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From the USA TODAY bestselling author of Behind Every Lie and The Night Olivia Fell comes an unforgettable and heart-wrenching novel about the lengths one woman will go to save her son.

Emma loves her life. She’s the mother of a precocious kindergartener, married to her soulmate—a loyal and loving police detective—and has a rewarding career as a doctor at the local hospital.

But everything comes crashing down when her son, Josh, is diagnosed with a rare form of cancer.

Determined to save him, Emma makes the risky decision to sell opioids to fund the life-saving treatment he needs. But when somebody ends up dead, a lethal game of cat and mouse ensues, her own husband leading the chase. With her son’s life hanging in the balance, Emma is dragged into the dark world of drugs, lies, and murder. Will the truth catch up to her before she can save Josh?

A timely and moving exploration of a town gripped by the opioid epidemic, and featuring Christina McDonald’s signature “complex, emotionally intense” (Publishers Weekly) prose, Do No Harm examines whether the ends ever justify the means...even for a desperate mother.

This reading group guide for Do No Harm includes an introduction, discussion questions, and ideas for enhancing your book club. The suggested questions are intended to help your reading group find new and interesting angles and topics for your discussion. We hope that these ideas will enrich your conversation and increase your enjoyment of the book

Introduction

From the USA Today bestselling author of Behind Every Lie and The Night Olivia Fell comes an unforgettable and heart-wrenching novel about the lengths one woman will go to save her son.

Emma loves her life. She’s the mother of a precocious kindergartener, married to her soulmate—a loyal and loving police detective—and has a rewarding career as a doctor at the local hospital.

But everything comes crashing down when her son, Josh, is diagnosed with a rare form of cancer.

Determined to save him, Emma makes the risky decision to sell opioids to fund the lifesaving treatment he needs. But when somebody ends up dead, a lethal game of cat and mouse ensues, her own husband leading the chase. With her son’s life hanging in the balance, Emma is dragged into the dark world of drugs, lies, and murder. Will the truth catch up to her before she can save Josh?

A timely and moving exploration of a town gripped by the opioid epidemic, and featuring Christina McDonald’s signature “complex, emotionally intense” (Publishers Weekly) prose, Do No Harm examines whether the ends ever justify the means . . . even for a desperate mother.

Topics & Questions for Discussion

1. Emma often reflects on her dad’s advice, including “You don’t get to choose which cards you’re dealt”; “Sometimes you’re dealt a losing hand, and that really sucks. But if you always fold, you’ll have a pretty tough time in life”; “Keep your hand close to your chest”; and “Never get caught drawing dead.” In which instances in the book do you think Emma uses this advice to justify her actions?

2. Throughout the book McDonald paints the opioid epidemic as a complex problem. Her characters recognize that opioids can provide lifesaving pain relief, but that they can also cause lifelong addiction that endangers people. When Emma discovers that her colleague and friend Julia has been stealing opioids, she thinks, “[Addicts] needed help, not criticism and ridicule.” How does Emma’s opinion of using opioids for pain management evolve?

3. Nate once said of Josh and Emma, “You need him as much as he needs you.” Do you think this is an accurate assessment of their relationship as mother and son? Why or why not?

4. When Emma encounters someone from Moira’s church who expresses her sympathy for Josh and their family, Emma has a particularly negative reaction: “Thoughts and prayers. . . . Like that does any good.” Why do you think she has that reaction to the church’s response to Josh’s illness?

5. When Emma visits Julia and sees her in pain, Julia tells her, “I’m not an addict. Maybe I’m addicted, but I’m not an addict.” What do you think the difference is for Julia? Compare her addiction to that of other characters in the story, such as Ben or Violeta.

6. Nate often feels pressure to provide for his family, at times relying on traditional roles of masculinity and, in moments of failure, thinking, “What kind of man was he?” Why do you think Nate has this idea of fatherhood? How do you think Nate’s vision of fatherhood drives his actions?

7. Emma states that her job as a doctor is “to help people, not watch them suffer.” However, at times Emma’s actions cause her to do both. Discuss points when Emma’s actions cause unintended pain or suffering.

8. When thinking about her brother, Ben, and the anger and resentment that he developed during his life, Emma asks herself, “What makes people go to war with themselves?” What are the reasons that the characters in this book “go to war with themselves”? What commonalities do you think Ben and Emma have as siblings?

9. In Do No Harm, the family receives some small donations through a GoFundMe account set up to help pay for Josh’s treatments. Do you think GoFundMe accounts and community donations should play a role in paying for medical care?

10. Do you agree with Emma that “the ends justify the means”? Why or why not?

11. One of the overarching themes in Do No Harm is sacrifice. Emma sacrifices her oath as a doctor to save her son’s life. Nate sacrifices his life to protect his wife. Discuss other sacrifices that characters make. Which do you think are justified?

12. Did Emma’s final choice surprise you? Why or why not?

Enhance Your Book Club

1. In 2017, the Department of Health and Human Services (HHS) declared the opioid crisis a public health emergency in the United States. Research the interventions the government is currently taking and discuss the different means of intervention. Do you think these interventions are working?

2. In Do No Harm, Josh’s leukemia diagnosis forces his family to take extreme measures in order to afford his treatments. Is there someone in your community who is facing similar circumstances? With your book group, organize a donation to their GoFundMe to help provide some support.

3. Author Christina McDonald captures many of the complexities of the opioid epidemic. Did the book change the way you view opioid addiction? Why or why not?
Photograph by Justyna Kantecka

Christina McDonald is the USA TODAY bestselling author of Behind Every Lie and The Night Olivia Fell, which has been optioned for television by a major Hollywood studio. Originally from Seattle, Washington, she now lives in London, England, with her husband, two sons, and their dog, Tango.

