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In the infamous Tuskegee Study (1932-72), researchers selected Black men with syphilis and then watched the disease progress without administering therapeutic aid, even though the patients thought they were receiving such care. This example is often cited as a rare horror within the history of medical testing, but it isn’t an exception, especially for the poor and people of color. Fiction can enhance our historical knowledge while adding a personalizing gaze, and Megan Giddings does just that in her debut novel, “Lakewood,” which intertwines historical fact and speculative fiction into a story about exploitative experimentation that monetizes the body and dehumanizes certain lives.

The novel begins with death. Lena Johnson, a 19-year-old Black woman, returns to her home after her grandmother dies, and Giddings brings us vividly into the world of mourning that Lena and her mother, Deziree, now inhabit. It opens with a slowed pace that renders and echoes its characters’ grief as they plod through each step, from following their matriarch’s final request to gamble after her funeral to their handling of the stacks of bills. This measured entrance immediately includes mention of medicine not from Lena’s grandmother but in reference to Deziree’s daily pills for her own long-term illness. Money is a worry right away: In order to help her mother with her medical costs, Lena joins a secret medical study.

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With its compelling opening pairing a family death with a mystery, this book has much in common with Chanelle Benz’s recent gripping novel “The Gone Dead” and its Southern Gothic sense of the ongoing costs of US racism. Although “Lakewood” takes place in Michigan, Giddings similarly discusses everyday racial terrorism, especially against Black women: “Almost every time [Lena] walked or ran, a car or pickup truck would drive by with a Confederate flag bumper sticker or front plate. She would force herself to smile as if her favorite song was playing, and nothing they could do or yell would make her unhappy.” These hostilities speak to larger systemic problems that Lena must navigate, and they also point to a long history of such hatred even as the book is situated in the now.

Lena’s story is positioned within today’s youth culture through references to vaping, jumpsuits, and the serious lack of job security. Her need for employment and medical insurance for her mother becomes the plot’s catalyst. At its foundation, this story is a virulent condemnation of the US’s lack of economic opportunities and its health insurance system: Lena must put her own health at risk as a means to secure health care.

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In this way Giddings’s work is part of a larger trend warning us about the dangers of a precarious and abusive health care system. Her narrative recalls aspects of “Homecoming,” the podcast-turned-Amazon series, where soldiers are studied without their informed consent, but at times the work echoes speculative narratives like “Black Mirror.” In “Lakewood,” one of the science fiction elements is Lena being given eyedrops that make her eyes blue, invoking Toni Morrison’s critique of internalized racism. Here, Lena’s transformation focuses on how this testing has nullified her humanity and commodified her life (she’s also told not to worry about the experiment because if her eyes remain blue, “you’ll get a bonus”).

This inclusion of near-future experimentation highlights the absurdity of real medical testing — even beyond the Tuskegee Syphilis Study. Lena begins her own research into historical experiments such as those performed on the testicles of inmates at San Quentin Prison, the mind control of potential assassins in Project Artichoke, and the testing of bio-chemicals on the city of San Francisco in Operation Sea-Spray. Like these earlier subjects, Lena and her fellow subjects wonder what they will be paid for each tooth they lose, even as their bodies are fetishized and broken down before them.

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One of the most impressive literary elements in this book is how Lena’s own perspective is rendered in one chapter. The test subjects are given a daily cover story to share with friends and family who are forbidden from knowing what they are truly doing. In this section, though, the cover story and Lena’s own experiences begin to blend. Eventually, her confusion is so great that Lena questions the identity of other test subjects and hears a raccoon talk, so that we, too, wonder what is real and what isn’t.

These highly creative moments balance out some of the places where Giddings could have taken her plot further. In the end, though, her book reveals the costs of the world of nontherapeutic research that already exists, without giving readers a catharsis that allows us to forget what we have seen. Like any good book mining such powerfully unsettling true stories, “Lakewood” will no doubt prompt many to read more about its subject. This novel is the start of a promising career, and I hope Giddings will continue to delve into places that many wish to avoid.

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LAKEWOOD

By Megan Giddings

Amistad, 288 pp, $26.99

Abby Manzella’s book, “Migrating Fictions: Gender, Race, and Citizenship in US Internal Displacements,” was named by Choice Reviews as an Outstanding Academic Title.