Laura's Blog

Page 229 of Wayne A. Wiegand's Part of Our Lives: A People's History of the American Public Library (New York, NY: Oxford UP, 2015) focuses on romance fiction. The excerpt below begins by drawing on a 1983 article in the New York Times:

Here are the end notes:


 

Following up on them, I think I found some things which were of just as much, if not more, interest than the details quoted by Wiegand.

The New York Times article on "Written Romance in the Stacks" from 1983 is available online here. It's significant that at Westville:

''We keep the collection primarily because it's very popular with the people, the ladies especially,'' says Shirley Moretto, the head librarian. ''We figure that if we get them in to read those, eventually they'll read the other books, too.''

She sounds like a parent trying to sneak some pureed vegetables into the diet of a picky toddler.

An admission of librarian cluelessness can be found in the 1998 Chicago Tribune article (available online - page 1 and page 2):

"We have changed our tune here at the library," said Vivian Mortensen, head of reader services at Park Ridge Public Library, near Chicago. "We used to feel that (romance readers) were sheltered housewives. But we find that many businesswomen read them, and every kind of person, from grandmothers to young mothers. We were thinking that this was a small group of people interested in this, and it's not. There are a lot of women out there who love them, and a few men. Some of my librarian friends say this is their favorite type of reading."

The Chicago-Tribune article on "The Color of Passion is Mostly White" from 1983 is available online here and it's worth reading in full. Here's an excerpt:

ethnic romances never gained momentum, despite the fact that Harlequin, the world's leading publisher of romances, estimated that 25 percent of its subscriptions went to blacks. [...]

Second Chance at Love, a division of Jove publishers, recently shelved plans for an ethnic line. " It was really a distribution problem," said senior editor Ellen Edwards. "If it were a strictly ethnic line, say black, we would have to distribute it only in certain bookstores."

In other words, Jove's management decided that the general readership would not accept ethnic romances.[...]

Editors, writers and readers offer various reasons for the failure of ethnic romances

One of those reasons is that the black romances were allegedly "missing [...] some flavor of the black experience" even though, as one AA author observed, they did reflect her experiences:

"My characters are college educated, professionally successful and well-rounded; they are the kind of people I know," said Stephens, who holds a masters degree from Harvard. "I wanted black characters, but the book is not about the black experience and struggle."

All of which seems to suggest that there was resistance to seeing black characters who were successful both professionally and in their personal lives.

Stephanie Burley, writing about popular romance fiction, asked her readers

to make a theoretical leap of faith based on two premises. The first is that the language of whiteness and blackness, light and dark, constructs the way readers imagine the fictional bodies populating these texts. The second is that this representational spectrum is indeed connected to our everday experience of actual bodies and the racial schemas that condition our understandings of those bodies. This color imagery invokes traditional racial taxonomies and their ideological investments in the erotic possibilities of light and dark skin. (326)

If that sounds fanciful, perhaps the reader would like to consider Lakoff and Johnson's research, in which they argue that although

metaphor is typically viewed as characteristic of language alone, a matter of words rather than thought or action. [...] We have found, on the contrary, that metaphor is pervasive in everyday life, not just in language but in thought and action. Our ordinary conceptual system, in terms of which we both think and act, is fundamentally metaphorical in nature. [...] Our concepts structure what we perceive, how we get around in the world, and how we relate to other people. (Lakoff and Johnson 3)

So, I was doubly perturbed to learn about "Dark Romance":

Forced seductions popped up fairly often in the historical romance novels published in the 1980s, wherein a lecherous duke or stable boy driven mad with wild lust would overpower a heroine and ignore her (ambivalent) protestations. Unadulterated rape fantasy, all but absent from romance paperbacks through the ‘90s, eventually came back to life through discreet self-publishing and has continued to gain momentum through online sales.

