1. Elizabeth and Jason’s first impressions of each other are less than favorable, and if they didn’t look beneath the surface, the story would have been far different (shorter too). Have you ever formed a first impression of someone that turned out not to be accurate? What changed your mind?

2. Elizabeth struggles to be accepted as a woman doctor in the nineteenth century, when women’s roles were most often traditional. Do you think gender prejudice has ended now that we’ve entered the 21st century? Why or why not? Can you give any examples?

3. Do you think that the 19th-century idea of propriety, which is offended when Jason becomes Elizabeth’s patient, has changed? Can you give any examples to support your opinion?

4. Why do you think Gwen and Harrison are so slow to recognize that their attraction is mutual?

5. Were you surprised at the lengths to which Gwen was willing to go to become more attractive? Why or why not? Do you see any modern parallels to her reliance on patent medicine?

6. Do you think Elizabeth should have realized what was happening to Gwen earlier? Why do you think she was so slow to recognize the signs?

7. At one point, Elizabeth asks Jason why he hasn’t married, and he says, “I never met a woman who...” but doesn’t finish the sentence. What do you think he meant to say?

8. How do you feel about Jason’s temporary courtship of Elizabeth? Was he misleading her? Was there something else he could have done to protect her?

9. Our pasts, particularly our childhoods, often influence the decisions we make as adults. What do you think is the reason for Tabitha’s behavior? Why did she marry Nelson, why does she want to remain in a loveless marriage, and why does she take the actions she does at the end of the book?

10. Elizabeth believes that “Elizabeth the doctor” is different from “Elizabeth the woman.” Why do you think that’s so? Have you ever felt that you were two different people? If so, why, and how did you resolve the differences?

11. Elizabeth is worried about the long-term effects of corsets on her patients. Can you think of anything in modern society that might have equally damaging effects on health? (Smoking and drinking don’t count.)

12. If you were writing a sequel to this book, where would you start and who would be the main characters?