This unique adventure based on fiction is a story, told in first person, about Jason Holt. A paramedic Emergency Medical Service (EMS) chief for a county ambulance service. During an annual quality assurance review of EMS records, he discovers several reports that have an unusual connection between them. 5500 to be exact that were healthy geriatric patients who died of natural causes, during transport by the ambulance service and were connected to a single individual. The bigger picture appeared to be one of the largest serial killings ever recorded. He needed more evidence to secure his claim. Near the end of his investigation he discovers only circumstantial evidence that points to not one individual, but a ring of individuals involved in this crime. Early one morning he prepares for a state inspection of the ambulance service. While he waits for the state inspectors to arrive he returns to his investigation, discovering the final key to his puzzle. Some, who have experienced the near death process, report that in their minds their life flashes before their eyes. Images he reviews are from past lessons learned, "Rules of Engagement" while running on adrenaline and attending the EMS School of Hard Knocks. Jason's graphic accounts of his past are burnt into his subconscious from adrenaline rushes, the payoff from running emergency, the thrill of a challenge, and a life saved. Reliving his personal struggles with the high rolling lifestyle of the paramedic image in the 1970's and 80's, the sexual and drug opportunities, the mental trauma he receives, and the pitfalls vs. rewards of his profession. He can't quit, he's an "ADRENALINE JUNKIE."