Currently, the taboo genre is thriving online under the banner of Dark Romance, which takes the rape fantasy even further by removing consent and kink. Books like Prisoner and Consequences are straightforward depictions of men taking women hostage and raping them; eventually falling in love with them, and then living happily ever after with their former victim. (Vargas-Cooper)

First of all, I'm finding it difficult to see how this really fits the definition of a romance novel in anything other than a technical sense. It seems to me much more like erotica with a tacked on happy ending. After all, the RWA definition of romance involves:

A Central Love Story: The main plot centers around individuals falling in love and struggling to make the relationship work. A writer can include as many subplots as he/she wants as long as the love story is the main focus of the novel.

An Emotionally Satisfying and Optimistic Ending: In a romance, the lovers who risk and struggle for each other and their relationship are rewarded with emotional justice and unconditional love.

That's not:

A Central Rape Story which centres around one individual forcing themselves sexually on another, who struggles to escape. The writer can include as many violations as he/she wants as long as the rape is ultimately legitimated by the victim's emotional capitulation.

An Emotionally Implausible Ending (unless you factor in Stockholm Syndrome): In a romance, the rapist who risks their victim's mental and physical wellbeing is rewarded with unconditional love.

And yes, perhaps the combination of the two was common in large numbers of romance novels in the past but I wouldn't have liked to read about it in the days of the "bodice-ripper" and I don't want to read about it now.

To get back to where I started, though, I'm also troubled that this is being called "Dark Romance" because I can't help thinking that in the past an association between darkness and rape led to the creation of

the figure of the "black beast rapist." In response to the mere rumor of such an outrage against a white woman, white men formed lynch mobs. They killed hundreds of Black men during the 1890s. (Martin 141)

The association, and the killing continued:

Make any list of anti-black terrorism in the United States, and you’ll also have a list of attacks justified by the specter of black rape. The Tulsa race riot of 1921—when white Oklahomans burned and bombed a prosperous black section of the city—began after a black teenager was accused of attacking, and perhaps raping, a white girl in an elevator. The Rosewood massacre of 1923, in Florida, was also sparked by an accusation of rape. And most famously, 14-year-old Emmett Till was murdered after allegedly making sexual advances on a local white woman. (Bouie)

And on 17 June 2015

A white supremacist gunman told his black victims "you rape our women and you’re taking over our country" as he massacred nine people inside a historic African-American church in the southern city of Charleston. (Sanchez and Foster)

Words matter. They shape how people think, often in a subconscious way. Instead of falling back on euphemistic language which has the consequence of reinforcing damaging associations between darkness, violence and rape, why not just call a romance with a central rape story a "rape romance"? And while we're on the topic, can someone come up with alternatives to "dark secrets" "blackhearted", accident "blackspots", "black marks" and the phrase which suggests it's a good thing to be "not as black as one is painted"?

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Bouie, Jamelle. "The Deadly History of 'They're Raping Our Women'." Slate. 18 June 2015.

Burley, Stephanie. “Shadows & Silhouettes: The Racial Politics of Category Romance”. Paradoxa 5.13–14 (2000): 324–43.

Lakoff, George and Mark Johnson. Metaphors We Live By. 1980. Chicago: U of Chicago P, 2003.

Martin, Joel W. “‘My Grandmother Was a Cherokee Princess’: Representations of Indians in Southern History”. Dressing in Feathers: The Construction of the Indian in American Popular Culture. Ed. S. Elizabeth Bird. Boulder, Colorado: Westview, 1998. 129–47.

Romance Writers of America. "About The Romance Genre."

Sanchez, Raf and Peter Foster. "'You rape our women and are taking over our country,' Charleston church gunman told black victims." The Telegraph. 18 June 2015.

Vargas-Cooper, Natasha. "My Hot, Consensual Introduction to the Rape Fantasy Romance Novel." Jezebel. 19 May 2015.

