Review: Butcher—A Novel...

I tend to be something of a traditionalist—more specifically, a Joseph Campbell traditionalist. The Hero’s Journey and the monomyth, with their familiar patterns of departure, conflict, and return, have long shaped my expectations of storytelling. Perhaps this reflects a certain lack of adventurousness on my part, but I am usually most comfortable with a clear central protagonist, a manageable set of conflicts, and at least the possibility of resolution.

I get itchy when a story has two protagonists. 

Still, when a story with two main characters is written well, I’m willing to change my mind. Mostly. If both characters are given equal attention, they can reveal things about each other and the story’s themes that one character alone might not. This can help me appreciate the novel, even if I was hesitant about it at first.

Don’t even get me started when the protagonist and antagonist are one and the same. 

Joyce Carol Oates handles these unusual storytelling approaches very well in Butcher: A Novel, enough to ease some of my usual concerns. The story is told through the journals and writings of three characters: Dr. Silas Weir, Brigit Kinealy, and Silas’s troubled son, Joseph Weir. Joseph also acts as an editor, putting together the writings of Silas and Brigit before adding his own thoughts near the end of the novel. Normally, I prefer a more straightforward story, but Oates makes this complicated structure work. After all, stories told through letters, journals, and personal writings—known as epistolary literature—were quite popular during the period in which the novel is set. By showing events through different characters’ eyes, she gives readers a deeper understanding of the story than any one character could offer.

The novel unfolds largely within the New Jersey Asylum for Female Lunatics. Through his journal entries, Dr. Silas Weir—who, much to my surprise, manages to be both the protagonist and antagonist(!!!)—recounts his progression from medical student to apprentice and, eventually, director of the asylum and self-proclaimed “Father of Gyno-Psychiatry.” He devotes much of his career to “experimenting” on female patients, guided by nineteenth-century medical theories that now appear both misguided and absurd. What Weir celebrates as pioneering research is, from any humane perspective, torture. As his procedures become increasingly cruel and dangerous, they place his patients at grave risk and set the conditions for his eventual downfall.

Brigit Kinealy, a deaf and mute albino indentured servant at the asylum, soon becomes Weir’s favored nursing assistant. Even I, sometimes a little too willing to trust a central character, found his interest in her difficult to regard as innocent. At first, Brigit views Weir as a savior because his surgery preserves both her life and that of her unborn child. Gradually, however, she recognizes the brutality concealed beneath his language of treatment and medical progress. With the help of Gretel, an asylum midwife, Brigit begins planning an end to Weir’s violent authority. That end does arrive, leaving him a chastened physician and a broken man. Through Brigit’s and Joseph’s accounts, his downfall gains more complexity than I might have expected from so many competing perspectives: each narrator reveals a different dimension of his ruin.

Joseph’s narrative begins when he refuses his father’s order to whip Brigit, establishing a bond that he gradually interprets as romantic—and, admittedly, I was inclined to agree. Years after Dr. Weir’s downfall, Joseph finds Brigit healed, confident, and established as a published poet, but she does not share his understanding of their past. Penguin Random House describes the conclusion as involving “unexpected romance”; its deeper surprise is Brigit’s firm claim to a life beyond both Weir men. Joseph’s heartbreak remains only one voice within his retrospective compilation of multiple testimonies, not the final authority on her story.

Butcher received strong reviews, though admiration was often accompanied by understandable discomfort. Critics praised Oates’s enduring narrative energy and her calm, unsparing descriptions of medical brutality; Vogue included the novel among its best books of 2024, while Publishers Weekly called it a compelling indictment of women’s mistreatment by the medical establishment. Several reviewers also connected its nineteenth-century denial of bodily autonomy to contemporary debates over reproductive rights, a parallel noted in an Associated Press review. Not every response was unqualified: some found the succession of cruelties repetitive or excessive. I can hardly fault that reaction—I occasionally needed a pause myself—but the severity remains purposeful. As i’s review observes, the novel is exceptionally brutal yet still vividly and compellingly written. 

