Joan is the novel’s protagonist and narrator. She is a 36-year-old attending physician at a large hospital in New York City. The child of immigrants from China who raised her in the United States before returning to Shanghai, she is characterized by her strong work ethic, her introverted nature, and her lack of emotional affect. Also part of her character are the difficulties that she experiences as the result of growing up in a Chinese American, immigrant family.

The theme of Work and Identity is central to Joan’s acceptance of her unique approach to life, marking her journey from struggling with criticism to embracing her capacity to set boundaries. Joan’s immigrant parents stressed the value of success and work and were always supportive of Joan in her career goals. Joan is highly intelligent, and her drive to succeed situates her well in the demanding medical field; she often works long stretches without days off. Although her colleagues, family, and the HR department in her hospital think that Joan works too much, her work ethic is a manifestation of her desire to be judged on merit and not based on her race or gender.