In this fourth and final novel in The Holly Goforth Quartet, just as Holly begins her medical career in San Francisco, she is forced to face a new challenge - debilitating clinical depression, an illness that is all too common in the medical profession. Every year, between 300 and 400 American physicians take their own lives. In the general population, male suicides outnumber female suicides four to one. But the suicide rate for female doctors is 250 to 400 percent higher than the rate for women in all other professions. Like most of her colleagues, Holly has no idea that she is at risk, because it is simply not talked about. If you read the first three novels in the series, Holly's disorder comes as no surprise. But this chapter in her life is about more than her struggle to survive "the black dog." (In Holly's case, it's a big, malevolent cat.) This is also a sad love story between Holly and a beautiful nurse she discovers in therapy. If she overcomes these challenges and survives, it will be because of the support provided by a new ally, her therapist, and her own grit, humor, and power to learn from the way people love and hurt each other.