‘The Lost Child’, Anne Atkins: review, Part Six

This is the last of a multi-part series reviewing the 1994 anti-abortion novel ‘The Lost Child’, in which protagonist Caz reacts to her mother’s abortion by constructing an elaborate lifelong fantasy about the younger sister she imagines she would have had. Part One is here and contains links to all the other parts.

At this point in the book, Caz has finished writing and publishing her book, in between a rapid and intense romance with her next-door neighbour Will, to whom she is now engaged.

Content warning: Talk of child death, life support cessation decisions, ablism (though this is presented as wrong in-story), inappropriate pressure from the medical profession, description of callous treatment of a body after death, and suicide plans.


The highbrow despair

Having ended the previous chapter (the conclusion of the book-within-a-book) on a positive note, with Caz looking forward to the future, Atkins starts this one with Caz in the depths of despair. In a very highbrow literary way, to the point where she actually lampshades it; ‘Oh, Caz, can’t you even watch your heart break without quoting effing literature?’ she writes after quoting Macbeth and rambling about how Laurence Olivier managed to howl effectively on stage when required by learning it from trapped minks.

The next several pages are Caz a) lamenting how awful she feels and b) telling the Greek myth of Cassandra because Atkins wants this for symbolic purposes which I’ll get to shortly. One slightly odd thing here (which will be relevant in a few minutes, so bear with me) is that Caz claims that, as part of the curse, Cassandra knows her prophecies will be believed just once in her life, on the day that she dies.  This would be a brilliantly effective addition to the curse (imagine not only never being believed, but knowing that when it eventually happens it won’t be a relief as it’ll be a sign of your own imminent death), but it isn’t one that I can find in any version online, nor could I find anyone who’d heard of it when I asked on Reddit. I’m not sure whether Atkins took liberties with the story deliberately, whether she actually had heard this version somewhere herself, or whether she simply got it wrong.

Anyway, we eventually find out what all this is about; her lover Will has finally told her the full story of his child’s death, and it turns out that he gave the doctors permission to turn off the life-support machine, which Caz finds unacceptable.

Will’s story (as told by Caz)

Late in her pregnancy, Will’s wife was hospitalised and unconscious with severe pneumonia. The baby was delivered by emergency Caesarean and put on a life-support machine. The next day, the paediatric team came to Will (his wife was still unconscious) and told him that ‘there was a considerable possibility of brain-damage to a greater or lesser extent’. We’re not told what sort of level of brain damage the doctors were suspecting here, but Caz implies that it’s on the level of ‘won’t get qualifications or go to university’. The consultant’s response to this level of uncertainty was…

Their medical opinion was that the continuance of life-support for the foetus was strongly contra-indicated.

As before, Atkins apparently doesn’t know that ‘foetus’ is a term specifically used for the stages of development prior to birth and thus no-one would have been referring to a child after birth by this term. However, that’s far from being the worst plausibility problem with this story. We’re told that the consultant not only recommended switching off the life-support machine, he wanted a fairly quick answer from Will about this because…

[…] as there was no knowing how long the machine would be needed … well, suffice it to say that Will would have to make up his mind while there was still the choice.

… and so the consultant was going to come back to Will at the end of the ward round, forty-five minutes later, and get his answer then, the clear implication thus being that this was framed as ‘switch off the life support right then or risk being saddled with a brain-damaged child which will, of course, be too awful a prospect for you to even consider it as a possible option’.

Aaaaand no, Atkins, that is not how decisions about switching off ventilators are made in real life.

There are rare and tragic cases where brain damage is so severe and the predicted quality of life so poor or non-existent that doctors will advise that life support be turned off. Typically, in such cases, the medical staff will do everything they can to be sure that the prognosis really is that bad. They will sit the parents down for a sensitive conversation about it. They will give them time to think about it. And, above all, they won’t make the suggestion in the first place unless they’re sure that the prognosis really is hopelessly dire.

This idea that a consultant would railroad a parent into making this sort of decision about a child who was already showing enough signs of improvement that they anticipated her shortly being able to breathe independently is just so far away from the reality of these sorts of situations that I’m flabbergasted that Atkins had the brass neck to write this. This is deeply insulting to all the doctors who’ve had to guide parents through these horrible decisions with sensitivity and professionalism. While I disagree with Atkins’ views on abortion, at least with abortion she’s objecting to something that actually happens and not to some strawman she’s invented.

