Terrible Love: Cara McKenna’s AFTER HOURS

There is almost nothing more inexplicable than a 12 hour nursing shift.after hours cover

I mean, you’ll live a whole lifetime in a 12 hour shift, and you’ll be hungry at some point, and completely nauseated at some other point. At least once you’ll enter a flow of competence that will abandon you so suddenly you’ll want to shut yourself in the med room and weep, but won’t be able to because there is a code. Or patient who was supposed to be discharged but is now a pre-op, or a fire alarm. More than once, all of your patients will need something STAT all at the same time, and you’ll run, and you’ll worry, and you’ll wish it wasn’t July because it means all the fucking residents are brand-new and one of them is going to kill one of your patients if you’re not there, right now, to stop them.

You won’t eat, or pee. You’ll watch your patients take their meds with their giant jugs of icy water and be so thirsty it’s tempting to snatch the straw from their mouth and take a drink.

You’ll be filled with so much tenderness when your most difficult patient, who you know wasn’t trying to be a jerk but was just in too much pain, finally falls asleep that you’ll put your hand on their leg for a moment and look out the hospital window at the streetlights turning on and instead of thinking it was 7 a.m. when I got here, and now everyone is getting reading for bed you’ll think of this patient’s daughter or wife or husband or sister, whoever sat bedside with them during visiting hours. You’ll think of how they looked at you when they had to leave, fearful and grateful, and you’ll think about how glad you are that they won’t ever have to read this patient’s chart, the hopeless puzzle of it that can only be solved one tragic way.

Twelve hours is a lifetime that only a nurse and a patient understand. Only the nurse and the patient share that time, its routines and its chaos. How it locks the doors against the rest of the world and distorts how long it takes for an hour to end.

When we meet Erin Coffey, she’s still in the rest of the world, standing right outside the doors to her first 12-hour shift as an LPN in a psychiatric hospital. She’s perceptive and aware of the boundary, her training and her role as a caregiver to her grandmother has infused her with a great deal of respect for the boundary and what lies on the other side of it, but we find her on our side of it at the beginning of After Hours, and this is important, because Erin’s our only guide through this transfiguration wrought from unnameable moments of fear, long stretches of boredom, unbearable empathy with patients, and most unlikely, the discovery of love with the most unlikely person possible.

Some of you know that I’m not a stranger to the 12-hour shift. I’m a Pediatric Nurse Practitioner as often as I am a romance novelist and there is less of a boundary between the two than one might think. Not because healthcare introduces some particularly fertile ground for romantic entanglement, but because two people finding each other opens up the experiences of two lives to the other in such a way that the intimacy can be painful and dangerous feeling. Likewise, in healthcare, in caregiving, I am invited into some of the worst days of a family’s life and some of the best (first newborn exam!) and there isn’t a time, still, that I’m not overwhelmed by that intimacy and trust. I spend my days mired in the consideration of intimacy and caregiving and love.

Kelly Roback is an unlikely hero not because he is a physically imposing, bossy orderly with rigid worldviews, but because he prefers the world inside the 12-hour shift because of what he can offer to it and his patients. He recognizes that his physical strength and rigidity provide powerful comfort to his mentally ill charges and he is relentless and tireless in what I would call decentralized care—he wears the colors of the patients’ scrubs, he approaches the patients on their terms, and he remembers, first, that they are individuals with individual needs. It is so easy for patients to lose their humanity when they are hospitalized and so reduced to their diagnosis and most basic parts, but Kelly Robak’s real strength is that he protects them from that dehumanization. He has to be as big and as strong and as rigid as possible to do so. He stays strong for them, for these shifts, for the world inside the walls that holds his patients.

