(1) Story Statement
M must identify the true nature of those around her, understand her childhood issues, and overcome her tendencies towards people-pleasing and perfectionism, to survive ophthalmology residency at the intense and toxic Infirmary.
(2) Antagonists plots to point
Dr. D is the initial temporary antagonist/antagonistic force at the Infirmary. She sees M as a rival, is jealous of her, but also identifies with her - beautiful, competent, and interested in the same subspecialty. She is driven by order, organization, rules, in a completely chaotic environment whereby the only way to enforce this is coming down hard on the residents and forcing productivity. She spies on the residents, and is the personification of the unnerving, "haunted" sensation that permeates the Infirmary. She also gets a hint of sadistic delight from watching people (especially her primary targets), squirm and fall flat of expectations, and enjoys setting them up for this. She is very passive aggressive and uses other more "minor" villains to enact shame on the main characters. Unbeknownst to the audience/main characters, she faces a lot of pressure from the mysterious powers that be, which motivates a lot of her actions, in addition to her own insecurities about her own competence. Thus, it is discovered later that she is human, and perhaps not as evil as initially imagined.
Further antagonistic forces include (the "truer" and darker antagonists) include HSR (introduced early on who becomes a more visible character later in the series; a covert masogynist and narcissist), MC ( a co-resident, revealed to be manipulative, two-faced, and ruthless – financially motivated).
However, the Infirmary itself is the true antagonist of the series, as it generates such an overpowering workload in an archaic, inflexible system, which pits the characters against each other, revealing their true flaws and selfishness.
(3) Breakout title: The Infirmary
It's the name of the hospital, it's a pun off the main character's name, foreboding/mysterious, and the characters are all a little deranged.
Alternative: Window into the Soul
(4) Genre + Similar titles
Genre: Women’s Fiction/Romance
Tell me Lies by Carola Lovering
The Wedding People, Alison Espach
(5) Core Wound + Primary Conflict
Hook line: An over-achieving young woman struggles to identify friends from foe while pursuing rigorous training as an ophthalmologist at the illustrious yet malignant Infirmary.
(6) Other Matters of Conflict
Internal Conflict of Main Character
As a result of how she was raised, M has an unwavering feeling that she needs to be grateful for every opportunity, every friendship, every kindness that the world has given, which she must overcome as she will otherwise be eaten alive in this environment. There is turmoil when the powers above/expectations of her residency are in conflict with what is moral, which is delivering good care to patients. She takes her sister's advice to put up boundaries at work, to “clock-in and clock-out” in order to survive, which serves her to a degree. She ultimately realizes that is not the solution, but rather a balance is needed between engaging with her community while exerting boundaries.
The secondary conflict is the complicated romantic dynamics at the infirmary - the love triangle (more like a pentagon) with JL, a senior resident, who is mysterious, stoic, but adores her (who represents security yet escapism) and MJ, a charming, charismatic, but married fellow (who represents elements she aspires to be – charming, charismatic, above the drama, bright, but unattainable).
She will also have smaller conflicts with other residents – KH (who she initially clocks as a nemesis who turns out to be a reliable ally), MK (initially marked as a mentor but turns out to be fake, undermining, and herself incompetent), MS (a toxic, aggressive adversary, but who pushes her), ML (passive aggressive but a foil to demonstrate her competence in the end).
(7) Setting
The setting is the New York Eye and Ear Infirmary in the East Village of New York City.
The building is tall, black brick, a foreboding structure with an uncharacteristically whimsical pink-blue awning declaring it a recently acquired product of Big Hospital. This juxtaposition is foreshadow to the clash which occurs with Big Hospital’s acquisition of the Infirmary—the new, financially motivated Big Hospital versus the archaic infirmary.
It is countless stories tall.
The first floor is the resident-run ophthalmology clinic – the urgent care is located near the front, where the security guards sit, since that is where the residents see patients after hours (alone, without supervision). In the back is the bustling clinic during the day, with a vacuous waiting room which usually becomes Standing Room Only by 2PM. The residents rotate through, along with the different subspecialties, which is a theme of the novel – characters always rotating through, as the infirmary sits, unchanged and unbothered, a silent witness to the events.
The second and 4th floor are the OR’s. The second floor is where more ratchet cases go down, where general anesthesia can go, lots of delays and where most resident cases go, especially early on. The fourth floor is much more organized, kinder staff, and runs more like a private practice. Seniors tend to operate here, and straight-forward cataracts are mostly done here.
The third floor is pathology, the conference room, and where ENT used to be.
The fifth floor is the old inpatient rooms, which are not used and almost certainly haunted. Later, Big Hospital will use this space for gender reassignment surgery.
The Infirmary sits in the vibrant and exhilarating city of New York—attracts interesting individuals, lots of diversity; underscores the fact that although these characters live amongst millions, they end up trauma-bonded to each other in this small world. As the book goes on, she makes fewer and fewer attempts to connect with this outside world—initially seeing friends, her sister, and dating outside the Infirmary, but eventually resigning.
