A Novel by

Mark Anthony Powers

Breath and Mercy cover

Available Now!

Breath and Mercy is the prequel to Mark Anthony Powers’ bestselling debut novel, A Swarm in May, and the first book of a trilogy.

Breath and Mercy cover

Life was supposed to get better for Phineas Mann in 1983. After the rigors of medical school, residency, and fellowship training, he lands himself a promising position directing a New Orleans hospital’s intensive care unit. His mental and physical limits are soon tested by the soaring demand for his expertise and an exploding AIDS epidemic.

Then Hurricane Jezebel floods the city and knocks out power, plumbing, and telephones. Temperatures soar. Supplies run low. As day follows miserable day, fatalities fill a make-shift morgue. Through the sweltering, fetid gloom Phineas employs his training to alleviate patient suffering…until he faces one terrible threat that will put his entire future in jeopardy. 

Through the character of Dr. Phineas Mann, the author explores the ethical dilemmas of providing supportive care for dying patients. 

Praise for Breath and Mercy


“In Breath and Mercy, we watch the emergence of the HIV epidemic and witness a health care system buckle under the destructive power of a hurricane. Powers skillfully portrays the role of religious framings on medical decision making, the intensity of medical training and practice, and the fatigue and strain it engenders. Compelling from start to finish, Breath and Mercy quickly draws the reader into a richly layered series of action-packed medical adventures.”

— Kim Talikoff, MD, Pediatrician, Educator, and Documentarian


“Through the character of Dr. Phineas Mann, Dr. Powers explores the complex responsibilities of the medical profession — to speak the truth, to improve health, and to relieve suffering, even in the face of extreme hardship and imminent death. The story is riveting and kept me guessing until the last page.”

— John A. Bartlett, MD, Professor of Medicine and Global Health, Duke University, and Co-Director, The Center for AIDS Research


“Dr. Powers sets the fictional Dr. Phineas Mann in a cauldron of ethical dilemmas brewed in a raging New Orleans hurricane. Mark Powers writes as one familiar with facing the challenges of life and death issues. As a former co-chair of a hospital ethics committee, I recognize a similar compassion in Phineas for patients and families as the author has. I already want Phineas in a third novel.”

— The Rev. Dr. Ralph Bright, Retired Director of Chaplaincy, Durham Regional Hospital


“Dr. Mann’s role as a physician in a New Orleans community hospital during a Category 5 hurricane is a harrowing account of doctors and nurses and other hospital personnel trying to provide humane care under inhumane circumstances. Readers interested in the humanity of health care, health education, and the human condition will find this novel interesting and compelling.”

— Nancy Chescheir, MD, Professor of Maternal and Fetal Medicine, University of North Carolina


“For readers who have not read A Swarm in May, I suggest that they read Breath and Mercy first, as it will add to its suspense and set the stage for Phineas’ subsequent adventures and exploits. Dr. Powers had a long and successful career as an outstanding and widely respected physician.  He is now well into a second career as a skilled and successful novelist.”

— Daniel J. Sexton, MD, Professor Emeritus of Medicine, Division of Infectious Diseases, Duke University


“Mark Powers’ new book Breath and Mercy left me breathless while reading the hospital scenes during the storm. He captured the emotion and exhaustion that I would feel in such a desperate situation. I applaud his courage in addressing a quandary well-known to health care providers who must navigate the intersection between religious faith, hope, and medical futility with each patient and family.”

— Carol Dukes Hamilton, MD, Professor Emeritus of Medicine, Division of Infectious Diseases, Duke University


“Wow, you will not want to put this one down!  I felt like I was making evening rounds with Dr. Mann during his early career and experiences grappling with the fragility of human life and then again, when he is tested under the most extreme circumstances, to be true to himself and uphold his commitment to his patients and the woman he loves.”

— Celeste Mayer, RN, PhD, Patient Safety Officer, Retired, University of North Carolina Hospitals


Powers’ fast-paced novel begins with a medical journey through the early days of the HIV epidemic. Powers beautifully captures the uncertainties and challenges of doctoring in that difficult time by weaving together carefully crafted vignettes of individual patients living with HIV. Power’s protagonist, Phineas Mann, is skillfully imbued with great passion for service and humanistic care, still core qualities in health care during our current challenging times.”

— Peter Kussin, MD, Professor of Medicine, Division of Pulmonary, Allergy, and Critical Care Medicine, Duke University School of Medicine

About the Author

Mark Anthony Powers

Mark Anthony Powers did not anticipate writing his best-selling debut novel, A Swarm in May, when he retired from medicine, although he has always enjoyed reading fiction. He grew up in the small town of West Lebanon, NH then attended Cornell University, where he strayed into Russian and creative writing while majoring in engineering. After receiving his MD from Dartmouth, he went south to the University of North Carolina for an internship and residency in Internal Medicine, followed by a fellowship in Pulmonary Diseases and Critical Care Medicine. 

After almost forty years in clinical practice and teaching, Mark retired from Duke University as an Associate Professor Emeritus of Medicine and began exploring other areas of his brain. Writing, gardening, IT, and magic courses were parts of his journey. A deep dive into beekeeping led to his presidency of the county beekeeping association and certification as a Master Beekeeper. Two cups of coffee and two hours of writing most mornings produced A Swarm in May and its prequel, Breath and Mercy. Mark is currently completing the third novel in this series.

Mark Powers photo