Book review: Butcher a reminder of the horrors and sexism of 19th-century gynaecology

Butcher

By Joyce Carol Oates Fiction/Alfred A. Knopf/Paperback/332 pages/$32.16

The prolific Joyce Carol Oates once more brings her sadistic eye to the task, dwelling with some unrestraint in the misogynistic and lawless frontiers of 19th-century medicine.

Like her 2022 novel Babysitter, she again puts her female protagonist through a baptism of fire, refusing to soften the atrocities of patriarchy by skimping over the gore and smut.

Here, though, there may be more erotic abandon than meaning, unlike, say, cinema auteur Michael Haneke, another artist operating in the same explicit mode.

Butcher, written mostly through the eyes of fictional father of gyno-psychiatry, Dr Silas Aloysius Weir, devolves into one perverse surgery after another, its repetitiveness ultimately not salvaged by Oates’ congenial Romantic language and winking satire.

There is promise at the start. Readers first meet Weir as the awkward, not-yet-formed novice doctor, not in the comforts of a clinic, but in the home of a well-to-do family home, a brief, dismissive memory told by Weir’s erstwhile love interest.

His skin an unhealthy sallow, “the very hue of earnest”, he is a failed suitor, “the least attractive bachelor in Chestnut Hill that season”. The young man with an overlarge forehead and spindly shoulders is the butt of jokes, overly solemn and harbouring a chip on his shoulder for being less successful than his brothers.

A short account by Weir’s unconvinced doctor mentor then establishes him as a pusillanimous amateur with a psychotic streak, who somehow weasels himself into the powerful position of director of a state asylum for female lunatics, with the remit to pioneer a new way of healing lunacy.

What follows is a familiar story of a callous man given the run of his own isolated kingdom, an incel with a God complex free of the shackles of polite society.

In the name of science and Providence, he begins to force fit results and dismiss deaths through contorted reasoning, completely dehumanising his patients as he removes their ovaries to cure lunacy or pierces their eardrums to dull their rebellious streak.

All the while, his reputation increases, as he announces medical “breakthroughs” that are patently false or arrived at only by accident.

Where Oates thrives is in inhabiting the worldview of Weir so fully, and there is at first curiosity in her deconstructing of the arbitrariness of 19th-century medicine.

Weir can barely recognise the differences between the patients and casually inserts sexist or classist views – “hysteria is indeed a convulsion specific to females”.

He also cannot help essentialising their beauty or ugliness and be titillated by his dominion over their bodies. Oates deftly draws parallels between the patients and indentured servants in the asylum with the black slaves in the American South.

Though an extreme case, Weir is not the only doctor to stray. In fact, Oates tells readers Weir’s story has been compiled from various real 19th-century doctors, including J. Marion Sims, “the father of modern gynaecology”.

Indeed, Weir is taught earlier by his mentor that “a physician is never guilty. Wretches come to us for help, and we provide what help we can, with God’s grace”.

He co-opts two women in the asylum for help in his depravities, but does not mention them in his medical journals. Weir believes this is only natural, for women are not in competition and must “take her place naturally as his subordinate and helpmeet”.

But Weir’s archaic views and Oates’ ornate language also risk the character becoming ridiculously over the top, which is perhaps why the author has invented a meta-structure for her novel to give it some pseudo-scholarly backing.

At first reading like testimonies given after a terrible crime, this is later revealed to be an attempt by Weir’s eldest son Jonathan to retroactively put together a more “fully shaped portrait” of his father for the historical record.

Other than Weir’s own unreliable autobiography, he has also included his own views and that of Brigit Agnes Kinealy, an indentured servant in the asylum in whom Weir had shown a special interest.

But the bulk of the tension comes during readers’ first encounter of the story through Weir, and there is not enough discrepancy with Weir’s in the later accounts for their retreading similar ground to be worthwhile, given that readers know from the start to read between the lines.

Brigit and Jonathan’s stories do extend beyond Weir but, by then, it feels exhausting, leaving one wishing for a firmer editing hand.

While not one of Oates’ better works – and this is a whole oeuvre, most people counting at least 63 novels – Butcher is still a reminder of the horrors of early modern medicine and the human toll of progress, with language that almost recalls Mary Shelley’s Gothic Frankenstein – a scientist and a monster as two sides of the same coin.

Rating: ★★★☆☆

If you like this, read: Babysitter by Joyce Carol Oates (Harpercollins Publishers, 2022, $32.10), about an upper-middle-class woman caught up in an abusive affair in Detroit, set against the backdrop of child serial killings.