Oh; we also get told a few pages later that the baby’s body was thrown out with hospital trash after death. Again, no. I get that Atkins is probably trying to make some sort of point about how much she disapproves of fetuses being treated this way after abortion or miscarriage, but that isn’t what happens when children die after birth. (For that matter, it’s also not what happens with stillbirths after viability or even with late miscarriages.) Both parents would have been given a chance to hold and say goodbye to their child and then a chance to plan a funeral and choose either burial or cremation. Atkins is arguing against a strawman.

Caz’s reaction

So, Caz has told us this heart-wrenching story of Will, left alone and without guidance under this sort of pressure while his wife is still unconscious. She tells us about how he desperately tries to get through to someone he trusts with whom he can discuss this horrible decision, and can’t manage it within the short time he’s been given, and how he prays for an answer and doesn’t get one, and eventually, after forty horrible minutes of this, tells the doctors that he’ll ‘be ruled by them’, because he just can’t think of any other way to make the decision. Regardless of what you think of the rightness or wrongness of the decision itself, it’s very hard to read this without your heart going out to anyone faced with such a horrible situation and so little support.

Well, except apparently for Caz. She writes in her diary that he ‘murdered his child’ and that he ‘must be a monster’ who ‘destroys everything I’ve ever lived for’. That’s the level of compassion she’s able to show for the man she supposedly loves so much.

And that’s completely in line with the way Atkins has written her character. So far, through the book, we’ve seen a judgemental woman with rigid views on right or wrong, whose main relationship has been with an imaginary person she can idealise, who doesn’t seem able to extend sympathy or grace to the flaws of real people, and who doesn’t even seem to understand the concept of being able to sympathise with a decision with which she disagrees. Meanwhile, she’s seen no problems with making a decision to marry her first serious partner only a few months after meeting him, while still in full-on NRE stage.

With that background, it feels very realistic that she has this kind of 180o reaction to finding out something about Will of which she disapproves. She doesn’t seem to have any kind of framework for accepting and forgiving someone who has done anything with which she disagrees, however long ago and however deeply regretted. And, now that she can no longer idealise Will (the way she idealised her imaginary sister), everything has crashed down for her.

But I don’t get any sense that this characterisation was deliberate on Atkins’ part. It could, in fact, have worked really well to present Caz deliberately as a flawed protagonist and unreliable narrator. But Atkins is trying to present her as Cassandra the ignored prophetess, the truth-speaker we should all believe. Atkins is on Caz’s side here.

Having given this scene a lot more thought than it actually deserves, I’ve eventually realised that Atkins is clumsily trying to make some point about non-Christians supposedly being unable to forgive:

So what do I do? I honestly don’t think I know anyone who’d understand. I once knew a man [her grandfather] who would have done. But then he had a future and a city with a crystal river to look forward to, where the sun never sets. He would have known what to do. But this, all this futility, wasn’t the end for him.

I don’t have his future or his faith, and my point of reference isn’t the Bible but the classics – which he understood well enough too – so I’ll have to look for my answers there.

So it seems Atkins thinks nonbelievers are incapable of forgiveness. At the same time, she seems to have no concept of reacting to a disagreement by thinking about the person’s reasons for acting the way they did and/or their feelings about it now and whether they regretted it and forgiving others in that way. In other words, she doesn’t really seem to understand forgiveness at all. I’m left with the impression that she sees forgiveness as ticking off a mental ‘there, forgiven’ box rather than actually trying to understand anything about the other person’s viewpoint or actions.

Atkins does not seem to see anything wrong with Caz’s lack of any such attempt to understand. As far as I can see, the only problem Atkins has with Caz’s reaction seems to be that she isn’t able to tick the mental ‘there, forgiven’ box which (in Atkins’ eyes) a Christian would be able to make everything all right by ticking. Other than that, Atkins seems to see this harshness and lack of compromise as completely justified. If this is how Atkins really feels about the matter, then that tells us quite a lot about her.

And just when you thought this was bad enough… (further content warning)

Caz, having broken up with Will because of a decision he made years ago under great pressure and clearly deeply regrets, feels she also can’t face living without Will. So, her reaction is to start planning her own suicide.