His worldview extends to his approach to Erin, which is to offer her what he is—which is primarily someone who is strong and who knows what he is and what he wants. I told Cara some time ago that I had this very singular experience watching Kelly and Erin’s romance develop in that it was incredibly visual for me. Their world in a post-industrial, post-urban Michigan is washed out, used up. Larkhaven hospital is colorless and bulky, indistinct. The entire novel is a canvas of institutional colors—the pale blues and yellows and grays of scrubs. The beige of linoleum and cinderblocks. As Kelly and Erin approach each other and scrub through all the ways they’ve been painted over like a cinderblock wall, they rise out of this canvas in stark, black relief. They sharpen, and find their edges.

They sharpen, too, as they discover the intensity of their feelings outside of and inside of the walls of Larkhaven. Inside, they share that hopeless tenderness for their patients that those who truly care for them cannot help, and they respect it in the other. This depiction of mutual professional respect provides a great deal of depth to a romance that in other ways is very dark. Because they also negotiate first, a sexual relationship that is urgent and explores power dynamics to the very edge of their comfort, and then their pain associated with increasing levels of intimacy and trust.

The marks their love story makes, against the unrelenting stretch of institutional canvas behind them, are monochromatic but beautiful and rich. This is fiction that takes up realism and characters that are tethered to our world, and it builds the world with devices that we are all so familiar with that we sit with a kind of pleasurable ache when we read and think about this story. Wonkomance guards the possibly of romantic love inside of a story like this and After Hours is evidence for such a mission.

I told Cara, too, that LPNs and orderlies and nurses and mental health patients and single moms (Erin’s sister) are not characters closely associated with romance, at least not when they are in their proper settings, facing the twelve hours in front of them. But this book makes expansive the limited settings and reflects the emotional atmosphere of the characters back on the world. When Erin is raging, she is driving the long, empty streets. When she’s considering and mulling and watching, she’s inside her workplace, locked in. This world and breadth of emotional palate is made with clean, spare language that belongs to the characters.

Twelve hours at a time, and the brief snatches of days off in between. These are the hinterlands where Erin and Kelly’s regard and erotic exploration and love are forged. Boundaries are created for each of them to step on one side of and then the other, and then the boundaries are redrawn. There is a way in which there is an incredible sweetness to their story. The mutual professional respect and encouragement to grow is one, their impulse to care for each other after moments of sexual intensity is another. It’s very beautiful and suggests how necessary these stories are to our genre—we need wonkomance. Kelly and Erin are reassurance that love grows from the best that is inside of us and not an ephemeral setting. The world we live in requires such reassurances. We require those moments, in the dark, where we can rest our hand in comfort on another who depends on us even as the world is racing by. We require that tenderness in the face of a world that tells us such tenderness is impossible.

We require such terrible love because it reminds us that we are not terrible.


I’m giving away two copies of Cara McKenna’s book After Hours via random drawing of those posting comments by 8 a.m. EST Thursday, 4/17/13.


About Mary Ann Rivers

Mary Ann Rivers writes smart and emotional contemporary romance. Read more >
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28 Responses to Terrible Love: Cara McKenna’s AFTER HOURS

  1. Mollie W says:

    This book sounds so good. Thanks for the awesome giveaway!!!

  2. JTReader says:

    I have been really looking forward to this book.

  3. keller knight says:

    Cannot wait! So tired of billionaires. Prefer real guys

  4. Debbie Pearson says:

    Sounds like a great read. Just from reading the outline of the story I know it is going to be better than 50 Shades.

  5. Laura Curtis says:

    Oooh, count me in. This sounds fascinating.

  6. Nicole says:

    I love that the genre is starting to embrace a grittier, more realistic view of the world and how love has a place even in that lack-of-millions world. Can’t wait to read this one.

  7. Maggie B says:

    I don’t think I’ve ever wanted to read a book by a new-to-me author more than this one!

  8. Amy R says:

    I have heard alot of good things about this book from the blogs I follow. Everyone is saying it is a must read.

  9. Rebe says:

    I’ve heard really great things about this book, too. Thanks for the giveaway!

