Two commitment-phobe doctors with conflicting views about burnout reluctantly fall in love
Reading Level: Adult Romance
Release Date: December 25, 2017
Pages: 198 pages
Reviewed By: Kate McMurry
Dr. Lily Reid, M.D., is 34. Seven years ago during her residency training, her fiance, a fellow resident doctor, committed suicide. Lily has avoided romantic relationships ever since and has no desire to ever have children. This horrendous tragedy also led to a permanent change of career for Lily. Unlike practicing medicine, which she realized at the time of her loss that she had only been pursuing because of family expectations, her new career became a passionate mission which got her through the darkest days of her life. Lily researches and lectures on the highly prevalent condition that led to her fiance’s death, “physician burnout.”
Dr. Wolf Knox, M.D., is 39. As a gorgeous, successful doctor, it is no surprise that he has never lacked for female companionship, even though he has made it extremely clear to every woman he has allowed to temporarily pass through his life that he is a confirmed bachelor who has no desire to marry or have children. He has no wish to be responsible to anyone but himself, and his only commitment is to his profession as a “hospitalist,” a dedicated inpatient physician who works exclusively at a hospital.
Ironically, though Lily preaches work/life balance, her own schedule is far more relentless than Wolf’s. She travels frequently for speaking engagements, and she has no outside interests besides her cause. She informs Wolf that burnout can be helped by cultivating interests outside medicine to relieve stress and put medicine in perspective, rediscovering what makes one go into medicine in the first place, and that hobbies can include anything from mountain climbing, to knitting, to joining a book club, to doing karaoke. But Lily has no hobbies, other than running for exercise.
Ironically, as well, though he argues forcefully and cynically in conversation with Lily against her passionate belief that physicians’ very survival depends on a healthy, work/life balance, Wolf himself is a living example of what Lily preaches. Though he vociferously defends systematic hazing of trainee-doctors in hospitals, he himself is well past his trainee days, and for many years now, he has had no reason to be burned out. He has no family obligations, and he has a terrific schedule at the Santa Monica hospital where he is employed. He works 7 days straight, 12-14 hours per day. Then he gets 7 days off. Repeat. As a result, he has plenty of free time to work out at the gym, ride his mountain bike regularly on a scenic, 14-mile trail, surf at the Santa Monica beach, and play a pickup game of hockey every other weekend. On top of that, he has a second passion, which he calls his “side gig.” He and his long-time friend Doug, another doctor, write parodies of hit songs substituting their own humorous lyrics which deal with important health issues. They call themselves Wolfman and WildDogg and have millions of followers on YouTube. These musical public-service announcements not only help the general public, but they also generate substantial extra income over and above Wolf’s hospital salary (which is presumably around $250,000/year, see below).
Though the sexual chemistry is explosive between Lily and Wolf, after their first date, during which he bluntly derides everything her life’s work stands for, she never wants to see him again. He presents himself as the embodiment of everything she is working to change in medicine, with an arrogant attitude reeking of the “suck it up or get the hell out of medicine” machismo that encourages and perpetuates the abuse hospitals heap on trainee-doctors.
Unfortunately for the powerful, shared determination of both protagonists to stay away from each other and stay comfortably single, they can’t resist the risky attraction between them.
I am a huge fan of Jill Blake’s romance novels about doctors. As a doctor herself, she writes with great authenticity about what it is like to be a doctor. As a therapist myself, with close friends who are doctors, I have long been appalled by the brutal system of hazing that interns and residents endure during their training in hospital settings. Dr. Blake has done a fabulous job of introducing this vital topic to romance fans as a gripping, dramatic backdrop to the main romance plot between these two fascinating, sympathetic protagonists. (I’ve added some more comments on the way physician burnout is presented in this terrific novel at the bottom of this review, for anyone as excited about that aspect of this romance novel as I am.)
Jill Blake consistently writes wonderful, multi-faceted protagonists. They are always decent, honorable people with strong growth arcs based on fascinating moral dilemmas. These two protagonists are especially memorable. We are allowed to get to know both the heroine and hero equally through their alternating points of view.
One of my biggest pet peeves in romance novels is when an author offers readers the prime requirement of a romance novel, a hero with a ripped physique, without the hero visibly doing anything to earn his sixpack. Ditto for the heroine having a sleek figure. I love it that Dr. Blake’s protagonists are healthy and fit because they eat well and exercise.
The sex scenes in this novel are sensuous, but never crude. They are romantic and tender and they aren’t just thrown in for their own sake. They contribute to the growth of the powerful connection between Lily and Wolf.
The setting of this book is Santa Monica, California, an area Dr. Blake is very familiar with and has written about extensively in this and other romance novels. It is accurately and enjoyably described.
I have read this book three times already, and I will probably read it many times again. I love all of this author’s books, but this is a particular favorite. It is definitely a “keeper.”
Below are some additional thoughts I have on the “ripped from the headlines” topic of physician burnout included in this outstanding romance novel:
Lily reminds Wolf, who knows this and doesn’t care, that doctors-in-training are supposedly protected by mandates from the Accreditation Council for Graduate Medical Education (ACGME). Their rules, which must be followed if hospitals hope to achieve and maintain accreditation, state that hospitals cannot force trainee-doctors to work more than 80 hours per week, which is already double time. However, in blatant rejection of these vital rules, hospitals routinely force trainee-doctors to work up to 100-120 hours per week. These doctors are also not supposed to be on duty more than 28 hours in a row, which is in itself destructively excessive, but many are required to be on duty, with no sleep, for up to two days straight. Sleep deprivation causes poor reaction time, cloudy thinking and can lead to chronic muscle pain. As a result, far too many trainee-doctors live off a terrible diet of coffee, junk food from vending machines, and fistfuls of Tylenol and Ibuprofen for pain from headaches, neck and back aches.
Trainee-doctors are also routinely forced to lie about these hospital, workplace violations to inspectors from the Joint Commission, a nonprofit organization that accredits more than 21,000 US health care organizations and programs. These generations-long, institutionalized abuses of trainee-doctors have continued unabated primarily due to a profit motive. Trainee-doctors are paid a very low salary (in a hospital, doing the same work, the average salary of a resident specializing in internal medicine in 2017 was $57,200, compared with the average pay of $247,319 for licensed medical doctors who have completed training in internal medicine). Salaried professionals, unlike hourly workers, are NOT paid overtime for hours worked beyond 40 hours/week. Thus, a resident working 120 hours per week makes about 1/5th of the salary of a regular doctor at the same hospital while working four times as many hours. In short, the hospital would have to pay four regular doctors approximately $1 million for the same work it pays a trainee-doctor a measly $57,200 for!
To enforce this corrupt system, the prevailing mentality that abusive hospitals force upon trainee-doctors is, “Take it until you die.” And hundreds do every year, due to clinical depression leading to suicide. These deaths are callously viewed as necessary collaterol damage in a constant effort to maintain a steady flow of cheap labor. Any trainee-doctors who dare to admit to being depressed, a depression that is almost entirely “situational depression” (depression directly caused by the horrible working conditions they are subjected to), are threatened with being reported to the state medical licensing board and potentially losing their license.
On top of the danger for the doctors themselves, sleep-deprived, unhealthy and depressed doctors are more prone to making mistakes which can lead patient injury and death. Johns Hopkins patient safety experts have calculated that, in the USA, more than 250,000 deaths per year occur due to medical error.
I rate this book as follows:
Romance Plot: 5
Physician Burnout Subplots: 5