First Do No Harm
by S. J. Rozan
DETAILS: Series: Lydia Chin & Bill Smith, #16 Publisher: Pegasus Crime Publication Date: January 6, 2026 Format: Hardcover Length: 320 pg. Read Date: February 18-19, 2026

My brother needs a lawyer,” I told Bill over the phone from the sky diving hut.
“Your brother is a lawyer. Unless it’s a different brother, in which case his brother is a lawyer.”
“It’s Elliott, he needs a criminal lawyer, and it’s for a friend.”
“That’s what they all say. What happened?”
“The friend was found at the hospital in the company of a dead body.”
“Did he make it dead?”
“No.”
“That’s what they all say. New York City? Long Island, upstate, New Jersey? ”
“That’s as far as your reach extends?”
“God no. You need Nebraska? The Leeward Islands?”
“Just testing. Manhattan.”
“The guy’s in custody?”
“Yes, and he’d rather not be,”
“That’s what they all say.”
What’s First Do No Harm About?
That’s basically all you need to know. Lydia’s brother gets a call from a coworker that he’s friendly with, who’s the prime suspect in a murder at the hospital. After Bill connects him with a good criminal lawyer, that lawyer hires the duo to do the investigating for her.
It doesn’t go well at first—there’s a lot of institutional resistance to helping them—the hospital just wants to put the incident behind them—they’re on the verge of a nurses’ strike, and the additional bad press associated with a murder is too much for them. They’re perfectly willing to let this staff member be arrested and convicted, as long as it happens fast and keeps them out of the news.
Thankfully, Lydia and Bill are good at making allies and cashing in favors—once they start learning secrets and talking to the right people (probably in the reverse order), they start finding more people who will talk to them (willingly or not), and a picture—very slowly begins to emerge.
They’ve had some real doozies of a case before—and honestly, this is one of the more straightforward cases they’ve had (if you ignore all the distractions they encounter along the way)
Why did I pick this up? Why did I keep reading?
I picked this up because it’s a Lydia Chin/Bill Smith book.
I kept reading for the expected reasons: the mystery/crimes they uncovered and their chemistry and banter. It’s also a “Lydia” book, so it’s a bit more upbeat and fun.
The way these two interact has always been something that attracted me to the books, and it continues strong here. There’s a little competition between the two of them early on about who can charm the most people connected to the case—and neither of them does very well. Dismally, really. But it’s fun to watch them go back and forth about it—it’s a nice twist on Spenser’s strategy of going around annoying people until someone does something that leads him somewhere. At least they’re (superficially, at least) trying to charm people.
But really, just getting the chance to watch the two of them talk to each other is enough to keep me reading.
What does this book tell us about humanity?
This is a tricky one, because like most PI Fiction, the core of this book is people being despicable and trying to get away with it. But there’s a focus to this one.
“Seriously,” I said, sipping the cinnamony froth off my mug, “I’ve never seen so many people doing so many nefarious things. It’s a little disheartening. No, it’s a lot disheartening. A hospital? Isn’t it a thing that medical people are supposed to at least do no harm?”
Bill shrugged. “I always thought so.”
Lydia has seen a lot of…well, a lot. Crime, corruption, organized crime, family dysfunction, murder, and so on. A lot of what she’s seen would be too much for many of us (myself included). Yet this case disheartens her. She’s seen the various and sundry corruptions, backstabbing, machinations, poor conditions surrounding the workers at this hospital—and we’re not even talking about patient care/conditions—who knows what would show up if that happened. It’s all behind-the-scenes stuff. And it gets to her. She mentions it frequently.
Even with a brother who works in the ER in this hospital, all of this mess shocks her. Bill doesn’t seem as disturbed, but I don’t get the impression that he expected it to be this bad, either. Even people like them—given their experience, profession, and what they’ve heard—they expect hospitals to be about helping people. Healing people. Not trying to profit at other people’s expense.
I think it says something about how all of us have illusions about institutions. Or that even in the best places for humanity, our collective depravity shows up. Or maybe, that despite all the nefarious things going on, there are people (like her brother) who help people—and that even those who are getting away with things still manage to do some good.
Okay, I’m not sure what this book tells us about humanity. It’s not cut and dry—and on one level, we all know that, but something that Crime Fiction is good at is reminding us all that humanity is a mess, but still some good things happen.
So, what did I think about First Do No Harm?
I thoroughly enjoyed it. I think my only complaints are that we didn’t get enough of Lydia’s brother—because I enjoyed him in his element; and we definitely didn’t get more time with the accused murderer—because he was such a fun ball of chaos and earnestness. Seriously, can he get accused of another crime soon? I’d like to see him back in this series.
Everything else was great—good red herrings, a good twisty mystery that exposed a lot of other criminal/crime-adjacent activities, some winning characters. And more than one scuzzy person that you wouldn’t have minded being guilty of the murder—sadly, some that get to keep being less-than-upstanding and successful. The final reveal of the killer? I didn’t see it coming, but in perfect murder mystery style, once revealed, I couldn’t not see it and was annoyed with myself for missing it.
As one expects, Rozan did it again. And now we get to wait for her next successful outing. This would make a fine jumping-on point for the series. I think every book in the series would, for that matter. You’ve got no excuse not to read it.
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