My academic garden/field has just thrown up a new bloom in the shape of an article by An Goris which is available, in its entirety, online at Belphégor. An focuses

on three standard elements of the category romance’s paratexts : the front cover iconography, the line template in the design of the category romance’s material packaging and the preview scene that is routinely printed on the first page of a category romance novel.

An's a member of IASPR and helped edit various issues of the Journal of Popular Romance Studies so she knows the field of popular romance studies well. Indeed, I'm sure she's met far more of the people working in this field than I have but, all the same, I'm not entirely convinced she's right about her romance-scholar-colleagues' attitudes towards romance cover art and so I started to feel a bit contrary early on in her article:

the popular romance genre is largely ignored by academics, who deem books that are supposedly all the same unworthy of their critical attention. Somewhat surprisingly, a similar mechanism plays out within the developing field of popular romance studies with regard to the genre’s materiality. Underlying this disregard is, I believe, the tacit assumption that the romance novel’s materiality, which even more than other aspects of the genre is imbued with stereotypes and conventions, is a relatively simplistic and straightforward aspect of the genre that is free of the interpretative complexities romance scholars now regularly (and, notably, against the cultural grain) uncover in the genre’s texts.

Speaking purely for myself, if I've avoided analysing romance covers at length (though I have taken brief looks at them from time to time here and at TMT) it's because I know I don't have the academic training required to analyse visual rather than written works. It should no more be taken as an indication that the cover art is "simplistic and straightforward" than my tendency to ignore rom-coms should be assumed to imply a lack of respect for their actors and directors.

I'd also have to query her statements about the conclusions to be drawn from the visual similarity of category romances which results from their branding by "line". According to An

the public tends to connote the extensive visual and material similarity of the line template in a rather negative way (category romances are generally considered inferior forms of literature because they are – or at least materially appear to be – so similar)

However, wasn't the iconic Penguin paperback design doing something very similar? 

According to Stacey Sheppard:

In the early days [of Penguin], [Allen] Lane insisted that all books followed a rigorous application of colour, grid and typography. Each genre was allocated its own colour: orange for fiction, green for crime and blue for biography. This commitment to design was further strengthened under the direction of German typographer Jan Tschichold in the 1940s.

He designed a template to be used for all Penguin books with designated positions for the title and author’s name with a line between the two. He also unified the design of the front, the back and the spine and redrew the Penguin symbol in eight different variations. This strict design ethos ensured that the same style was always applied.

So perhaps it's not the branding which causes members of the public to make assumptions about Mills & Boons/Harlequins, but their pre-existing beliefs about HM&B books which cause them to interpret HM&B's "strict design ethos" in a very different way from Penguin's or, indeed Virago's?

(photo from Paperback Reader's blog).

 

BowringI also noticed that although An is focussed on the cover art of category romances, she doesn't mention Joanna Bowring and Margaret O'Brien's The Art of Romance: Mills & Boon and Harlequin Cover Designs (2008). Admittedly Bowring and O'Brien's book doesn't provide rigorous academic analysis:

Part of a centenary celebration, this collection of some two hundred Mills & Boon covers offers a fascinating visual record of how our perceptions of romance, love, and drama have evolved over the years. With titles such as Romance Goes Tenting, Egyptian Honeymoon, and Beware the Beast, these novels' contents have changed dramatically as women defined their roles in the 1920s and 1930s; searched for heroes during World War II; strove for careers in the 1950s; engaged in free love in the 1960s; yearned for sexual emancipation in the 1970s and 1980s; and ultimately learned a lot about self-reliance while waiting for Prince Charming to show up.

These social transformations are reflected in the covers, chronologically arranged as full-color plates. An introduction charts the changing themes of the novels and explores the reasons behind the enduring popularity of the romance novel.

However, I did enjoy looking at all the covers and with over 200 "full-color plates" it would presumably make a good resource for someone interested in the genre's "materiality".

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Goris, An, 2015. "Hidden Codes of Love : The Materiality of the Category Romance Novel." Belphégor.

