I want to review for you an excellent though often very sad novel by Diane Chamberlain, Necessary Lies. There are two primary  narrative voices. Ivy, a fifteen year old girl who lives on a tobacco farm and takes care of her intellectually challenged sister, Mary Ella,  her grandmother whom everyone calls Nonnie, and her nephew, Baby William, Mary Ella’s infant son. Jane, the other narrator, is a recently employed social worker for the state of North Carolina, and Ivy, her sister and the household are some of her first clients. Jane has just married a doctor who is not at all happy with her taking a job at all, let alone one in which she deals with welfare recipients and even people of color.  Mary Ella has her baby out of wedlock and refuses to name the father. Mary Ella is a beautiful blond girl who is intellectually challenged, and although the reader is not informed of this until fairly far into the novel, she has already been sterilized (under the pretense of an appendectomy) due to her low IQ, and her being on welfare. Nonnie, the grandmother has agreed to the sterilization because she thinks the family simply cannot afford another baby, and May Ella shows no signs of changing her behavior with the boys who chase after her. Mr. Gardiner, the owner of the tobacco farm allows the family to live for free in a tiny shack on the farm; he also allows a black family headed by a mother, Lita, to live in a similar shack with her three sons, one of whom is almost completely blind. Nonnie lives in constant fear that Gardiner will force them to leave the house and to stop giving them produce (which they refer to as a little something extra). Both girls work on the farm for very low wages, and even the grandmother, much hampered by arthritis, works some in the tobacco barns stripping and wrapping tobacco leaves.  It is only after some weeks on the job that Jane learns of the eugenics program in North Carolina. She is just beginning to gain the trust of Ivy when she is told by her superior that the state is preparing to take away Baby William. She comes to learn that Mary Ella has already been sterilized, although Mary Ella has not been told, tricked into the procedure and told that she simply had an appendectomy. Ivy is the good girl who worries about the promiscuity of her pretty sister and the declining health of Nonnie. Mary Ella has a wonderful relationship with her infant son, but she is neglectful and the State decides that Baby William is in danger living in the household. Soon, Jane is fighting on two fronts, fighting her husband and his family over her work which they find unnecessary and demeaning, and her superiors who think themselves entirely justified in performing sterilizations without informing the victims for a variety of trumped up reasons, but most of it coming down simply to their being on welfare.  Although Ivy does well in school and seems quite bright to Jane (certainly bright enough to keep her family together and fed),  IQ tests brand her her as low normal, and when she, despite her success in school and her general rule of staying away from boys also turns up pregnant, Jane is instructed by her superiors to draw up a petition for sterilization of Ivy at the time she is to give birth to her baby. Ivy has been in love with the Gardner’ youngest son for much of her childhood, and when he insists that by pulling out before ejaculating, she will not/cannot get pregnant, she defers to his “wisdom”. Because Ivy is a minor, she does not need to consent to the sterilization or even to be told about it. Her grandmother is essentially forced into giving permission by the threat of losing her home and her welfare checks. When Jane informs Mary Ella that she has been sterilized and threatens to tell Ivy what will happen to her when she gives birth, she is summarily fired for insubordination. Her husband wants out of the marriage, and it seems her life is about to come completely apart. I hav