The Book of the Unnamed Midwife by Meg Elison

The premise of this book really drew me in. It fits with other dystopias like Stephen King’s The Stand and Cormac McCarthy’s The Road. It also has a feminist twist that amped my eagerness to read it. The story is that of a woman who is an obstetric nurse at a hospital in San Francisco when an airborne plague breaks out that kills nearly everyone who gets it. The thing is, women and children are ten times more likely to die from it, leaving a world of almost no women or children. Everyone is left to fend for themselves. What does a lone woman do in a world like this? That is the premise. Unfortunately for me, it did not live up the the promise I saw in it, despite it having won the 2014 Philip K. Dick Award.

The thing that really spoiled this book for me was the editing. This book really needed better editing. Many times, especially in the beginning, I found myself struggling to understand the action happening in the story. It was unclear and seemed to subtly but not clearly contradict earlier action. For example, in one paragraph the characters might be facing each other; in the next, one turns around to face the other. Huh? When and how did they end up facing away from each other? But I also found a complete, glaring error.

This mistake occurs in chapter eight where the author describes the scientists seeking a vaccine for the plague. They develop one and then look for those who are already infected to test it on. “They developed a vaccine, and a FEMA crew flew it into St. Louis to find infected persons on whom to test it.” Except that is not how vaccines are tested or used. They don’t treat disease, they prevent it. Vaccines are tested on those who are not infected. In challenge trials, those who receive the vaccine are deliberately exposed to the disease-causing agent to see how effective the vaccine is. That is how the editor and author could have handled that part of the book.

Despite this very distracting mistake and the at times poorly written action, I found the story itself fascinating and engrossing. The main character struggles realistically with what she faces. The expressions of emotions feel real as do the people and their responses. And the responses are not all the same. Some people act to help others. Most are more selfish. It is a dark world but an interesting exploration of a plague-ravished world written before the COVID-19 outbreak. Despite the interesting story line, though, the poor editing really pulled me from the action and frustrated me.

My rating: 3/5

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