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  • Written by Maggie Leffler
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  • The Diagnosis of Love
  • Written by Maggie Leffler
  • Format: eBook | ISBN: 9780440336730
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Written by Maggie LefflerAuthor Alerts:  Random House will alert you to new works by Maggie Leffler


List Price: $9.99


On Sale: February 27, 2007
Pages: 352 | ISBN: 978-0-440-33673-0
Published by : Delta Bantam Dell
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This charming and accomplished novel chronicles a young doctor’s journey to heal her own heart–in a tale that will resonate with every woman who has ever tried to make a new start.

Dr. Holly Campbell is trying to outrun the symptoms of her life: her grief over her mother’s recent death, her chronic missteps at love, and, most of all, the doubts she’s had about her career since she started resenting her patients for being sick. So answering an ad for a residency program in rural England seems like the perfect escape.

By leaving home, Holly is following in her mother’s footsteps. But while her mother fled to medical school on Grenada, Holly has come to an odd little English hospital–where fate intervenes. For Holly no sooner learns that practicing medicine in England is like driving on the wrong side of the road than her twin brother’s runaway fiancée shows up on her doorstep, her grade-school crush turns up in her dormitory, and her mother’s old lover appears at lunch. How can Holly cure their ailments if she can’t even diagnose her own? Filled with the heartbreaking and healing powers of love, The Diagnosis of Love is the witty, warm, perceptive tale of a young doctor colliding with the past–and choosing her own future.


Chapter One


“Sometimes a sign can be equivocal or even contrary to what you’d expect.” –Oxford Handbook of Clinical Medicine

My brother, Ben, says that the story starts here, in the Volvo going 80 mph on our way to Chautauqua, New York. I think it started four months ago when Mama died. Or twenty years ago, when she left for the first time. But Ben says no. He says this is The Beginning, and I defer to him because a) He’s six minutes older than me, and b) If it weren’t for my ruse, we wouldn’t be on our way to Chautauqua in the first place.

I’m becoming more and more nervous as we hurtle down Route 79 in the pouring rain. An ominous oil tanker looms in my rearview mirror, while tandem tractor trailers rumble just ahead. I’m nervous because the last person on earth that I want to be doing me a favor–Dr. Mary Worthington–is doing me a favor: making hospital rounds in the ICU this morning so that I could get an early start on our road trip. No doubt Mary will try to negotiate completely unreasonable paybacks for her trouble. Then there’s the real reason my palms are clammy and my heart keeps turning over: I’m afraid that Mama isn’t going to show up.

Meet me there, Mama, I pray, gripping the clumsy steering wheel.

“Are you okay?” Ben asks, glancing up from his Time magazine. I can’t understand how he is able to read in a moving vehicle without vomiting.

“Why?” I ask, downshifting.

“You look funny. And you’re driving so . . . erratically.”

“I am not,” I say, stamping on the gas as we dodge past the tractor trailer train. I don’t remember much from college Physics except that there’s something about a pressure drop between two moving objects that will cause one of the trucks to suck the Volvo toward it and subsequently destroy us in a ball of fire.

“Promise you won’t get mad?” I ask finally.

“No,” Ben says, turning a page of his magazine.

I open my mouth to confess the truth but he realizes it before I can make a sound. “We’re not going to hear J. D. Salinger speak, are we?”

I shake my head.

Ben laughs, only he’s not happy.

My brother owns about four different laughs. There’s his Courtesy Laugh, a lifeless chuckle as if generated from the wind of a sigh. There’s his Leader-of-Silliness Laugh, which is startling and infectious and reminds me of a bad guy rubbing his hands together and booming moo-hoo-ha-ha. Then there’s his Don’t-Make-Me-Laugh Laugh, a snicker when he’s doing his best to stay in a bad mood but can’t. And his Disgusted Laugh, which Ben is doing now, something on the verge between a snort and a scream.

I know his noises well. After all, we shared a womb. Laughing-shakes probably rippled through Mama’s belly like electricity.

“Unbelievable, Holly. You made me drive two and a half hours from Pittsburgh–”

“I’m driving,” I say.

“All for J. D. Salinger’s book tour, which doesn’t even exist–”

“He’s a recluse!” I say, as if he’d been on the schedule and suddenly remembered he couldn’t come out in public. “He hasn’t written a book since 1965!”

“Who are we going for?” Ben asks.

“We’re going for Mama,” I say, even though Mama is dead.

“Come on, Holly. Who are we–” Ben stops and glares at me. “Oh, no. Not What’s-his-face.”

In fact, we are going to see What’s-his-face, also known as Joshua Peter, the star of Passing On, a show where the famous psychic talks to people who have already passed on to an alternative universe and now want to communicate to loved ones back on earth.

“Seriously?” Ben’s voice reaches a baffled pitch. “You dragged me 150 miles to witness this–this con artist waltzing around pretending to talk to dead people? You’re a doctor, Holly!”

“Meaning . . . ?”

“You’re supposed to be logical–and scientific!”

