My PCA Paper in Gifs

I presented on Harlequin medical romances at the PCA meeting. Here’s the paper in Gifs. Don’t hit the jump unless you don’t mind gifs, have a fast connection, and are prepared to wait for all the gifs to load.

Bioethicists have gotten interested in all kinds of narratives, including fictional ones. But genre fiction tends to be overlooked in favor of an emerging canon of Literary Novels of Bioethical Significance.

Usually depressing…


Some bioethicists look at commercial fictional narratives to show how they misinform their uneducated lay readership…


“Wait. How am I able to speak normally while trached and vented?”


…or stoke anxieties that trained bioethicists can allay with public health education…


“I don’t even know what ‘conscious uncoupling’ means!!”


Those are all important aims, but I think it’s possible to view commercial fiction as actually participating, however indirectly, in bioethical conversation. If movies like Contagion tells us about the anxieties of the age, maybe medical romances tell us something about its ideals. It can offer a snapshot of socially salient views of medicine that, despite being “niche” (the group that reads medical romances in the UK and the US is demographically narrow, as far as I can tell), interacts in interesting ways with more widely disseminated images.

My paper focuses on the sixteen books in the Penhally Bay series. I make some broader claims, but the main thesis is limited to those sixteen books.



The Penhally Bay series was written in the first decade of the 21st century, a time when organized medicine was having a lot of internal debates about what “professionalism” means. Organized medicine perceives a number of threats to medical professionalism, among them commercialism, third party interference, conflicts of interest, loss of trust, less autonomy, and inappropriate dancing:



In response, organized medicine, represented by a wide array of global partners, including national medical organizations, specialty groups, accrediting bodies, and private companies, launched a coordinated and comprehensive professionalism project.

gray's anatomy

The professionalism project emphasizes old fashioned values of altruism, compassion, and integrity. It focuses on individuals, and on maintaining continuity with a perceived tradition of medical professionalism dating back 200 years. Medical sociologists, identifying a number of competing accounts of medical professionalism, identify this as “nostalgic professionalism”.



I think that the Penhally Bay series presents a version of medical professionalism closely aligned with nostalgic professionalism in several ways:

1. Technical mastery; medicine as possessing a discrete, highly specialized body of social knowledge that occupies a uniquely important social position. Doctors restore health and save lives.



2. Altruism: Doctors are not in it for the prestige or money. They are supremely hard working, always on behalf of patients.

gray 2

3. Doctors have an integrity that helps them withstand threats to professionalism. They don’t sweat pesky lawsuits, third party payers, commercialism, Dr. Google, or any of that stuff:


4. If there are injustices in society, medicine is positioned outside of them. Medicine is not implicated in these: it can help. I imagine this would be the reaction of the doctors in Penhally Bay if someone actually named organized medicine as part of the problem:




5. The technical mastery medicine requires is nothing without emotional intelligence. These doctors are caring, compassionate, and empathetic. When their patients suffer, they suffer.



The medical romance series, at least as much as, but probably more than most other subgenres of romance, presents protagonists who are really good people. Since medical romances are workplace romances, it helps to have the hero and heroine work in a profession that requires excellent people skills, a high level of emotional intelligence, and that maintains a fairly high level of social status and approval. A number of the qualities that make for good doctors in the Penhally Bay series also make good romantic partners.



Although other scholars have written that medical romances are basically propaganda for the NHS, I detected some critique of the NHS, and also of medicine more broadly. I describe this critique as a counternarrative, or at least a minor counterpoint to the main narrative of nostalgic professionalism. Here are three of the counterpoint narratives I detected in the texts:

6. The texts go to great lengths to portray the doctors are hard working, not just because they want to, but because they have to. They are always understaffed and underfunded. Why? If they are so effective in their work, and so badly needed by their community, why aren’t they being funded properly?




7. Organized medicine is a hierarchy with the more specialized doctors at the top and general practitioners at the bottom. They are paid more, have more power when it comes to individual patients and hospital policy, and demand, and get, more social esteem. Not in Penhally Bay, where the skills of the GP reign supreme.