Sheppard, Stacey, 2011. "Judging a Book by its Cover." We Make Magazines.

In the wake of yet another article which warns women to be on their guard while reading romance because

bad romance novels cross a line. They go from being misinformed and silly to being visibly dangerous. [...] Is this really our “porn for women”, our romantic fantasy fulfillment? I think it’s actually a regurgitation of some of the basest forms of sexism sugar-coated with the guise of romance. (Townsend)

I thought it might be reassuring to look at some recent research published in Psychology of Aesthetics, Creativity, and the Arts:

Perhaps somewhat surprisingly, although the romance genre is associated with both sexual content and traditional portrayals of gender roles, exposure to this genre was not related to more gender role stereotyping or reduced sexual conservatism in our regressions controlling for other factors. In fact, in raw correlations, exposure to the romance genre predicted more egalitarian gender role attitudes and less gender role stereotyping [...]. A past content analysis might shed some light on why romance novels did not predict less conservative attitudes toward sexual behavior. This analysis found that romance novels contain rather typical depictions of sex, consistent with Western sexual scripts and with little mention of atypical sexual activities [...]. Although romance novels might contain sexual content, the nature of this content does not appear to be inconsistent with traditional Western norms surrounding sex. (Fong et al 6-7)

Maybe those worried about whether romance readers are being brain-washed into accepting patriarchal dominance should take some comfort from this. Even if, in statistical terms, "the association between romance and decreased levels of gender role stereotyping failed to reach threshold for statistical significance" (5) it certainly didn't provide any evidence at all that reading romance increases "levels of gender role stereotyping". As for "attitudes towards sexual behavior", the depictions of sex which you can find in romances do vary quite considerably so the conclusions researchers reach about "attitudes toward sexual behavior" will probably depend on which types of romance they select for study. Townsend's comment that "rape scenes in these books are depressingly common, so much so that it’s noteworthy when there aren’t any" does make me wonder if she was reading only decades-old "bodice-rippers".

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Fong, K., Mullin, J. B., & Mar, R. A. "How Exposure to Literary Genres Relates to Attitudes Toward Gender Roles and Sexual Behavior." Psychology of Aesthetics, Creativity, and the Arts. Advance online publication. 27 April 2015.

Townsend, Alex. "Tropes of Love: Gender Roles in Romance Novels." The Mary Sue. 10 June 2015.

Rosemary Johnson-Kurek has noted that:

The punishing kiss is generally unique to the hero; however, at least one Temptation heroine indulges in the practice. Driven by a furious jealousy, Nikki grabs a handful of Carter's hair and plunges her tongue into his mouth when he gasps at her action. "Reveling in her power she changed the tenor of their kiss, caressing rather than branding. Rewarding instead of punishing" (MacAllister 119).

The nature of the punishing kiss is a phenomenon definitely open to feminist criticism. It is the intent that is important. Some punishing kisses are passionate, lip-bruising consummations: "He took her lips in a powerful, punishing kiss, pushed beyond gentleness by two days of more frustration than a man should ever have to endure" (Schuler, Passion 172). Joshua's kiss, however, [in Summer Surrender by Abra Taylor] "started in anger, a seal to stop the provocation of her words" (79). The former is physically punishing in that it is a bruising kiss; the latter is a kiss meant to punish the heroine by intimidating her. (134)

If the "punishing kiss" is less common nowadays (and I have the impression that it is), perhaps that's because, as the heroine of Nora Roberts' Cordina's Crown Jewel (2002) acknowledges after having given one to her hero,

She'd pushed herself on him. All but forced herself on him. It meant nothing that she'd been angry and insulted and aroused all at once. Why if a man had behaved as she had, Camilla would have been first in line to condemn him as a brute and a barbarian.

