Anybody who ever has had occasion to sit at the bedside of a loved one in a hospital ICU begins to understand, in the starkest of terms, the delicate balancing act - the numbers, the levels, the chemistry - that our bodies undertake in every living second of existence
Readers will be reminded of this when they pick up the novel "Gemini" and are yanked into the 3 a.m. medevac helicopter delivery of a catastrophically failing Jane Doe to the intensive care unit of Seattle's Beacon Hospital (a fictional stand-in for Harborview Medical Center).
A combination mystery, romance, medical procedural and morality tale, "Gemini" is the latest from Bainbridge Island author Carol Cassella, who juggles her own dual careers as practicing anesthesiologist and best-selling author.
In this story, as in her previous books ("Oxygen," "Healer"), Cassella creates characters, relationships and situations to reckon with the increasingly uncomfortable intersections between money, law and medicine's scientific advances and ethical underpinnings.
Dr. Charlotte Reese is an emergency care physician in her late thirties. Her romantic relationship with Eric, a science journalist, appears to have stalled. It isn't that they have stopped loving one another, but that their views of the future are different. She is ready to start a family. He, for particular reasons, is not.
In the meantime, Charlotte's life is kept busy with her work, which at the moment includes keeping this Jane Doe in her ICU alive, and trying to figure out where she comes from.
Alternating with Charlotte's story is the tale of Raney, a teenager on the Olympic Peninsula. Growing up in the unconventional but loving home of her gruff grandfather, Raney is carving out her identity with the tools available to her - her talent as an artist, the limited opportunities in her small town, her allegiance to her grandpa, and her on-and-off friendship with Bo, a rich boy from Seattle.
And eventually, there is Jake - an exceptional kid in more ways than one.
Charlotte, meanwhile, is becoming consumed with her mystery patient. Despite working with law enforcement, the hospital has not turned up any next of kin to make decisions regarding Jane Doe's medical treatment. Assigning a guardian ad litem to make decisions is hardly the preferred outcome. Charlotte pushes hard to learn more.
Overall, Cassella has created a work of insightful characterizations, finely crafted language and socioeconomic contrasts that are detailed in almost Dickensian fashion. "Gemini" is an emotionally wrenching book on many fronts, although the contrast between Charlotte's anguish and Raney's tenacity presents a lopsided equation of hardship and dashed hopes.
In the end, "Gemini" relies on one of those quirky medical phenomena you'd expect to encounter in an episode of the old TV series, "House," and a plot twist that is remarkable at the very least.
I'd wager that with this book, more than many others, how you perceive the outcome may well depend on your own circumstances in 21st century America. Some readers will find it optimistic, and others will be downright offended.
The Bookmonger is Barbara Lloyd McMichael, who writes this weekly column focusing on the books, authors and publishers of the Pacific Northwest. Contact her at firstname.lastname@example.org.