The Blue Cotton Gown by Patricia Harman

Patsy Harman is not an unusual woman. She worries about finances. She gets irritated with her husband's ability to sleep no matter what their current crisis is. She feels the need to listen to her patients and colleagues, and is just as sensitive as any other woman you're likely to meet (even if she doesn't cry as much).

What makes Patsy Harman a bit of an anomaly is that she's a midwife in Appalachia, and she and her OB-GYN husband operate their own medical practice, even though they don't deliver babies anymore (obstetric malpractice insurance got ridiculously high). They've had a bit of bad luck with accountants, and Patsy finds it difficult to balance the problems of her patients and friends with those of her own life.

One of the early reviewers said that The Blue Cotton Gown (a memoir) reads like a novel--and it really does. I didn't want to put it down. I had to know how Patsy was going to handle the accountants, whether she was ever going to get to sleep on her own, whether her teenage patient who lost twins was going to see the light about the loser she was sleeping with--or her friend's daughter, who was having a similar problem in her love life.

I cheered her victories and good decisions and commiserated in her frustrations and worries (seriously, how many inept accountants are there?). She introduced me to the business side of medical practice, which I hadn't really considered before. As with all businesses, there's a fine line between solvency and bankruptcy, and the Harmans are walking it. But even the financial worries--they got a letter from a legal firm; are they getting sued? or how do they get the IRS to quit taking the money they no longer owe them?--are nothing like worrying about whether or not you have cancer, whether or not you'll have to have a hysterectomy, whether that kid's overdose was an accident or suicide. And Harman balances them all beautifully in this memoir, with a generous splash of humor and other bits of light-heartedness to keep you from losing sleep over her problems.

If there's one thing that didn't quite sit comfortably with me, it's that most of the time, I had no idea this book was taking place in Appalachia, which has its own distinct character. Harman's practice could have been in Idaho or Maine or Texas if it weren't for the occasional references to local geography or the very rare mention of an Appalachian trait of the locals. Maybe it's because Harman isn't from the area, but I think I would've appreciated a little more local color.

All in all, highly recommended. I really wish I could remember whose blog I read a review of this book on--whoever you are, thank you!