She'd made him kiss her, taking advantage of the situation and her physical advantage. That was unconscionable. (82)

And, as she adds in her apology to him, "A sexual act of any kind must be mutual or it's harassment. Worst, molestation" (86). Of course, the hero's response is to initiate a punishing kiss of his own:

It was an assault, a glorious one that made her weak-kneed, light-headed and hot-blooded all at once. Even as she started to sway toward him, he gave her a light shove. Stepped back.

"There, that clears the slate," he said.  (86)

While I think romance readers are probably a lot less likely to tolerate abusive, sexist behaviour from their heroes than they once were, there are clearly times when the use of force is portrayed as sexy. There is much more recognition, though, of how problematic its use can be. And perhaps that's why, just to be on the safe(word) side, a modern hero is more likely to want to have a signed contract before he initiates any punishing.

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Johnson-Kurek, Rosemary E. "Leading Us into Temptation: The Language of Sex and the Power of Love." Romantic Conventions. Ed. Anne K. Kaler and Rosemary Johnson-Kurek. Bowling Green, OH: Bowling Green State U Popular P, 1999. 113-48.

Roberts, Nora. Cordina's Crown Jewel. New York, NY: Silhouette, 2002.

gender, sexuality

At the 2015 International Conference on Enabling Access for Persons with Visual Impairment (ICEAPVI) Shi Qiu, Jun Hu and Matthias Rauterberg observed that "Human communication contains both verbal and nonverbal information, which interplay in our daily lives. Nearly 65% of all human interpersonal communication happen through nonverbal cues" (157) and therefore

Nonverbal communication plays an important role in social interactions. However, most nonverbal communication relies on visual signals such as eye contact, head nods, facial expressions and body gestures. Visual nonverbal signals are inaccessible for the blind and hardly accessible for low vision individuals. (157)

These researchers "interviewed 20 blind and low vision participants over [the] Internet" (157); "Ten were from Yang Zhou Special Education School in Chinese mainland and the other ten were from Hong Kong Blind Union" (158). When asked a question about whether "Eyes were important or not in the communication” (161)

one participant said she understood the importance of eye contacts from romance novels, which highlighted the description of the eye contacts between lovers. (161)

It's true that lovers are known for staring into each others' eyes. For example, in 1970 Zick Rubin

predicted that college dating couples who loved each other a great deal (as categorized by their love-scale scores) would spend more time gazing into one another's eyes than would couples who loved each other to a lesser degree. The prediction was confirmed. (265)

The information about lovers' communication via their eyes which can be gleaned from romance novels may, however, be somewhat misleading to blind and partially-sighted readers:

Most participants in the interview gained the understanding of the eyes based on three primary different resources: 1) sighted people tell them (parents, teachers or other people); 2) read novels and other literary works, especially some romance novels described the eye contacts between lovers in details; 3) understand from their own life experiences, which were mostly based on the problems they met due to a lack of visual nonverbal signals. Partially because of using some metaphor and analogy to describe eye gazes or eye contacts in novels and other literary works, participants tend to exaggerate the function of the eyes. For example, one participant stated looking at a person could clearly know he was kind-hearted or not. In fact, it is rather difficult to determine a person’s inner character at the first sight even for the sighted people. (Shi Qiu and Rauterberg 162, emphasis added)

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Rubin, Zick. "Measurement of Romantic Love." Journal of Personality and Social Psychology 16.2 (1970): 265-273.

Shi Qiu, Jun Hu and Matthias Rauterberg. "Nonverbal Signals for Face-to-Face Communication between the Blind and the Sighted." Enabling Access for Persons with Visual Impairment: Proceedings of the International Conference ICEAPVI-2015, February 12-14, 2015. Ed. Georgios Kouroupetroglou. Athens, Greece: ICEAPVIA, 2015. 157-165.

[Both the articles cited and the whole conference proceedings are available online, in full, for free, via the links provided.]

 

Following on from the rancher's view of the happy-ever-after, here's one presented to a racing driver hero by his friend, Jerry:

"The way I see it, [...] marriage is a lot like racing five-hundred miles at top speed. The only sensible way to tackle that big a challenge is a lap at a time. Right?"

