1. Carolyn Jourdan must leave her glamorous, fast-paced life in Washington, D.C., in order to return to her small hometown to help her parents. What kinds of sacrifices have you made for your family? In what ways did those sacrifices affect your life? Were you, like the author, surprised by how you were changed by them?

2. Jourdan reflects on the differences between Michael and Harley’s lives: “Harley had a death wish. He’d been graced with an extraordinary physique, and he abused his body and sought release from the world. Michael, who’d been born with a bad heart . . . struggled heroically to stay alive day by day” (page 28). She then concludes, “If there was one thing I’d learned growing up in a doctor’s office, it was that people’s mood was rarely dependent on their external circumstances. Its origin was almost always internal” (page 29). Do you find that this distinction holds true based on your own experiences? Are there people you know who reflect Michael and Harley’s different approaches to life, and if so, in what ways?

3. Early on, Fletcher says to the author, “Your daddy’s smart. He could’ve done anything, could’ve been any kind of doctor and got rich, but he came out here instead cause he wanted to help people” (page 45). What are the trade-offs in being a small-town doctor versus being a doctor in the big city? What is gained and lost on both sides? What would we lose if small-town doctors disappeared?

4. When Jim Garrison comes to the office with a life-threatening emergency, the author thinks, “Somebody’s gotta do something about this” (page 79). She suddenly realizes that her father is the only person who can help. Have you ever been in a situation where you were the only person who could help, and if so, how did you manage it?

5. How would you characterize Carolyn Jourdan’s relationship with her father? In what ways is it similar to or different from her relationship with her mother?

6. After Taylor Jackson leaves the office, the author thinks, “Every day in this place was spent viewing the most personal and critical moments of other people’s lives.... I was inadequate to the experience” (page 124). Do you believe that’s true? How would you respond to the situations Carolyn Jourdan faces in her father’s office?

7. During one of her telephone conversations with Jacob, the author says, “You know how we always talk about wanting to be in public service so we can help people.... Well, in this place I feel sometimes like I really am helping people. Actual people. It’s not just an idea. I can’t help them much. I know it’s not glamorous, but sometimes I think maybe I’m doing more good swabbing up body fluids and being a friendly face here than I ever did working in the Senate” (pages 177 – 78). Discuss the different ways people help each other. How do you think caring for others informs who you are? Share an experience you had directly assisting someone.

8. Discuss the ways in which Carolyn Jourdan’s view of her father and mother shifts over the year. For instance, early on she describes them as “stoic” and “utterly self-contained” (page 41). How does she see them by the end of the book?

9. When the author catches a glimpse of a human heart during surgery, she says to Henry, “If that’s the heart, I gotta say, it don’t look like much” (page 278). Henry smiles and says, “A lot of the most important things in life ‘don’t look like much.’ ” Can you think of other examples in the book for which this holds true? Does this statement reflect a situation you have experienced?

10. Near the end of the book, the author realizes the true significance of the story about performing surgery with a pocketknife: “I’d always thought the story was about the astounding surgery. But it wasn’t. It was about using the talents you had, whatever they might be, to the most constructive purpose” (page 296). Who else mirrors this sentiment and why? Historical figures? People in your own life? To what degree is this true for yourself?