She doesn’t go through with it; after a few days of relating her despair at great length (and, to be fair, with beautifully written vivid description; Atkins is good at the wordsmithery part of writing), she posts a more positive diary entry which is all very vague but does effectively imply that she’s going to go and make it up with Will. On top of which, she is apparently a major character in Atkins’ next novel, and, from the look-inside feature on Amazon, it seems she is back with Will, so clearly that’s what happened. But we do get these few days in which, although she never specifically says in so many words that she’s planning to kill herself, she makes it very clear that that’s what she’s thinking.

Now, I’m trying to think how to say this next bit, because I do not want either to minimise the horrendous pain that leads so many people to take their own lives or to make assumptions about what anyone does or doesn’t feel they have to live for. I know that people whose lives seem wonderful on the surface can have unsuspected torments beneath that surface. I know that depression is a tricksy lying weasel that can convince someone that their life is hopeless even when it seems objectively good. So please, please, do not take my next comments as being any sort of judgement on the real people who are faced with real problems that drive them to suicide, and please, if anyone reading this feels that way themselves, know that I believe in your pain and hope for you that you have people who will take it seriously and help you.

But here is the problem with Atkins’ portrayal: We’ve been reading Caz’s diary all along, so we know that she doesn’t have that level of problems. This isn’t a case of someone who seems fine on the surface while feeling terrible underneath. This is someone who has not been suffering from depression, who has not been struggling with hidden problems, whose life has by her own account been going splendidly up until the point where she chose to break up with her fiancé purely because she is too rigid and lacking in compassion to accept that he once, long ago, did something she believes to be wrong. And the result of writing Caz as planning suicide solely for that reason is that what would otherwise have been a genuinely excellently written portrayal of someone struggling with despair comes across more as a teenager having an ‘I shall DIE and THEN they’ll all be sorry!’ strop.

On top of which, we get this:

Cassandra died the moment she’d been believed; with the truth, as always, on her lips.

…which Caz ties in to the fact that she got such good reviews of the advance copy of her book:

My book has been hailed as prophetic, the catalyst to change the law. ‘The tide of morality is turning (I quote) and soon the law will protect the unborn child again, as it has throughout most of history until 1967.’

Oh, yes, they believe me now.

They believe me now.

So, Atkins is trying to draw a parallel between Caz’s planned suicide and Cassandra’s death, with both of them presented as the prophets who die only at the point where people finally believe them. I’m sure she meant this to be powerful and symbolic, but it doesn’t stand up well.

Firstly, Caz isn’t making a prophecy; she’s expressing an opinion. So people aren’t disbelieving her, they’re disagreeing with her. There’s a difference, although Atkins doesn’t seem to get that.

Secondly, the reason Cassandra’s realisation of her upcoming death was a tragedy was the inevitability of what she predicts. She knows that she’ll die later that day and she knows that there is absolutely nothing she can do to prevent it. Caz, on the other hand, is making a choice. She has the options of either facing the grief and learning to make a life without Will, or being less unbendingly rigid in her requirements for the people in her life, forgiving him, and taking him back. However much she might dislike the idea of either of those choices, they still exist.

The result of all this is that her comparison of herself with Cassandra comes across as not so much powerful as grandiose. (It also occurs to me that it is really quite rich for Caz to be comparing herself to someone who had ‘the truth, as always, on her lips’ when she has in fact spent years lying to her publishers.)

However. We are not done yet; there is still a layer of hypocrisy icing on this particular intolerance cake. Because we now find out…

Will and I are having a child.

This, by the way, is written on August 26th. Caz also says it’s a boy, so she’s supposedly far enough along to have had some sort of test for (apparent) gender. Caz and Will met on the first of May and became lovers some time in the middle of June. If Caz is not only pregnant but far enough along to have had a gender check, she must have conceived almost as soon as they started going to bed together, which was only about a month and a half after they met. That is… not a good timescale for making decisions about creating a new person for whom the two of you will be forever jointly responsible.

However, setting that aside; Caz, ferocious defender of fetal life, is pregnant. And considering suicide. So, surely, according to her own beliefs she should be planning on postponing her suicide until the baby is born? Nope. We’re back to the Greek mythology-based symbolism:

Procne took her beloved son, her Itylus, and killed him out of vengeance for her sister.


Will and I are having a child. A boy. Our Itylus.

…so Caz’s plan is, apparently, to commit suicide while she is pregnant and to view this as some kind of symbolic vengeance against Will in a gospel-according-to-Greek-mythology way.

