The Book of X

Barrelhouse Reviews: The Book of X, by Sarah Rose Etter

Review by Rachel Cribby

book of x cover.jpg

Publisher: Two Dollar Radio
$17.99
ISBN: 9781937512811

Sarah Rose Etter writes beautifully, but don’t let that fool you: she does not fear the grotesque. In fact, the very premise of The Book of X is enough to induce a physical cringe in the reader.  Cassie, the protagonist, was born with her abdomen twisted in a knot, in the most literal of ways. This means that her body is twisted in a visible way. It is a malady that has affected both her mother and her grandmother before her, and although the aesthetic implications would be premise enough for a compelling novel, the knot’s effect is not merely superficial. Indeed, every woman who is born this way experiences excruciating pain that only worsens as the knot’s host ages. The reader feels a sense of impending doom throughout the entire novel as it follows Cassie in the footsteps of her tortured matriarchs. 

As a young child, the knot is far from Cassie’s only problem. Her mother is grumpy and preoccupied, with no time or patience for her only daughter, and her father and brother completely exclude her from participating in the family business. This family business, by the way, happens to be a highly prolific “meat quarry” where the family rips animal flesh off the walls to sell for money. Cassie explains: “each day, my father and brother pull meat from the quarry to sell in town like my father’s father and his father before him.” It is dirty work that leaves its harvesters with pungent smells and bloody residue, but it is also a livelihood – one that Cassie not only wants to be a part of, but feels a connection with. 

The style of writing in The Book of X is dizzying, switching back and forth from the tangible present moment to hazy visions where the events are unclear. For example, in one vision, Cassie shows a schoolmate the meat quarry, which results in an exchange that places the novel’s magical elements front and center: 

“What is this place?” he asks. 
“The Meat Quarry. My brother and father discovered it. It’s ours.” 
“What do you do down here?”
“This is where we harvest the meat.” 
“Weird,” he says. “Smells like hell.” 
“It’s my favorite place.”

While some aspects of The Book of X create concrete symbolism, such as the literal tearing of flesh from walls in the meat quarry juxtaposed with the endless commentary on Cassie’s body, other elements are left to the imagination. Etter leaves both the time period and geography of the novel’s world unspecified in a way that tantalizes the reader and creates an uncanny experience. It is like our world, but different. On the make-believe side, there’s the aforementioned meat harvesting. But events that happen in Cassie’s world could be lifted directly from our own – she dates disappointing man after disappointing man, and her boss tells her that she should smile more. 

This novel is so delicate in its absurdity, in its mixing of time periods, that it captivates. The Book of X signals a bygone era, including archaic medical practices and long rickety train rides, but some elements seem to place the characters in a modern world, such as modern cities and colloquial dialogue. Given the book’s hefty themes of isolation and self-image, the reader has to be comfortable with the fact that there may be no decade more synonymous with the dystopian than the current one.  

It is difficult for a book to touch upon the story of women’s bodies in a way that feels original and refreshing. But The Book of X succeeds in making the reader just uncomfortable enough that they feel called to think about, and to feel, their own inner knot. 


Rachel Cribby is a musician and occasional writer from Montreal, Canada. When she’s not reading a book or cuddling with her cats, you can find her drinking tea or listening to sad music.