One of our recommended books is The Second Life of Mirielle West by Amanda Skenandore


A story of resilience, repulsion, and the Roaring 20’s based on the little-known history of Carville, America’s only leper colony, by RUSA Award-winning author and registered nurse Amanda Skenandore.

Based on the little-known true story of America’s only leper colony, The Second Life of Mirielle West by RUSA Award-winning author Amanda Skenandore brings vividly to life the Louisiana institution known as Carville, where thousands of people were stripped of their civil rights, branded as lepers, and forcibly quarantined throughout the entire 20th century.

For Mirielle West, a 1920’s socialite married to a silent film star,

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A story of resilience, repulsion, and the Roaring 20’s based on the little-known history of Carville, America’s only leper colony, by RUSA Award-winning author and registered nurse Amanda Skenandore.

Based on the little-known true story of America’s only leper colony, The Second Life of Mirielle West by RUSA Award-winning author Amanda Skenandore brings vividly to life the Louisiana institution known as Carville, where thousands of people were stripped of their civil rights, branded as lepers, and forcibly quarantined throughout the entire 20th century.

For Mirielle West, a 1920’s socialite married to a silent film star, the isolation and powerlessness of the Louisiana Leper Home is an unimaginable fall from her intoxicatingly glamorous life of bootlegged champagne and the star-studded parties of Hollywood’s Golden Age. When a doctor notices a pale patch of skin on her hand, she’s immediately branded a leper and carted hundreds of miles from home to Carville, taking a new name to spare her family and famous husband the shame that accompanies the disease.

At first she hopes her exile will be brief, but those sent to Carville are more prisoners than patients and their disease has no cure. Instead she must find community and purpose within its walls, struggling to redefine her self-worth while fighting an unchosen fate.

As a registered nurse, Amanda Skenandore’s medical background adds layers of detail and authenticity to the experiences of patients and medical professionals Carville – the isolation, stigma, experimental treatments, and disparate community. A tale of repulsion, resilience, and the Roaring ‘20s, The Second Life of Mirielle West is also the story of a health crisis in America’s past, made all the more poignant by the author’s experiences during another, all-too-recent crisis.

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  • Kensington Books
  • Paperback
  • July 2021
  • 384 Pages
  • 9781496726513

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About Amanda Skenandore

Amanda Skenadore is the author of The Second Life of Mirielle WestAmanda Skenandore is a historical fiction writer and registered nurse. Her debut novel, Between Earth and Sky, was the winner of the American Library Association’s RUSA Reading List for Best Historical Fiction Novel of the Year. She lives in Las Vegas, Nevada.

Author Website


“Effie’s community of freedmen and Creoles in Reconstruction New Orleans is unforgettable. Skenandore’s second novel is recommended for readers who enjoy medical historical fiction reminiscent of Diane McKinney-Whetstone’s Lazaretto, and historical fiction with interpersonal drama.”Library Journal on The Undertaker’s Assistant

“Readers who like complex characters amid a roiling historical setting will be fascinated by Effie’s quest…Teen readers who are not turned off by the embalming details will empathize with a young woman’s search for identity and love.” – Booklist on The Undertaker’s Assistant

“Intensely emotional. . . . Skenandore’s deeply introspective and moving novel will appeal to readers of American history, particularly those interested in the dynamics behind the misguided efforts of white people to better the lives Native American by forcing them to adopt white cultural mores.”Publishers Weekly on Between Earth and Sky

“At its heart, this luminous book tells a Romeo and Juliet story. But Skenandore’s book is so much more than a simple romance. This novel examines the complex relationship between love and loss, culture and conquest, annihilation and assimilation.”Historical Novels Review on Between Earth and Sky

Discussion Questions

1. What assumptions did you have about leprosy before reading this book?

2. Patients at Carville fought for decades to promote the name Hansen’s Disease over leprosy because of its strong, negative connotation. What power, if any, does language hold in eras­ing stigma?

3. Who was your favorite character in the story and why?

4. Mirielle begins the novel a broken, selfish woman. But through her experiences at Carville, she is able to grow and heal. Are there instances in your own life that may have been unwelcome but forced you nonetheless to change or grow?

5. How is Mirielle’s approach to motherhood different at the be­ginning of the story than at the end? How does her approach compare to modern views of motherhood?

