
“A year never passes without me thinking of them. India. Erica. Their names are stitched inside every white coat I have ever worn. I tell this story to stitch their names inside your clothes, too.”
Wow! This novel absolutely blew me away. In fact I loved it so much that my other half kept asking whether I was ok and I couldn’t understand why, until I looked at the clock and three hours had gone past without me speaking. I was three quarters of the way through the book and even went to bed early so I could finish the story. This writer pulled me in from the very first page and Civil was as real to me as my poor other half. I’ve been interested in eugenics since I wrote my undergraduate dissertation on disability and 20th Century literature. I knew a lot about the movement in the U.K., US and Germany in the lead up to WW2, but this book shocked me because I had no idea that forced sterilisations were still happening in the 1960s and 70s. I knew this had happened in earlier in the century with Native American communities, so I shouldn’t have been surprised that it was still happening to African American women, especially where the woman has a disability too. I think this jumped out at me, because people with disabilities are having a very hard time currently, something that able-bodied people aren’t always aware about. For example, the University of York published research in the BMJ Open that concluded the joint impact of cuts to healthcare, public health and social care since 2010 caused at least 57,550 more deaths of disabled people than would normally have been expected between 2010 and 2014. Disability groups place the figure at 120,000 deaths over a seven year period and some activists even think that the government’s COVID policies were based on herd immunity and eugenics. It seems like eugenics never really goes away.
This novel shows how our biases and emotions feed into the work we do within the caring professions. Having worked in mental health and disability as a support worker, advocate and counsellor, I did identify strongly with Civil and the way she became involved with the Williams family. As a nurse, Civil is professional and is aware of things like codes of practice and ethics, but we are never the finished article and Civil’s naïvety plays a huge part in how she works. Civil has been brought up to care for and look after others as part of her Christian faith. However, there are other personal circumstances that she isn’t aware of taking into work with her. Civil’s mother struggles with depression and events that took place in her personal life have also left her vulnerable, particularly where it comes to her nurturing instincts. Her very name brings to mind civil rights, equality and fairness, so it’s not a surprise that where she sees injustice she’s willing to fight. The Williams girls are her very first patients and she is sent out on a home visit to give them a Depo Provera injection, a long term method of contraception. When she notices that India is only 11 years old her brain immediately starts questioning, who put this little girl on this injection, has anyone asked if she has a boyfriend or worse, is she being preyed upon? We are privy to her thoughts and her shock at the way the family are living is evident. Her first thought is that she must do something for them, get them away from the dirty shack where their clothes seem to be stored on the floor. What she does notice is that the girls smell and when she finds out they don’t have sanitary towels, she decides to buy some for them from her own money. This is the first line crossed and although Civil’s actions are generous and could change the family’s lives for the better, it’s a boundary crossed. This makes it so much easier to cross even further as time goes on.
I thought the author grasped the complexity of Civil’s feelings and her role in the girl’s lives beautifully. Civil knows that she should be following instructions, asking her supervisor the questions that have come to mind, and advocating for the girls. Yet she knows that just by talking to the right people and calling in a few favours she could get the girls some clothes, find a job for their father, perhaps get them a new flat in town. What she doesn’t realise is that she’s acting from a bias, not racism but a classism of sorts. Civil’s parents are a doctor and an artist, they live in a nice home and have a certain status. She has walked in to the Williams’s home and assumed they want to move, go to school, and have better things. She’s looking at them through her own world view, instead of moving into theirs and then takes their agency away by filling in forms on their behalf. Her heart is in the right place, but she’s mothering the girls; the girls have lost their mother and Civil has maternal feelings to spare. It’s a co-dependent dynamic that could get complicated and painful on both sides. Her nursing instinct is to gain the girl’s trust and find out who put them on contraceptive injections, especially when India hasn’t even started her period. There are no boys around where they live and neither girl goes to school. As she confides in fellow nurse Alicia and friend Ty, they start doing some research. There are many conclusions they could draw: the federal government could be experimenting on poor black communities; there could be a programme of stopping certain groups in society from reproducing; the government are leaving local employees to make decisions based on their own biases about poor communities; their supervisor believes the Williams girls aren’t safe and could be open to abuse from within the family. All are based on so many assumptions, but what was angering me was that no one had sat down with the family and asked the questions about the girl’s development, access to the opposite sex, or India’s ability to make decisions. Life changing decisions are being made, based on judgments made with no real evidence.