"Of course."

"Well, the only sensible way to tackle marriage and forever after is a day at a time." (Varner 166)

It's a metaphor which suggests that marriage, and the happy-ever-after, will continue to throw up challenges, all the way to the finishing line. Dan, the racing-driver hero, adds an extra touch of realism to the metaphor by observing that some cars are more likely to reach the finishing line than others:

Though he tackled his five-hundred-mile races a lap at a time, just as Jerry pointed out, he did it in a dependable car, with good tires and plenty of fuel. If he and Torie tried to tackle marriage, whether a day, an hour or even a second at a time, they would be doing it unprepared - without the two most important prerequisites: love and a willingness to compromise. They would not be able to survive the long haul; they would not win the race. (172)

Shortly after this, of course, they discover that they do indeed have enough love to fuel them all the way to the end of the race, along with an ability to compromise which will make sure the wheels don't fall off their romance before they reach the finishing line.

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Varner, Linda. A House Becomes a Home. New York, NY: Silhouette, 1991.

 

The photo is of "NASCAR driver Scott Gaylord's car, when he ran in the Winston Cup race at Sears Point in 1991" and was made available under a Creative Commons licence by Jay Bonvouloir. I came across it via Wikimedia Commons.

In 1992 Frances Whitehead, at the time the Editorial Director at Mills & Boon, had an article published about popular romance, in which she traced its history back to "the Greek novels of the 2nd and 3rd centuries AD" (62). She goes on to mention Richardson and Austen, then observes that

Throughout the 19th century, romance continued to appear in all guises and those at the top of the literary tree influenced the writers below them. [...] This curious situation, with romance simultaneously occupying the high and the low ground - the literary and the lowbrow - has continued in the present century. (Some romantic passages from D H Lawrence could be said to qualify for inclusion in both categories.) But whereas romantic love is an acceptable theme for a "literary" author, it is often a source of ridicule in more popular, down-market fiction. (63)

This sounded to me like a defence of popular romance novels, so I read on eagerly, and was pleased to see Whitehead comment that "writing romance isn't like painting by numbers" (64). It began to seem as though the main distinction, in her mind, between "literary" and "genre" fiction, was that, in "genre" fiction, the reader can expect the plot to develop in particular ways, according to which genre is involved:

Having followed the fortunes of hero and heroine throughout the book, the reader demands that they are united for all time. To have them decide that they don't want to spend their lives together would be comparable to James Bond admitting defeat or Christie's Hercule Poirot failing to solve a case. Predictability, the cardinal sin in the "literary" novel, is a necessary and reassuring factor for the reader of genre fiction. (64)

I was, therefore, rather dismayed to see the following statement in the closing paragraphs of the article:

Romantic novels are entertainment, not literature, and do not need to apologize for what they are. They serve their purpose and in the process keep countless women amused and happy, off the valium and out of doctors' surgeries. This in itself is justification. (68)

Sometimes, it seems the defenders of romance are indistinguishable from its detractors.

Edited to add: a response on Twitter reminded me of something I'd read before, which makes me think that Whitehead was probably echoing her boss.

Joseph McAleer, in his Passion's Fortune: The Story of Mills & Boon, states that:

The Mills & Boon imprint, like any successful commodity in a mass market, stands for a quality product, a kind of guarantee of an easy, thrilling, and satisfying read with an obligatory happy ending. This flavourful confection, wrapped in a brightly coloured paperback cover with a dreamy scene, is to many addictive in its escapist nature. Alan Boon, the acknowledged genius behind the stylized Mills & Boon romance, admitted the restorative quality of the novels which he edited for some forty years: 'It has been said that our books could take the place of valium, so that women who take these drugs would get an equal effect from reading our novels.' (2)

It's possible that Boon was just quoting something others had said, but with which he disagreed. However, the context in which it's reported, and Whitehead's reference to valium, make me fairly sure he shared her views and, probably, shaped them.

