Ami McKay’s debut novel The Birth House was inspired by the former midwife’s home she and her husband bought in Nova 'Scotia near the Bay of Fundy. Her 2011 novel The Virgin Cure also has a real-life inspiration — McKay's great-great grandmother was a woman doctor who ministered to the poor in the 1870s in New York's Lower East Side. Dr. Sarah Fonda Mackintosh was in the first graduating class of the medical school founded by Emily and Elizabeth Blackwell, the first women ever to practise medicine in the U.S.
Her graduating thesis was on syphilis in young girls and she moved directly into residency at the Blackwell sisters' infirmary for the poor in Manhattan. The Blackwells' infirmary was the only hospital that would accept a woman doctor at the time — the medical field considered too crude for ladies. At the time, that part of Manhattan was home to waves of immigrants and destitute people of all backgrounds, and the hospital would have dealt with waves of diphtheria and cholera that killed the very young as well as venereal diseases that blighted the lives of those not much older.
McKay models her character Dr. Sadie on the women doctors of the New York Infirmary for Women and Children, but the crusading doctor doesn’t make an appearance until half-way through her new novel. The Virgin Cure is essentially a young girl’s story — of what it was like to grow up poor in a Manhattan teeming with homeless children. McKay told CBC she tried writing about this time, just after the Civil War, from the point of view of her great-great-grandmother. But the voice that emerged was not of an educated woman with a mission among the poor, but an almost illiterate girl who has grown up without love or care.
"I tried writing from a first- or third-person perspective and even from her point of view primarily, and it just … wasn’t hanging together the way I really wanted," McKay said in an interview in Toronto. "I thought about her role in all of this and how selfless she must have been and then, when I started to think about what role would she want to take in telling this story, I realized the stories she was chasing after in her own life were of these children."
'We hear that and it's in sub-Saharan Africa and it's around AIDS and we think it's far from ourselves — it's easy to dismiss it. But I found it's part of our history as well.' —Ami McKay, author of The Virgin Cure
The protagonist is Moth, who is sold into domestic service by her mother the year she turns 12. Cruelly treated by her mistress, she is warned by the kindly butler Nestor to leave the house before the return of the master, who has a taste for young girls. Nestor helps her steal and fence some jewelry, but once the money from that has run out, she is wholly desperate. McKay gives a vivid picture of life on the Lower East Side — the packed tenements, the filth on the streets, the gangs of toughs hanging out together and the complete lack of options for abandoned children.
Moth — her name is from Shakespeare’s Love’s Labour’s Lost — is used to being hungry, to fending for herself and to innovating in the face of want. But she’s also a child, prone to daydreaming of a better life, charmed by pretty things or fascinated by a dime museum of freaks and oddities. She knows she will eventually have to barter her body, though she’s far from sexual maturity, but is content to live in the present, postponing that day as long as she can. Her bleak predicament is offset with short selections from ladies’ magazines and etiquette guides, highlighting the fashions of the day and expected demeanour of young ladies. The picture of the all-American girl created by these excerpts contrasts with the paucity of Moth’s life.
Selling young bodies big business
She falls into the hands of an "infant school," a brothel specializing in selling off the virginity of young girls. The madam invests both time and money in feeding her, dressing her and teaching her comportment and it is a reputable house, where the gentlemen are checked for disease before they are allowed access to the girls. Moth meets other young girls in training, though she doesn’t seem to make close friends as one would expect with a child so starved for affection. As loathsome as the business seems to modern readers, it was in fact spelled out in great detail in travel guidebooks of the period, which McKay found in New York archives. "It was a big machine in the city at the time. Everyone worked to keep it going — the age of consent was 10, that is astounding to me — that doesn’t change for another decade," she said.
Which brings us to the virgin cure — the title of the book refers to the belief, prevalent at the time, that intercourse with a virgin could cure syphilis or gonorrhea. Moth is aware of the bodies of young girls found in poorer parts of the city, raped and killed. Belief in the virgin cure leads to one of the climactic scenes of the book, and helps set the course of Moth's life. It's a sordid and wrenching subject, and not even Moth's matter-of-fact point of view makes the scene easy to read. McKay is forcing readers to face an unpalatable fact of 19th-century life that she herself discovered by combing through archives of the period.
The parallel with the myth, circulating in the developing world today, that sex with a virgin can cure AIDS, is one of the touchstones of McKay’s story. "We hear that and it's in sub-Saharan Africa and it's around AIDS and we think it's far from ourselves — it's easy to dismiss it," McKay said. "But I found it's part of our history as well." McKay said she herself refused to believe the practice was so prevalent in the 1870s, until a doctor at the downtown hospital that replaced the Blackwells' infirmary pointed out the significance of the title of her own great-great-grandmother's thesis. McKay has no diaries or letters from Dr. Sarah Fonda Mackintosh, nor does she have the thesis itself, only the title. If the crusading doctor had been writing about congenital syphilis, she would have studied both boys and girls, and if she had been talking about prostitutes, her title would have been syphilis in young women. But Dr. Macintosh wrote about syphilis in young girls — girls used and discarded and faced with a bleak, unhealthy future because there was no cure.
Pot-boiler of a read
As in The Birth House, McKay uses spritely storytelling to draw readers into this world. Her dialogue is true to the period and her description enough to quickly paint scenes without an excess word. The Birth House became a best-seller by word of mouth — passed from mothers to daughters to grandmothers and snapped up by book clubs. The author says that success bought her time to write this book. Despite its gruesome subject, The Virgin Cure is a quick pot-boiler of a read and will appeal to the same audience — people interested in the real world of women 140 years ago.
McKay said she is fascinated with women's stories from history. "There are so many accounts of men's lives, men's work. There are accounts or diaries and you can find them easily. Whereas with women's lives, I felt a real sense of having to track them down and then I found there are a lot of missing pieces. That's where fiction came in, filling in those gaps," she said.