Considering the time period it was written in, I was surprised at the liveliness and directness of this quick-reading Victorian novel.
While the parochial themes (Will that cad get her fortune?) characterizations (oh, feminine jealousy! Angelic female lead!) and hyper-emotional actions (ladies weep a creek!) are par-for-the-course Mid-Victorian, Stretton's writing is actually lively from the first sentence, rolling along at a pace averaging the speed of thought, with very few purple-prose passages.
The rather stereotypical characters moved along at a pace that allowed me to appreciate an action they've taken, then get on to the next development. While they are a bit stiff, main characters Martin Dobree and Olivia Foster are likable. I can root for them, and by association, their rather two-dimensional friends as well. Folks get swifted off to foreign countries to evade nasty baddies - and get chased to their exact locations. Marriage seems to be a biological (re: plot advancing) weapon. And at least Stretton *tried* to justify those coincidences, even if she did it only halfway.
In reading "Dilemma," I became painfully aware that Stretton was either recalling information at the outer edge of her knowledge base or wasn't doing it right: descriptions of all medical terminology related to Dobree's doctoral career are vague; foreign words are shoehorned into sentences to denote other language speakers;
Reading up on author Stretton (real name, Susan Smith), I find she was a devout Christian as well as a vigorous charity-worker, and every light wave of her traditional Christian belief spectrum shines through in every character and development. Christ's name or image is invoked many times, and there are some Biblical allusions. This ought to be a nice tale for a Christian reading group - the nits to be picked about the weak characterizations and hokey plot will supply much critical discussion fuel, but Stretton's heart is in a very moving place.
Overall, I call "The Doctor's Dilemma" a pleasant surprise. Apparently this is not her best or most famous work. I guess she's no Dickens (a wannabe, perhaps), but it would be unfair to sweep her under the rug as she's been.