The female doctors in the Parkview Hospital emergency department decide that they will no longer allow gang members who assault healthcare workers in their community to escape justice. The neighborhood of Parkview is being terrorized by the Plagues, a gang of violent criminals and drug dealers, and the local police department is taking pay-offs to ignore their activity. After one of the ED doctors, Elita Romanov, is kidnapped and raped, she and her best friend, Dr. Kate Taylor, resolve to take definitive action against the Plagues, whatever the consequences. They systematically recruit co-wokers, friends and family members who are willing to break the law in order to restore the rule of law in Parkview. THE FIRST TO SAY NO is Kate's journey to achieve peace with her past and to eliminate those who threaten her future and the future of her neighborhood. Set in contemporary America, this novel illustrates many of the failings of today's healthcare system as Kate and Elita's startling solution unfolds in Parkview.