59 pages 1-hour read

The Medicine Woman of Galveston

Fiction | Novel | Adult | Published in 2024

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Chapters 41-50Chapter Summaries & Analyses

Chapter 41 Summary

Content Warning: This section of the guide includes discussion of mental illness, illness, death, sexual content, sexual violence, ableism, and racism.


The next day, after a morning of preparations for the show, Huey asks to speak to Tucia after the others leave. Huey and Mr. Darby show Tucia what lies in the “GENTLEMEN ONLY” section of the museum: Pictures of scantily dressed women with obvious and grotesque symptoms of venereal disease, leading up to a room where Tucia will be required to independently “examine” the men who come through. Tucia, realizing the men want her to perform sex acts in the name of a genital examination, refuses and flees.


Huey catches up with Tucia and threatens to have Darl and the others thrown in prison if she refuses. He reveals that Darl killed a man when they escaped prison together. He also reveals that he knows both about her secret medical consultations and her affair with Darl.


Trapped and terrified, Tucia ends her relationship with Darl back at their quarters with no explanation, not wanting him to face the fallout of Huey’s anger. She numbly acquiesces when Huey reiterates they will begin their “little upstairs operation” (335) the next day. Still in a state of shock, when Toby fusses at her, she slaps him. His crying shakes Tucia back into her senses and she picks him up, holding him until he stops crying and falls asleep. Tucia, however, is horrified at herself and unable to fall asleep for a long time.

Chapter 42 Summary

Tucia wakes up to a rainy morning the next day and discovers that Toby and Kit are both missing. She panics when she realizes Huey has stepped out as well and believes he has taken her son.


Fanny and Tucia set out to look for Toby at the beach while the men head out to look elsewhere; they decide to meet up at the museum. However, the weather grows increasingly stormier, and when Fanny and Tucia are at the beach, they witness wooden buildings breaking apart and crashing into the water.

Chapter 43 Summary

At the museum, Tucia and Fanny discover that Huey left half an hour ago, when Mr. Darby closed the museum because of the weather. He can’t remember whether Toby was with Huey but asserts the other group members never arrived at all.


Tucia and Fanny head back to the boarding house amidst the unrelenting wind and rain. The streets are emptier, and the water levels are rising. Tucia overhears someone saying that this is a hurricane.


After the women lose their bearings and Tucia almost gets swept away in the now waist-high water, they stop at a brick building to ask for help. The inhabitants, Mr. and Mrs. Baker, usher them inside, and forbid them from going back outside as the water level continues to rise at an alarming rate.

Chapter 44 Summary

Fanny, Tucia, and the Bakers head up to the second story, where some others are already sheltering. The wind picks up speed, and one of the glass windows shatters; one of the shards strikes Fanny in between her ribs. Fighting back the anxiety that instantly emerges, Tucia springs into action and commands the women in the room to help her as she lays Fanny down, removes the shard that has pierced her spleen, and stitches her up as best as she can. Fanny’s pulse grows weak, and Tucia is not sure if she will survive.

Chapter 45 Summary

Tucia stays beside Fanny the entire night. The storm eventually subsides, and as soon as day breaks, Tucia carries Fanny to the hospital on a makeshift stretcher with the help of the others. The doctor who inspects Fanny is impressed by Tucia’s assessment of the injury and her handiwork with the stitches. He promises to take care of Fanny and tries to convince Tucia to stay and help at the hospital when he discovers she is a doctor. Tucia refuses, intent on finding Toby, but takes the medical bag she is given and promises to administer assistance to whomever she can along the way.


After checking the morgue and thankfully not finding Toby there, Tucia heads to Postoffice Street through the ruined streets of Galveston. At the boarding house, Tucia is relieved to discover the rest of the group, including Darl, holed up and safe. However, none of them have seen Huey or Toby, and Darl sets out with her to find them.

Chapter 46 Summary

As they search for Toby, Tucia reveals that she knows about how Darl and Huey killed a man when escaping prison, but that she loves him anyway. Darl embraces her, then tells her the full story: Although they escaped together, Huey is the one who stabbed a prison guard to death on the way out.


Tucia and Darl search everywhere they can, with Tucia stopping to help care for all the injured she meets along the way. However, they are accosted by three men on horseback leading a group of men on foot; they claim they have been deputized to conscript all able-bodied men with clean up and force Darl to join the group. They also warn Tucia about the curfew that has been imposed: If she is caught outdoors after dark, she might get mistaken for a looter and be shot.

Chapter 47 Summary

Tucia spends the night at the county courthouse where Darl had promised to meet her, but he hasn’t arrived even by the next morning. Tucia heads to the hospital to check on Fanny. She is still in danger and under observation, her wound having bled again the previous night, but Cal and Al are by her side now.


Tucia wanders through the wreckage in town again, looking for Toby. She comes across Mr. Baker again, who has been conscripted to unearth and collect the dead. He appears numbed and unsettled by all the death and destruction he has encountered.


Tucia loses her way and, desperate to get back to the boarding house before dark, asks a group of armed riders she meets for directions. To her surprise, as she heads in the direction they point her toward, she finds Huey digging through a pile of rubble.

Chapter 48 Summary

Tucia is both relieved and terrified to discover that Huey had never taken Toby at all; then she grows frantic with worry, wondering where he could be, even as Huey asserts that if he has been missing this long he is probably dead. Tucia is further horrified when she discovers that Huey is looting from the dead, having cut off the fingers of a woman’s corpse to collect her jeweled rings.


