When Nashville identified its first case of coronavirus in March 2020, the city was between Public Health Department directors and as unprepared as the rest of the world for what was to come. Dr. Alex Jahangir, a trauma surgeon acting at that time as chair of the Metro Nashville Board of Health, unexpectedly found himself head of the city's COVID-19 Task Force and responsible for leading it through uncharted waters. What followed was a year of unprecedented challenge and scrutiny. Jahangir, who immigrated to the United States from Iran at age six, grew up in Nashville. He thought he knew the city well. But the pandemic laid bare ethnic, racial, and cultural tensions that daily threatened to derail what should have been a collective effort to keep residents healthy and safe. Hot Spot is Jahangir's narrative of the first year of COVID, derived from his op notes (the journal-like entries surgeons often keep following operations) and expanded to include his personal reflections and a glimpse into the inner sanctums of city and state governance in crisis.