In her debut novel from 2020, author Megan Giddings writes about a young Black woman who drops out of college after the death of her grandmother, determined to find a high-paying job that will help her family get out of medical debt from her mother’s illness. In “Lakewood,” she finds a job that pays well and provides health care benefits, in exchange for her participation in some strange medical research studies. This is how this character, Lena, is extending herself to help take care of her loved ones; and the ways that people care for each other is something Giddings has been thinking about deeply in this and her subsequent works of fiction.
“I think some people might disagree with me, but the way that I view care is that you can’t really talk about the ways you care about and love someone, at least in the United States, without having to touch on deeper social issues,” she said. “We want to act like there are so many things that are isolated from one another, (but) a lot of the times, when we need care or love, it’s still, there’s pressure always coming from social and societal issues.” Issues like the cost of health care, the ethics of research studies, or whether we’d happily (or begrudgingly) see our tax dollars be used on social safety nets for people with fewer resources.
Giddings, who’s an assistant professor in the English department at the University of Minnesota, Twin Cities, will talk about “Lakewood” and her books “The Women Could Fly” (2022) and “Meet Me at the Crossroads” (June 2025) during the annual Black History Month author series from 6 to 8 p.m. Monday on the first floor of the Neil Morgan Auditorium at the San Diego Central Library. (She’s also scheduled to speak from 7 to 9 p.m. Tuesday in the Mother Hill reading room at the University of San Diego’s Copley Library.) She took some time to talk about enrolling herself in medical studies as part of her research for “Lakewood,” the history of the suffering of Black people and people of color in the name of scientific advancement, and balancing how we make decisions for others when we’re navigating how to care for them when they’re in need. (This interview has been edited for length and clarity. For a longer version of this conversation, visit sandiegouniontribune.com/author/lisa-deaderick/.)
Q: In “Lakewood,” Lena accepts a new job in the fictional town of Lakewood, Mich., which involves participating in secret medical experiments—where she and all but one of the other participants are non-White while the researchers are all White. For me, what immediately comes to mind are the historical examples of this kind of exploitation, like the Tuskegee study, the experiments in gynecology performed on enslaved Black women by J. Marion Sims in the late-19th century, or the sterilization programs of the early 20th century that were largely directed at women of color. Were there ways that this history informed your approach to telling Lena’s story?
A: I did do a lot of research, thinking about how, often, for the level of care people receive in the United States, Black women’s contributions, forced or otherwise, have been disappeared. I was also simultaneously thinking deeply about these histories and about a very modern or contemporary story in this country—when you learn that Lena’s grandmother has died and by the end of chapter one you also know that her mom is suffering from chronic illness, and that makes Lena the breadwinner of her family, despite the fact that she is in college. One thing that I think happens very quickly is that you have to make a lot of decisions around money and care when someone is dying because we don’t have universal health care. We don’t have a health care system that allows people to even be able to make measured decisions. Sometimes, one day someone you love is there and, if you’re lucky, you might have time to prepare a little bit. Often, you have to deal more with the cost of dying, in the way that many health care insurers work. So, I wanted to write a book that kind of bridges the gap between these two social issues, where you have both this long history, this Black history. There are so many studies that, the most famous ones are done off of Black labor, but there are also issues around the Latinx community, around Asian communities, around poor, White communities. Essentially, you are selling yourself so that we can, in some ways, hopefully learn something that will enhance medical knowledge. Also, I kind of just tied all of those together because I think the minute you have an encounter with the American health care system, where, even if you have insurance, if it’s something where someone’s life is at risk, you are more inundated about the costs and potential procedures than being able to process how ‘My loved one could possibly die from this experience.’ Both of those things kind of coalesce to me about how little we value life in this country.
Q: How do you view the relationship between science, ethics, and human rights, and how did that point of view find its way into Lena’s experiences?
A: One of the things I did while I was researching “Lakewood,” is I enrolled myself in different medical studies. Most of them were for lenses and I want to say that some of the scientists who did these were great, excellent doctors. Excellent at laying out every part of what I was consenting to, and even willing to answer questions for me about what an actual ethical research study looks like and allowing me to use it for the book. Then, I had one experience where I was working with a younger researcher. It was a lens study and I wasn’t allowed to take them out of my eyes. It was just this situation where someone is already touching your eyes for you, and you’re already uncomfortable, and then you express that discomfort and she said, “You signed up for this.” Not, “Yeah, this is weird, where I’m touching your eyes and I can’t get these very tight, weird lenses out,” but instead it’s, “No, you did this to yourself.” I think I feel like that situation-both seeing the really ethical side of it and then seeing just a slight touch of what it feels like to be deeply dehumanized for science and knowledge, to help a manufacturer make a slightly better product that might make a very small impact on someone else’s quality of life-I wanted to portray both sides. I don’t want people to leave “Lakewood” thinking, ‘Never see a doctor again. There is no point to scientific knowledge’ or anything like that. We shouldn’t be hesitant because the things that you do medically, they impact your family, they impact your community, they impact yourself. The choices you make are often not in a vacuum when it comes to your care, even if you might think so; but I am also trying to think about the uncomfortable middle ground of exploitation. There are so many things that make our lives better that involve other people’s suffering and other people’s deaths, and I felt really urgently when I was writing that book about thinking about giving people the space, just like I gave myself while writing it, to think about the complications of all of these decisions and things that happen.