And she’s planning this despite the fact that her defining character trait throughout the book has been her utter opposition to abortion, which she firmly believes to be child murder. Despite her protest in the end of her book, written only weeks ago, about how having to live through ‘a few short months’ of unwanted pregnancy shouldn’t outweigh a child’s right to life. Despite her childhood vow ‘never to kill my children, I mean a baby in my tummy’. Despite the fact that the entire reason she’s upset in the first place is because she’s angry at Will for what she believes to be child murder on his part. The hypocrisy is utterly breathtaking.

And it could still have worked in-story if called out. After Caz’s eventual decision not to commit suicide after all, she could have had a scene of looking back with horror at how nearly she had done something she found abhorrent. It could have been a learning moment in which she realised for the first time what it was like to be desperate enough to get to that point. She wouldn’t even have needed to change her views on abortion; just find the understanding and compassion that has been so missing from her character until now, maybe look back at her mother’s decision with new insight and sympathy. But we don’t get any of that.

The outcome, and final thoughts

After several entries in which Caz despairs of ever feeling happy again (and also some letters, including one from Caz to her niece for her sixth birthday in which she sends her the story she once wrote of Procne and Philomela, because of course that’s a totally appropriate present to send to a six-year-old, especially when you’re planning to commit suicide knowing what a traumatic event that will be for her), we get a final entry in which Caz seems to have found her way back to inner peace and a wish to go on living. And, again, the wordsmithery part of the writing here is very good. Caz goes out to look at the Thames and we get shown-not-told that she’s focusing on more positive imagery, in ways that are very nicely bookended with the negative images she was writing about back in the novel’s opening pages. The final line, in a callback to a pleading letter Will wrote Caz a few days earlier in which he told her he’d get a bottle of Moet and wait for her, is:

Well, I thought as I turned away, who ever said you couldn’t have Moet for breakfast?’

So, without being explicitly told that Caz has decided to try again with Will, we can still pick it up from that line. In these ways, this chapter is good writing.

The problem with it, however, is that we’re given no indication of how Caz got mentally from Point A to Point B. In real life it is of course fairly normal for a few days of letting the dust settle to be enough for people to find they’ve moved quite naturally from ‘LET’S CALL THE WHOLE THING OFF’ to ‘Potayto, potahto, whatever’; not every argument needs a big definitive resolution. But, when you’ve gone to the trouble of throwing a nuclear-level disagreement in as a plot twist forty pages from the end of your novel, you need to actually address it in some way, not just let it peter out vaguely into nothingness.

Caz could have realised that, while she still disagreed with what Will had done, she could nevertheless feel empathy for him and forgive him. Even better, she could have come to the obvious realisation about her own hypocrisy in planning suicide while she was still pregnant and could have learned the more general lesson of ‘people can make decisions they deeply regret later, especially in acutely stressful circumstances, while still being basically good people’ and extrapolated that to understanding and forgiving Will. But we don’t see any of that. We just go from Caz being all ready to commit suicide to make a point, to Caz waking up feeling a bit better, to Caz apparently feeling positive about life again and being about to go back to Will. So, as plot resolutions go, it’s a damp squib.

However, good or bad (I’m voting ‘indifferent’), it is the end of the book. As I mentioned, Caz does show up in a subsequent Atkins novel titled ‘On Our Own’, and if anyone does happen to have read that I’d be interested to know what happens with the plot and whether the dangling threads from the end of this one are ever addressed. But I’m not interested enough to bother ordering the book, so unless I happen to find a copy in a charity shop somewhere I will not be reading any more about Caz.

And, since I have finally ranted myself out on the topic, this is also the end of this book review. I am sadly behind on responding to comments – for which my apologies – and will try to do so in upcoming days. Meanwhile, I will close by once again channeling Richard Ayoade: Thank you for reading, if indeed you still are.


  1. Katydid says

    You might not be aware of the anti-choice USA favorite lies of the late 1980s/early 1990s that I feel “Caz” is stealing from. There was a whole speaking circuit (traveling circus) of speakers who were either a) aborted after viability and thrown in the trash can like a leaky pen, where they were somehow fished out by a savior, b) came across a viable baby in a trash can and fished it out and raised it/adopted it out. You being a doctor, you realize human tissue is never just discarded like that.

    I’m also hung up on Caz’s happy hypocrisy. Throughout the book, she’s been unwavering in her belief that abortion is wrong because it’s killing a life. She loves, loves, loves, loves the embryo/fetus. Despite that, she’s considering killing the embryo inside her?!? So, is fetus-worship actually a belief of hers, or just a weapon she levels at people who aren’t as superior as herself?

