On The Book of X by Sarah Rose Etter

Amanda Silberling

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Columbus, OH: Two Dollar Radio, 2019. 284 pages. $17.99.

Let’s begin with how it ends: Cassie swallows a handful of her mother’s pills, lies beside her father’s grave, and waits for death to come. It’s a foreboding conclusion to a novel that so poignantly represents the ageless trials of womanhood.

We can glean much about a novel from the writers who blurb it, so it’s appropriate that we are primed with praise from with Roxane Gay and Carmen Maria Machado, two of the boldest contemporary authors addressing the public scrutiny of women’s bodies. With such topics at hand, The Book of X is not a read that strives to uplift—yet, as with the works of Gay and Machado, I emerge from Sarah Rose Etter’s The Book of X with the inexplicable joy that is feeling understood.

In this lyrical coming-of-age novel, Cassie is born with a knotted stomach. Outside the realm of Etter’s surrealist landscape—an eerie place where men mine raw, bloody meat from the ground—to have a “stomach in knots” is merely a figure of speech, an anxiety. But for Cassie, the knot is a real genetic abnormality, passed down via the X chromosome from her grandmother, to her mother, to herself. Etter explains, “Picture three women with their torsos twisted like thick pieces of rope with a single hitch in the center.”

Cassie’s life is presented to us through staccato vignettes, resembling a series of prose poems. One reads, in its entirety:

THESE ARE THE DAYS OF NOTHING: SLOW motion, under water, distant from other bodies, other thoughts, other humans. I stop wanting and become very still. I want to cut my life off at the legs.

Etter’s language is grippingly poetic. She commands a daring story structure, even interspersing bulleted lists into the narrative that reveal the origin of the verb to kiss, or the nature of an octopus’s three hearts. In a series of Visions, Etter is further able to experiment within the surrealist space where her writing shines—even in an alternate universe, we find familiar pain, more poignant and recognizable against a backdrop of dystopia. Cassie imagines a shop where she can purchase a boyfriend, but when she can only afford half of the payment, she must choose between the top and bottom halves of the man’s body. Later, she imagines a shop that can zap jealousy out of her body.

Etter’s experimental form is rich, and The Book of X is most gripping in its depiction of the fraught relationships between its female characters. In spite of the protruding knot on her abdomen, Cassie’s mother is hellbent on pursuing conventional beauty standards. As an adolescent, Cassie is forced to follow a weight-loss diet in which all of her food—even her birthday cake—is made of rocks. “The dirt and meat particles have calories that burn fat in them. I read about it in a magazine,” her mom says.

Cassie finds a news article about her family that describes the deformity’s impact as “largely emotional, rather than physical.” What troubles the women of Cassie’s family so acutely is not the presence of the knot itself, but rather, the shame that they are conditioned to harbor towards their own bodies. As her mother continues to enable such self-hatred—she forces Cassie to stand naked in front of a mirror and point out where she can become slimmer—Cassie dreams she is the queen of cake in one of her Visions. “There are cakes everywhere and no one can stop me, not my mother, not my father,” Cassie imagines. “I can eat another and another and another and no one can stop me.”

Cassie’s best friend Sophia, like her mother, is well-meaning, yet never a proper source of solace. She asks to see the knot, only to balk at the protrusion. In turn, Cassie tapes magazine cut-outs of flat-stomached women in her closet, until the walls are covered with these figures. She calls them “The Sophias,” or “the girls a boy would like to touch.”

After many failed attempts to remove her knot via experimental injections, it seems that Cassie’s condition is truly permanent. But, the flat-stomached future of her dreams emerges—or, a version of it does. She eventually finds a doctor in the city who can surgically remove her knot. But even as she is severed from the physical abnormality that has defined her otherness, the psychological scars of the knot remain, “a life of pain pressing sharp against me whether I was knotted or changed.”

What is the titular X we seek to discover in Etter’s debut novel? It’s the X-shape of Cassie’s knot, the X that marks the spot on the map of the meat quarry, the X chromosome where her deformity lies. X also appears in the form of Cassie’s last name, which makes the three knotted women seem alien: Eleanor X, Deborah X, Cassandra X. Even after Cassie manages to remove her knot, she still suffers the reality that is womanhood: to suffer through any and all pain to achieve an arbitrary standard of beauty, and to continue to face ridicule even if this standard is achieved.

Despite her impossible, knotted condition, Cassandra X is an everywoman. The X operates best as a fill-in-the-blank—her family name could be our family name. Any of us could be Cassie—knotted or unknotted—a woman who is drafted against her will into a life-long war against the public opinion of her body. The Book of X is the book of us: women who have cried in shopping mall dressing rooms, who have been taught to subsist on Diet Coke and low-sodium chicken broth, who have learned from our mothers how to best hide the truth of our bodies.

As we witness Cassie’s death in the final pages of The Book of X, we watch a version of ourselves die, too.

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