My Notorious Life

A prefatory note frames the novel as a memoir discovered after the death of its author, Ann, in 1925. A descendant named Teresa Smithhurst-O'Rourke explains that seven leatherbound diaries were hidden by the family for nearly a century due to their controversial content.

The memoir opens on April 1, 1880, when Ann discovers a woman dead in the bathtub of her Fifth Avenue mansion, her throat cut in an apparent suicide. Ann's criminal trial is set to begin that morning, and she knows her enemies will blame her for the death. Exploiting her physical resemblance to the dead woman, she places her own diamond jewelry on the body, then flees with cash while her husband, Charlie, stays behind to tell authorities the body is his wife's. At the courthouse, Ann's lawyer telegraphs that Madame DeBeausacq, Ann's professional alias, has killed herself. Her accusers celebrate. Ann declares she will now tell the whole truth of her life.

In 1860, twelve-year-old Ann Muldoon (called Axie), her seven-year-old sister Dutchess (called Dutch), and baby brother Joe are begging outside a New York bakery. Their father is dead, and their mother, Mary, lies bedridden in a squalid tenement, her arm mangled in a laundry accident. Charles Loring Brace, founder of the Children's Aid Society, finds the family and persuades the reluctant Mary to enter Bellevue Hospital. He places the children in an orphan asylum, where baby Joe is taken to a separate nursery despite Axie's violent protests. Mary's arm must be amputated, and Brace enrolls the children in his Western Emigration Program, commonly known as the orphan trains, which transported destitute urban children to farm families across the Midwest. In Rockford, Illinois, the three siblings are separated: A couple named Ambrose takes Dutch, a woman named Mrs. Trow claims Joe, and Axie, whose fierce defiance scares off every prospective family, is taken in temporarily by Mrs. Henrietta Temple, the local reverend's wife, who teaches her to read. When both families stop bringing the younger children to church, Axie loses contact with her siblings entirely. She and Charlie, a cocky orphan boy she befriended at the asylum, board a return train to New York.

Back in New York, Axie finds Mary alive but remarried, pregnant, and living in deeper poverty. When Mary goes into labor, thirteen-year-old Axie must deliver the baby alone. The infant girl dies within a day, and Mary develops a fatal hemorrhage. Axie is taken in as a servant by Mrs. Evans, a midwife at 100 Chatham Street, honoring Mary's dying wish. Over the next several years, Mrs. Evans trains Axie in medicine and midwifery while the household cook, Mrs. Browder, becomes her surrogate caretaker. Axie secretly reads medical texts, including Dr. Benjamin S. Gunning's Diseases of Women, where she discovers the probable cause of her mother's death: retained afterbirth leading to hemorrhage. Mrs. Evans takes Axie on house calls and teaches her about what she terms "premature deliveries," explaining that turning away a desperate pregnant woman endangers the woman's life because she will attempt the procedure herself or be killed by the father. During these years, Axie writes letters to Dutch and Joe that go unanswered or produce only impersonal replies. Dutch, now calling herself Lillian Ambrose, writes of parties and dresses but never acknowledges their shared past.

On her sixteenth birthday, Axie reunites by chance with Charlie Jones, now about twenty and working as a typesetter at the Herald. He courts her, and their relationship deepens. When Axie's monthly courses stop, she is terrified she will die in childbirth like her mother, but they eventually return. After Mrs. Evans dies of her opium addiction, the widower Dr. Evans dismisses Axie with a fraction of her promised wages. She pilfers medical tools and recipe books as compensation. Now married to Charlie in a small 1865 ceremony, Axie mixes pills from Mrs. Evans' formulas and sells them as remedies for women's ailments. Charlie invents the persona "Madame DeBeausacq," a fictitious French female physician, and places advertisements in newspapers. Mail orders pour in from desperate women describing exhaustion from repeated pregnancies and fear of death in childbirth. Their marriage is initially strained by Axie's terror of conjugal relations, but Charlie obtains a condom from a freethinker acquaintance, and they consummate the marriage. Despite precautions, Axie becomes pregnant and delivers a healthy daughter, Annabelle, on October 1, 1869.

A packet of diary pages arrives from Dutch, revealing that Mrs. Ambrose told Dutch her sister and mother were dead, a lie maintained for over a decade. Dutch discovered scraps of Axie's letters in a wastebasket and realized her sister was alive, but she was forbidden from discussing her origins. Now married to Eliot VanDerWeil, a wealthy cousin of the Ambroses, Dutch begs Axie to meet her, but the letter arrives a day late, and Dutch has already sailed for France.

Axie's practice grows. She opens formal offices at 148 Liberty Street, hires her old friend Greta Weiss as an assistant, and treats a widening circle of patients. Charlie writes pamphlets under the Madame DeBeausacq name, and their income soars. But success draws enemies. When Axie helps Susan Applegate, the pregnant daughter of the president of Columbia Medical School, deliver a baby and place the child with a wet nurse, the arrangement unravels. Susan later tries to reclaim the child, who has vanished. Her father allies with Dr. Gunning, the elderly doctor he had intended for Susan to marry, and turns to the press, branding Axie a murderess. A young woman named Cordelia Purdy, sexually exploited by her guardian uncle, then comes to Axie for help, but police follow her. Axie is arrested and charged with manslaughter. She spends five months in the Tombs jail before the charges are dismissed when Cordelia fails to appear for cross-examination. Charlie reveals he paid Cordelia to relocate to Philadelphia.

The Joneses build a lavish mansion on Fifth Avenue and Fifty-Second Street. Axie continues practicing from discreet basement offices. At a housewarming ball, lawyer Andrew Morrill warns of the new Comstock Law, which criminalizes sending contraceptive materials through the mail. The law is championed by Anthony Comstock, a postal inspector and self-appointed moral crusader. Axie dismisses the warning. Dutch arrives unannounced, now Mrs. VanDerWeil, and the sisters reunite after nearly twenty years. Dutch is horrified to learn her sister is Madame DeBeausacq, flees calling the work murderous, and returns to Chicago without responding to Axie's pleas.

Over a year later, in February 1880, Dutch reappears, pregnant by a lover named Pickering, with her husband due back from Europe in April. She moves into the Fifth Avenue house but refuses both Axie's offered remedies and a return to her husband. Comstock, posing as a customer named Cameron, visits the office and purchases contraceptive supplies. Days later he returns with police to execute a search warrant. Dutch, terrified of exposure, gives her real name to Comstock before fleeing upstairs. Axie is arrested and released on bail, her trial set for April 1.

On the eve of trial, Dutch promises to care for Annabelle if Axie goes to prison. They share a tender evening singing a French song about sisters. In the early hours of April 1, Axie finds Dutch dead in the bathtub, her throat cut with a kitchen knife. Dutch's farewell letter explains she cannot bear more shame and does not wish to testify against her sister. Axie places her jewelry on Dutch's body, writes a suicide note blaming Comstock, and flees before dawn. Charlie removes all evidence of Dutch's presence and identifies the body as his wife's. The coroner's jury rules it a suicide, and Comstock boasts it is the fifteenth death he has inspired.

After six months hiding in Boston under an alias, Axie is reunited with Charlie, Annabelle, and a young red-haired man: Joseph Trow, her lost brother Joe, now twenty-two and raised on a Pennsylvania dairy farm. Greta and her son Willi join them, and the group sails for Liverpool under assumed names. They settle in London, where Annabelle marries a barrister and has four children, the youngest named Lillian, called Dutchie. Axie continues practicing midwifery among London's poor. She writes her memoir surrounded by family, declaring she does not forgive her enemies and recording her story so the truth will outlast the lies told about her.