Despite having some of the trappings of a standard reverse harem school story, Mia and the Forbidden Medicine Report is much more of a science drama than a romance. The story takes place in a vaguely early 20th century steampunk setting, where country girl Mia Baumann has been accepted to the prestigious Royal Academy, something of an anomaly even in supposedly non-classist Isea. Of course, she's entering the Pharmacology department, which is the least prestigious of the four (the other three being Medicine, Law, and Magic), but that's fine with Mia, because she has a goal, one she'll do anything to accomplish.

In the story's world, magic seems to be on the wane, or at least not quite as prevalent as those in power would like. In part this seems to be because of a specific illness, called Angel's Tears, that only affects people with natural magical power – it functions like a combination of dementia and mania with bonus hallucinations. Because mages are so highly prized by the military (who appear to have an almost exclusive claim on them), all other illnesses have been neglected in terms of research and development. This is what Mia takes exception to – her mother has a different, deadly disease, and Mia is bound and determined to find a cure for it, no matter the cost. Because her mother was her only parent, when she was taken into a state-run hospital Mia was raised by one of the doctors at the hospital, resulting in her entering the Academy with a basic working knowledge of both medicine and first aid. Ultimately this is what sets her on the path to accomplish her goals, not because of her practical information, but because it throws her into the orbit of Felix.

Despite the fact that there are two other boys who could ostensibly vying for Mia's heart (and Henrik might be), Felix is very clearly the romantic interest. He falls for Mia instantly, not because she fits any of the more usual reasons in young adult fiction (she's special, she's pretty, etc), but because she's the first person who doesn't make him feel badly for having panic attacks. Felix's experiences with panic disorder are very well portrayed, not just in terms of what it feels like to have one and how hard it can be to calm down, but because he's been treated as somehow “less” and “weak” because of them. A common misconception surrounding panic attacks is that you can somehow talk yourself out of one, or that you only have them for attention or to get out of something you don't want to do. This is how Felix has spent the last seventeen years of his life, and that's debilitating to say the least. Mia, however, simply soothes him, telling him that he'll be fine and quietly, slowly talking him back to calm. It's revolutionary to Felix, who feels like a real person for the first time in years, making his instant attachment to her feel more believable than it otherwise might have. For her part, Mia just did what she was trained to do, so she's not sure why Felix is so keen on her; the slow build of her feelings offsets his more sudden ones well to form a good romance subplot for the novel.

The major thrust of the narrative, however, is Mia's drive to find a cure for her mother. Because that's her motivation, she's able to overlook the bullying she endures at the hands of the ironically named Angelica; in fact, she's so intensely zeroed in on her goal that she runs the risk of isolating herself from the boys who offer to help her with her research and the professor who is attempting to guide her in the right direction. This is another well done theme throughout the book – because Mia has never felt like she had anyone to rely on, she doesn't trust other people enough to rely on them. Felix is the only one who can really get through to her, although Henrik tries in his more abrasive way, and it is when he takes things farther than she'd ever expect him to that she's finally able to both look at the clues around her about the set-backs she's suffering.

Author Fumi Yamamoto says in her afterword that she was inspired to write this novel based on current events about the lack of available drugs and treatments for people in less affluent parts of the world. She incorporates this theme into her steampunk story fluidly, raising our awareness without ever sounding preachy or too intense for the relatively light book. While the plot and characters could have sustained a longer story, Mia and the Forbidden Medicine Report never wears out its welcome nor rushes too much through its content. Were a second volume to appear, it would be a treat, but as a stand-alone story about a girl determined to right at least one wrong in her world, this is a very good book.