Review: "Medicine at 50° Below" by Mary Ellen Doty

Medicine at 50° Below by Mary Ellen Doty
Published February 2026 via Nelson Bond Publishing
★★★

Doty was new to her role as a nurse practitioner when she took a job that was off the beaten path—literally and figuratively. A clinic in the remote wilds of Alaska needed staffing, and a two-year commitment would pay off her loans and give her (or so she thought) a relaxed entry into her field.

I picked this job in a similar manner to the way I picked my husbands—hot, exciting dates, commitment in the middle of the night, and then donning dark glasses the next morning to block out any sunlight on our way to the chapel. (loc. 192*)

As it turned out, Doty loved it, and stayed well beyond her two-year commitment—but it was not relaxed, and she soon learned that there were deep staffing shortages for such positions, both because of the challenge (she was a one-woman family medicine clinic and emergency department and preventive health services clinic all rolled up in one) and because two years is a long time to uproot yourself and your life. And eventually it occurred to her that there must be a better way.

The first half of the book I found really compelling—Doty finding her footing in Alaska, falling in love with the community, the community gradually starting to trust her. (The previous provider was...not one to inspire trust.) It was not easy, and she does not make it out to be: It was more than she signed up for, and she quickly understood why so many didn't stay the distance; she was effectively on call 24/7, and depending on the situation it could be just Doty standing between life and death.

We had been flying for over an hour and a half, and not since that last small mountain to the northwest of Fairbanks—about 150 miles ago—had I seen a road. (loc. 107)

In the second half of the book, Doty describes leaving her first posting in Alaska—first for somewhere a bit less isolated, then back to her home territory of Montana, where she tried and quickly became disenchanted with corporate medicine (basically the opposite of what she'd been doing in Alaska). When she realized she wasn't the only one, she started to dream up a better model of locum care for remote clinics in Alaska, one that would let providers from the lower 48 practice the way they wanted to practice without uprooting themselves and would ensure continuity of care for remote communities. I admit that I did not find this part of the book as interesting; I find medicine (and especially the less discussed parts of medicine, such as work in villages with extremely limited resources on hand) compelling to read about, but the stress and frustration of building a start-up rather less so. A lot of that material is about long hours in cramped quarters, overworking to the point of burnout, and meaningful dreams, and while there are absolutely readers who will love this, for me as a reader that part of the book wasn't as engaging.

Still. This was the hardest work I had ever loved, writes Doty (loc. 801); that she was able to take that feeling and translate it into something that enabled other people to love the same work is nothing short of wonderful.

*Quotes are from an ARC and may not be final.

Thanks to the author and publisher for providing a review copy through NetGalley.