Brad Watson’s second novel, “Miss Jane,” opens with the birth of a baby nobody wants. It is 1915 in rural Mississippi, and Mr. and Mrs. Chisolm live on a large farm with their only surviving daughter, Grace. Befitting the reticent nature of hardened farmers, Watson uses actions, not words, to introduce these characters. He begins with the night of delivery, depicting each Chisolm’s wariness of what is to come. Everything goes smoothly until the doctor examines the baby. Notices something. He looks at the midwife, who is washing the child with “narrowed eyes.” Neither says a word as they carry out their postpartum duties. Mrs. Chisolm looks at the baby as if it is “some kind of potentially dangerous creature.” Mr. Chisolm waits outside, “his long face half in shadow.” The newborn, held carefully in the doctor’s arms, cries heartily.

(Norton)

That fraught night beautifully establishes all the key personalities in this story, inspired by the life of the author’s great-aunt. Mrs. Chisolm remains haunted and bitter. Mr. Chisolm toils over his cotton, corn, tobacco, his pecan grove and his cattle, and finds refuge in his homemade whiskey. Grace, saddled with babysitting duty as soon as her sibling is weaned, takes up smoking at 11 and leaves home barely five years later, “like some wildcat tethered to the family.” But Dr. Thompson continues to offer support as the child grows up, and it is their ever-expanding relationship — doctor and patient, mentor and student — that propels the entire narrative.

Watson plays with his plot points, waiting a few pages after the delivery before letting the doctor pronounce the baby’s gender: “A little girl, I believe.” Something is clearly different about Jane. The child “doesn’t have everything she ought to have,” the doctor says, “but I believe she’ll be all right.” He visits the family regularly because Jane will be a “learning experience for everyone, but especially me, as a doctor I mean.” In a letter to a colleague, he describes Jane’s “interesting if apparently manageable urological condition.”

Using language that is both candid and askew, Watson infuses the story with curiosity, uncertainty, and, not unlike Jeffrey Eugenides’s “Middlesex,” a certain wildness:

“She was fascinated by the mushrooms and their dry or slimy tops and delicate stems and gills beneath their caps. She liked to pop her toes against the ones that burst into orange dust that bloomed in the breezeless air. But it was the quiet, modest ones that were most interesting. If they didn’t want you to see them, you would not. They lived out their lives in shade and dampness, quivering when you passed and going so still if you happened to notice and squat down to take a closer look, to touch.”

Mushrooms are not limited to two sexes. Similarly, the oysters that Dr. Thompson brings the Chisolms one evening, fresh from the town market, are ambiguous in gender. Dr. Thompson knows that Jane’s condition — yet unnamed — makes her different from other girls. Like the mushrooms in the woods behind her house, Jane grows up sending a “silent message to all that her presence in the world was impenetrable beyond a point of her own determination.” Impenetrable. Another deliberate choice by Watson.

Author Brad Watson (Nell Hanley)

More than half the book is about Jane growing up a young, unaffected girl on her family property. She is endlessly captivated by plants and animals, their life cycles and mating rituals. Nature’s indifference, even complicity, toward her condition emboldens her to attend school. But after taking great efforts to curb her condition, she quits after a few months. “A loneliness she didn’t even know how to name welled up in her so swiftly that she didn’t realize she had tears in her eyes until she felt them cold on her cheeks, and for the first time since she was very small she let them come, blurring her vision, pushing the hurtful feeling from her heart.”

After that, Jane enters her own fungous life cycle, develops her own rituals. Her mother teaches her to cook while her father lets her roll his cigarettes, and Grace takes advantage of having a younger sister whose innocence is boundless. Dr. Thompson gives her books to read — Brontë, Flaubert — and continues explaining Jane’s biology to her. These moments of pure honesty ground the book in the reality of medical conditions that, a hundred years ago, changed lives permanently.

Toward the end of the book, Jane and Dr. Thompson go for a walk and encounter a group of peafowl. The doctor, “a little loose-lipped” with bourbon, imparts one final lesson to his perennial student, this time not about her, but about birds:

“I was going to say they don’t have obvious genitalia. It’s mostly on the inside. The males and the females have this little puckering down there, called the cloaca, and when they’re ready to mate the cloaca swell up, and they simply press their little puckerings together. . . . They call it a cloacal kiss. Now, don’t you think that’s just kind of endearing?”

“I do,” Jane replies. “Maybe I’m part bird.”

“Miss Jane” covers a quiet, often solitary lifetime enriched by the unfettered outdoors, the tough routine of farm life, and the ache of unconsummated love. Watson’s characters are mentally dexterous in spite of their physical hardship. The book plays on the tongue like an oyster — first salty, then cold — before slipping away to be consumed and digested.

Aditi Sriram is a writer based in New Delhi. Her work has appeared in the Atlantic, the Guardian, Guernica and elsewhere.

Miss Jane

By Brad Watson

Norton. 284 pp. $25.95