  • Publisher: Gallery Books (April 7, 2021)
  • Length: 368 pages
  • ISBN13: 9781982142612

"Gripping and unflinching, Do No Harm explores the ferocity of a mother's love–and shows, in heartbreaking detail, how she'll risk everything to save her child."–Sarah Pekkanen, New York Times bestselling author of The Wife Between Us and You Are Not Alone

Do No Harm by Christina McDonald is an intense, emotional page-turner that’s impossible not to devour in one sitting.”Real Simple

"Do No Harm is a pulse-pounding deep dive into the dark heart of addiction. The stakes couldn’t be higher in this smart, breathlessly-paced, and emotional novel about love, family, and how far we’ll go when our child’s life hangs in the balance. Riveting, ripped from the headlines, and not to be missed.”–Lisa Unger, New York Times bestselling author of Confessions on the 7:45

"McDonald’s third domestic thriller delivers a jaw-dropping plot…the suspense, along with the body count, ratchets up with their every encounter. McDonald offers a painful look at two hot-button topics: the desperate opioid crisis, and a system that allows the cost of cancer pharmaceuticals to extend far beyond the reach of so many. Is what Emma does an unforgivable betrayal of her medical oath, her husband, and herself? It will be up to the reader to decide if the ends justify the means."Booklist

"Gripping and timely."Book Riot

"Christina McDonald has a real talent for bringing suburban domestic suspense to life, and showcases it to great effect in Do No Harm. Tense, taut, and absolutely unmissable, you’ll find yourself wondering how far YOU would go to save your child’s life."J.T. Ellison, New York Times bestselling author of Lie to Me 

"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...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.”Bookreporter

"McDonald takes the heart-wrenching premise that has become her trademark and ratchets it up a notch in Do No Harm, blurring the lines between good and evil in a doctor desperate to save her sick child. A gripping, emotional roller coaster with a sting in the tail."Kimberly Belle, internationally bestselling author of The Marriage Lie

“Grace Fraser and Do No Harm's Emma have a lot more in common that what meets the eye…From the outside, selling opioids sounds like a horrible and irresponsible idea, but readers will quickly become fans of Emma, Christina McDonald's protagonist…”PopSguar

“Christina McDonald knows how to pack an emotional punch! Do No Harm is a riveting, thought-provoking novel that keeps you reading even as it breaks your heart. This might be my favorite book by McDonald yet.”–Samantha Downing, USA Today bestselling author of My Lovely Wife 

Do No Harm is a cross between Breaking Bad and Kohlberg’s theory of moral development.”CrimeReads

“A gripping page-turner with a heartwrenching moral quandary at its core. Do No Harm is tense, moving, and disturbingly relevant.”–Robyn Harding, internationally bestselling author of The Swap and The Party

"[A] complex medical thriller that will have the reader asking themselves what they would do if they were in Emma’s position…McDonald explores the many perspectives of the opioid crisis with insight and compassion…Readers looking for a fast-paced and emotional story will enjoy Do No Harm and be thinking about it long after the last page is read.”The Seattle Book Review

"Devastating, heartbreaking, and incredibly timely–this risky and brilliant examination of when the ends justify the means will captivate you from moment one. The talented Christina McDonald dissects the crumbling marriage of two good people,  and reveals how love and obsession can combine to destroy even the most perfect family. As a doctor's vow of 'do no harm' twists into 'do whatever it takes,' you’ll be riveted by this thought-provoking and tragically believable story."Hank Phillippi Ryan, USA Today bestselling author of The Murder List 

“This raw, emotional story echoes fear that would result when denied necessary available health treatment due to lack of funds. And it brings into question how far a parent can morally go to save their child.”Authorlink

“With her trademark emotionally gripping, outstanding writing, Christina McDonald tackles the moral and ethical lines crossed by a doctor desperate to save her child. A stunning gut-punch of a suspense novel, Do No Harm expertly merges the dangers of the opioid crisis with a mother’s love, leaving readers gasping for more. A breathtaking read.”–Samantha M. Bailey, #1 bestselling author of Woman on the Edge

"A deftly woven blend of suspense, family life, amateur sleuthing, and an opioid epidemic "Do No Harm" is an inherently fascinating and engaging novel by Christina McDonald examines whether the ends ever justify the means -- even for a desperate mother."Midwest Book Review

"Do No Harm is a gripping and unflinching novel. Christina McDonald demands an answer to the ultimate question: How far would you go to save your child? One thing is for sure: your heart will be ripped out as you whip through each page to discover the answer. Highly recommend!"Liz Fenton & Lisa Steinke, authors of How To Save a Life

"In her suspenseful new thriller, Do No Harm, Christina McDonald brings a controversial topic right out of the real-world headlines and displays a fantastic ability to truly examine it from all sides...Do No Harm is an absolute page turner! McDonald has once again perfectly balanced little twists that the reader can feel clever for figuring out with big, sudden gasp-out-loud moments. Fans of the author’s previous books, Behind Every Lie and The Night Olivia Fell, should be ready to jump right in to this intense new thriller!"The Nerd Daily

"A family-driven medical thriller that's unique and propulsive, Do No Harm by Christina McDonald is as gut-wrenching as it is jaw-dropping. Not to be missed!"—Hannah Mary McKinnon, bestselling author of Sister Dear

Do No Harm poses morally gray questions...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."Fairfield Citizen

"Nobody writes motherhood like Christina McDonald. Her third novel, Do No Harm, is a riveting thriller which braids the complexities of modern parenting with the pressures of finding a moral centre in a devastating opioid crisis. Heartrending, heart-pounding and fearless to the last word."—Amber Cowie, author of Loss Lake

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