Critical theory offers several useful ways to understand Butcher, even for readers like me who occasionally need the terminology translated into plain English. Through Michel Foucault’s concept of biopower, Weir’s surgeries reveal how medical institutions can objectify, classify, and discipline vulnerable bodies. Judith Butler’s account of precarious life and vulnerability sharpens this point: the inmates’ physical exposure reflects their unequal social dependence and lack of protection. The novel’s many journals and testimonies also create a form of polyphony, allowing competing voices to challenge Weir’s authority rather than leaving him in complete control of the story. Finally, a feminist reading emphasizes bodily agency and the historical tendency to treat female sexuality and nonconformity as illnesses requiring correction. An Associated Press review connects this concern directly to contemporary debates over reproductive rights after the overturning of Roe v. Wade.

The novel’s major themes are closely connected. Most prominently, it examines the loss of bodily autonomy as women—especially poor and institutionalized women—are denied control over their own treatment and reproductive lives. Weir’s belief that female behavior originates in the reproductive system reflects the misogyny and paternalism embedded in nineteenth-century medicine. His long, largely unchecked career also shows how institutional authority can disguise cruelty as scientific progress. Finally, the novel considers complicity and inheritance through Joseph, whose retrospective collection of journals and testimonies becomes an effort to confront—and perhaps distance himself from—his father’s legacy. I may prefer simpler narratives, but these intertwined themes make the novel’s complexity difficult not to admire.

Several motifs give the novel its unsettling power. As a deaf and mute indentured servant subjected to Weir’s experiments, Brigit represents silenced women yet ultimately helps bring about his downfall. Surgical instruments blur healing and butchery, reflecting concerns about medicine, power, and patient objectification. The asylum becomes a closed world of surveillance and confinement, given historical weight by the New Jersey State Library’s asylum collections. Meanwhile, journals and clinical records lend official authority to the narrative while exposing the suffering that bureaucracy conceals. Even with my preference for straightforward narration, I found these documentary layers remarkably effective.

Butcher is historical fiction assembled from several troubling medical histories rather than a biography of one man. Oates has explained that Dr. Silas Weir is a composite of three celebrated physicians who believed their experiments served a greater good. J. Marion Sims, often called the “father of modern gynecology,” developed surgical techniques through repeated operations on enslaved Black women, a legacy still debated in medical ethics scholarship. S. Weir Mitchell, whose name echoes in Oates’s protagonist, became known for the rest cure imposed especially on women with nervous disorders. Henry Cotton, director of the New Jersey State Hospital at Trenton, pursued the disastrous theory that mental illness could be treated by removing teeth and organs, a career later examined as a cautionary tale in medical history. I confess that knowing these horrors were drawn from several respected careers made the novel more unsettling, not less: Weir represents a culture of confident medical authority rather than one uniquely monstrous individual.

At its core, Butcher is a Gothic warning about institutional misogyny, unchecked medical authority, and the ease with which “progress” can erase vulnerable people. Weir’s brutal experiments reflect historical abuses examined in medical ethics scholarship, while the asylum setting is grounded in the documented history of New Jersey’s state institutions. Brigit’s lack of bodily autonomy also gives the novel contemporary force; an Associated Press review connects her experience to post-Roe v. Wade debates over reproductive freedom. Joseph’s moral blindness adds another caution: good intentions mean little when injustice close at hand goes unchallenged. The inmates’ revolt finally turns silence into resistance—a severe conclusion, perhaps, but after everything Oates has shown us, hardly an inexplicable one.

Ultimately, I have to admit that Butcher made me angry—and I suspect Oates intended exactly that response. Its graphic, historically grounded portrayal of medical abuse and misogyny occasionally made me want to throw my Kindle across the room. Despite my traditionalist trappings, I recommend the novel, but with a sincere warning: it is powerful, important, and decidedly not for the faint-hearted.