The prologue introduces the main character Inspector Lindsay Boxer, San Francisco P.D., who is in a depression and holding a gun to her head as a result of losing a love interest in a case called "The Honeymoon Murders".

The doctor, Dr. Roy Orenthaler, tells Lindsay that she has a rare, and deadly, blood disease called Negli's aplastic anemia.

Throughout the book, Lindsay struggles with the physical side-effects of getting blood transfusions for Negli's and the emotional aspect of having a life-threatening disease.

Kirkus Reviews stated the novel has "bargain-basement plotting, fewer thrills than a tax audit, and cardboard sleuths poised to return for a sequel.

"[1] In 2003, the novel was adapted into a television film, First to Die, starring Tracy Pollan, Carly Pope, Megan Gallagher, Pam Grier, Gil Bellows, Robert Patrick and Sean Young among others.