A heady concoction of marriage, sex, and born-again religion, Martha Moody's The Office of Desire exposes what happens when personalities clash in a tightly knit private Ohio medical practice. "We all yearn and desire the things that we can't have" says Caroline, the thirty-something office receptionist of this small and intimate Midburg office.

The staff are far too concerned with their own traumas to let the world's distresses in; to be sure, Caroline looks at her colleagues with a discerning eye. The principle narrator of this tale and a cancer survivor less one leg, Caroline is willful, determined, and sexually voracious.

The other narrator is middle-aged Hap Markowitz, who actually owns the practice. Recently he's been distracted by his wife, Janis, and he wonders why for all these years she has remained childless and whether she is happy or not. "I must have stifled her, I must have let her down," he contemplates to himself as he thinks about his attachment to his practice and his patients.

Hap worries that he's made himself a "walking duty" and feels that because he's given over too much of his life to work, he's not a complete person, certainly not a good husband. Meanwhile, Hap runs the medical practice with much younger Dr. William Strub, who as the novel opens is getting off on looking at Internet porn.

Strub's entrepreneurial ideas for the practice often set him at odds with William, but when William has an affair with Alicia, the brassy, ambitious office nurse, then later marries her, the relationship sets off a chain of events opening the door to more pain and trouble.

Suddenly, demure Alicia turns into an ambitious, overly officious monster whom Caroline labels the "Lady Macbeth" of the office. Overly protective of her teenage son, Jessie - whose own bourgeoning sexuality is placed in question - Alicia is driven not out of love for any particular person, but for power. Soon enough she morphs into someone who feels as though she's just stumbled into a marriage she suspects is less than the staggering stroke of luck she'd thought it might be.

While Caroline allows herself to become sidetracked by septuegenarian Roy, a regular patient who ends up giving her "some of the best orgasms she's ever had," William, and Alicia turn into fanatic born-again Christians when they hook up with the shifty pastor of the local community church. In the interim, Brice, the diffident, insecure office manager, is doomed to disarray. Despite "his cuff links and carefully rumpled hair," his inner life is impossibly messy. An old-time movie aficionado, Brice worries about the health of his over-protective mother while also waxing poetic over the young, naïve Jessie when Alicia brings him into the office to work over summer.

This is a world of petty power struggles and backstabbing, where paltry status-seeking and crazy self-righteousness are undoubtedly the order of the day. It's also an environment where loyalty eventually becomes a sickness and faithfulness to someone else becomes a way to destroy one's self.

The novel starts out packing a punch, and the author excels in presenting her flawed characters with their petty opinions in all their self-congratulatory glory, as well as their inherent problems. Although the story loses a bit of steam in the end - maybe because so many of Moody's observations of office life are detailed in the set-up - The Office of Desire is still a fun satirical romp covering familiar territory for those who have ever worked in an enclosed office environment.

Even when the narrative falls into the category of the absurd, there are some astute observations on the nature of the medical industry. Moody also trained as a physician, and she brings this experience to her novel, especially in detailing the different patients and their various problems, as well as the idea of the doctor being able to give comfort even if he can't necessarily give peace.