I had to look up "geek" because it surely didn't mean the detailed interest of , say, a computer geek. So I learned the carnival meaning. Luckily the really gross and bloody part occurred only briefly at the beginning. The next oddity was the father deciding to produce his own freak show for the carnival (based on his seeing horticultural variety at the International Test Rose Garden). The mother dutifully took drugs to alter her offspring. Their living children were four: Arty with fins for arms and legs; Elly and Iphy, the Siamese twins; Oly, the hunchbacked, dwarf narrator; and Chick the youngest, with his special powers. 
 Had it not been a group read, I might have stopped there. However, I remembered a comment of a professor about other novels with "grotesques": What could the author say through them that couldn't be said through more average characters? I decided to read a bit more through that frame. Then the next chapter captured my attention with its narrative strategy of jumping into the future with Oly and her daughter Miranda. Several events are revealed that make a reader wonder how they happened. That same strategy is used a few more times, like a carrot to keep one reading. For the first two thirds of the book, the pacing was very effective. Then the notes of a reporter/participant were introduced, and while they provided important information that Oly, the narrator, couldn't have known, they dragged the pace considerably. Also the very ending of the book, while motivated, seemed to take too long. It also left me wondering to what extent it was a change in her character instead of an extension. 
 I have not yet answered the What could be said question. First hypothesis, something about disability issues. Did not hold up. Second hypothesis, something about minorities. The carnival provided a sort of ghetto where deformities were normal; however, the carnival was dependent on the money of the norms buying tickets. Oly didn't feel odd till she no longer lived in the carnival setting. 
 One group member read an interview with the author and learned she is an environmentalist and is anti-war. Perhaps the father's manipulation is an extreme of the various pollutants in our atmosphere, food, and water. And there was one paragraph in the reporter's notes where Arty ponders how people could criticize his followers who are maimed by choice and not criticize war with the injuries it produces. Maybe. And is it really choice when there is cult-like power in the leader and manipulation? I feel the need to think more on the followers' willingness to endure amputation and what it might say about other things we readers may be willing to give up and for what.