  10. Shelley Ann Clark says:

    First, I just have to say that I absolutely love this post, and loved this book, and especially today, I want to hug you so hard for being a nurse. It’s difficult to quantify the part of jobs of caring that is, truly, CARING– but it makes such a difference to those you serve, whether it’s the patients of a nurse or a CNA, or the clients of a social worker, or the students of a teacher. (And the fact that the book’s two protagonists both care, even when working in a tough environment, was part of what rang so true to me and part of why I rooted for them.)

    It’s been interesting to me– and frankly, a source of some social-class-based insecurity– to see the discussion around this book. I was lucky enough to read it before today, and I immediately loved it. But I suppose I didn’t anticipate the number of reviews I’d see describing it as “gritty” or, in a few cases, “bleak.”

    I said this on Twitter as well, but my main sense when reading After Hours wasn’t of bleakness or grit, but of a deep and abiding familiarity. When my husband and I were first married, he had the same job as the hero in After Hours. He worked as a Certified Nursing Assistant at a state-run psychiatric hospital. He worked nights, 12-hour shifts, between 40-70 hours a week, while studying psychology and social work. We drove a 1983 pickup truck that didn’t always run and leaked gas. The issues with siblings and the choices they make, parents who aren’t storybook perfect– I’ve experienced all of those things.

    And yet, I never thought of my life as gritty. Or bleak. And I didn’t think of After Hours that way as I read it. I think I saw a lot of hope for Kelly and Erin. They were competent at their jobs. They cared deeply about and respected their patients. I firmly believed, at the end of the book, that Erin (and possibly Kelly too) would continue her education, and be a damn good RN (or, perhaps, social worker or doctor or licensed counselor). And their patients would be better off for having those two people involved in their care.

    I actually have a whole bunch of feelings about windows and mirrors and the challenges of writing fiction that is authentic enough to be an accurate mirror for people, and how to do it successfully (though I’ll save those for my own post, I think). Cara did it for me with this book. But the discussion around it has made me feel, in some ways, like I’m looking in a window from outside at the rest of the reading community.

    • Corina says:

      I love this comment so much. So so so much. I haven’t read this book yet, though I definitely will, but your comment that you didn’t see it as bleak or gritty, but familiar just bumped it up a few notches on my “to-buy” list.

      • Shelley Ann Clark says:

        Thanks! You won’t regret it. (At least, I really hope you won’t, since I loved this book & I’ll feel guilty if you don’t like it!)

  11. Michelle G. says:

    I’ve been so excited for this book for a while now, thanks so much for a chance at winning a copy!

  12. Alexandra says:

    I was so looking forward to this release, and now I hope I win a copy!

    And thank you for this incredible, beautiful review. I didn’t realise a book review could be as touching as a book itself. Thank you.

  13. Jane says:

    Happy Release Day to Cara. I’ve heard many great things about “After Hours.”

  14. Ruthie Knox says:

    In response to Shelley’s comment – it’s interesting, how often the word “gritty” is used to talk about Cara’s writing.

    When I think about AFTER HOURS and why it is “gritty,” I think it must have to do with the vulnerability associated with the heroine’s work, her poverty, and the poverty of the place where she lives. Erin is vulnerable because she’s taken a job in which she will routinely be assaulted, verbally and physically. She’s put her SELF on the line in her work.

    One of my best friends in college, who grew up in an upper-middle-class Indiana home, took a job at age 22 as a social worker at an adolescent psychiatric hospital. She was routinely verbally and physically assaulted by the patients. She stuck it out for several years — longer than most people do — and I still remember the reactions she got from people when she told them she was going to take that job. That low-paying, dangerous, heart-wrenching job.

    Why would she want to? She could get hurt. It wouldn’t pay well. It would chew her up and spit her out. She should do something SAFE instead.

    Shelley, when you talk about your work as a librarian, both here and on Twitter, I see this same kind of vulnerability. You’re doing work that USES you. It’s heart-wrenching, sometimes dangerous, often physically uncomfortable. You never just go to work and put in the eight hours and go home, without anything really HARD happening. Likewise, Mary Ann’s work as a nurse — there is no clocking in and clocking out. No drifting through the day, detached.

