Advanced Review by Rafa: Necessary Medicine, by M.K. York

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necessary medicine mk york

Necessary Medicine, by M.K. York
Publisher: Carina Press
Release Date: April 24, 2017

Rating: 2 out of 5 Stars


With intelligence and humor, debut male/male author M.K. York delivers an emotionally charged slow-burn romance set in a prestigious Bay Area teaching hospital 

In the high-intensity world of hospital residency programs, there’s no room for romance. So it’s a good thing for first-year surgical resident Neil Carmona that his crush on the gorgeous cardiologist Eli Newcombe is sheer fantasy. Not only is the sexy doctor Neil’s superior, he’s also recently divorced.

As Neil’s skill as a surgeon grows, so does his friendship with Eli, and his silent, hopeless longing for more. It isn’t until Neil’s final year that Eli at last admits his own deepest desires. But Neil’s joy is short-lived: Eli has no intention of pursuing a relationship. Their positions in the hospital would make it unethical, even if he was emotionally ready for someone new.

Wounded and furious, Neil is determined to forget about Eli once and for all. But when a near-tragedy strikes, a new question arises: Is a life without love—without Neil—a greater risk than laying his heart on the line?


M/M Pairing
Gay Character
Bisexual Character
General Fiction
Age Gap
Workplace Romance (Hospital)*
*see review for more details

Content Warning for:
Graphic and Detailed Description of Surgeries

I have to start off by saying that I think the publisher is doing a major disservice to the author and readers by marketing Necessary Medicine as a romance. Basically, a good 90% of it read like a very detailed memoir of a medical intern/resident, with only the last 10% dipping into romance. That’s not to say the main character Neil didn’t have a love interest throughout the length of the book – he absolutely did. But it’s difficult to consider awkward crushing and embarrassing interactions over the course of 3 years as “romance,” especially when the book focused so heavily on his career.

I liked that the anecdotal style kept the book moving at a pretty fast pace, and it’s probably the reason why I was already halfway through when I rejected the idea of the book as a category romance. Identity crisis notwithstanding, in my opinion the ARC I received could’ve used further editing  (which it likely will). Apart from minor cleanup, I noticed the tense wasn’t consistent at one point. The biggest problem for me though was that the book was really bogged down with medical jargon including industry abbreviations and acronyms. And not just a smattering of the watered-down, audience-friendly lingo you hear on TV. While it probably made for realistic chatter, I did feel like I needed an appendix 75% of the time (no pun intended).

“Any interesting cases lately?” asked Neil after a while.
“I’ve got a woman with HOCM in the hospital right now. She was in for a procedure to ablate some of the hypertrophic tissue.”
“That’s pretty cool.”
Eli nodded. “I don’t see a lot of HOCM, although I would guess I see more than my fair share. I’m co-managing with Wei.”
“That must be fun.”
“Oh, he’s a charmer. But he’s good. How about you? Any good surgeries?”
“I’m starting colorectal. So, it could be better, could be worse.”
“What are you going to do for your elective block?”
“Hepatobiliary. It’s really applicable to gen surg practice.”
“So you’re still thinking general surgery?”

Also this, which was a small excerpt from a case that eventually Eli was called in on to work with Neil.

It took Neil twice as long as it should have to finish the surgery, because the bowel was so frail. But finally, finally, he had the intestines patched together, and he could start sewing up the surgical incision.
“Aorta’s still looking good ,” he reported to the Vascular attending, who was hovering at his elbow. “No mystery blood?”
“No mystery blood. How far did the aneurysm extend? Iliacs?”
“Common iliacs, yeah. We cut clear down to the bifurcations.”
“Well, it’s not like the rest of this isn’t going to have to go sooner or later.”The attending nodded in the general vicinity of the rest of the aorta. “It’s all going to fall apart on him. Best replace it while we can.”
“For now, I’m just going to focus on getting him put back together. You can cut him open again later.”
“Do you want me to close?”asked the intern.
“No, this one’s tricky because the tissue is so friable. I’ll take it.”
The intern nodded.
Neil layered the muscles and then the skin back together. “How’s his aortic root look?”
“Didn’t get a good look at it yet, we don’t have imaging on him. My money says it’s dilated, though.”
“With this kind of widespread aneurysmal degeneration, it pretty much has to be, right?”
“There are a couple other options, but that’s what I’d guess.”
Neil hummed softly in agreement as he finished the closing sutures. “All right. Think we’ve got him about patched up for now.”

As you can see, the book was very heavy on details and not just on surgical procedures: conference trips, staff meetings, workgroups, hospital initiatives, you name it. Yes, Neil and his crush Eli interacted during some of these times, but I thought the level of specifics were extremely tedious and detracted from the already nonexistent romance. In short, they had zero chemistry even when they became friendlier over the years.

From the way he behaved with Eli (both professionally and personally), Neil felt younger than his 30-odd years, and Eli… Eli was a complete mystery to me. The few times their conversations turned personal, Eli seemed torn up about the HIV/AIDS epidemic (which struck when he was in high school), and I kept waiting for more of his story to be revealed. I thought perhaps it had scared him into the closet, or he’d had a first love pass away, etc, but nothing ever came of those conversations.

One major positive is that when the romance finally kicked in, it was surprisingly heartfelt and hot. But I can’t lie, it took a lot to get to that point – a whole lot of nothing, followed by a lot of denial and petulant avoidance (ie. more nothing), until they finally acknowledged their attraction in the home stretch.

As a category romance, I’d rate this book a 1 star. As general fiction, I might give it a 3. So I settled somewhere in between with a 2-star rating. You might enjoy this book if you work in the medical field as long as you keep your romantic expectations in check. But if you’re looking to lose yourself in a romance – even a workplace romance set in a hospital – this book isn’t it.


Michelle K. York is a medical student on the West Coast with a master’s degree in psychology. Necessary Medicine is her debut novel. Previous work includes fanfiction, as well as academic publications on the social perception of sexual orientation and the intersections of sexual orientation and gender identity with patient experience in the medical profession.

You can purchase Necessary Medicine at:
Carina Press
B&N Nook

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I received an advanced copy of this novel in exchange for a fair and honest review.

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