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Whitehead, Frances. "Love Makes the World Go Round (?): The Romantic Novel as a Publishing Phenomenon." Logos 3.2 (1992): 62-68. [The article has recently been reprinted elsewhere, and you can read the whole of it here.]

A Rancher's HEA, from Head to Toe

 

A Rancher's HEA, from Head to Toe

 

Nancy Cook has observed that,

true to its pastoral and bucolic roots, ranch life in romance novels almost always centers on "husbandry" activities. [...] the ranching activities in a romance novel don't build power or empire for power's sake; they don't speak primarily of sound business practice and land management; they speak of husbandry, of sensuality, of "Nature" as procreative force. [...] Most of the novels set on ranches make the link between animal husbandry and human husbandry explicit" (65-66)

"Husbandry" in this context, then, refers to "The care, cultivation, and breeding of crops and animals" (OED) but, as the existence of the word "husband" demonstrates, can easily be understood to have implications for our understanding of human romantic relationships.

In Robin Wells' Plain Jane Gets Her Man (1997), the hero, Jake Masters, is a rancher who has

only seen examples of what not to do in a marriage. He had no idea how two people were supposed to act behind closed doors in order to have a successful relationship. Could a person exhibit behavior they'd never seen modeled before? He didn't know. He only knew it was a huge emotional risk.

His eyes rested on the shadowed outline of trees across the pasture. He was accustomed to taking other types of risk, of course - that was the nature of ranching. Things like weather and market prices and the health of his herd were all subject to sudden changes, all beyond his control. He'd always accepted the ups and downs of his business, understanding that every drought would eventually end, every bad season would eventually be offset by a good one, every rough spot would sooner or later be replaced by a period of smooth sailing. He'd always taken a long-term view, rationalizing that if he just hung in there, and gave it his best effort, things would all work out in the end.
But marriage was entirely different.

Wasn't it? The question made him stiffen in the saddle.

Maybe it wasn't so different. Maybe he could apply the same principles to a relationship. (181)

Romance may have been accused of giving its readers unrealistic expectations of romantic relationships but this seems to me to be a fairly realistic assessment of marriage, and one which puts into ranching language the old words about a couple taking each other

"for better for worse, for richer for poorer, in sickness and in health, to love and to cherish, till death us do part" (Book of Common Prayer).

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Cook, Nancy. “Home on the Range: Montana Romances and Geographies of Hope.” All Our Stories Are Here: Critical Perspectives on Montana Literature. Ed. Brady Harrison. Lincoln, NE: U of Nebraska P, 2009. 55-77.

Wells, Robin. Plain Jane Gets Her Man. New York, NY: Silhouette, 1997.

 

The image of "Cowboy Boots and Hat" was created by MaurieF, who made it available under a Creative Commons licence. I found it at Wikimedia Commons.

According to Joseph McAleer,

After the Second World War, the NHS [National Health Service] inspired a new kind of popular novel that was [...] supportive and sympathetic to the emerging health care system. [...] the new 'Doctor-Nurse' novels first published by Mills & Boon in the 1950s [...] reinforced a positive view of the NHS among middle- and working-class readers. [...] the almost fanatical endorsement of the medical profession is striking. The message sent, and met with approval by adoring readers, was this: nurses are heroic and selfless; doctors are larger than life; the delivery system works; and hospitals are places of romance as well as healing. The NHS could not have asked for a better endorsement. (174)

By contrast, here's a short passage from a US-set romance from 1994, whose hero is a recreational therapist:

"Private insurance companies aren't willing to spend money entertaining people, as they call it." Matt's lips curled derisively. "They'll cover physical therapy costs, but most baulk at recreational therapy."

"I find that hard to believe."