I don’t even think that we’re often taught to think about things that way. I mean, it’s a personal pet peeve of mine that we’ve been so ahistorical, at least here in the U.S., about all of the innovations that we have that give us relative comfort. We should be thinking really deeply about how often these things come from someone else’s sacrifices.
Q: Lena takes this job and agrees to being subjected to these experiments because of money, to get out from under medical debt. This is such a common concern with the Consumer Financial Protection Bureau reporting last year that around 100 million Americans owe more than $220 billion in medical debt. Why were these questions about money-what people will do to get more money, what people will do to get out of debt-important to you to position in the book in this way?
A: I think it’s twofold. To be straightforward, I had a family member have a medical situation that we were told could be very serious. We, theoretically, had good insurance and it still wiped out our savings to get the diagnosis and care in the months we spent waiting to go to different appointments, to see specialists because we weren’t near a major metropolitan area. Even in a major metropolitan area, you often have to wait. I felt like the book came together for me emotionally when I realized how angry I was and also, simultaneously, how much shame I had over those months of having to mostly prioritize money. I couldn’t prioritize spending time with my loved one, who I was worried might die because I still had to keep our lives above water. I had to figure out how to keep making money. I had to figure out what we could afford. Also, just the fear, simultaneously, of having no money and not being able to afford rent, the fear of losing this person, and it was overwhelming. I still think of those months as some of the worst months of my entire life, and I came out lucky in that situation. It turned out he was fine, it was just a misdiagnosis and we got to have our life and move on.
I think the profound difference is I can’t imagine what would have happened if we found out that it wasn’t a misdiagnosis, that he would die within the next year. I don’t know what it would have done to the rest of my life to have spent that year trying to figure out how to live and figure out how to live without him, and it’s still really upsetting to me to think about it. It was upsetting, too, that I knew this was a common experience, in of how many of us will face cancer in our lifetime, which is an extraordinary cost. How many of us don’t realize how close we are to one accident destroying our financial stability. I don’t know if I ever would have been able to write “Lakewood” without that experience, but it’s still not an experience I’m grateful for.
Many of us deserve a much more stable life in this country. Then, we are treated as silly or like we’re asking for too much to want that for ourselves and for other people. It feels even worse when you can compare that to many, many other countries in this world where they have far more stable health care. People don’t have to worry about medical debt like we do.
I live in Minnesota right now, and I’m usually not surprised, in my big age, about people’s reactions to social progress. We have a real “must be nice” culture instead of a “all of us deserve this” culture…It feels like many of us have been taught to view other people through a limit of, ‘Here are the people who are people to me, and here are the people who you can’t really use the word “people” with.’ If you start listing the ways that rights get taken away, we’re arguing about a level of humanity and inhumanity that we’re still reckoning with. I’ve read some scholars in Black studies who feel like slavery was this breaking point that cannot be reconciled because it always allowed people to view some people as people, and some people as tools. Every country has a different social structure in history that has allowed some people to be people and some people to be objects, so it’s not like this uniquely U.S. thing, but I think that where our culture intermixes with capitalism-and there are many excellent things that have come out of capitalism-there is still a culture of “there’s always someone who’s going to be the best and better than everybody else, and they deserve the most.” That can really impact the ways we look at and see one another.
Q: You’ve said in previous interviews that “Lakewood” is about grief and anxiety, and also about family and “about the ways even deep love can lead us astray.” Lena’s grandmother’s death compels her to take this job and this study. Can you talk a bit about the influence of grief and about deep love leading us astray? What do you mean by this?
A: What I mean by “deep love can lead us astray” and how that is tied into grief is that, for a character like Lena, I think this is something a lot of caregivers can experience: you often put the person suffering above yourself and build a lot of structures and ideas around them. There’s this beautiful thing of selflessness and love that comes with caring for a family member or wanting to be there for them. There’s also a level of how some caregivers aren’t listening to what the person getting care needs. They have this idea of what care is, and one of the reckonings in the book is that Lena makes all of these decisions without letting her mom be in the loop at all. She’s in charge now, and there’s a reckoning between these characters, in some ways, around actually talking to one another. “Lakewood” is a book that, in some ways, has the easiest flaw that most of us have experienced-most of these things in “Lakewood” might never have happened if these characters had had open, honest conversations with one another. That especially becomes fraught when you’re trying to take care of someone and you want them to feel safe and secure, and yet you might be making some decisions that are bad for both of you because you’re not taking a beat to just talk things through, to be honest and vulnerable with one another. I think, sometimes, for some people, grief makes that worse because when I’ve lost people that are important to me, I’ve felt that I’m simultaneously trying to make decisions that aren’t even for my benefit, but for the idea of what that person might have wanted for me. It’s the type of decision making that’s really easy when you’re emotionally overwhelmed by something like loss, but you start making decisions that kind of make this person still feel alive, even when they’re not. They’re also sometimes the type of decisions that you make so that you don’t have to think about loss. It might even purposely be bad decisions because it’s at least something else to think about.
