The ending was a little abrupt, but I kind of expected that. I was kind of surprised that the drama wasn't some type of relationship drama, but her father having alzheimer's (which I'd really expected long before he showed up - calls he didn't remember making, leaving a patient in the OR were big hints).
I was a little lost at the start of this book, since it's been a while since I've read the first three books in this series. I had a little trouble remembering who everyone was. I even had some trouble remembering who Laine was, until she talked about the commune.