Love in the emergency department

Here is what I learned from reading medical romance novels

Every 10 years or so, like a migrating bird returning to an improbable nesting spot, I revisit the strange, undiagnosed world of medical romance novels. I cannot explain this – not even vaguely. These are short, melodramatic romantic tales in medical settings, with invariably happy endings.

My first foray was in 2007, when I reported on 20 randomly selected medical romance novels in The Lancet. This was followed by a further instalment in 2016, when – with scant regard for my own mental health – I read 20 more such novels. The third instalment appeared in The Lancet this year: 20 more medical romance novels filled with stolen glances, dramatic pauses at the nurses’ station, and romantic outcomes unlikely to withstand routine clinical audit.

So, after countless furtive exchanges, stolen kisses, and amorous encounters in airborne medical settings, what can we conclude? First, emergency departments are vortexes of passion, primary care is a hotbed of romance, and airborne medical teams are passports to wedded bliss. Second, medical romances feature a bewildering number of babies. These include sick babies who miraculously recover from injuries and illnesses which would be fatal in any setting other than a romance novel. There are surprise babies who appear after little more than a fluttering of eyelashes across the clinic. And, finally, babies of unclear provenance whose sole role is to humanise their fathers – bereaved surgeons who devote themselves heroically to their patients to avoid dealing with their own personal losses, but whose emotional openness with their child is irresistible to their brilliant, dedicated, compassionate, athletic, dark-eyed colleagues in the operating room.

Third, love never dies, despite some extraordinarily complex medical circumstances which rarely make much sense. Love blossoms. The risk of eternal bliss is especially high when protagonists are located near defibrillators, beside neonatal incubators, or in air ambulances flying to rescue people from deeply unlikely predicaments in desperately remote settings. Happily, everyone survives. Babies follow.

Fourth, medical terminology abounds, but always in the best of taste. Hearts flutter. Stomachs lurch. Knees weaken. There is enough racing of pulses to worry the most experienced cardiologist, enough tingling of nerves to make a neurologist swoon. Truly, medical romance is not for the faint of heart.

The most exciting development in recent years is the appearance of psychiatrists. Up until this round of the study, no medical romance novel selected for this project featured a psychiatrist. It is fascinating that psychiatrists were not more prominent from the start. After all, medical romance relies on unprocessed emotion, life-altering epiphanies, and dramatic denouements – territory that any psychiatrist will recognise instantly from a routine day at work.

Despite the belated, happy arrival of psychiatrists, much remains stable in the world of medical romantic fiction over the past two decades. There is an endless supply of brilliant, towering, improbably muscular male doctors – each carved, it seems, from the very concept of heroism and many stationed in emergency departments. These rugged heroes radiate a distinctly Mediterranean heritage and are burdened by just enough personal tragedy to guarantee emotional depth once they meet the right person. And who is that person?

Female doctors and nurses are supremely competent, compassionate, beautiful, and propelled by a steely determination forged through personal and professional adversity. Protagonists of all genders have, as a rule, sacrificed their own lives outside the hospital in the service of their patients – patients who, despite presenting with an impressive array of life-threatening conditions, stage miraculous recoveries.

In the end, medical romance novels are a parallel clinical dimension where diagnostic certainty is high, emotion regulation is low, and the incidence of spontaneous lifelong commitment far exceeds anything reported in the peer-reviewed literature. It is a world painted in bold primary colours, where every corridor hums with latent desire, every on-call room crackles with impending revelation, and every helicopter landing pad doubles as a launch site for destiny.

Babies proliferate with the cheerful abandon of confetti. Surgeons brood magnificently. Psychiatrists gaze meaningfully into the middle distance, sensing – correctly – that everyone might benefit from a little more therapy and a little less helicopter turbulence.

And yet, for all its absurdities, medical romance offers something rare: A reminder that amidst chaos, yearning, loss, and wildly inaccurate resuscitation techniques, hope refuses to die. Minds meet. Hearts mend. Love triumphs.

Also: Babies. I cannot emphasise this enough: There are babies everywhere.

Prof Brendan Kelly is Professor of Psychiatry at Trinity College Dublin and author of Buddhism and Psychiatry: Moving Beyond Mindfulness in Mental Health Care (Open access: https://link.springer.com/book/10.1007/978-3-031-96045-1).