Judgement is at the heart of this terrible case, I won’t reveal more about the decisions made, but it does lead to a court case and repercussions for everyone involved. The colour of the family’s skin, their poverty and the death of the girl’s mother has led to assumptions about the girl’s morals and safety but also the possibility that a black man is not safe, even around his own children. India is non-verbal, but whether that’s through trauma or a learning disability is not clear. Civil’s superiors have decided that it would be disastrous to bring a child into this family, but it’s amazing to see how much the Williams do change over the course of the novel. Civil has taken the decision to act on behalf of the girls, rather than making suggestions and motivating them to advocate for themselves. The changes we see in them, just from having different surroundings, is incredible. Civil believes that we adjust our standards according to where are in life, so once their home becomes a clean, dry space they start to look after it. Civil’s happiness when she sees the girl’s grandmother has bought guest towels for the bathroom is so funny, because these are her standards, what she sees as the correct way to do things, without question. I could see her attachment to the girls growing, the way she brings her support network into their lives also leaves their lives further enmeshed with hers. How will they separate themselves? If Civil takes their part in their court case, she may lose everything, so what happens when the Williams start to have confidence to make their own decisions? What if Mace meets a woman – a potential stepmom for the girls? I wondered if Civil would cope were these girls taken away from her, whether by her work or by changes in the Williams’s circumstances.
The author weaves fact into fiction so seamlessly here, with contemporary medical research questioned and the family’s meeting with real life senator Teddy Kennedy. This grounds the book beautifully and it feels even more true to life; the girls aren’t real, but I’m guessing that this story could be the reality for many poor, young, African American women. I thought Civil’s home life was really interesting, especially when her Aunty arrived and talked plainly about her Mum’s depression. Even in a household where there are always guest towels, there are struggles and issues that are overlooked, either due lack of understanding or through avoidance of something too painful to acknowledge. In fact there’s a way this whole episode is fuelled by avoidance, because if Civil buried herself in this family’s trouble she could avoid her own loss. The present day sections are evidence of that avoidance, because we see Civil finally having to confront and process feelings long buried. She’s close to retirement, yet is still haunted by what happened back then. There are positives in her visit back home, in that her relationships have adjusted so there’s more equality with some people than there was back then. I was left with a sense of how incredible women are, the strength we have to survive life altering circumstances and what can be achieved when we support each other.
Meet The Author

Dolen Perkins-Valdez is the New York Times bestselling author of WENCH, BALM, and the forthcoming TAKE MY HAND. *USA Today* called WENCH “deeply moving” and “beautifully written.” *People* called it “a devastatingly beautiful account of a cruel past.” *O, The Oprah Magazine* chose it as a Top Ten Pick of the Month, and NPR named it a top 5 book club pick of 2010. Dolen’s fiction has appeared in The Kenyon Review, StoryQuarterly, StorySouth, and elsewhere. In 2011, she was a finalist for two NAACP Image Awards and the Hurston-Wright Legacy Award for fiction. She was also awarded the First Novelist Award by the Black Caucus of the American Library Association. Dolen received a DC Commission on the Arts Grant for her second novel BALM. Publishers Weekly writes “Her spare, lyrical voice is unsentimental yet compassionate.” Library Journal writes “No sophomore slump is in evidence here. Readers who were captivated by Perkins-Valdez’s first novel, Wench, will be intrigued by the post–Civil War lives of three Southern transplants to Chicago.” Dolen is an Associate Professor of Literature at American University. A graduate of Harvard and a former University of California President’s Postdoctoral Fellow at UCLA, Dolen lives in Washington, DC with her family.