Crash

The first installment in the Sinners and Saints series, this novel alternates between the perspectives of Tessa Kincaid, a 33-year-old wedding planner, and Dr. Blake Morrison, an emergency room physician at Mercy Harbor hospital in Chicago.

Tessa faints on a sidewalk and is brought to Mercy Harbor, the one hospital she has been avoiding for two years. She has battled unexplained symptoms for over a year, including fatigue, nausea, headaches, and dizziness, but lies to the staff about having no medical conditions. The attending physician turns out to be Blake, her older brother Ryker Kincaid's best friend and the man she has had a crush on since she was 16. Blake has suppressed his own feelings for years, maintaining distance since a drunken kiss two years earlier led to a painful estrangement.

Blake's exam reveals weight loss, low blood pressure, and an elevated heart rate. When Tessa tries to prove she can leave, she collapses. Blake orders a full workup. Shortly after, Tessa's heart stops. Blake performs chest compressions, shattering his composure as he begs her to fight. Her heartbeat returns after 60 agonizing seconds. In the aftermath, Blake has a private breakdown, flashing back to the Christmas Eve he lost both parents, a trauma compounded when his grandmother died from the shock.

Tessa's ex-boyfriend Eli, her listed emergency contact, arrives and reveals that Tessa has been seriously ill for a year. When Blake confronts her, Tessa recounts her medical odyssey: The illness began with a flu-like infection and progressed through debilitating fatigue, stomach problems, and dizziness. She was bounced between specialists, none of whom found an answer, with one dismissing her by saying she was just getting older.

Blake notices a faint scar on Tessa's collarbone. When she is sedated for an MRI, Tessa inadvertently reveals she was assaulted at a college party by a classmate named Eric Voss, who attempted to rape her before being interrupted. She also mentions that Voss has been sending threatening letters for years. Blake calls Ryker, a criminal defense attorney, under attorney-client privilege and reveals that someone assaulted Tessa. They drive to Voss's home but find him absent.

All of Tessa's test results come back normal. Tessa explains the catch-22 of a medical mystery: She dreads a diagnosis but also dreads the absence of one. Blake persuades her to give him four weeks to investigate. Meanwhile, her client Shelly, a high-profile influencer, insists on moving her wedding up to seven weeks away because her father has pancreatic cancer.

Blake proposes that Tessa move into his penthouse to eliminate environmental triggers. She reluctantly agrees after her symptoms worsen. As they live together, suppressed feelings intensify. Blake confesses he knows about her assault from what she said under sedation, and Tessa accepts his honesty. He reveals that the night she came home from the assault, he sat outside her bedroom door all night.

Blake mobilizes his close-knit brotherhood, the Sinners and Saints, a group formed in college around principles of absolute loyalty and mutual protection. He enlists Jace Lockwood, a billionaire CEO, to orchestrate a hostile takeover of Voss's talent agency; Axel, another member of the brotherhood with PR connections, to expose Voss publicly; and Ryker to build a legal case.

On Blake's rooftop terrace, an argument leads to raw confessions. Blake admits he wanted more than a kiss two years ago. Tessa reveals she ran because she feared intimacy might trigger her assault trauma. They share a passionate encounter, but Blake abruptly pulls back. Tessa interprets the withdrawal as rejection and begins packing. Her best friend Scarlett advises that Blake's behavior suggests deep-seated fear, not indifference.

The turning point comes when Tessa discovers a secret room where Blake has covered a wall with her medical records, timelines, and notes. She accuses him of seeing her as a puzzle. Blake erupts: He loves her, has always loved her, and the room is proof he is terrified of losing her. They have sex for the first time. Afterward, Blake shares his full history. His parents died on Christmas Eve, and his grandmother died from the shock. He and his younger sister Faith entered foster care, enduring eight placements in six years. In the worst, their foster father beat them. One night, watching the man beat Faith so severely that Blake believed she would die, he killed him with a baseball bat. He also tells Tessa about Sarah, a foster mother who made him feel loved but gave him up when diagnosed with what she said was a degenerative illness, cementing his belief that everyone who loves him will leave.

Ryker catches them kissing and physically attacks Blake. Inside, Tessa reveals her illness to Ryker, and Blake discloses a poisoning theory. An intern has proposed testing for poison, reasoning that scattered symptoms with repeatedly normal results could indicate deliberate poisoning.

When Voss arrives in Blake's ER with injuries inflicted by his latest victim, Blake confronts him. Voss admits to assaulting countless women. Blake manipulates Voss's wound to ensure he bleeds out, calling a code blue only when it is too late.

The medical breakthrough comes at a dinner party when Blake notices hives on Tessa's arm and nasal congestion, recalling a lecture about mast cell activation syndrome (MCAS), a rare disorder in which mast cells release excessive chemicals throughout the body. Tests confirm the diagnosis: MCAS was likely triggered by Tessa's original viral infection and is manageable with medication, though not curable. Tessa breaks down with relief. Blake reflects that he found the diagnosis because he allowed himself to care, reversing his belief that emotional detachment makes a better doctor, and invites Collins, an intern who challenged that belief, to shadow him.

Tessa pulls off Shelly's wedding in seven weeks. Shelly surprises Tessa with a front-page magazine feature exposing a corporate rival's sabotage and positioning Tessa as the industry's rising star. At the reception, Eli corners Tessa and reveals he has been poisoning her all along, lacing her tea bags with low doses of thallium to keep her dependent on him. He tells her he has put a lethal dose of cyanide in her champagne. Tessa collapses.

Blake pursues Eli. Dr. Vaughn, the chief of surgery, warns that leaving will cost Blake the chief of emergency medicine position. Blake chooses Tessa without hesitation. Through a physical struggle, Blake manipulates Eli into revealing the poison is cyanide, texts Dr. Vaughn to have the antidote ready, then injects Eli with the contents of his own syringe, killing him.

Tessa survives after treatment with the cyanide antidote. Blake confesses to Ryker, now officially his lawyer, that he killed Eli deliberately. Ryker counsels him to frame the death as self-defense. A police search of Eli's apartment turns up toxins and a hit list. When Tessa asks how Eli died, Blake says there was a scuffle, and Tessa silently understands, accepting him completely.

In the aftermath, Blake reconnects with Faith, and they discuss the night he killed their foster father. He visits Sarah, now terminally ill, who explains she fought to get him back through the foster system but was denied. Blake stays by her side until she dies. He turns down the chief promotion, choosing to open a clinic for patients with difficult-to-diagnose conditions. He introduces Tessa to the Sinners and Saints as family. The novel sets up the next book: Scarlett confides to Tessa that she has been sleeping with Jace, who is the new owner of her company, and that Jace's best friend is hurting her at work. Scarlett receives an urgent text from Jace and rushes out in a panic.