The title of “Butcher,” the very starkness of it, gives a clue to the lurid, bloody tale Oates has in store. Like several previous works (her seminal 1966 short story “Where Are You Going, Where Have You Been” and the 1992 Chappaquiddick reimagining “Dark Water,” for example), it is inspired in part by real figures who committed real crimes — including, in this case, an undertrained doctor named J. Marion Sims, who in the 1840s began performing experimental surgeries on women recovering from difficult childbirths.
Here, the “Butcher” of the title is now called Silas Aloysius Weir, who for 35 years oversees the New Jersey State Asylum for Female Lunatics, where conditions range from abysmal to horrifying. His medical instruction is minimal, consisting of only four months of training at an inferior school, though he is happy to tell everyone that he comes from a distinguished family (one of his uncles is a renowned astronomer at Harvard, from which two brothers have also graduated; Weir seems to be the bad egg).
Silas becomes heralded and then ultimately detested as a pioneer in the field of gyno-psychiatry, through which misogynistic scrim he views the vagina as “a veritable hell-hole of filth & corruption” and the female genitals as “loathsome in design, function & aesthetics.”
It is a time when the seat of hysteria is thought to be the uterus, and pesky clitorises — “the offensive little organ at the mouth of the vagina … like a miniature male organ, with an obscene fire lit from within” — are held accountable for obstreperous behavior in young women and snipped without a second thought. Various ailments are treated, without aid of anesthetic, by scalpel and sometimes a shoemaker’s awl, and the most frequent cure-all is phlebotomy, or bloodletting (“When in doubt, bleed”), even if in many cases it causes death. The arsenal of drugs includes laudanum, foxglove, mercury, belladonna, “small quantities of arsenic” and cocaine drops.
“Butcher” is told by different narrators, all of whom cast alternating lights on Weir and his God-given (or so he believes) commitment to the patients in his care. From the start, we are given a sense of his unease and unattractiveness: “His head was overlarge on his stooped & spindly shoulders; his stiff-tufted hair of no discernible hue … his eyes rather deep-set in their sockets, like a rodent’s eyes, damp & quick-shifting.” (Reading, I wondered whether a rodent’s eyes are, in fact, deep-set; from the little I have spotted of them, their eyes seemed flat against their heads. But that is a quibble.)
