Free Study Guide: The Cider House Rules by John Irving

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CHAPTER 2 - The Lord’s Work


Larch was born to a servant of the mayor of Portland, Maine. The mayor was the so-called father of the law that introduced Prohibition to Maine. His mother worshipped her employer and advocated temperance reform. On the other hand, Larch’s father was a drunk. His disappointing parents made Larch a very good student.

Larch attended Harvard Medical School. While there, he discovered he had gonorrhea, contracted from a prostitute his father had bought him as a gift to express his pride for Larch getting into medical school. His father rarely showed any gestures toward his son, and Larch was too embarrassed to refuse and touched that his father had given him anything. After his engagement with the prostitute, Mrs. Eames, Larch awakened to find another woman in the room, whom he later found out was the prostitute’s daughter. To relieve himself from the pain caused by the gonorrhea, Larch used ether, which he became addicted to. This single sexual encounter, the resulting gonorrhea, and his parents’ loveless marriage convinced Larch that a life of sexual abstinence was medically and philosophically sound.

The same year Larch became a doctor, his mother died. His father sold all her belongs and moved to Montreal, where liquor could be acquired more easily. He died of cirrhosis of the liver.

One night the prostitute, Mrs. Eames, arrived at Boston Lying-In Hospital pregnant. Larch delivered by Caesarean section a stillborn child, and he was forced to remove her uterus. He was baffled by the disintegration of her uterus. Mrs. Eames faired well for 2 days. But on the third day, she filled with blood. Three days later, she died of scurvy according to the pathologist. The next day, Mrs. Eames daughter came to see him, bringing with her a bottle of liquid that was supposed to end pregnancy. Miss Eames was also pregnant but not as far a long as her mother had been. Mrs. Eames had taken this liquid in such large amounts that her intestines had lost the ability to absorb vitamin C; she had died of scurvy.

Mrs. Eames could have gone to an abortionist that charged $500, which was much more than the poor women who came to him could afford. To pay off the debt, they worked for him as prostitutes. This abortionist and others were located “Off Harrison,” unlike the Boston Lying-In Hospital, which was located on Harrison Street. Knowing the methods of such places, Miss Eames wanted Larch to perform her abortion. For the first time, he said the word. He thought about the procedure and hesitated to long. She told him to “Shit or get off the pot,” and then Miss Eames left. She was brought back a week later beaten with the dead fetus from a failed abortion imprisoned in her uterus. Pinned to the shoulder of her dress was a note that said: “DOCTOR LARCH--SHIT OR GET OFF THE POT.” Her panties had been pinned to her other shoulder. She died before he could operate.

The next day, Larch visited “Off Harrison” to see for himself where women who had been turned down by doctors went. He entered the establishment. A German choir was singing loudly; the only form of pain-killer the establishment provided. Going through the single door, he told the man at the desk that he was a doctor and wanted to offer free medical advice. The man said Larch was not the first and told him to wait. Sitting, Larch saw the woman whose child was his first delivery. She was too pregnant to have an abortion safely, but he could not tell her because she only spoke Lithuanian.

A scream cut through the closed door, causing a young girl in the waiting room to jump from her seat, then sit down and cry into her mother’s lap. Larch learned the girl was about 3 months pregnant and 13 years old. He told the man at the desk to pay the woman back because he would help the girl. Then the door opened to reveal an old couple. The woman, known as Mrs. Santa Claus, was in charge. Larch told her she didn’t know what she was doing. She replied that at least she was doing something and asked him why he didn’t do anything if he knew how. She also asked him to teach her. He advised the woman under the sheet to come to the hospital immediately if she had more than a little fever or a little bleeding. Mrs. Santa Claus asked Larch where her advice was.

Larch returned to the waiting room and told the mother and daughter they should leave. Mrs. Santa Claus told the man at the desk to pay them back all of their money. Mrs. Santa Claus then told Larch to ask the daughter who the father was. She then told him herself. The father of her child was her own father. About a third of the woman that come in are like her, said Mrs. Santa Claus, raped by their father or brother. He took the child to the South Branch of Boston Lying-In and performed the abortion. No one at Boston Lying-In ever questioned his decision. He made up a convincing story as to why the abortion had to be performed, but afterwards, he was never treated the same.

News traveled fast that there was an alternative to “Off Harrison.” The women followed him everywhere. Larch fled home to Maine. He became an obstetrician in Portland. He wondered why there were no orphans or women in need in Portland. He did not feel of use.

