In the 20th century, doctors and nurses became sex symbols and romantic heroes and heroines as medical Mills & Boon novels grew and spread with the newly created NHS. Agnes Arnold-Forster explores the surprisingly nuanced pictures of women’s lives and clinical labour that they depict.
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We can all probably identify some key features from the ‘doctor-nurse’ romance trope. As in this image from the mid-20th-century, male surgeons and physicians were portrayed as aloof, decisive paragons of masculine authority, and increasingly idolised in both fiction and in real life. Female nurses, too, became symbols of idealised femininity, capable of being both virtuous and compassionate, and, by the swinging Sixties, the sexually available “naughty nurse”. These stereotypes played out on film and television screens and in the pages of romance novels. They reshaped public perceptions of medical professions and altered the experiences of real-life doctors and nurses.
Night Nurse Lucy cover. Source: Author's photograph. © Mills & Boon.
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One of the most enduring examples of fictional portrayals of doctors’ and nurses’ love lives is the medical romance novel. Shortly after the Second World War, Mills & Boon began publishing a new sub-genre, the doctor-nurse romance. These were incredibly popular, sold very well, and are still published today. The author of this novel, ‘Night Nurse Lucy’, wrote over 60 romance novels between 1957 and 1977. When writing, she drew on her twelve years of experience as a staff nurse at Nottingham City Hospital. ‘Night Nurse Lucy’ was one of her first books, published in 1960, and it follows the traditional format. Female nurse meets male doctor, they fall in love and get married. Lucy was everything a nurse ought to be: kind, chaste, and as depicted on this front cover by artist Jack M Faulks, an angelic English rose.
Surgeon for Tonight cover. Source: Author's photograph. © Mills & Boon.
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Many medical Mills & Boon novels (including ‘Surgeon for Tonight’, as indicated by the front cover) involved a conflict between two women over the affections of a man. Many of them also tended to endorse the widespread cultural trope that nursing was a route to marriage for working-class women. In Hilda Nickson’s 1962 novel, ‘Staff Nurses in Love’, the heroine’s best friend, Brenda, says, “For every one Florence Nightingale in nursing… there are dozens more like me who take up nursing because they think they might be able to hook a famous doctor or surgeon.” Despite their sometimes saucy titles and sultry cover art, post-war Mills & Boon novels were very chaste. Couples rarely even shared a kiss before their inevitable engagement, and the stereotyped nurse in this context was more angelic than naughty.
The Gentle Surgeon cover. Source: Author's photograph. © Mills & Boon.
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While some medical romances tied their heroines to restrictive gender roles, and confirmed stereotypes, many others crafted subtle and emotionally engaged men, and equipped their female protagonists with the freedom to find meaning and satisfaction in their work. Hilda Nickson’s early novels might have adhered to the conventional story of male doctor and female nurse (as in ‘The Gentle Surgeon’, 1963), but she also included female surgeons and physicians. In ‘Surgeons in Love’, published in 1962, the heroine, Madeline Keys, was (as the title suggests) a surgeon in love with her colleague, Francis Meyland. Like her nursing colleagues, Keys is not only beautiful, but professionally competent and skilled.
A Yankee Surgeon at St Bride's cover. Source: Author's photograph. © Mills & Boon.
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Delving into Mills & Boon’s back catalogue of medical romance fiction reveals some unexpected details. These novels frequently put forward much more nuanced visions of womanhood, professional identity, and clinical labour than we might expect. The authors of medical Mills & Boons always had professional healthcare experience, and they were expected to make their novels accurate and authentic. Elizabeth Gilzean (who also used the pseudonym Elizabeth Houghton) trained as a nurse in Canada before moving to the UK to continue her hospital work and launch her writing career. Gilzean conducted extensive research for the ‘background’ of her romances, and always insisted on the brilliance and ability of her female healthcare heroines.
A nurse, advertising hospital open days. Source: Wellcome Collection. © Central Office of Information.
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The history of the doctor-nurse romance is intertwined with that of the NHS, and Mills & Boon’s editorial policy was designed to shape its readers’ perceptions of, and attitudes towards, the health service and its employees. Editors maintained a positive portrayal of the NHS and insisted that their main characters uphold the highest standards of the healing professions. Romance novels worked as a sort of NHS propaganda – emphasising the benevolent, devoted, and respectable conduct of its staff, and insisted on the technically advanced nature of its interventions and institutions. Much like the open day advertised by this flyer, medical romance fiction allowed members of the public to peek behind the curtain and witness idealised versions of healthcare professionals at work.
Ship's Surgeon cover. Source: Author's photograph. © Mills & Boon.
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Despite some of these more progressive features, post-war medical romance fiction wasn’t exactly a paragon of virtue or progressive social values. It wasn’t until the end of the 20th century that the novels started to feature queer love stories, and Mills & Boon heroines from earlier decades were invariably white, though real NHS hospitals were ethnically diverse places and the NHS relied on the labour of migrants from British colonies and the Commonwealth. As novelist and cultural historian Hsu-Ming Teo has observed, “white women – primarily of British heritage – were naturalised as the heroines of romance”, because historically, “white women function as emblematic objects of heterosexual desire”. In ‘Ship’s Surgeon’, a woman of colour appears on both the cover and in the plot, but only as a temporary distraction from the white British heroine.
A medical drama: a film director talks to actors playing a surgeon, a nurse and a patient. Source: Wellcome Collection. © John Heseltine.
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In this painting of a film set in the 1970s, a director speaks to actors playing a surgeon, a nurse, and a patient. Medical romance fiction kicked off a cultural phenomenon that soon made its way onto our screens. Movies and television soap operas set in hospitals (also known as “carbolic soap operas”) became incredibly popular and continued to portray healthcare professionals as vaunted stereotypes of masculinity and femininity. Unlike their novelistic equivalents, they also became increasingly raunchy, and by the 1980s, characters were more complex and the storylines getting grittier.
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However, even today, doctors and nurses tend to benefit from cultural representations. Take the TV drama ‘Grey’s Anatomy’ as an example. Against a backdrop of lies, affairs, manipulation, and misdeeds, the healthcare professionals remain fundamentally motivated by care and compassion, and rarely, if ever, cause harm to their patients. Indeed, while the world of healthcare has changed a great deal since the 1950s, and we see far more high-tech medical procedures, more diverse casts, and more nuanced characters, some things remain constant. The idea that doctors and nurses are driven by love and care is remarkably enduring, and is a testament, at least in part, to the power and influence of mid-century medical Mills & Boons.
About the author
Agnes Arnold-Forster
Dr Agnes Arnold-Forster is a writer and historian of healthcare, medicine, and the emotions. She is the author of two books, ‘The Cancer Problem’ (OUP, 2021) and ‘Cold, Hard Steel: The Myth of the Modern Surgeon’ (MUP, 2023) and her third, ‘Nostalgia: A History of a Dangerous Emotion’, will be published by Picador in April 2024. She is a Chancellor’s Fellow at the University of Edinburgh, and together with Caitjan Gainty, she runs the Healthy Scepticism project.