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Book and media review
The Knotted House
  1. Michael L Cox
  1. Correspondence to Dr Michael L Cox; manducox{at}

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The author of The Knotted House was a founder member of the National Association of Family Planning Doctors, a precursor of the Faculty of Sexual & Reproductive Healthcare. Having written extensively about psychosexual medicine, she has now turned her attention to fiction. In this first-person account, ‘Meena’, a divorced primary school teacher, bereaved following the death of her mother, has a huge psychosexual problem. We learn of the sexual encounter that exposes the problem. Throughout the book Meena searches for a solution. It’s like a ‘whodunnit’ as she considers various possibilities. Her struggle involves searching her family history for any evidence of an inherited mental disorder. She is frequently reminded of this history by two rather sinister pictures of ancestors on her wall, which confront her every time she walks past, and which seem to speak to her. Could there be clues in previously hidden documents? They reveal a murder; could this be relevant? Could there be significant forgotten memories? Could a new lover help or hinder? Why does Meena never seek professional advice as her general practitioner advised?

There are also a couple of subplots. There is the problem of an abused child in her school: a problem that her teaching colleagues typically fail to notice for a while. This is described very sensitively. Another episode is of a threatened abortion of a pregnancy which was regretted at first. The subplots do not interfere with the main story but rather add to the atmosphere which builds throughout the book.

As the novel gradually reveals information we are drawn slowly – and, for me, with some impatience – to discover the final answer. The author uses her considerable experience and expertise in the field of sexual and reproductive healthcare (SRH) to produce a truly good novel. As the book back cover blurb states: “A tension between present and past grows to a climax as Meena feels her way from inner turmoil to a new state of being". This is a tale that should intrigue not only readers who work in SRH, but also those who do not.


  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.

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