6. When Elena’s infant is whisked away to the orphanage, Sister Verena tells Mirielle it’s for the infant’s own good. Do you agree?

7. The title of the novel implies something akin to a death, fol­lowed by a rebirth for Mirielle. What moment would you identify as her death? At what point did her new life begin? Was it a gradual process or an immediate change?

8. Frank believes that hope is as essential as medicine in sur­viving their disease. How big of a part does hope play in a struggle, particularly a struggle for survival?

9. For half a century, patients at Carville lived without the right to vote or marry or leave the confines of the hospital. Which of your freedoms would you most hate to give up?

10. In the aftermath of Carville and the tragic quarantining of Hansen’s Disease patients, society continues to grapple with pandemic infectious disease (think of HIV and COVID-19). In what ways have we as a society progressed in dealing with these diseases? In what ways have we remained stagnant? Does stigma still play a role?



Los Angeles, California

Such fuss over a little burn. Some salve and a gin rickey, and Mirielle would be right as rain tomorrow. But Charlie had insisted on ringing the doctor. Look how it’s blistered, he said.

Off in the nursery, the baby was crying. Mirielle’s head beginning to pound. She didn’t have the energy for another quarrel.

Dr. Carroll had set Mirielle’s broken arm when she was six. Delivered all three of her children. Cared for her after the—er—accident. So she knew well how to read his expressions. The affable smile he wore when he greeted her in the great room and asked after the baby. The shrewd glance when slipping in a question about her moods.

But his expression upon examining her hand made her insides go numb as if she were sixteen again and trussed up in a corset. The way his lips clamped shut and pushed outward, causing his graying mustache to bunch and bristle. The furrow that deepened between his eyebrows. The slow, deliberate way his features reset themselves.

Mirielle pulled her hand away. She’d seen his face morph that way before. But this was just a little burn. Mirielle wasn’t dying.

“The spot on the back of your hand,” he asked. “How long has it been there?”

She glanced at the pale patch of skin at the base of her thumb. What the devil did this have to do with her burned finger? “This little thing? Can’t say I remember.”

“And when you scalded your finger curling your hair, you didn’t feel any pain?”

She shook her head. It was the smell that had alerted her. Like meat in a frying pan. She ought to have let the hairdresser give her a permanent last week when she’d bobbed her hair. Then Mirielle wouldn’t have had to bother with the iron. Or the doctor. “It’s just a burn. A trifle. I thought you might prescribe some ointment. Maybe a little whiskey while you’re at it.”

Still that serious expression.

She reached out and batted his arm. “Oh, come on. That was a joke. You know I can’t stand that cheap medicinal stuff.”

He mustered a weak smile while brushing off the sleeve of his jacket where she had touched him. “Is your husband home?”

“He ran off to the studio. Be glad you missed him. Charlie’s been in a bum mood ever since his last picture. That reviewer at the Times sure did—”

“Mirielle.” His eyes fixed her with unsettling intensity. “I’d like you to go to County General.”

“The hospital? Whatever for?”

“There’s a dermatologist there, Dr. Sullivan. I’d like him to have a look at your hand. Perhaps your driver can—”

“Of course.” Her insides squeezed all the tighter.

“I’d take you myself but . . .” His steady gaze became skittish.

“I’ll ring for the driver as soon as I finish making my hair.”

“No, best go right away. I’ll telephone ahead so they’ll expect you.” He gave her arm a hesitant pat and forced another smile. “Perhaps I should give them an alias when I call.”

Mirielle almost laughed. It’d have to be an awfully slow day in the newsroom for anyone to care about her going to the hospital for a silly little burn. But then, maybe Dr. Carroll was right. She and Charlie had been fodder enough for the press these last few years. She drained what remained in her highball and glanced at the framed posters hung about the great room. Every one of her husband’s motion pictures was displayed, from his very first to his latest flop. “Tell them to expect a Mrs. Pauline Marvin.”


Q&A with Amanda Skenandore

How did you research The Second Life of Mirielle West?