(That gif doesn’t fit. I just wanted to use it.)

8. Nostalgic professionalism focuses primarily on individual integrity to solve the professionalism crisis, tending to underemphasize the importance of the medical and social environment. Penhally Bay, set in a close knit rural community, is almost another character. The books emphasize the role of community in good doctoring. Our environment, natural, built, and social, partly makes us who we are:




9. This is the reaction I was hoping for from the audience:



10. Instead I got this:



11. And this from one lady in the back:




12. Seriously, nobody made fun of romance, although I was ready:



The conference was fun and educational, as always. Chicago is great. The people attending the con were great, as always. And now I’m back home and back to life.




Thanks for reading. Gif free blogging to come later this week.

11 responses

  1. This is the BEST conference paper I have ever read through. Interesting and hilarious and the Zoolander gif definitely fits in. You have raised the bar, Jessica. 😀


  2. Great paper, great Gifing. I read all your conference tweets and am looking forward to your reflections. How many people ended up at your 8am on last day session?


    • Thanks Merrian. I am hoping to figure out how to Storify the tweets. I’m not sure whether I’ll do a reflection post on the con.

      Welllll.. there were 3 panelists and a mod, so that’s four. Maybe five additional people. ! The conference had been in full swing since Wed and the place really cleared out by Saturday. My co-panelists were fantastic, tho. Their papers were very evocative for me, and one in particular made a number of connections between our work.


  3. Love this! It showcases your substantive and thoughtful scholarship but also your sense of humor.

    I was at your session, and I know that the discussion focused primarily on narratives that lacked a “happy” ending (chronic illness/chronic pain). I’m wondering now whether the more upbeat narratives of the medical romances (always an HEA or HFN) made them appear as if there was less to debate. Medical romances (I’m presuming here) must conclude with a “cure,” which narratives about chronic illness/chronic pain cannot. I’m thinking that the technical mastery that is part of that nostalgic professionalism requires the hero and heroine of a medical romance to always conquer illness and injury.

    So I’m wondering about the audience for medical romances that may, if I understood you correctly, include some medical professionals. (The books were advertised in nursing magazines, right?). Does the medical romance have a dual HEA for this audience, one that positively resolves the romantic relationship and one that makes certain the sick and injured get cured/healed by the doctor and nurse?

    Or, is this double HEA part of the fantasy for all readers of medical romances, especially, perhaps, for people suffering from chronic illness/chronic pain? In other words, the appeal of the medical romance is more than just the romance itself; it’s the comfort in knowing that the illness narrative has an HEA as well.

    Sorry I didn’t think to ask this at your session.


    • Very interesting question. I’m not in the medical field, but I tend to find romances that get very close to home re medical issues more infuriating than comforting. I can certainly see it working another way though, especially since the medical romances I have read seem to make an effort to get details right. (Unlike, say, Harlequin Presents that include medical issues.)


      • Good questions. And thank you Dr. M, for coming! There was one hero with fairly significant injuries from a bombing. They caused him scarring, pain, a limp, and fatigue, and would never go away.

        There was a heroine with infertility, but, it was Magic Romance Novel Infertility. She was pregnant by the end.

        There were also some patients who had chronic illness, and at least one IIRC who was elderly and died. But, in a short category, no characters other than the hero and heroine really get much page time.

        I know that editors seek writers in nursing journals, but I did not see ads for the books in nursing journals. I’m wondering if the audience for medicals is aging, since they are published in large print, and are still more conservative and chaste compared to a lot of other romances.

        My sense was that the comforting vision of medicine is geared to the lay reader.


  4. The actual paper sounds fascinating. While I’m not generally a big gif fan, I was prepared to do it for you Jessica! (And I don’t know what “conscious uncoupling” is either. It sounds like something that happens at a railway station…


  5. Pingback: Links: Thursday, May 1st | Love in the Margins


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