"It's true, though. If medical insurance companies subsidized places like mine, there'd be hundreds of them across the country. Unfortunately, there aren't, and only the well-off can afford the few that do exist. I try to take on as many needy cases as I can, but that's not a huge lot," he admitted. "I have to pay my therapists' salaries and feed the animals, and I can't do that without charging."

"What a shame!"

"It certainly is. The United States is one of the wealthiest nations in the world, but we have no comprehensive national health plan. It's a crime that people have to pay so dearly for medical treatment. To make matters worse, the more medical problems you have, the less likely you'll find an insurance company willing to underwrite you. [...] I'm involved with a group that's been lobbying Congress for a national health care system. So far there's been a lot of talk about legislation, but not much else." (Duquette, 29-30)

I haven't yet seen any comparison between medical romances from the US, UK, Australia, etc but I think one could be very interesting given how different their medical systems are. The descriptions of some of US author Adeline McElfresh's medical romances, for example, are intriguing: in Doctor for Blue Hollow (1971)

The rundown clinic at Blue Hollow was a far cry from big, modern Bayley Memorial Hospital where Ann Tyler once worked. But for the lovely young surgeon, this tiny Kentucky mining town seemed a perfect refuge from the memory of a handsome doctor who betrayed her love.

Waiting for Ann was the challenge of protecting the health of the miners and their families, even though this meant battling the owners over safety in the mines.

It sounds as though the novel deals with inequalities in healthcare provision and also with the ways in which the interests of big business can conflict with the health needs of their workers and their communities. Another of her novels, New Nurse at Dorn Memorial, features a heroine, Celeste Weller, who

had never walked away from a challenge, and her new career at Dorm Memorial Hospital would prove to be the greatest challenge yet. Not only was she the first nurse to break the racial barrier at conservative Dorn, but through the bigotry of one of its influential patients, she was transferred from the Surgery Department, her first love. From there she was thrust into the hectic schedule of double shifts in Emergency and the clinic purposely designed to force her to resign.

Celeste knew a bigger city might give her a better opportunity for acceptance on her own merit, but she was determined that her small hometown would have to make room for her. And she had allies on the staff. But more than that, Celeste was the best nurse Dorn had ever had.

As far as I can recall, the medical staff in the UK-set romances I've met have been pretty much exclusively white, which doesn't seem very accurate given that

Once the NHS was up and running in 1948, demand for health service labour increased rapidly, not only for basic care but also for new techniques and technologies such as radiology and blood labs. At a time of overall labour shortages in the British economy, health service workers from abroad were vital, with recruits from the Caribbean and the Indian subcontinent especially prominent. [...]

The overall scale of recruitment from abroad is striking. By 1960, between 30 and 40 per cent of all junior doctors in the NHS were from India, Pakistan, Bangladesh and Sri Lanka. “The Health Service would have collapsed” said eminent doctor Lord Cohen of Birkenhead, if it had not been for this “enormous influx”. [...]

Around 30 per cent of doctors and 40 per cent of nurses in today’s NHS were born outside the UK. Those proportions may yet rise as an ageing population limits the potential supply of British-born staff while adding to increased demand for health care. (Bowlby)

I do know that Anne Fraser's The Playboy Doctor's Surprise Proposal features a hero whose "parents are from India originally"; it's set in Australia.

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Bowlby, Chris, 2011. 'How Immigration Saved a British Institution', History Extra, 28 July 2011.

Duquette, Anne Marie, 1994. The Dinosaur Lady (Don Mills, Ontario: Harlequin).

Fraser, Anne, 2010. The Playboy Doctor's Surprise Proposal (Richmond, Surrey: Mills & Boon).

McAleer, Joseph, 2011. ‘Love, Romance, and the National Health Service’, Classes, Cultures, & Politics: Essays on British History for Ross McKibbin, ed. Clare V. J. Griffiths, James J. Nott, & William Whyte (Oxford: Oxford University Press), pp. 173-191.

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