    My heart also breaks for the imaginary Will. You captured his situation clearly: he was very young, under great stress, and out of his element. He was not a medical professional, so he listened to the actual medical professionals. In other words, he was making the best decision he could given the tools he had to work with. If he reconciles with Caz, he’s going to have to hear about how he’s inferior to her–a monster, in fact–for the rest of his life.

  2. Katydid says

    Oh! I forgot to discuss the other anti-choice trope of the early 1990s: the idea that doctors (people who spend years learning medicine and then make it their life’s work to provide medical care) are all bumbling idiots who have absolutely no idea about anything regarding medicine. There was a case of an anencephalic fetus (nothing from the eyeballs up)–there was no chance if the baby was born that it would survive, because it was completely lacking a brain including the brain stem that regulates breathing. That caused a whole lot of “just-so” stories being shotgunned into media that can be summed up as “ALL THE DOCTORS ON EARTH said there was no way that (insert fictional baby) would live, but he/she was born PERFECT! Praise God!”

    I’m sure it’s this thinking that led to, “The doctors are all wrong. Wearing a mask and washing your hands is useless against catching Covid–inject bleach into your veins, gobble sheep wormer, and shove a light bulb up your butt instead.”

  3. says

    Based on everything you’ve written about Atkins and what she wrote, I have to say this Atkins person is either knowingly spouting reich-wing-forced-birther lies as easily as she farts, or desperately, frighteningly out of touch with reality, and in need of some sort of professional help or intervention. I’m pretty sure that’s how most readers, and publishers, would think of someone that far out of touch if he/she was of any other ideological stripe.

    …So please, please, do not take my next comments as being any sort of judgement on the real people who are faced with real problems that drive them to suicide, and please, if anyone reading this feels that way themselves, know that I believe in your pain and hope for you that you have people who will take it seriously and help you.

    For what it’s worth, I’d just like to add that when we (both blog author and commenters) ridicule and debunk stories like this, we are responding to a story, and a character, that we know are clearly not only fictional but delusional or dishonest to boot, and have absolutely no connection to real people or their real-world problems. This is all completely separate from our understanding of real people who have really contemplated or attempted suicide.

  4. Katydid says

    Yes, I echo Raging Bee: anyone who is suffering so much that they are considering suicide gets my full sympathy.

    I don’t believe the author of this Chick-like Tract is the least bit honest or suffering.

    For those unfamiliar: Jack Chick self-published a bunch of ridiculous Evangelical Christian nonsense in the 1970s and 1980s and people bought them by the carton to force on unsuspecting people–especially children.

  5. Pierce R. Butler says

    … the consultant not only recommended switching off the life-support machine, he wanted a fairly quick answer …

    As Katydid notes, the anti-choicers in the US delight(ed?) in painting mainstream ob/gyns as technocratic killers, and Atkins parrots this.

    … there was no knowing how long the machine would be needed …

    Which reminds me of a man I know put in a very similar situation of getting pressured to turn off the life-support machinery sustaining his COVID-comatose mother, so it could be used for others. However, in his case the differences included that this happened in the US, so unbearable expenses accrued by the hour, and specifically in Texas, to a Black family (do I really need to explain further?).

  6. Jazzlet says

    Will should ask for protective custody of the child when it is born, and a restraining order against the clearly disturbed Caz.

  7. says

    @7: That would fit right into the Christians’ “godless secular child-hating anti-Christ persecution” narrative. In fact, I wouldn’t be surprised if that turns out to be the plot of one of the sequels. I’m sure Atkins would treat such a story with the same honesty and perception she’s shown in this book…

  8. says

    As Katydid notes, the anti-choicers in the US delight(ed?) in painting mainstream ob/gyns as technocratic killers, and Atkins parrots this.

    No past tense necessary, they still do, and surely always will. And it’s not just ob/gyns either, but the entire medical profession. Remember the Terri Schaivo meltdown? She’d been in a persistent vegetative state for FIFTEEN YEARS — with her husband taking care of her the whole time — and all the legal disputes about removing her feeding-tube had been going on for the last FIVE of those years. And yet all the loony-right “friends of Terri” were asking that whole time “why are you meanies in such a hurry to murder poor Terri Schaivo?” Like they really seemed to believe all the doctors want nothing more than to get everyone on an assembly-line to quick efficient Nazi-style euthanasia.

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