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Beetle is a smart, compassionate girl, but a timid one, too. She allows Jane Sharp to boss her around and the local boys to tease her mercilessly.
Karen Cushman chose the England of the Middle Ages as a setting for the book, and has researched the subject exhaustively. We learn about village life, medicine, feudal structure, and the place of women in that society. Most enjoyable to follow is Beetle's progress from a scared, meek little girl to a self-assured young woman who has chosen her own name: Alyce.
While not romanticizing Alyce's situation, Cushman makes it clear how much more is available to her than to upper class women of her time. At the end of the book, Alyce chooses her own future from several options. She selects the life that will allow her the most independence. With a name and a career of her own choosing, Alyce has come far indeed from the dung heap.
There were some slightly odd moments in the book. The midwife is described as being an envious/jealous type who cannot abide the notion of having a rival. Yet she is overheard later in the book, almost praising the girl's abilities. Still, this is a small quibble. I enjoyed reading about the girl's progress. It would be wonderfully paired with "Crispin: The Cross of Lead". Both stories follow ignorant orphans who learn a new profession and end their stories by going into the respective honest professions they desire. The time periods are not far off either. This book may or may not read aloud well. I don't know. There are some touchy moments (the near rape of Beetle by drunken boys, the midwife's affair with the baker, the well described births) that might make the squeamish (or their parents) uncomfortable. Nonetheless, I found this an important book and one worth remembering.