One day, he was invited to the home of Mrs. Channing-Peabody. The Channing-Peabodys were members of Boston’s high society who spent their summers in Portland. Though not accustomed to high society, Larch accepted the invitation. When he arrived at the Channing-Peabody’s, he discovered that he had Miss Eames panties in his jacket pocket. Sitting down to dinner, the only conversation was that of Dr. Larch and a retired surgeon, who insisted on discussing modern obstetrical procedures. Larch knew from the tension, the visible anger of the young man sitting across the table, the lack of conversation, and the pale color of Missy that she needed an abortion. Even rich people needed him. The room and Missy were completely prepared for the procedure when he entered.

His admiration for their preparedness was overtaken but his inability to forgive them for the obvious loathing they felt for him. He sent for the hostile young man that was either the outraged brother or lover or both and made him watch. When he left, he told the servant that had prepared Missy that he should be called if Missy had a fever or more than a little bleeding. He also told the servant and the young man that Missy should be treated like a princess and that no one should be allowed to make her feel ashamed.

When he put on his coat, he could feel the envelope bulging with money it. He proceeded to distribute the money to the servants in the house. He then took a pair of forceps and pinned the panties he had had in his jacket pocket to the lapel of the sleeping retired surgeon. By the time he arrived back in Portland, Larch knew that he was an obstetrician delivering babies, the Lord’s work, and he was an abortionist delivering mothers, the Devil’s work, but to him it was all the Lord’s work. When he arrived, the letter from the prostitute from St. Cloud’s was waiting for him and off he went.

In his first week at St. Cloud’s, he delivered three children, one who would be an orphan, and performed one abortion. As he tried to educate the population about birth control, the ratio stayed the same. One abortion for every three births, then it went down to one in four, and then to one in five.

When he served in World War I, the replacement physician would not perform abortions, the Devil’s work. The birth rate climbed, and the number of orphans doubled. Larch wrote to Nurses Angela and Edna to tell the fool that he was seeing the Devil’s work in the war, shell and grenade fragments, shrapnel, and the gas bacillus infection, and that the work at the orphanage was all the Lord’s work.

Larch returned. Though he and the nurses referred to both the Lord’s and the Devil’s work, just to keep it straight which operation was being performed, they all believed it was the Lord’s work. They did not encounter their first problem until Homer Wells, who left and came back to St. Cloud’s so many times it was necessary to keep him and put him to work. They wondered how long it would take Homer to figure out that there were more women than babies and if he would understand.

At 13, walking back from the incinerator, Homer found a fetus he had dropped from a wastebasket. Yes, the quick and the not quick were delivered at St. Cloud’s. (Quickening refers to the time that movement of the fetus can first be felt.) Homer thought it had fallen from the sky or was from some animal. But he recognized that it had hair not feathers, eyebrows, eyelashes, nipples, and fingertips. With it in his hand, he went straight to Dr. Larch. Larch placed it on a piece of typing paper. It was 3 perhaps 4 months, almost quick. Homer asked what it was. Larch replied that it was the Lord’s work because he realized that teaching Homer Wells everything was the Lord’s work too.


In this chapter, Irving provides us with Dr. Larch’s background. Several important events in Larch’s life made him the man who would do both the Lord’s and the Devil’s work and be willing to do it in the isolation of St. Cloud’s. First, Larch realized his parent’s were servants. This disappoint propelled him to be a very good student and eventually a doctor. Second, his only sexual encounter with a prostitute, a gift from his father who rarely should him any love and affection, ended in his contracting gonorrhea and becoming addicted to ether.

This encounter along with witnessing his parents’ loveless marriage made Larch decide to spend the rest of his days practicing abstinence, which could be done in the isolation of St. Cloud’s. The next events that affect Larch were the deaths of Mrs. and Miss Eames and his visit to “Off Harrison.” Larch knew that these women could have been saved if abortions had been legal and inexpensive. Lastly, the Channing-Peabodys showed Larch that the need for abortions had no social or class boundaries. These events in his youth make Larch capable of running the orphanage at St. Cloud’s and performing abortions. These events solidify his strong belief that women should have the right to choose whether they want to have a child or not. He believed that women at the mercy of the men in their lives, whether they were fathers, brothers, pimps, or the male-controlled government, had the ability to choose taken from them. Larch took Miss Eames words to heart: “Shit or get off the pot.” Realizing that women were in need and that he could provide them with the services they needed, Larch chooses to be an obstetrician and an abortionist.

This chapter also touches on the social and ethical issues surrounding abortion. Irving uses the terms the Lord’s work and the Devil’s work to show the contrast. Throughout the novel, we see people, as we do today, on both sides of the abortion debate. Larch’s colleagues treat him differently when he performs his first abortion. When Miss Eames died, the officer at the hospital said it was good that Larch had not performed her abortion. The Channing-Peabodys, despite their need, could not hide their hostility for Larch. On the other hand, the nurses at the orphanage supported and assisted his work.

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