Huey attempts to force her into looting alongside him to help recover all the money he has lost. He begins insulting her abilities as a doctor, lover, and mother. Finally having had enough, Tucia strikes him in the head with her medicine bag, screaming, “Looter!” (387).

Chapter 49 Summary

Huey pulls out a gun to quiet Tucia. She manages to knock it out of his hand, and the two grapple for control of it before Tucia gets a hold of the gun and shoots Huey in the abdomen. Quickly growing weaker, Huey begs her to help him. Tucia decides she will not be like Dr. Addams, who refused to step in and save a life when he could: She dresses Huey’s wound.


The riders return, and Huey attempts to convince the men that Tucia is the looter and that she tried to kill him. Tucia admits to shooting him, but in self-defense. She urges the men to search Huey’s pockets, and when they find everything he has looted, they shackle him on the spot before escorting him to the hospital at Tucia’s urging. Dr. Burns informs Tucia that Fanny is doing much better and praises her handiwork with both Fanny and Huey. Tucia promises to return the next day if the hospital still needs assistance.


Tucia returns to Postoffice Street heartbroken and tearful, believing Toby is dead by now. When she is almost at the boarding house, however, she discovers Kit and Toby in one of the neighboring houses. They are healthy and safe, with Anna having taken care of them: She had discovered them on the porch on the morning of the storm, and brought them in to wait it out. Overjoyed, Tucia thanks Anna profusely and takes her son and his monkey back to the boarding house with her.

Chapter 50 Summary

Three weeks after the storm, Fanny is discharged, entirely healed. She and Cal will leave the next day: They plan to start a music and dance troupe of their own, with Lawrence already having returned to his home territory. Huey is in jail, awaiting his trial. Tucia has been working at the hospital the entire time, with the girls at the brothel taking turns to watch Toby when she is away.


Tucia plans to stay on in Galveston, with Dr. Burns having spoken to the hospital board about taking her on permanently. She plans to employ Anna as a babysitter when this happens, and Darl decides to stay on with Tucia and Toby. Both of them relish the idea of a fresh start.


The book ends with Tucia reflecting on how she may never be able to shake off the past or be free of struggle in the future, but that “the here and now wasn’t a place to hide. It was hers to live” (399).

Chapters 41-50 Analysis

The hurricane of Galveston dominates the narrative in the final chapters, directing all the action and thematic exploration. The rising stakes of Toby’s absence, Fanny’s injury necessitating Tucia’s surgical skills, Tucia and Darl’s reconciliation, and the eventual freedom all the characters find with Huey’s arrest, are each brought about by the storm directly or indirectly. The hurricane thus becomes a literal and metaphorical cataclysmic event that shakes things up for each of the characters and sets them on their eventual paths of resolution.


The day before the storm hits, Tucia finds herself in a situation where, once again, she is forced to confront The Workplace Challenges Faced by Women. Huey is determined to coerce her into performing sexual acts as part of the show, and Tucia believes she has no option but to acquiesce to protect not only Toby but the others as well. However, this time, the storm offers Tucia an unexpected way out, functioning as a deux ex machina: Tucia’s handiwork in treating both Fanny and Huey during the crisis is admired and appreciated by Dr. Burns, who treats Tucia with respect instead of exploitation or contempt. Tucia thus finally receives an opportunity to prove her worth in the workplace, subsequently finding a space for herself in medicine again.


Additionally, the storm raises The Ethics of Survival, with Tucia and Huey once more functioning as important foils to one another. Whereas Huey begins looting the dead in search of valuables and money, Tucia tends to all those she meets along the way even though Toby is missing. Furthermore, even after she is forced to shoot Huey in an act of self-defense, Tucia refuses to let Huey die the way Dr. Addams did with his patient years ago. Instead, Tucia tends to Huey’s wounds and ensures he is taken to the hospital, despite everything he has done to harm her. In saving Huey’s life, Tucia demonstrates definitively that she is committed to remaining true to her ethical values even when she has clear motives for violating them, and even when she could prioritize her own survival instead.


These final chapters also address Examining and Dismantling Stereotypes and Prejudice. When the medicine show first arrives in Galveston, they only receive accommodation in the part of the city that also houses brothels. This housing arrangement highlights how sex workers, too, are a community of people regarded with distrust and disdain by society. Nevertheless, it is these sex workers who prove the most helpful and trustworthy in a moment of crisis, as they rescue Toby. Their selflessness and kindness stand in sharp contrast to the lack of attention and care Toby received from his actual babysitter, Mrs. Harsnatch, in the beginning of the book. Whereas Toby was neglected by the presumably “respectable” woman who was paid to take care of him, he is treated with true love and care by women who are widely shunned and discriminated against by mainstream society. In presenting sex workers in a positive and respectful light, the text implicitly criticizes the societal prejudice that marginalizes sex workers.  


Thus, the hurricane of Galveston becomes the climax of the book. It offers a chance for the characters’ lives to start afresh, giving Tucia in particular an opportunity to prove her mettle to herself and to everyone else. It also puts things into perspective for Tucia, clarifying what is important to her: her son, her friends, her relationship with Darl, and ultimately, life itself.

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