The novel twines several plots together: the love story of Emilia Sauri and Daniel Cuenca; the Mexican Revolution; Emilia's medical practice; the love story of Emilia and Dr. Zavalza.

Emilia Sauri is the daughter of upper-class Mexican parents and is raised in relatively idyllic surroundings. Her father is a pharmacist and she learns his craft through a long apprenticeship with him. Emilia's long-time childhood friend, Daniel Cuenca, becomes her lover as they grow older and their love grows in passion while Daniel's involvement in popular struggle increases.

The Mexican Revolution is brewing and the Sauri's and Cuenca's lives are intertwined and involved in the struggle in various ways. When a wounded fighter is brought to the Sauri's, Emilia takes care of him, her "first patient," and thus begins her thirst for practicing medicine. She studies with Daniel's father, the indomitable Dr. Cuenca ("I leave but one bequest to my children: paralysis of the spine before the tyrant").

Drawn more and more into the struggle, Emilia joins Daniel on the front and practices medicine with the most desperate cases, along with the myriad poor people she meets along the way. Emilia also practices medicine with Dr. Zavalza, and finally marries him, although she never stops loving Daniel.


This novel represents the practice of medicine in some of its most desperate moments: on the battlefield, with the poor, with combatants wounded in spirit as well as body. Most useful, however, is how the novel deals with learning medicine.

Emilia's training is non-conventional (her medical school training is cut short) but incorporates most of the primary aspects of traditional medical education. Emilia learns medicine because she must, because she has a passion for it. She learns medicine because she cannot NOT work to heal people. Her mentors are equally passionate.

Dr. Cuenca, for example, teaches her "to be attentive to her patients' breathing, to listen keenly to the sound of their blood beneath the skin, to look into their eyes to discover the source of the illness . . . " (190). He also teaches her that "no one heals without the intense and single-minded desire to be a healer." (190)

With Zavalza, Emilia "verified the things she had learned from Cuenca." (203) Zavalza and Emilia delight in learning from many different sources and methods, including indigenous herbal medicine, homeopathic medicine, Chinese medicine, and others. The novel raises the question of what makes a good doctor ("Doctors who don't feel pain are terrible doctors" says Zavalza) and to what happens when physicians become engaged with the communities, especially those of the oppressed and poor.

The vision of engaged medicine the novel constructs is quite wonderful: "When the entire country was laid low by an epidemic of Spanish influenza, besides their own team of licensed physicians, Emilia called in an equal number of unlicensed healers whose presence gave the hospital the reputation of being a place where everything was possible. Living together there, enriching each other with an indiscriminate exchange of knowledge, were three celebrated homeopathic doctors, two Indian authorities who called themselves traditional practitioners, and a midwife more skilled in the critical art of birthing babies than the most famous New York gynecologist. In addition . . . each semester the hospital had a visiting physician eager to pursue innovative treatments." (357)

The novel is not short, but well worth the time it takes to read and would be quite provocative and instructive for medical students and other health care practitioners.


Penguin: Riverhead

Place Published

New York



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