Bleak story of a Jewish family in early 20th century New York. Coming of age story in century-ago New York City that's sweet at times, but ends tragically for almost all of the characters. Paints New York of a hundred years ago as a very very different sort of life than today; it was still the age of people just dropping dead all of the time from things we take for granted don't kill people anymore (e.g. the flu, pregnancy, abortions). Even with the services of the “lady doctor”, gynecological & obstetric care pretty much consisted of hoping for the best. Basically, it's the world that conservatives, including a good portion of corporate America, wants us to go back to. I thought Fanya's death was especially bitter, since the book begins with her as a child witnessing how she dies later as an adult. Feminism of the day was completely circumscribed by patriarchy. The local lady doctor is so afraid to bring up contraception & family planning that she instead campaigns against sex after marriage. Compares the life of the respectable family life with that of the life of the whores & dancers over at the bordello, with the book seeming to come down in favor of the bordello. Affecting & thought provoking.