59 pages • 1 hour read
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Content Warning: This section of the guide includes discussion of mental illness, illness, death, substance use, sexual content, sexual violence, rape, ableism, and racism.
Dr. Tucia Hatherley is the protagonist of the book and the “Medicine Woman” referenced in the title. Tucia is a licensed doctor, a rarity for a woman at the time. After passing medical college, she interned at a hospital where a series of traumatic events, including sexual assault and a mistake made in an operating theatre, ended her internship. Tucia is unable to practice medicine for years after this, with the trauma of the operating theatre causing “hysterical attacks.” She is left working odd jobs to support herself and her son, Toby, whom she conceived after Dr. Addams raped her. After losing her job and facing insurmountable debt, she agrees to join Huey’s traveling medicine show.
The defining characteristics of Tucia’s character arc are her struggles with mental health, her financial circumstances, and her joint identity as a woman and a doctor. Tucia’s success at earning a medical license despite the hostile circumstances she faces points to her deep passion and skill in the field. For much of the book, Tucia’s medical skill is not apparent as she is unable to practice for different reasons—initially, her mental health stops her, and later on her circumstances prevent her from practicing openly. In the final moments of the book, however, when confronted with crisis, she proves herself a fine doctor. Tucia’s work tending to the injured after the storm in Galveston is so impressive that it lands her a position at the hospital under Dr. Burns.
Tucia also deals with mental illness, displaying symptoms of PTSD and trichotillomania (compulsive hair-pulling). She is especially haunted by flashbacks of seeing a patient die on the operating table following a mistake on her part. The overwhelming guilt Tucia feels over this incident contributes to her mental health challenges; however, they also underline the kind of passion, concern, and humanity Tucia displays as both a doctor and an individual. She cannot reconcile having accidentally contributed to a patient’s death, even when the incident was neither an accurate reflection of her ability, nor ultimately her fault.
Tucia eventually finds her way back to feeling worthy, purposeful, and loved—as a woman, a doctor, and a human being. By the end of the book, she has a relationship with Darl, her work in Galveston, and a renewed sense of purpose and capability in her medical abilities.
Hugh “Huey” Horn is the antagonist of the book. He is the owner and showrunner of “The Amazing Adolphus Show,” the traveling medicine show. Huey offers Tucia a job with the show, needing the cover of a licensed physician to lend his show legitimacy. Not much is known about Huey’s past. He is revealed to have been in prison with Darl, though the original crime he committed is never clarified. Huey and Darl escape prison together, with Huey killing a prison guard on the way out, following which it is implied he put together the medicine show.
Huey’s success with the show comes from his charm and salesmanship. He is a captivating storyteller, as Tucia witnesses him sell the audience at his shows the story of having discovered a magical elixir made of snake oil while in Siam. Huey’s charm, however, belies his deeply manipulative and exploitative nature. Huey lures performers into the show by presenting a charming front, but keeps them there through blackmail and manipulation when they try to leave. Huey is also as volatile and temperamental as he is charming. He physically lashes out at Tucia in more than one instance, and his sordid past reveals his capacity for actual, cold-blooded murder. This is hinted at toward the end of the book as well, when Huey almost shoots Tucia. Huey’s inherently cruel and violent nature, alongside his consistent dishonesty, render him a true villain. Thus, his end is one of poetic justice: He is arrested after the storm, with each of his victims finally being released from his bondage.
However, there are also nuances to Huey’s character that go largely unexplored in service of the larger narrative. No complete details of his past emerge, leaving the reader with little context to explain his motivations; his actions in the present timeline are the only things available to form an opinion of his character, and these paint him in a bad light time and again. Huey also has an opium dependency, but being cast as a villain, this aspect of his life remains an unexplored detail. Unlike the representation of other mental illnesses in the book, like Tucia’s PTSD and trichotillomania, Huey’s substance use is not presented empathetically—rather, it is painted as a character flaw that contributes to his villainy.
Darl is a non-performing member of the medicine show and Tucia’s eventual love interest in the book. Darl is the character with the oldest association with Huey, both of them having escaped prison together. With their checkered pasts binding them together, Huey has substantially less power over Darl than he does the others. This is why Darl doesn’t perform in the show and why the show doesn’t have any “blackface” acts: Darl is part Black.
Darl’s character primarily serves two functions in the book: He contributes to Tucia’s journey of love and self-worth, and he helps explore the idea of unconscious stereotypes in the larger narrative. By proving a respectful and trustworthy partner who loves and cares for Tucia, Darl reaffirms Tucia’s faith in men and allows her to explore romance and sex in a safe space. Their relationship becomes a sign of personal progress that Tucia has made in these areas. Similarly, Darl’s backstory opens Tucia’s eyes to stereotypes and prejudices she had never thought of before, allowing her to see why instances of “blackface” are problematic. Tucia’s insights in this instance contribute to the exploration of how stereotypes and prejudice can be dismantled with enough information and empathy.
The Trouts are a family that perform in the medicine show: Calvin “Cal” Trout is a musician, and Franziska “Fanny” Trout is a ballerina. Their son, Al, becomes a playmate for Tucia’s son, Toby.
Cal and Fanny are characters who help expose Huey’s deep unethicality, flesh out themes of stereotypes and prejudice, and in time become a support system for Tucia. Their presence in the medicine show is a result of Huey blackmailing them about their past; they are as trapped in their situation as Tucia is, underlining Huey’s exploitative nature.
Additionally, Cal and Fanny’s physical conditions, juxtaposed against their talents and capabilities, help dismantle stereotypes and prejudices about physical appearance. Despite Fanny’s gigantism, she is a graceful and talented ballerina; similarly, the moment Cal begins playing onstage, people are awed by his ability and look past his bowlegs.
Additionally, Tucia’s neutral reaction to them from the outset reiterates the power of information in breaking down stereotypes: She does not see Fanny as unusual or Cal as physically lacking; rather, she understands that biological differences are what contribute to each of their conditions, and does not shun or judge their characters because of this.
In turn, Tucia’s acceptance of them as people is rewarded with support and community. Fanny, in particular, helps Tucia overcome her “hysterical attacks,” and goes on to become a close friend and confidante over the course of the book. Like the others in the medicine company, Fanny and Cal also find their freedom through the storm of Galveston—they set out to create their own music and dance group at the end of the book.
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