Uncontrolled passion in medical romance

As regular readers know, I’ve been working on an academic paper on medical romances, so I’ve read just about everything published from an academic or clinical point of view on medical romances — not exactly an amazing feat, since there is so little. Sometimes I come across a claim that has me scratching my head, like this one:

“These [medical romance] novels draw attention to the romantic possibilities of primary care and the apparent inevitability of uncontrolled passions of emergency medicine, especially as practiced on aeroplanes.” — Brandon D. Kelly, thelancet.com, Vol. 370, October 27, 2007.

Kelly is an Irish psychiatrist who read twenty medical romance on holiday and wrote a short tongue-in-cheek letter to the editor on them for The Lancet, which is one of the oldest and most influential medical journals. the BBC picked the story up, and Kelly elaborated:

If you were to take these novels literally, one would think uncontrolled passion is an inevitable consequence of working in the emergency room

The most amusing thing about this coverage is that it led major news outlets like the BBC and US News to breathlessly report, about fifty years after medical romance was well established, that “The medical romance novel appears to be a major subgenre within this category.” US News is on it!

While of course it is true that medical romance fiction highlights workplace romance, I disagree with the “uncontrolled passions” bit, at least as far as the ocntemporary medical romances I’ve been reading.  I haven’t found a single case of “uncontrolled passion” in the clinical setting.

It’s true that the protagonists experience occasional “intrusive thoughts” about their romantic interest. Here are some examples from the Brides of Penhally Bay series:

For now he was going to have to switch his brain into rescue mode and, as hard as it would be, he’d have to force himself to forget that the slender woman up ahead was anything other than a professional colleague. — Metcalfe, Josie (2011-03-01). The Doctor’s Bride by Sunrise (Brides of Penhally Bay) (p. 24). Harlequin Enterprises. Kindle Edition.

Every second of the journey she’d been overwhelmingly aware that the car following in their wake was being driven by Adam Donnelly, — Metcalfe, Josie (2011-03-01). The Doctor’s Bride by Sunrise (Brides of Penhally Bay) (p. 25). Harlequin Enterprises. Kindle Edition.

He wasn’t going to let the fact that he could smell the fresh apple scent of Alison’s shampoo affect him. No, siree! Neither was he going to pay any heed to the fact that he could hear her breathing. …Kacj made himself breathe slowly, in and out, and gradualyl his concentration returned.” Taylor, Jennifer (2011-04-01). The Surgeon’s Fatherhood Surprise (Brides of Penhally Bay) (Loc. 1489. Harlequin Enterprises. Kindle Edition.

Dragan. ‘All right. I trust you.’ Melinda hadn’t. The thought skidded into Dragan’s mind before he could stop it. He pushed the idea away. Now wasn’t the time to start thinking about the way his life had been turned upside down. He had a duty to his patients. — Hardy, Kate (2011-05-01). The Doctor’s Royal Love-Child (Brides of Penhally Bay) (p. 89). Harlequin Enterprises. Kindle Edition.

Despite a busy surgery, the afternoon dragged by and Oliver had a tough time concentrating and putting invasive thoughts of Chloe MacKinnon from his mind. — McDonagh, Margaret (2011-08-01). Virgin Midwife, Playboy Doctor (p. 17). Harlequin Enterprises. Kindle Edition.

‘I’m so sorry, Mike, I was…distracted.’ Guilt surged through her because she had been daydreaming about Gabriel instead of focusing on her patient. — McDonagh, Margaret (2011-12-01). Dr. Devereux’s Proposal (Brides of Penhally Bay) (Kindle Locations 632-633). Harlequin Enterprises. Kindle Edition.

I wouldn’t call these “uncontrolled passions.”  Actually, if I called them passions at all, I would call them “controlled passions.” Uncontrolled, to me, would mean acting on them despite not wanting to. At the very least, if we are going to call the thoughts themselves “passions”, “uncontrolled” would mean – to me — not being able to banish them.

