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For a quite a while, she is simply Jane Doe, a gravely injured unidentified woman who lands in Dr. Charlotte Reese’s intensive care unit in Seattle’s Beacon Hospital and tears at the young doctor’s heart, a medical and personal puzzle.

Carol Cassella presents two separate story lines in “Gemini” and unites them.
Carol Cassella presents two separate story lines in “Gemini” and unites them.Handout

The quest to discover who the woman is, notify any family or friends of her condition, and determine how best, and for how long, to keep her alive, sets up the intriguing medical mystery and morality tale at the heart of Carol Cassella’s new novel, “Gemini.”

Compassionate yet conflicted, Charlotte questions the existence of God and the afterlife, but sees her ultimate mission as a doctor clearly. “My job is to keep people alive as long as possible. Whatever they find on the other side will still be there waiting.”


But Jane Doe’s grave condition and poor prognosis test her resolve, as she shares with Eric, her loving if sometimes moody boyfriend. A science writer with a rare chronic disease, Eric has his own distractions as he works on his fourth book.

Before we get too invested in Charlotte’s dilemma, we are pulled in another direction.

“Gemini” unfolds as two separate story strands. Through alternating chapters, we follow Charlotte’s personal and professional life in the present day and track the coming of age of Renee “Raney” Remington, a budding artist who lives with her grandfather in out-of-the-way Quentin, Wash., where “the mountains and woods and water rooted her soul here as surely as the outside world tempted her away.”

Raney’s story is a heart-breaker. Tough and withdrawn, she is a self-described “bastard” with a fierce loyalty to her grandfather after being abandoned by her mother at the age of 6.

One summer Raney, now 13, meets Bo, a 12-year-old Seattle boy of privilege and neglect, deposited by his unhappy parents for three months at his aunt’s house in Quentin while they gallivant about Europe.


Instead of being resentful, “Bo was a prisoner set free, starting that summer off in a tight fist and every day . . . letting a little more light inside.” Over two summers, Raney and Bo tussle and bond, setting the groundwork for a star-crossed love.

After a medical emergency sends Bo abruptly home to Seattle, the two lose contact. “It was like Bo had been snatched back into his natural world and left Raney’s completely behind.” Raney shuts down and hardens emotionally, dealing stoically with the disappointment “the same way she effectively dealt with the other desertions in her life.” Over the years we follow Raney's turns through love, lies, and loss, birth, and betrayal.

Cassella deftly, if somewhat predictably, brings the two story strands together, setting up a suspenseful narrative of emotional depth and moral complexity with a sharp little twist that binds the main characters. A practicing anesthesiologist, Cassella has keen, beautifully rendered insights into genetics, neuroscience, and medical ethics.

A resident of Bainbridge Island across the Puget Sound from Seattle, she also paints a vivid portrait of the Pacific Northwest, especially the stark, rural areas of the Olympic Peninsula where the land was “splattered in channels and islands like a messy afterthought of creation.”

Cassella (“Oxygen” and “Healer”) is the mother of two sets of twins and seeds “Gemini” with references to the lives we are dealt versus those we might have led, if only . . .


The most poignant is when Raney runs into Bo years after their abrupt parting. “All the years of forgetting someone can backfire . . . it gave your subconscious free license to build an entire parallel life of might-have-beens. An imagined twin. You don’t even realize how much space you’ve given it until the invented life is blown to bits.”

For all the characters in “Gemini,” life is about the resilience to continue picking up the pieces.

Karen Campbell can be reached at karencampbell4@rcn.com.