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Book Review: Killing Season

Many years ago, when I started Peter Canning’s first book, Paramedic: On the Front Lines of Medicine, I was between shifts at a 9-1-1 agency wondering why I’d given up a six-figure salary in the corporate world to play civil servant.

The apathy and harsh habits of some patients were getting me down. Was I the only paramedic who dreaded going to work? No, but it seemed so.

Canning’s writing encouraged me to see my role as more of a problem-solver than a healer. Eventually I stopped seeking grand heroics, settled for small successes, and felt better about my midlife career change. Two decades later I’m still a medic, and Canning is still an author—good news for me times two.

Canning’s latest work, Killing Season, isn’t so much a mood elevator as a reminder that compassion is a crucial part of prehospital care. The book focuses on substance abuse in Hartford, Conn., where opioid overdoses became an epidemic long before anyone had heard of COVID-19. If you get as frustrated as I did by some patients’ self-destructive behavior, have a look at Killing Season—not to reinforce your opinions of addicts, but to change them.

Style and Substance

Canning is a writer who happens to be a paramedic. That much is clear from his easygoing, engaging style. The native New Englander knows how to tell stories and packs plenty of them into Killing Season. We’re not talking about superficial, been-there-done-that tales; rather, purposeful, patient-centered anecdotes meant to remind us addiction is an illness more than a choice. That’s an unpopular theme among those in our industry who favor Darwinism and “thinning the herd” over public access to naloxone.

Canning brooks none of that nonsense but is careful not to get preachy about helping others. He even concedes in Chapter 3 that he struggled with indifference during his early years in EMS. His greatest strength as a commentator is the way he titrates his Schweitzer-like observations about addiction. By the time you’re halfway through the book’s 270 engrossing pages, you notice your own exasperation with humanity softening. Killing Season made me want to be a better patient advocate—not a role I always find easy.

The author dummies-down drug-seeking behavior by offering examples of how trauma followed by painkiller prescriptions led to tolerance and dependence. That may sound like a no-brainer, but as a near-victim of that syndrome after several back injuries, I wish I’d been more familiar with the science of opiates covered in Chapter 5.

Do Less Harm

Perhaps the most valuable part of Killing Season is the concept of “harm reduction” introduced in Chapter 12. The term implies teamwork between healthcare providers and their patients to improve short- and long-term outcomes. That begins by labeling addiction as largely incurable. Three days’ cold turkey leading to redemption is a myth. Even rehab in a first-class facility succeeds less than a third of the time.

The next step is to go easy on judging others. “One thing we can do to end the suffering is to end the stigma,” says Canning, whose credibility is solid after a quarter-century patrolling Hartford’s seediest streets. By stigma he means the way society isolates drug users from the safety and opportunities offered others. Such bias adds emotional pain to an addict’s physical sickness and reduces chances of recovery even further.

Another important chapter, “Responder Safety,” tackles hysteria within the essential services about passive intoxication from fentanyl, a powerful painkiller used by dealers to cut heroin and increase profits. Despite what you may have read about cops and firefighters succumbing to secondary exposure, you’d have to bathe in fentanyl to incur any real risk.

Writing Killing Season required more than creativity and conscience; it took guts. It’s not easy to promote a point of view ridiculed by warped social-media groupthink. Canning won’t convince all of his colleagues that substance abusers are people first, but I think most of us who read this book will get better at our jobs and be happier doing them.

Mike Rubin is a paramedic in Nashville and a member of EMS World’s editorial advisory board. Contact him at

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