I’ve read a lot of romance, and so I’ve read a lot of scenarios of uncontrolled passion. In these situations, passion makes people do things, usually sexual things, that are clearly not in their best interest, and not even, on reflection, what they actually want to want. The virginal historical romance heroine who has a clandestine sexual encounter at a ball, the romantic suspense couple who decide to have a quickie while being pursued by the bad guys, the contemporary heroine lawyer who sleeps with her client, and and the vampire hero who can’t resist sex with the vulnerable human heroine are examples of what I mean.

What’s happening in these medical romances is a bit different. It’s related to what Aristotle called “continence.” A truly virtuous person wouldn’t even have the passionate urges if those urges conflicted with reason. A vicious person, on the other hand, would have them and act on them without trying to resist them. An incontinent person would have the wrong desires, know they are contrary to reason, but would fail to stop herself from acting on them. But the protagonists in the medicals are “continent”: they have the improper passion, but they get it under control and don’t act on it.

One possible way of looking at the medical romance narrative is that the happily ever after, because it provides reliable and appropriate channels for those passions (that is, they are no longer contrary to reason), restores the protagonists to a state of virtue.

Kelly’s letter in The Lancet closes with this cheeky comment:

These novels suggest that there is an urgent need to include instruction in the arts of romance in training programmes for doctors and nurses who intend working in these settings.

But the joke’s on him, because funnily enough, Kelly himself

does fit one stereotype of these books: He is a (male) doctor who married a (female) doctor. Kelly met his wife of three years while in medical school and admits, somewhat chagrined, that his “no conflict-of-interest” statement to The Lancet was perhaps not quite accurate.

13 responses

  1. Great post, Jessica. I’m really enjoying your intellectual travels through the Medicals line.

    I think one of the things that makes the Medicals framework attractive to me is that they’re essentially workplace romances, but in a somewhat realistic sense (especially compared to boss-assistant romances in HP, or father-nanny romances in the Romance line). And as you point out, people keep their heads and their professionalism even while they are experiencing all these lustful/romantic feelings. It’s the way we’d like workplace attraction to operate, even as the professional caregivers are humanized.

    I’m still giggling at the fact that this made it into The Lancet, though.


    • Thanks! I think one of the reasons I’m so interested in medicals is that the protagonists are such good people. They often have tragedy in their past, but they deal with that in a very internal way (including, of course, refusing to fall in love!). It’s a stark contrast to some currently popular versions of romance, like New Adult or PNR, in which one or both protagonists has backstories full of tragedy (they are “broken”) and deal with it by behaving badly (drugs, dropping out of school, dangerous promiscuity, etc.)

      Then again, medicals are now published in one size larger print, so I guess that says something about its audience… and maybe about us, lol!


    • Hey Bev. Kelly doesn’t specify the publication date of the books he described, but I am guessing they were published around the time he write the letter, i.e. 2007.

      The ones I am referring to were published 2008-2010 in the UK, a year or two later in e in the US.


      • Wow, I did not realize medical romances were STILL being published. Or had made a comeback. Whichever applies.

        The ones I’m familiar with were circa 1950s-1970s. At least I know when I first started reading romances in the early 70s I ran across them a lot, but I was also getting them at the library then and quite a few of those were, well, not current. Like a couple of decades old at times. But they could also be found on the new shelves in stores then too, alongside or even within some of the category lines.

        I never could figure out whether I liked the format or not. The really odd thing to me was that if I remember correctly most of the ones I did run across then were set in continental Europe or someplace like Denmark or Sweden. There were occasionally some set in Great Britain proper but most of them seemed to be about English, or the rare American, heroine working abroad in an non-English speaking country.

        And as to that, I do also know that “doctor-nurse” romances, many of them set in third world countries, were very popular in the early, early days of paperback publishing (1940s, maybe early 50s) because I’ve run across a lot of their covers when browsing vintage sites.


  2. Oh, yeah, I knew there was something else I intended to say about those vintage “doctor-nurse” books. It’s not exactly proper to call them romances because in that era (1940s or even before that) of paperback publishing the genres as we know them know now hadn’t solidified. Some of them were published more as “adventures” with romance tossed into the mix but they were rarely if ever actually called romances then.

