The Cider House Rules book cover

The Cider House Rules book review

John Irving has said that he always starts with the last sentence, then works his way backwards through the plot, to the beginning of the story. It’s a technique that has served him well; he’s written 14 novels and nine of them have been best-sellers. The Cider House Rules was his sixth; published in 1985, it ends like this:

“To Nurse Edna, who was in love, and to Nurse Angela, who wasn’t (but who had in her wisdom named both Homer Wells and Fuzzy Stone), there was no fault to be found in the hearts of either Dr. Stone or Dr. Larch, who were – if there ever were – Princes of Maine, Kings of New England”.

Set in rural Maine in the first half of the 20th century, The Cider House Rules tells the story of Dr. Wilbur Larch, the director of an orphanage in the town of St. Cloud’s, and his favourite, beloved orphan, Homer Wells. Parallels have been drawn between this book and Oliver Twist, but I can assure you that Charles Dickens never wrote a character like Dr. Larch, whose story is told in flashbacks. An obstetrician, an abortionist, and a saint, the doctor contracted gonorrhea from a prostitute while he was in medical school and takes ether to relieve the pain. Later, while working as an intern at Boston’s Lying-In Hospital, he’s called to deliver a dead baby and recognizes the woman as Mrs. Eames, the prostitute.  Her uterus is so terribly disintegrated he has no choice but to remove it. She survives the operation but dies a few days later when her abdomen fills with blood. The next day her daughter comes to see him, and shows him a bottle of something that’s supposed to induce a miscarriage. Her mother drank so much of this liquid her intestines lost the ability to absorb Vitamin C, and she died of scurvy.

The woman’s daughter is also pregnant, although not as far along as her mother. She wants Larch to give her an abortion. The risks, for both doctor and patient, are significant. At the time (near the end of the 19th century) performing an abortion was punishable by a year in jail or a thousand-dollar fine, or both, and you could lose your license to practice. When Larch refuses, she leaves, after telling him to “shit or get off the pot”. A few days later she’s brought into the hospital with a dead fetus imprisoned in her womb, the result of a failed abortion. Her panties are pinned to one shoulder of her dress; to the other is a note that says, “Shit or get off the pot”. Before Larch can operate on her, the young woman dies.

This death weighs heavily on his conscience, and will do so for the rest of his life. His guilt is compounded by the discovery of an old photograph of that same young woman posing with a pony’s penis in her mouth. Larch wonders if she agreed to pose in order to pay for the abortion. He resolves that he will never again turn away any woman who comes to him with such a request. As long as abortion is illegal, he will be of use to these women. Under his directorship, the orphanage becomes a place of sanctuary, where women can come to deliver their babies or receive a safe abortion – free.

It’s a tough subject, abortion, and it takes up much of the narrative. It’s definitely not easy reading, no matter what you think about abortion rights. While one doctor calls it the work of the Devil, Larch argues that what he’s doing is actually the Lord’s work. And he’s disgusted with those who condemn the women who choose that route:


“These same people who tell us we must defend the lives of the unborn – they are the same people who seem not so interested in defending anyone but themselves after the accident of birth is complete! These same people who profess their love of the unborn’s soul – they don’t care to make much of a contribution to the poor, they don’t care to offer much assistance to the unwanted or the oppressed! How do they justify such a concern for the fetus and such a lack of concern for unwanted and abused children?”

In this endeavour, Larch is assisted by his two nurses, Nurse Edna and Nurse Angela, and by the one orphan who never finds a home. Larch cares for all the orphans, calling them “princes of Maine, kings of New England”, but he grows to love Homer Wells like a son. When Homer’s adoptions fail to work out, Larch accepts that Homer belongs to the orphanage and begins to train him as an obstetrician. Although Homer assists in these procedures, even delivering a child when the doctor’s unavailable, he refuses to perform abortions. The “products of conception” are human; he believes they have a soul.

Larch hopes Homer will attend medical school; by the time he’s a teenager he’s already adept in many surgical procedures and would make an excellent doctor if he can find a patron to put him through school. But Homer is ambivalent, not sure what he wants to do, and when a handsome young couple come to St. Cloud’s for an abortion, he ends up leaving with them. He and the young man, Wally, become best friends, working together in the family apple orchard, Ocean View. He secretly falls in love with Candy but is careful not to reveal it to Wally, as he and Candy plan to be married. When the Second World War breaks out, Wally joins up and is trained as a pilot. His plane is shot down over Burma and he’s presumed dead. Homer stays working at the orchard; Dr. Larch has falsified Homer’s records, stating that he has a heart condition, making him unfit to fight. Believing Wally to be dead, he and Candy finally give in to their mutual passion and make love. When Candy gets pregnant, they return to St. Cloud’s so she can have the baby. They name him Angel and bring him back to Ocean View as an orphan whom Homer decided to adopt. Angel grows up believing Homer to be his adopted father and Candy a loving mother figure who isn’t really his mother. When Wally eventually returns to Maine, having lost the use of his legs but survived, he and Candy marry, and the four of them – Homer, Angel, Wally, and Candy – live together in the big house on the orchard estate.

It’s a long book, with a few too many characters and several subplots. One concerns Melony, another orphan who was never adopted. A tough, angry young woman, she initiates Homer into sex and makes him promise he’ll never leave the orphanage without her. When he leaves with Wally and Candy, Melony devotes her life to looking for him, but when she does eventually find him she immediately recognizes Angel as the spitting image of Homer when he was young. She also sees traces of Candy in the boy and is devastated that Homer, whom she considered a hero, would do something so terrible: have sex with the wife of a man in a wheelchair. In the end, she forgives him and when she dies, she has her body sent back to St. Cloud’s so it can be used for anatomical research.

As for Homer, he ends up doing what he refused to do for years. A young woman named Rose is impregnated by her father, the head picker on the orchard estate. His son, Angel, is in love with Rose and comes to his father for advice about procuring an abortion. Homer calls the orphanage asking to speak to Dr. Larch only to learn that the doctor has died, having succumbed to an accidental overdose of ether. It’s up to Homer to be “of use”. He gives Rose a safe abortion and then heads back to St. Cloud’s to succeed Wilbur Larch as the director of the orphanage. He retains his distaste for abortions but decides that as long as they’re illegal, he’ll honour the wishes of the women who come to him.

The cider house rules, by the way, are a list of rules posted every year for migrant workers to follow. The rules are consistently ignored, because the workers can’t read. Like the antiquated laws against abortion, some rules are made to be broken.