MedHum Mondays Book Review: Orphan Number Eight

DailyDose_PosterGood morning and welcome back to MedHum Mondays on the Daily Dose! Today, Review editor Anna Clutterbuck-Cook reporting on a novel that seeks to strike a balance between history, medicine, and fiction: Orphan Number Eight by Kim Alkemade.


Iorphan_number_eight_cvrn her debut novel, Orphan Number Eight, essayist Kim van Alkemade (Shippensburg University of Pennsylvania) seeks to offer readers a glimpse into the multiply-marginalized life of Rachel Rabinowitz. Orphaned in 1919 by the quasi-accidental homicide of her mother by her father, four-year-old Rachel is separated from her older brother and sent to an infant’s home. There, she is enrolled as a human subject in a number of medical experiments, including a radiology experiment conceived and conducted by ambitious medical resident Mildred Solomon. The prolonged exposure to radiation leaves Rachel hairless, a condition that makes her a target of bullying in the Home, and continues into adulthood causing her a great deal of body shame. Decades later, working as a nurse in a home for the elderly, Rachel finds herself caring for the now cancer-ridden and dying Dr. Solomon. The seemingly-fateful encounter prompts Rachel to  seek out a more complete picture of the medical “treatments” she endured as a child. What she discovers shocks and angers Rachel to such an extent she finds herself contemplating revenge.

Orphan Number Eight is written with a great deal of passionate anger about the complex and often ugly history of twentieth century medical ethics — a history that reveals a great deal of what, today, we would consider human rights violations. As an institutionalized child, the fictional Rachel had countless real-world counterparts — orphans, the mentally ill, the imprisoned, the poor — whose socially vulnerable, othered bodies became a testing ground for medical research under circumstances that precluded informed consent. van Alkemade seeks to explore this history and its human cost through the fictionalized account of one such survivor. This decision to use the medium of fiction could have been a powerful narrative choice, yet despite its triumphs, as a reader I came away ultimately unsatisfied.

Warning: plot spoilers after the jump.

Told in alternating third-person flashbacks (within which the perspective is often unstable, shifting unpredictably from the child Rachel to other characters for the sake of convenience) and first-person passages narrated by adult Rachel, Orphan never quite finds its emotional or narrative rhythm. The historical contexts through which the characters move are both over-explained and underrealized, invoked when required to drive the plot forward yet rarely developed as a backdrop within and against which the cast of players live their lives. The individual characters, likewise, struggle to find life on the page, their lives constructed of a series of situations and identity markers rather than being shaped by the complex interplay of personality and circumstance. This is particularly problematic in the cases of Rachel and the two women who have been most influential in shaping Rachel’s life: Dr. Mildred Solomon, the surrogate mother figure by whom Rachel feels betrayed — perhaps even destroyed — and Rachel’s childhood protector, friend, and eventual lover, Naomi.  

As the central narrative character, Rachel Rabinowitz never fully emerges as an individual amidst the multiple social statuses through which she is defined: Jew, orphan, woman, sexual deviant, and eventually cancer patient. The cumulative effect these identities and marginalizations would on Rachel’s development remains frustratingly under-explored. Having been systematically stripped of individuality and ultimately personhood in the infant’s home, Rachel is a passive character whose erratic behavior and obscure motives make her difficult to connect with as a reader. The adult Rachel’s sense of self-worth remains so low that her sudden anger regarding her medical maltreatment is hard to believe: why would she assume she had the right to bodily integrity when, for most of her formative years, she had enjoyed none? Without an explanation of where Rachel’s outrage originates, it ends up feeling somewhat forced in order to set up the tension between herself and her nemesis Dr. Solomon.

As the most direct representative of Rachel’s past trauma, Mildred Solomon unfortunately fails to move beyond a cruel caricature of the ambitious Progressive-era research scientist seeking to prove herself in a male profession. In Dr. Solomon, van Alkemade invokes, without complicating, a number of historically-bounded stereotypes regarding the supposed unnaturalness of early female medical professionals, particularly those uninterested in working in the area of maternal and children’s health. Dr. Solomon’s un-womanness — used repeatedly to both illustrate and explain her monstrous behavior — exists in uneasy parallel with Rachel’s own un-woman status. While Rachel’s individual personality collapses beneath the weight of her subject positions, Mildred Solomon’s status as both agent and subject of social oppression is never fully explored.

One part of Rachel’s un-womanness (which she may or may not share with Dr. Solomon) is, of course, her same-sex desires. I wanted to cheer the presence of a female protagonist with same-sex desires, but Rachel’s lesbianism (or bisexuality) feels less like an authentic aspect of her personality than it does an opportunity to invoke another degree of social marginalization. Her relationship with partner Naomi, a fellow orphan, remains emotionally guarded and at times opportunistic. In flashbacks the two girls develop a cautious camaraderie, with the slightly-older and more self-assured Naomi protecting the traumatized Rachel from her peers. This relationship could have, if more fully developed, offered the opportunity for Rachel’s (re)development of self-worth and agency — and it is possible that van Alkemade imagined Naomi playing just such a role for her protagonist.

Yet adult Naomi is out of town for all but the final scene of the first-person narrative, a silent partner. What may have been an attempt to make Rachel “just happen to be” a lesbian ends up making the protagonist’s central relational attachment central in name only. To further complicate matters, the couple’s few scenes of “on screen” sexual intimacy take place in contexts where Rachel is keeping significant information from Naomi — leaving the reader with the uncomfortable feeling that the connection the two women share is built of fairly shaky foundations; their relationship a site of further alienation rather than hope or redemption.

In the end, the narrative momentum and character development of Orphan Number Eight falters under the weight of the many sociohistorical injustices van Alkemade seeks to illuminate through the lives of her characters. Readers with an interest in the fictional treatment of immigrant history, Jewish-American history, history of sexuality, history of science/medicine, and history of disability may wish to read this novel for its completeness. There is much on offer here. But those looking for a gripping tale with fuller development of relationships along similar themes may do better with the works of Andrea Barrett, Emma Donoghue, or Sarah Waters.

–Meet us here again for more reviews and “conversation” reviews of books pertaining to history, medicine, and humanities!

One Reply to “MedHum Mondays Book Review: Orphan Number Eight”

  1. This is a very fair and thoughtful review. I also think the book would have worked better as a work of nonfiction — along the lines of “Henrietta Lacks”. I interviewed the author, and completely understand why she chose to fictionalize the story — and I give her credit for doing so — but I don’t think it is completely successful as a novel.

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