New York Times and USA Today bestselling author of eighteen novels, former pediatric ER doctor CJ Lyons has lived the life she writes about in her cutting edge Thrillers with Heart.

CJ has been called a "master within the genre" (Pittsburgh Magazine) and her work has been praised as "breathtakingly fast-paced" and "riveting" (Publishers Weekly) with "characters with beating hearts and three dimensions" (Newsday).

Learn more about CJ's Thrillers with Heart at

Nerves of Steel by CJ Lyons

Dr. Cassandra Hart is fighting a war. And losing.

A deadly drug epidemic, a killer stalking her the ER doctor who never gives up.

Cassie's Pittsburgh ER has been deluged by young patients who have overdosed on a new drug, FX. After Cassie discovers that the source of the FX on the streets is her own hospital, her best friend is killed, and Cassie's life is threatened. She is forced to place her trust in Detective Mickey Drake.

Drake's irascible charm eventually penetrates the barriers Cassie has built around herself, and their relationship progresses from professional to passionate. After Cassie discovers the truth behind the thefts, she and Drake must confront a killer. In the end, their only weapons are their new found love and the courage that it gives them.



  • "A perfect blend of romance and suspense. My kind of read."

    -Sandra Brown
  • "Everything a great thriller should be—action packed, authentic, and intense."

    -Lee Child
  • "Her three-dimensional characters resonate with the reader long after the final page."

    -RT Book Reviews
  • "Tense, whip-smart medical scenes."

    -Tess Gerritsen
  • "…Harrowing, emotional, action-packed and brilliantly realized. CJ Lyons writes with the authority only a trained physician can bring to a story, blending suspense, passion and friendship into an irresistible read."

    -Susan Wiggs


Chapter 1

The Sikorsky helicopter thundered through the icy February night, its blades chopping against wind gusting off the Ohio River. In the rear-facing passenger seat, Dr. Cassandra Hart swallowed hard to keep down the chilimac she'd eaten earlier. Wishing it was only motion sickness, she tugged at her safety harness. There was no room to breathe, not enough air.

Motion sickness she knew how to fix. Irrational claustrophobia was another story. A curse, a weakness she refused to reveal, forcing her to mask her panic.

The view outside Cassie's window wasn't helping. The helicopter's blades tore into the low-hanging clouds, shredding them into tattered, ghostly remnants. Rain pelted the scarred Lexan windows, ricocheting like shrapnel.

Typical of Pittsburgh, a city constantly teetering on the edge of bankruptcy, few of the buildings they passed were lit. The ones that were, such as the Cathedral of Learning and PPG Place, stood like sentries in the dark, guarding against a pre-dawn invasion.

She bit down against another wave of nausea, her pulse drumming through her ears in time with the rotor blades. Across from her, Eddie Marcone, her flight paramedic, lounged in his seat, playing a hand-held computer game, oblivious to her distress and their impending doom.

A blast of wind catapulted the Sikorsky skyward. Cassie's restraints tightened against the sudden motion, squeezing against her chest. Gravity yanked them back down with a jolt strong enough to snap her jaws together.

"Weather's moving in fast," Zack Allan, their pilot, said. His voice reverberated through her headset. "Might have to turn back, doc."

Turn back? Cassie rubbed her clammy palms on the legs of her Nomex flight suit. Right now the landing pad at Pittsburgh's Three Rivers Medical Center seemed like a distant Nirvana. A Nirvana that would have to wait. The patient they were flying to retrieve, a girl found in the frigid waters of the Ohio River, couldn't.

"Ten minutes," she told Zack, denying the fight or flight instinct raging through her, every muscle quivering with the desire to escape. "We'll scoop and run, just give me ten minutes."

The Sikorsky bucked again. "They can send her by ground," Eddie said, his glare reminding her that her decision affected all of them, not only her patient.

"It'll take too long. This girl doesn't have that kind of time."

That was the problem with living in a city built around three rivers and several mountains. Tunnels, bridges and roadwork conspired against the rapid transport of trauma victims.

Zack's sigh resonated through her headset and she knew she'd won. Hah. If you could call being locked inside this flying death trap winning.

"You've got five minutes," he said.

They flew lower. The turbulence decreased from head-swimming, stomach-flipping to mere filling-rattling. The Sikorsky shuddered then landed on the last intact slice of macadam remaining at the on-ramp of the West End Bridge. Rotor wash overturned several orange PennDOT barrels, sending them skittering across the broken asphalt. Sleet pounded the helicopter. Cassie didn't need to look; she knew Zack was scowling.

"Hey, Hart," he shouted over the rumble of the engine, "one second late and I swear—"

Her fear drained away, replaced with the adrenalin of anticipation. A rescue squad sat at the entrance to the bridge, its lights aimed down the embankment that led to the Ohio River. At the water's edge two medics struggled to roll a small, pale form onto a neon orange backboard. Her patient.

Eddie joined her and they scrambled down the gravel slope. "Why do you have to always push the envelope? You know the pilot's got the final call."

"Zack's a worrier." Her gaze focused on the medics, and the girl's unmoving body.

"There's nothing wrong with that. Not when it's my ass on the line." He slipped in the wet scree and fought to catch his balance. "What makes this patient so important you're willing to risk my life?"/p>

Cassie ignored him, rushing forward as one of the medics slipped, almost dumping her patient into the river. She reached out to help stabilize the backboard, splashing icy water over her boot tops while Eddie arranged their gear on a pile of torn-up paving bricks.

"What've we got?" She raised her voice to be heard above the wind whistling through the bridge girders as they sloshed their way onto solid ground. A dark, tangled curl whipped free of its barrette. She twisted it behind her ear where it joined the rest of her rain-frizzled hair dripping down the back of her neck.

"Don't know. Could be a jumper," one of the medics shouted.

The girl was maybe fourteen, fifteen tops. Her lips were blue, her face pale, her blonde hair waterlogged. For a long moment Cassie couldn't find her pulse. There. Slow, thready, but definitely there. Good girl. Don't give up now.

"Severe hypothermia." Mud squished beneath her, revealing sharp rocks below it as Cassie knelt at the girl's head. "She's apneic. I need to tube her."

"We don't have time," Eddie said.

"Just give me a second," she muttered, her attention focused on her patient. The girl's skin felt cold, waxen. Wake up, Sleeping Beauty. Cassie's fingers parted her patient's blue- tinged lips. It was a difficult position to maneuver in, but she slid the endotracheal tube into place in one smooth movement. She reached for the ventilation bag to force oxygen into the girl's starving lungs.

"Slick," Eddie said in grudging admiration as he secured the tube with a few quick wraps of tape.

"Now or never, Hart," Zack shouted down from the helicopter.