    The reason they came to mind, however, is because of this line in one of the quotes you mentioned: “of emergency medicine, especially as practiced on aeroplanes.”

    If I had to guess, unless the newer books have that type of stuff specifically, he was talking about those vintage era books because, like I said, they were many times set in remote locations – and I’m not talking about Australia there – and did involve airplane travel. In fact I could probably find a lot of covers with panes on them for that era of “romance”.

    I could be completely wrong but that’s exactly what popped into my head when I read that line.


    • I hadn’t thought about it, but you’re right, his reference to “aeroplane” does make it sound like the books are older. I just assumed he grabbed 20 off the shelf. Unfortunately, there is no way to find out short of asking him.

      As part of my project, I have tried to find out how well medicals sell these days, without much success. I believe they have always sold better in the UK and Europe than in the US. I think the heyday was likely the period you mention, the doctor-nurse books, but I have no way to be sure.

      As for whether they were genre romances, I personally do think of them as such, especially having read some historical material that includes editors’ conversations about guidelines, which look very much like what we have today in many ways — the alpha male, the HEA, the emphasis on an emotional courtship. But I definitely see your point about adventure and I suppose the lines between literary genres are never as clear as they at first seem.


      • After I commented on this I did a quick search online and found a blog you might be interested in if you don’t already know about it – http://vintagenurseromancenovels.blogspot.com/ – I was definitely fascinated by the covers alone. 😉

        As to them very much being genre romance, absolutely, at least from around 1960 on. Before that, it can get a bit iffy as how the books are labeled but even then the covers gave hints as to how the idea of certain “genres” were being played with in terms of money-makers and slowly coming into their own.

        Check out bookscans.com and look at some of the earliest covers by some of the publishers. Most of the earliest collections seem to contain a little bit of everything. That’s what made (makes?) the covers so important in telling what might “possibly” be in the books. Which is not all that different from nowadays I suppose, just that they (the publishers) hadn’t latched firmly onto the broad genre names we have now.

        The adventure part I was getting at with regard to the medical romances is the “travelogue” thing that was so much a part of so many of those early stabs at romance whether they were medical or, say, some kind of mystery/suspense. Or Gothic in tone if not time period. On so many of those early covers, if it wasn’t an airplane in the background behind the couple, then it was a train or a boat. AKA “off on an adventure” in some form or other. And, yes, sometimes the travel adventure was replaced with an occupation location adventure such as jobs in offices, hospitals or some other impression locale.

        As to how well they sell nowadays, I had no idea they were still around as a definite theme so I’m completely at a loss there. You might simply want to just ask someone at whoever is selling them now because If anyone could ballpark the numbers for you certainly they should be able to.


      • I think the Medicals sell well worldwide, too. I’ve certainly seen them in bookstores and airports in India and Southeast Asia. I’ll ask around, but my sense has been that the lower heat levels (at least until recently) and the fact that hospitals have similarities regardless of what country you’re in makes them familiar and accessible. Plus, there’s apparently a reliable readership for doctor-nurse romance that is somewhat harder to explain, even though I have been part of it over the years.


        • I’m surprised that Betty Neels’ name hasn’t popped up yet. She certainly kept the doctor/nurse romance going for Harlequin/ MB from 1970-2000. I don’t think any of her stories featured ‘aeroplanes’ (except as a mode of transport); I do know that several of her books featured doctors/nurses working on cruise ships.
          Her books would also be interesting to look at from an ethical POV (see, especially, “The Fateful Bargain”).
          I do wish the current medical books from Harlequin MB were easier to find in libraries or stores. I’m not quite ready to pay e-book prices for authors I’m unfamiliar with.

          @BevBB–yes! I’ve read a number of those really oldies (back in the day) and often the travel descriptions and the covers were the most memorable parts. That’s how I discovered Betty Neels–I was looking for more doctor/nurse stories–and I was hooked.


          • I agree that Neels is very important to the history of medical romance. and I do quote her once in my paper.

            But my project is very focused on a 16 book series published in recent years.

            I hope someone does a Neels project. She deserves it!

            And I will check out the Fateful Bargain.



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