This is a strong 4.5 Close to a 5.
Really enjoyed this book, and was surprised (shouldn't have been if I'd paid more attention to author etc) that this was a sequel to The Girl In His Shadow that I had also enjoyed. I liked this book even more, and not sure if it's because of the sequel factor or not, but it was a good love story, a good historical novel and had real meaning of how difficult it was for a woman to be respected as a man is as well as some of the just logistical hardships of the day (wearing long skirts being one of many.
I liked/didn't like that the ending didn't go exactly where I expected it to. I felt it was building up for a predictable ending and was pleased/sad when it didn't. Pleased because I don't always want to be able to predict what's going to happen, and sad that what I had predicted didn't.
I also am not a medical professional but this book gave quite an insight into what went into advancements in medicine such as ether and c-sections. One never thinks about the beginnings of these things we take so for granted, but they had to start somewhere.
Looking forward to another book in this series!