This novel reads like a memoir, filled with the tales of women giving birth during the depression in West Virginia, the poverty and squalor of lives in crisis, as mines collapse and families hunker together for survival. The protagonist, midwife Patience Murphy, attests to that in the beginning of her tale: “Love, birth, death, my trilogy.”
Newly arrived in Union County, Patience has been the beneficiary of her mentor’s generosity. Mrs. Kelly took the frightened woman into her home after Patience (really Elizabeth Snyder) fled Pennsylvania, where her union-activist husband was killed in a deadly conflict between police and mine workers. Sorrow is familiar to Patience, having also lost her first lover and infant baby to death. When Mrs. Kelly expires suddenly, Patience is alone on the small farm she inherits, with no friends, few reserve supplies and Kelly’s midwife instruments.
Events move swiftly as the Depression settles a mantle of suffering over the country. Many of Patience’s mothers cannot pay for her services, but this is her calling now: helping babies into the world. The chapters consist of accounts of these births, each ending with a diary entry to validate the new child delivered into a troubled world, babies both white and black. Patience goes where she is called, deeply troubled by the discrepancies of race: “I’ve associated with Commies and radicals, suffragettes and anarchists, but this is something new to me, the level of powerlessness blacks suffer in a white community.”
The economic devastation of these years leaves a lasting imprint on the survivors, but this novel is also filled with the other social issues of a country in turmoil: the aftermath of World War I; the 1919 Race Riots in Washington, DC; the experiences of Murphy’s immigrant grandparents; Prohibition; New York after the crash in 1929; and various movements for social justice. Once part of the activist community in Chicago and Philadelphia, Patience has sought refuge and found a calling in West Virginia under an assumed name, her past left behind.
When circumstances demand that Patience offer a place to live to a young black woman, what feels at first an imposition blooms into friendship and a broader understanding of the black community. Patience and Bitsy (whom she is training) deliver babies in dilapidated mining camps and back country enclaves, even with a resurgent Ku Klux Klan threatening to teach them a lesson. The author, herself a midwife, beautifully captures the essence of time and place, the human face of suffering—with moments of joy at the sound of a baby’s first cry—the country in one of the most challenging periods of its history.
Before sophisticated technology, in a rural setting where Patience can’t even afford a telephone or vehicle, the only sound of history being made is the scratch of the midwife’s pencil in the journal she faithfully records. It is an extraordinary time and Patience Murphy an extraordinary character in a novel with great compassion and appreciation for struggle, an affirmation of life in the most dire of times.