Author Patricia Harman treats us to a fabulous debut novel which combines the reality of the Great Depression, race relations and labor organizing in the 1930s, with the personal stories of characters so real that they practically leap off the pages. Simple but compelling narrative, authentic dialogue, evocative settings, and a flesh-and-blood heroine who needs no rescuing, combine to make this a top-notch piece of fiction deserving of a much broader audience than home-birth enthusiasts.
The story is the first-person account of Patience Murphy, who has fled her radical past in Pittsburg and a dark guilty secret of her own to end up in the impoverished coal town of Liberty, West Virginia, during the depths of the Great Depression. The 36-year-old widow is working as a midwife of just a few years’ experience, living in an unheated cabin and surviving on garden vegetables and payment in the form of the occasional chicken, ham, and sometimes a dollar or two. Haunted by her past and fearful of exposure and arrest, Patience has shed her real name and lives in relative isolation with only her bicycle for transportation around town and to surrounding ethnic communities. Her only friend is the public health nurse who is afraid of the birth process; the only doctor in town won’t treat black people or those who cannot pay; and the midwife of the black community is in her eighties and ill.
Patience’s life changes when she reluctantly takes into her home and under her wing the tough young daughter of the local mine owner’s black maid. On the verge of bankruptcy, the desperate mine owner plans to throw Bitsy into the street, and when Patience comes to deliver his baby, she acquiesces to the mother’s plea to take her daughter and train her as a midwife’s assistant. Bitsy takes to it immediately, and in return, gives Patience access to the life she has kept at arm’s length until now. Her growing friendship with the black community through Bitsy catches the attention of the Ku Klux Klan, and warnings that she needs to be “careful” ratchet up the tension.
Pulling the novel together, of course, are the marvelous stories of the births (not all of them happy ones) that Patience attends, and the exciting overlap between her medical knowledge, creativity and sheer grit that the midwife offers to her laboring mothers, the majority of whom are too impoverished—or the “wrong” color—to avail themselves of a hospital birth. As Patience expands her circle of clients and friends—including the local vet–we see her grow in confidence and move out of her self-imprisonment.
This is an inspiring tale, based on many of the true life experiences of the author, who worked as a midwife in West Virginia and on rural communes around the country for decades, and one suspects that the author has much of the same indomitable spirit as her heroine. We are the richer for it.