    So maybe the question is, if romance is to write about these professions, how? We can write about Mary Ann’s job but drift over it, highlighting the sexy bits (or making them up) and ignoring all the pain, the pathos — or we can really try to INHABIT THAT JOB and be honest about what kind of person wants to do it, how they feel about it, what frightens them, what redeems them, what they want from it, and — here’s the romance — what sort of person they might partner with who could support them, lift them up, without their having to change who they are and how they’ve chosen to interact with the world.

    I think when someone does the latter — when someone does what Cara does — it gets called “gritty.” And “gritty” means, not low-class, quite, but more like “uncomfortably vulnerable.” “So honest it made me flinch.”

    There is a sense in which readers go to romance for safety. “Make me feel comforted. Make me feel safe.” And Cara’s books don’t do that, or they don’t do it in the way that readers are accustomed to having it done. But what they do is so much better, because they show us the actual world that we inhabit, and then they show us the beauty in it. They introduce us to a vulnerable, skeptical, caring, GOOD heroine, and then they give her a man who is just right for her.

    And that was a lot of words. Sorry. I love this book, is the main thing. And Mary Ann’s post. And your comment.

    *group hug*

    • Shelley Ann Clark says:

      You basically wrote what I was going to write for my next Wonkopost. Ha! –The part about how to create authenticity and not just “background” for our characters has to do with emotional honesty. Cara’s not an orderly or a nurse, but her characters’ motivations and actions ring true to me. Mary Ann’s not a librarian, but she so perfectly captured a character who is one, and all that implies, in The Story Guy. Even if neither one of them knows every single detail of the work they write about, I’m along for the ride and I believe in these characters, including the jobs they do, because of that emotional honesty.

      I think it’s really interesting when you bring up vulnerability and my own work. When I first moved to Chicago and was working with teens on the South Side, I had no car. I was being sent into neighborhoods where I was afraid, and I asked my boss if I’d be safe. She looked at me and said, “There are kids who LIVE in those neighborhoods. What makes you think your life is worth more than theirs?”

      It was an eye-opening comment, to be sure.

  15. Mary Ann Rivers says:

    Grit wears us smooth and files down the places that were too rough or malformed. Erin and Kelly begin their relationship getting worked by the coarsest grit possible until so many of their rough places are knocked off, and so many of their more tender places are exposed, they’re polished. New to the other.

    Romance that features the occupations of the protagonist are complex because the occupation will become a character, too. The reader will watch how the protagonist engages with their work, how it changes or develops them, what their relationship is with the work and if it’s a good one or a bad one. There has to be emotional clarity associated with the job for the reader as well as truth, even if the facts are variably authentic.

    I’ve read romances that feature medical careers that are technically perfect but don’t argue for why the protagonist holds the job, or develop a world or relationship surrounding that work. I see that the RN character dropped an NG tube perfectly, but have no real idea why this character is a nurse. And just like I am left unmoored and unengaged if I can’t figure out why the h/h would choose the other; those settings that are described in technically perfect ways but unexplained ways cut my connection to the book right off, even as I can acknowledge accuracy.

    I’ve also read romances featuring medical careers that exalt or demean the role inauthentically–and like a too perfectly perfect character or a one-dimensional villain, it’s frustrating. The job should not stand as the primary characterization–a heroine who is a nurse is not also selfless and giving and kind by the singular virtue of earning her RN. One who is a doctor is not also noble and intelligent and sexy by the singular virtue of going to medical school.

    The best are like Cara’s here: Erin is an LPN because her a loci of her durable strengths and her personal experiences and her access to education suggested the career. More, she still has to learn it, understand how she fits into it, what it means to her. There is technical aspects and an art of it, and there are emotional, physical, and economic consequences. It shapes her, with its grit ever finer, and she pushes against it, exposing the parts of herself she wants to use in the job.

