56 pages • 1-hour read
The Surgeon
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Background
Content Warning: This section of the guide includes discussion of gender discrimination.
Sociopolitical Context: Male-Dominated Fields
Leslie Wolfe’s The Surgeon uses the parallel settings of medicine and politics to explore how professional ambition intersects with gender dynamics and morality. The novel depicts both the operating room and the state’s attorney’s office as high-stakes, male-dominated arenas where power is fiercely contested. Dr. Anne Wiley, a respected cardiothoracic surgeon, confronts overt misogyny from her colleague, Dr. Robert Bolger, who questions if her “pretty little hands [are] tired” during a critical procedure (10). This interaction reflects documented gender disparities in medicine. The American Medical Women’s Association (AMWA) reported the following in September 2025:
Despite progress in medicine, women remain significantly underrepresented in surgical specialties, comprising less than 20% of permanent faculty and only 7.7% of surgical chairs. […] [S]ystemic gender bias, cultural norms, and institutional barriers continue to hinder women’s entry and advancement in surgery (Mallory Johnson, Bethany Fenton, Meghan Etsey, Vaishnavi Patel, DO on behalf of AMWA’s Gender Equity Taskforce. “Barriers to the Scalpel: Why Women Remain Underrepresented in Surgery.” AMWA, 2025).
Bolger’s behavior in The Surgeon isn’t just a personal conflict but an example of the systemic sexism that women face in such professions. This theme is mirrored in the novel’s political subplot, in which Assistant State’s Attorney Paula Fuselier engages in a quid pro quo affair with mayoral candidate Derreck Bourke. Their relationship is a calculated transaction of power, and Paula envisions a future in which “[he’ll] be mayor, and [he] can endorse [her] for the state’s attorney role” (37). However, Derreck is deceiving her. This storyline parallels real-world political scandals in which personal relationships and professional ethics collide, as in the downfall of presidential candidate John Edwards, who destroyed his campaign in 2008 due to having an affair. By juxtaposing these two professional worlds, the novel critiques how ambition can erode ethical boundaries, particularly for women navigating fields historically shaped by male power.
Genre Context: Conventions of the Psychological Thriller
The Surgeon uses conventions of the psychological thriller to create suspense and explore its protagonist’s moral and mental state. This genre prioritizes interior characterization over external action, focusing on the protagonist’s perceptions, anxieties, and ethical dilemmas. The novel establishes this focus immediately via Anne’s first-person narration, which begins with a moment of intense self-doubt: “What have I done?” (1). Her account is colored by shock and emotional turmoil, positioning her as an unreliable narrator whose version of events constantly raises questions.
This technique is a hallmark of the genre, used in many novels (like Gillian Flynn’s Gone Girl, Paula Hawkins The Girl on the Train, Alice Feeney’s Sometimes I Lie, and Ruth Ware’s In a Dark, Dark Wood), in which shifting, biased perspectives force readers to piece together a subjective and elusive truth. By adopting this narrative strategy, Wolfe immerses readers in a fraught psychological landscape, making uncertainty and fear central to the reading experience. Furthermore, the novel uses the genre to examine moral ambiguity. The central conflict isn’t whether Anne made a medical error but whether she made a deliberate ethical choice. Her admission that “once I knew who my patient was, I wanted him dead” (27) shifts the novel’s focus from a simple procedural failure to a moral crisis. The suspense arises not from a “whodunit” puzzle but from the question of what a respected professional is capable of when faced with a catastrophic ethical test. This interior conflict is characteristic of the psychological thriller, which uses suspense to probe the darker aspects of human nature.
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