Miss Bates anticipates an Elizabeth Camden novel. She appreciated Camden’s previous novel, Into the Whirlwind. Since then, she follows Camden into her inspirational-lite, historical bent because Camden is a writer with ideas. Into the Whirlwind had grand sweep and great drama in its setting, the Great Chicago Fire of 1871. Camden is a thoughtful writer who considers context and a story to tell about how historical circumstances affect individual lives, important. She researches carefully and conveys time, place, and the concerns of ordinary people living in that time with skill and sensitivity. Miss Bates lays, however, the same caveats at With Every Breath as she did Into the Whirlwind. Those shortcomings are more apparent in the former. Set in the fictional Washington Memorial Hospital in 1891 Washington D. C., Camden tells the story of Dr. Trevor M. Kendall, tuberculosis specialist and researcher, and his statistician assistant, Kate Livingston, as they battle to cure a deadly and widespread disease. What a compelling idea for the background to a romance, thought Miss Bates, how unique and interesting. Moreover, how inspiring to have a mathematician heroine! Camden’s novel offers all this in concept, but suffers somewhat in execution.

With Every Breath has a delightful opening; our hero, Trevor, and heroine, Kate, are high school academic rivals. In their graduating year of 1879, they compete for the opportunity to be valedictorian and win a college scholarship. To Kate, whose parents run a boarding-house and restaurant, the scholarship is the difference between her love of study and merely working in the family business, worthy as it may be. Kate has dreams. Kate and Trevor’s rivalry is fierce and funny. It appears that the wealthy, standoffish, and Scottish-accented Trevor doesn’t need the scholarship, but he nabs it from Kate anyway. Yet there’s more to Trevor’s story than Kate’s working-class judgement is willing to concede. Twelve years elapse, during which Kate marries the love of her life, Nathan, and loses him to a workplace accident. She makes a career working in government as a statistician, but still lives with her family in their boarding-house. Trevor uses the scholarship money to become a doctor specializing in finding a cure for tuberculosis. After twelve years, in 1891, he searches out Kate and offers her work. Though Kate still resents Trevor wresting that scholarship from her when he didn’t need it, the challenge of the work excites her and she accepts his job offer.

This set-up to the novel, with its stubborn, smart protagonists and description of a devastating and near-forgotten part of medical history, was thoroughly engaging. One snippet of delight, for example, comes when Kate realizes that her new employer is none other than her old academic rival,”A fence post showed more emotion than his stern features.” Thus Camden also creates a wonderful dichotomy in her protagonists: the rational mathematician is a deeply emotional woman and the ostensibly compassionate, dedicated doctor is a man of deeply checked emotions. It looked, at this point, as if the old rivalry would see sparks fly, but the narrative is strangely flat after this promising start. It doesn’t pick up again until the mid-point, then ebbs again, and concludes with a too-neat resolution and some not-quite-understandable reversals to the characters.

Trevor and Kate settle into a routine: he visits patients and researches the disease and she compiles his findings and helps him keep his studies organized. They banter, argue, and grow to like and respect each other in a way they didn’t in high school. Their budding love is endearing; but overall, the narrative drags. To add conflict and mystery, Camden includes a suspense thread: threats in the newspapers to discredit Trevor, which escalate into more ominous threats in his office and invasive tactics that include Kate. Miss Bates didn’t enjoy this aspect of the novel: finding it tedious and sensationalistic. Miss Bates understands that it was meant to ratchet up narrative tension and provide external conflict, to move the plot along, and offer a rallying point for the protagonists. But the malevolence of Trevor’s mysterious enemy is not quite believable and makes the novel too long. Miss Bates wishes the thread could have been resolved in a more timely way. Kate and Trevor also suffer from what Miss Bates noticed in the protagonists of Into the Whirlwind: their obstinacy goes hand-in-hand with a certain unappealing peevishness. Kate and Trevor disagree on everything as regards the TB study and patients: especially Trevor’s emotional distance from his patients, one that goes so far as to refer to them by number and letter. Kate, on the other hand, is sensitive to them and mourns their loss deeply. Once we understand why Trevor behaves the way he does, however, we and Kate are sympathetic to him. Nevertheless, Kate and Trevor persist in a peevish adherence to their point of view that makes them difficult to like throughout the narrative.

As with Into the Whirlwind, Miss Bates enjoyed how meaningful work was important to the characters. It is a Protestant virtue and Camden’s portrayal is insightful, even when that peevish obstinacy interferes. It was a tad lugubrious to Miss Bates, however, and she would have really enjoyed some respite from the well-researched but persistent detailing of the ravages and history of tuberculosis. She’d have liked to see Trevor and Kate take a stroll in a park, share a dinner, do something to bring us out of the ward and relentless threats: even in romantic suspense novels, heroine and hero get to take a break from baddie pursuit. But the Protestant work ethic is uppermost here and that brings Miss Bates to the inspirational aspect of the novel, which, as she indicated above, was “lite,” but not as “lite” as it was in Into the Whirlwind, which was near-nil. This thematic concern made this a better, more complete inspirational romance novel.

With the history of tuberculosis in late 19th century America as the background of the novel, the inspirational aspect focuses on the characters’ coming-to-terms with death. Though in the same lugubrious vein, Miss Bates appreciated this theme and thought it added depth to the novel. Kate and Trevor’s past responses to loss and grief mar their present; the working-out of how they reach for love and, well maybe not laughter, but quiet joy at the end is one of the novel’s strengths. We learn how Trevor’s loss of two precious patients serves as the background to his purportedly cold demeanor. But his feelings for Kate, his desire for her friendship and support, for her love, change Trevor for the better. And, in the end, he is the one who is emotionally brave. Kate’s fears and anger in the face of her losses are more difficult to overcome: the loss of two brothers to diphtheria with Kate as their primary care-giver and the sudden accidental death of a husband she cherished. It is understandable that Kate is leery accepting another man in her life who works in a risky environment. But Kate’s dilemma is existential and spiritual: because of her experience, she cannot accept that God took her beloved brothers and husband. Kate’s anger manifests itself as anger against Trevor, but her true struggle is with God. It is to the novel’s credit that Camden portrays Kate’s surrender to God’s will without taking away her free will. Miss Bates loved this aspect to the novel.

Elizabeth Camden’s With Every Breath is, like all her novels thus far, worthy of a reader’s respect and consideration. She is one of the more interesting writers of historical inspirational romance, but Miss Bates would like to see a little sunshine in her storytelling, and not of the therapeutic variety, as we see portrayed in With Every Breath. Camden’s fifth novel is “almost pretty,” Northanger Abbey.

Elizabeth Camden’s With Every Breath is published by Bethany House and has been available since August 5th in the usual formats and chez the usual vendors.

Miss Bates is grateful to Bethany House for an e-ARC, via Netgalley, for her review consideration.