I inform him that a medical education can only do so much to reshape one’s basic psychological makeup. Besides (I think), when it comes to psychics, Ben shouldn’t be so narrow-minded, considering he’s in seminary and believes that God impregnated a virgin who bore a son who performed miracles. Joshua Peter doesn’t even resurrect anybody.

“You need to get out more,” Ben says. “You need a boyfriend.”

This stings more than I want to admit. As an SUV speeds past, spraying us with water, I steady the wheel and point out in a stiff voice, “I could have a boyfriend if I wanted.”

I’m thinking of Matthew Hollembee, a third-year surgery resident who has asked me out on several occasions since we met in July when he rotated through my hospital, St. Catherine’s Medical Center. It’s funny he should come to mind when I honestly don’t know much about him, except that he’s tall, thin, and wears thick, black glasses. I also know that before St. Cate’s, Matthew’s home base was London. And the fact that I’ve never accepted a date with him doesn’t seem to deter him from inviting me out again.

“So why don’t you?” Ben asks.

“Why don’t I what?”

“Want a boyfriend?”

“It needs to be the right person,” I say, feeling unusually prim, feeling like my grandmother Eve, who never stops harassing my brother for “shacking up” with his girlfriend. It still baffles me how my normally gun-shy twin ended up in such a whirlwind affair. They met in New York eight months ago, when Ben still believed he’d make it as a filmmaker and Alecia as a morning news anchorwoman. By June, just eight weeks after Mama died, they’d moved to Pittsburgh together so Ben could start seminary. According to Alecia, my brother’s Calling just happened to neatly coincide with her new job as a reporter for Channel Four Action News (“Alecia Axtel, taking Action for You!”). But this still doesn’t explain why they bought a dining room set and a couch together. (“Relax. It’s just IKEA,” Ben told me.) I can’t imagine sharing my sacred living space, much less buying furniture with another human being, no matter how inexpensive and convenient.

“How will you ever know who’s right if you don’t take a risk?” Ben asks. After a moment, I reply, “What did you think of Matthew?”


“Dr. Hollembee? The guy who saved your life?”

I’m only half exaggerating. In early July, Ben showed up in Saint Catherine’s ER with excruciating right lower quadrant abdominal pain. Matthew Hollembee was the surgery resident on-call that night who helped the attending remove Ben’s appendix.

“Oh, yeah, him. The guy with the thick glasses. He seemed smart. Competent,” Ben says.

“I mean personally,” I say, though the circumstances weren’t ideal for male bonding: a rectal exam followed by laparoscopic surgery.

“He’s nice, Holly. The sort of guy who gets beaten up and stuffed in a trash can in middle school, and now he’s got the last laugh because he’s a surgeon.”

“ENT,” I say, and then add when Ben looks puzzled, “He’s required to do a preliminary year of general surgery, but he’s going to be an Ear, Nose, and Throat surgeon eventually. Fundamental personality difference.” By this, I mean that Matthew is nicer than your average surgeon. Or maybe he’s nicer because he’s British; I don’t know.

“I’m kind of rooting for the guy,” Ben says.

“You say it like he’s the underdog,” I say.

“Every man is the underdog with you, Holly.”

We make a pact outside the amphitheater not to talk before the show starts. Ben has it all figured out. He’s convinced the place is bugged, and that’s why the audience has to sit around so long before Joshua Peter appears. Then, he says, the TV crew listens to the conversations, and Joshua Peter uses the information to fool people.

“I’ll prove it to you. We’ll say we miss someone like . . .” Ben starts snapping his fingers, “Aunt Velma. And then see if he mentions her name.”

“Someone in the audience is bound to have an aunt Velma who died.”

“Really? Velma?” Ben is doubtful, but I put my finger to my lips to make him shut up. We’re approaching the gate of the outdoor theatre, where an older woman is checking to be sure we have day passes. It has stopped raining now and evolved into a humid, sunny August day. There’s something about the crowd’s nervous energy that reminds me of hope. Just as I’m about to mention this, Ben says there’s something about the throngs of people that reminds him of the inscription on the Statue of Liberty: “Give me your tired, your poor, your huddled masses.”

Once we’re finally in our wooden seats, I start to pray, only I feel sort of funny about it. Ever since Mama died, she’s the one I pray to.

Meet me here, Mama. Meet me here. Say something to make me understand.

I am talking about the letter I found when I was going through her things after the funeral, a letter written to my mother in 1983, the year she left home for seven months to go to medical school in Grenada. She had applied to school in the United States and didn’t get in. Ben and I were only eight at the time–just six weeks before our ninth birthday. There probably isn’t a good age to have your mother leave, even if you know she’s coming back, but for me, it wasn’t easy. Still, Mama’s departure always seemed justified. She had a Calling to fulfill, no matter where it took her. Only it turns out that my mother was pursuing more than medicine that year. She was pursuing another medical student, Simon Berg.

Let the record show Mrs. Bellinger kissed me first, he wrote in his letter, apparently not knowing that her married name was Campbell.

Did you love him, Mama? I wonder now. If so, why did you come back? Did you always wish, after that, that you were someplace else? I add that if she’s going to answer any of my questions through Joshua Peter, to please do it in code, so the rest of the audience won’t find out the truth. I never even showed the letter to Ben. At this very moment it’s hidden in a fireproof safe, back at my apartment. I don’t want to ruin Mama’s memory, but I can’t let my questions go.

