonald tells the story of Nate and Emma, two loving parents who find themselves scrambling to find a way to get their son his lifesaving cancer treatment.

In “Do No Harm,” Emma is a respectable doctor and her husband is a dedicated detective. When the couple learns that their son needs an exorbitantly expensive treatment, Nate throws himself into work, hoping that if he solves a murder investigation with ties to a recent spate of overdoses that he’ll get the promotion he needs to afford the treatment.

Emma, on the other hand, gets herself involved with a few drug dealers in the hope that selling opioid prescriptions will be enough to save her son’s life. As Emma risks everything for her son, she has to stay on her toes to keep Nate’s investigation from getting too close to her drug scheme.

Written from Emma and Nate’s perspectives, the story bounces back and forth as the two play a pulse-pounding game of cat and mouse using different methods to save their son.

McDonald’s novel doesn’t just tell a story of a doctor trying to use the opioid crisis as a quick payday, she examines different angles of the crisis and how it plays out for different people, exploring who benefits, who suffers and who is left behind.

Through Emma’s eyes readers see how the medical community has become wary about prescribing opioids, while also revealing how this wariness has pushed those who have become dependent on pain medication to seek it out through less legal means that put them at risk.

Emma finds herself debating whether she’s doing more harm than good by enabling addicts even if doing so helps her save her son. She tries to find a way to justify her actions.

As McDonald’s novel pushes her characters into morally gray areas, she poses the question, How far is too far to go to protect someone you love?

Readers should note that the book includes plot lines dealing with suicide and self-harm.

5 stars! ⭐️⭐️⭐️⭐️⭐️

Wow. Just wow! Christina McDonald has knocked it out of the park again with this one.

How far would you go to save your child? I could not get enough of this book. It was super addictive and had me hooked from the get go.

Emma is a doctor at the local hospital and happily married to a police detective. When their five year old son Josh is diagnosed with a rare form of cancer, they are obviously devastated. There’s hope - but the life-saving treatment he needs is very expensive - one that their medical insurance will not cover. Determined to save his life, Emma makes the risky decision to sell opioids to pay for it. When a drug deal goes wrong and somebody ends up dead, Emma‘s husband is the lead detective on the case. Can she keep this from him long enough in order to save their son?

This book is a gripping, heart pounding adrenaline rusher filled with twists and heartbreak. I can’t wait to see what McDonald comes up with next!

Thank you to NetGalley, Gallery Books and Christina McDonald for my advanced copy to read and review.

I enjoyed The Night Olivia Fell by Christina McDonald so was really looking forward to digging into Do No Harm. The premise of this crime thriller sounded promising but unfortunately it was very disappointing. The plot wasn't plausible, every twist felt like such a leap, and even the dialogue/relationships amongst the characters felt contrived. As a mom who would literally do almost anything for my own children, I surprisingly felt zero connection to the main character, Emma. If I didn't owe a review for this book, it would have been a DNF at the halfway point.