    This book is titled AFTER HOURS, and to me, as someone who works in the field of medicine, that’s an important clue to how authentications versus truth versus trope is handled, here. Inside the shift, there is little but the shift, the next moment in front of you, even as you collect what you will have to deal with, later. After hours is the dangerous space where you must come to terms with what you’ve seen, what your hands have done, who you’ve connected with. After hours is also supposed to be your own time–yet, as we see with Erin and Kelly, it is almost impossible to steal this time because it belongs to those you’ve abandoned during your shift and it belongs to the patients you can’t stop thinking about and it belongs to your increasingly complex relationship with your job. Erin and Kelly need the grit. They need their friction to be coarse. They need to feel something that belongs only to them.

    That’s why I said that how I think when I’m writing and how I think when I work with patients don’t have many distinctions. In both cases, I am very highly engaged. In both cases I have to think myself around very complex technical and emotional considerations. In both cases there is little time that isn’t occupied with the work. Even in the time I steal for myself, my relationship with my work is such that I choose to do things like comment and blog, talk to author friends, research on behalf of patients and argue with insurance companies. When I steal time, I steal it so those that I love have access to me (I play Pokemon and Lego with kid and make-out/make dinner with my husband).

    Like Erin, more and more, my setting doesn’t much matter. It’s the work in front of me, me doing it, and who is at my side.

  16. Shari Slade says:

    When my alarm went off at 5:45am this morning, my first thought was “how many times can I hit snooze?” My second thought was “NONE! After Hours should be in my Kindle.”

    I’d felt like I’d been waiting for-freaking-ever to meet Kelly Robak. Every little snatch of him I’d caught on blogs & in tweets had me on high alert. Blue-collar, imposing, a bit of a jerk…not afraid of a drunken polka. I wanted to meet him because…I married him.

    And I was not disappointed. I could totally picture my hubs & Kelly having a beer, shooting the shit over the fence, and sharing a good-natured gripe about their “chicken salad eating women.”

    I don’t often see my husband, my terrible love, represented in romancelandia and the fact that Cara captures this “guy” so well is part of the reason I fangrrrl so embarrassingly hard.

    For me, these stories aren’t gritty…they are REAL. But real in an emotionally satisfying way…the endings that much sweeter because they ring true.

    This is going on my DIK shelf.

  17. kare_bear83 says:

    So excited that we get new Cara! Have been going through withdrawal and taking the edge off my need for a fix by rereading her backlist.
    I recognize Cara’s characters. They are my people. My mom is a nurse who still works 12 hour shifts. I know the exhaustion and scheduling issues (we still get up at 5am every other year to celebrate Christmas morning together when she’s scheduled to work). My extended family are factory workers, tow-truck drivers, and other blue-collar workers in Buffalo. These people are familiar to me, and their happy ending seems more fulfilling because of it.

  18. Lee-Ann says:

    I’ve been looking forward to this book especially after reading the DA review. I don’t think I’ve ever been disappointed by a McKenna/Maguire book.

  19. Laurie Evans says:

    Beautiful blog post. Looking forward to this book.

  20. erinf1 says:

    Wow… i was already blown away by this fantastic review and reading the comments have made me equally thoughtful about this book.

  21. Kate D. says:

    First, I simply cannot wait to read this book. It sounds amazing. Second, the posts and comments on this site are so well written and thought provoking. I am such a fangirl of Wonkomance (the blog and the genre). If you, the First Ladies of Wonk, ever had a Wonkomance conference or retreat, I would go in a heartbeat.

  22. Justine says:

    Mary Ann’s post describing the (emotional) claustrophobia of 12-hour hospital shifts intrigued me, but then the thoughtful comments really prompted me to take a closer look at Cara McKenna’s work. I haven’t read any of her books before.

  23. Readsalot81 says:

    What an excellent review :) I’ve heard terrific things about After Hours and I can’t wait to check it out!! :D

  24. Kaetrin says:

    Want. Have been eagerly awaiting this book. Can’t wait to read it. :)

  25. Pingback: What-To-Read Wednesday: After Hours | Ruthie Knox