“Twizzler?” the woman next to me offers. She is sixty- something and has the rotund body habitus of a lady with type 2 diabetes, one who shouldn’t be eating candy.

Wiping my wet eyes, I decline. She takes a bite and remarks as she chews, “It could be a while. I hear he meditates before each show.”

On the other side of me, Ben snorts.

The woman asks us where we’ve come from and who we’re hoping to get a message from.

“Pittsburgh. And we’re not here for anyone in particular,” I say, forgetting to mention Aunt Velma. “We were just curious.”
Maggie Leffler

About Maggie Leffler

Maggie Leffler - The Diagnosis of Love

Photo © Hill’s Studio

Maggie Leffler is a family practice physician in Pittsburgh, where she lives with her husband and sons.


“This novel celebrates the support system that family and friends can offer in difficult times.”—Booklist

“I loved this book and loved its voice. How often is one both charmed and intrigued on page one and ever onward? Maggie Leffler's writing accomplishes that thing I enjoy the most: lively storytelling that is in equal parts wryly witty and touching.”—Elinor Lipman, author of My Latest Grievance and Then She Found Me
Reader's Guide|Discussion Questions

About the Book

What happens when a person works hard to be the ideal child and student, grows into a dedicated professional and all-around good person, but then suddenly realizes she doesn’t belong in the life she has carefully designed?

Dr. Holly Campbell is a young physician who is on a quest for answers that can’t be found in a medical textbook or be explained by the logic of science. After her mother’s death, Holly learns that she and her twin brother were nine years old when their mother had an affair. Shocked to discover this long-buried secret, Holly tries to reconcile this new facet of her family’s history with her version of the happy childhood she remembers. When Holly sets off for England, even she doesn’t know why she is there.

The adventure Holly embarks on when she lets go of everything familiar is brimming with hope, some fateful turns, and many unexpected discoveries.

The question and discussion topics that follow are intended to enhance your reading of Maggie Leffler’s The Diagnosis of Love. We hope they will enrich your experience of this charming novel.

Discussion Guides

1. Holly was motivated by a number of factors to make improvements to her life. What seemed to be the most significant catalysts, and why?

2. “I think of Matthew talking about truth lying in the space between things. That’s what I’m hoping for: to be convinced of just one true thing.” (page 189). Does the scientist in Holly allow for truths to exist without doubt? Does science leave any room for faith, or must every truth be proven beyond a doubt before it is accepted?

3. What does it mean to heal? Can doctors ever really be responsible for healing a person, or can they only heal part of the person? Beyond the physical, does the patient need to be a participant in the healing process, or can a broken person be “fixed”?

4. “It occurs to me that as a woman, I’m supposed to bring people into this world, and that as a doctor, I’m supposed to keep people from leaving it. By these standards, I am a failure.” (page 105). Whose standards does Holly refer to in this passage? Society’s, her family’s, or her own? What determines if your life is successful? Do you define your own standard of success, or is it your interaction with the world and others’ opinions of you that define your successes or failures?

5. At one point Holly wonders, “Is love a decision?” How much control do you have over whom you do, or don’t, love? Can you decide to be loved?

6. Did Sylvia, Holly’s mother, abandon her family when she went to Grenada to study medicine? Was she running away from her role as a wife and mother, or was she running toward something; a future as a doctor? What do you think would have happened to Holly’s family if the students had not been evacuated?

7. Do you agree with Holly’s father’s decision to stay married to someone who came back to their marriage not of her own free will but due to the outside circumstances that ended her affair? Once there, why did she stay?

8. Alecia, Holly’s future sister-in-law, advises her to “Let yourself go. At least long enough to believe that someone thinks you’re beautiful.” (page 125). Where do you suppose Holly’s self-esteem issues stem from? As a young woman who has accomplished a lot professionally, why do you think she is too insecure to feel she deserves a loving relationship or to live without putting up walls between herself and others?

9. Roxanne serves as a surrogate mother figure for Holly, Alecia, and others as the story unfolds. Do you think it’s her intuitive gift, illness, or her past relationships that gives her this nurturing disposition?

10. Sight is an important theme in this novel. Sylvia was an eye surgeon, and upon meeting Holly, Roxanne urges her to “Look around you…Maybe you need new lenses.” (page 144). Sometimes it takes stepping out of the world one is accustomed to, to be able to see oneself more clearly. Does Holly develop a rose-colored view of the world, or the ability to see herself being happy in an imperfect one?

11. A “recalled” minister-in-training, psi forces, God, a spirit guide named Clifford, a nationally ranked psychic, and Plato are all spiritual inspirations to Holly and her closest friends. In a modern age, is a confluence of beliefs encouraging or bewildering to those seeking guidance?

12. Each chapter begins with a piece of prescriptive advice or a diagnosis. What would your life be like if it came with its own textbook or instruction manual? Would it be a help or burden?

13. Does The Diagnosis of Love make you believe in fate? Why or why not? How does fate or serendipity traverse the lives of these characters?

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