I always try to visit the location I’m writing about. Not only for research, but to get a feel for the sights, sounds, and smells of the place. During the writing of THE SECOND LIFE OF MIRIELLE WEST, I flew from Las Vegas, where I live, to New Orleans in early January of 2019. From there, I rented a car and drove about 75 miles down a two-lane road that paralleled the Mississippi River to Carville. In the 1920s, when the novel is set, this was home to Marine Hospital Sixty-six, the national leprosarium. People from all over the country with Hansen’s Disease (leprosy) were sent here for treatment and, often, lifelong quarantine. Even after a cure for Hansen’s Disease was discovered there in the 1940s, patients remained onsite, the last leaving in 2015. Now it’s a Louisiana National Guard base. But many of the old buildings remain, including the infirmary, where I stayed during my visit.

Another of the original buildings, the staff dining hall, has been converted into the National Hansen’s Disease Museum and archive. I spent four days reading old letters, perusing photographs, studying maps of the facility and grounds, and combing through articles in the patient-run magazine, The Star. More than dates and figures, I wanted to get a feel for day-to-day life at Carville. In the evening when the museum closed, I roamed the maze of covered walkways and oak-dotted lawns, imaging what it would be like to be confined here behind a barbed-wire fence, uncertain if I’d ever make it home.

I visited the cemetery at the edge of the grounds and read the names on the white gravestones. Patients at Carville, especially in the early days before there was a cure, took new names to spare their family the shame and stigma associated with the disease. So oftentimes, the names on the gravestones weren’t the patients’ real names. Sometimes only a first name and patient number were carved into the stone. It was a somber but important reminder of whose story I was trying to tell.

Did anything change significantly in your book during the writing or editing process?

I spend a lot of time researching and outlining before I begin writing my first draft. That usually helps cut down on the number of big changes I have to make in subsequent drafts. But when I finished the first draft of THE SECOND LIFE OF MIRIELLE WEST and sent it to my agent for feedback, he suggested a major overhaul. The stakes were weak and the main character utterly unlikable, he said. After a few weeks of denial and mourning, I took his advice and that of my early beta readers and reimagined the plot. I also spent more time developing my heroine.

In the end, I rewrote about 80% of the novel. My edits were waylaid by the arrival of COVID. But the pandemic gave me a greater understanding of the fear and desperation people experience when facing a life-threatening disease. I also got a firsthand taste of the loneliness of isolation. Suddenly I was relating to my characters on a much deeper level. And in writing about their experiences, I gained perspective on my own. Still, I was nervous when I sent the finished manuscript off to my editor. Had I done enough to create a compelling story? Was the main character someone readers would relate to and root for? He wrote back a month later, saying he really enjoyed the story, in particular its plucky heroine, Mirielle. It was a long journey getting there, but both the book and I were the better for it.

What work do you do besides writing?

 In addition to writing, I work part time as an infection prevention nurse. It’s never felt like a distraction, but for a while the two parts of me, nurse and author, existed separately from one another. More and more, however, I find myself drawn to writing stories with some medical component—embalming, leprosy, or most recently, early nurse training schools. Conversely, during the pandemic, writing became a lens through which I could better understand my work as a nurse.

Were you an avid reader as a child? What kinds of things did you read?

Many writers, I think, were avid readers as children, but I was not. In part because I’m dyslexic, I struggled with reading throughout elementary school. I remember crying my way through pages in an attempt to earn a free pizza through Pizza Hut’s BOOK IT! program. (I loved pizza more than I hated to read, I guess.) I was lucky, though. My parents, both avid readers, didn’t let me give up. And they read aloud to me often, so I grew to loves stories. They also gave me leeway to read things forbidden to my older sister (V.C. Andrews, Stephen King, and the like) because they figured any reading was better than none. It wasn’t until the summer after high school when I joined Up with People (a service-minded singing and dancing tour group) and began spending hours on a bus that I really became a reader. We had a box of books that members of the group shared, and I devoured whatever was available. Since then, it’s become one of my favorite past times.

What was the first piece of writing you ever published or saw in print?

The first piece of writing I ever saw in print was a short story titled PROVING GROUND that I wrote for a local anthology. The story takes place in the 1950s when the U.S. government was still doing above-ground nuclear testing northwest of Las Vegas. The main character is a scientist at the test site (formerly called the Nevada Proving Ground) who gets revenge on an unfaithful lover by killing him and dumping his body at ground zero the night before a scheduled bomb drop. It was a fun piece to write and research. A small town—replete with a diner and bowling alley—was erected at the test site for workers and their families. Tourists used to come to Las Vegas to see the blasts. At the National Atomic Testing Museum, where I did most of my research, there’s a small room where they simulate the burst of light, roar of sound, and gust of wind workers at the proving ground would have experienced during an explosion. I still flirt with the idea of writing a full-length novel set at the test site during this fascinating (and frightening!) era of history.

