I found Butcher a fascinating portrayal of medical history and its relationship to women, as well as the dark origins to some of our modern medical practices. It was at times, quite a slow paced book, but was beautifully written and gave me a lot to think about.

Pretty disappointed by this one as I was certain it would be a new favourite. I mean, a book about a terrifying doctor working in a women’s asylum in the nineteenth century?? Who is able to continue his practice unchecked by focusing on women neglected by the state? True nightmare fuel. And my favourite time period as well!! Alas, no. The start was very promising and I was inhaling the novel at an alarming rate. Then… it got incredibly repetitive and kinda boring? I was dragging myself through the last pages, which was such a shame after such a strong premise/incredible start! Sad about this one. 3 stars.

Joyce Carol Oates is a stalwart of American fiction. Ever ready to tackle big issues with her unique style. Every outing of hers is as stunning as the one before.

Butcher by Joyce Carol Oates is a horrifying and powerful historical novel that explores a dark issue perfectly blending both fact and fiction.

<I><blockquote> It's true, most of my surgeries were performed without anaesthesia, for the practical reason that, in the early years of my Directorship, anaesthesia was scarcely known. Also, it is scientific fact, as I have explained to Brigit, that female organs have fewer nerve endings than other parts of the body, no doubt to make the rigours of childbirth less painful.</I></blockquote>

JCO is an extraordinary writer and not least for maintaining the quality of her fiction across so many years. In lots of ways this feels like it couldn't have been written by anyone else: a dark story of misogyny, medical 'research', 'knowledge' of the female body and 'madness' in mid-nineteenth century America.

Dr Silas Weir is one of JCO's monsters: both obsessed and horrified by the nascent science of gynaecology and still in thrall to ancient medical knowledge going back to Aristotle and Galen which related female psychology and maladies to hysteria originating in the idea of the 'wandering womb'. As Director of a 'lunatic asylum' in Trenton, New Jersey (old stomping ground for JCO's fiction), Weir has unlimited access to abandoned women on whom he can experiment to 'prove' his medical theories and procedures, as well as indentured workers who he can make into complicit helpers.

As usual, JCO has done her research and the first person narrative of Weir is based on authentic doctors' papers. Weir's story is a complicated mix of arrogance, fear and a desperate attempt to win Freudian approval from his distant father. His acute misogyny, his lack of knowledge, his contempt for his patients, and his more indictable flaws (desire for the albino Irish Brigit; a gentle slide into laudanum and whisky, more violent appetites that he represses but which slip through his self-justificatory narrative) are offset against some genuine attempts at pushing the boundaries of scientific knowledge, however inadequate the foundation.

JCO cleverly widens the scope of the book's points by setting it against debates about chattel slavery and comparing them to the situation of indentured workers such as Brigit. She also, eventually, gives us alternative views from women, including Brigit whose poetic, lyrical style of writing contrasts to the clinical prose of Weir.

There are, inevitably, horrific operation scenes which, importantly, JCO doesn't shy away from and she makes clear the connections between cultural constructions of femininity and the problematic, for many men, female body and associated sexuality which both come under patriarchal ownership:

<I><blockquote>I was likely the sole surgeon in New Jersey trained to treat vaginismus, at the request of frustrated husbands, who brought me their hysterically 'frigid' wives, to undergo a delicate surgery widening the mouth of the vagina, while at the same time severing nerves in the surrounding flesh, to kill sensation; this, often combined with a clitorectomy of which the wife was unaware.</I></blockquote>

So definitely a Gothic version of real medical history awash with blood, agony and disturbing ideas. But this remains a fascinating story of the history of women's medicine and 'madness', and the extent to which they were framed via out of date, unscientific and misogynistic schemes of thinking for so long.

She strikes again! Brimming with atmosphere and searing in its approach, Butcher is a book I'll long remember!

One of the scariest books I’ve read in a long time – a literal butcher doing experimental gore on women imprisoned in asylum. Not for the faint of heart