What are your interests outside of writing and reading?

I’ve always enjoyed puttering around the backyard with my spade and garden shears. (Not always with great success.) I have a dozen or so houseplants I try to keep green too. But recently, I’ve taken my botanical aspirations a step further and begun dabbling in plant propagation. The spare bedroom is now a nursery, and I have a collection of leaf-cuttings rooting in jars of water and sphagnum moss. I can’t look at a houseplant anymore without wondering how I might propagate it. I eagerly await the day when my cuttings will be ready to share with friends and neighbors. My newest additions are from a Monstera deliciosa (also called a Swiss cheese plant). I’m not sure what it is about these fledgling plants, but one of my favorite times of the day is when I go into the nursery/spare bedroom to check on their progress. It’s a tiny glimpse at the miracle of life.


Dear Reader,

As a writer, I’m drawn to voices lost to history. As a nurse, I’m fascinated by the evolution of medicine and healthcare. The stories of patients quarantined at the national leper hospital in Carville, Louisiana spoke to me on both these levels. For the first half of the twentieth century, Americans who contracted leprosy—or Hansen’s Disease as it’s known today—were torn from their homes and sent to Carville, many never to return. They took new names to spare their families the shame and ostracism that accompanied the disease. They underwent painful and experimental treatments in the hopes of someday rejoining society and their families. All this for a disease that is only feebly contagious.

As our own modern-day, not so feebly contagious health crisis unfolds, I hope Mirielle’s story offers you a glimpse into the past when quarantine meant something altogether different. When the stigma surrounding a disease could be worse than the illness itself. I hope you find comfort in Mirielle’s realization that there’s more than one way to make a home. Mostly, I hope you find encouragement in this journey to reclaim and redefine self-worth while fighting an unchosen fate. We, like Mirielle, are fighters too.

I’m so grateful to share The Second Life of Mirielle West and would love to hear what you think! If you’d like to post your thoughts on social media, please use the tag #TheSecondLifeOfMirielleWest so I can see your posts.

Warmest Wishes,

Amanda Skenandore


Facts Behind the Fiction

Facts about Leprosy, now known as Hansen’s Disease:

  • Because of the stigma associated with Leprosy, the term Hansen’s Disease is preferred.
  • It’s not very contagious. Most adults (95%) have immune systems equipped to fight off the bacteria before it ever takes hold and causes disease.
  • Modern scholars believe that the illness described in the Bible and other religious texts is not leprosy.
  • Though historically it was believed that leprosy was the result of a curse or a dirty and sinful lifestyle, it is actually a bacterial infection.
  • Today Hansen’s Disease is cured with antibiotics
  • Each year in the United States between 150-200 cases of Hansen’s Disease are reported.
  • Leprosy disproportionally affects men.

Facts about the National Leprosarium, also known as Carville: 

  • It began as the Louisiana Leper Home in 1894.
  • The state of Louisiana selected an out-of-use and decrepit plantation along the Mississippi to be the site of the leprosarium. They initially told neighboring townsfolk that the land was for an ostrich farm (to keep the townsfolk from protesting, which they did as soon as they learned the truth). The first patients arrived on a barge in the middle of the night.
  • In 1921 the U.S. government purchased the facility and it became the National Leprosarium.
  • Patients were encouraged to take new names to spare their family the shame of the disease.
  • Patients at Carville couldn’t vote until 1946.
  • In some states, it was legal to quarantine people with Hansen’s Disease until the 1960s.
  • Patients couldn’t marry at Carville until 1952.
  • None of the nurses, doctors, or other staff at Carville ever contracted the disease.
  • In 1992 Carville was placed on the National Register of Historic Places by the National Park Service.
  • In the 1990s the site was also used as a minimum-security prison.
  • Carville remained an active hospital until 1999, with some patients choosing to remain onsite for several years after.
  • The Catholic Daughters of Charity of St. Vincent de Paul served as staff at the facility from 1896-2005.