OK, I admit, I'd always sort of read the title that way. After reading the book, I can say that, in fact, it does.
If you're looking to get lost in something, this sprawling tale by John Irving is a good choice. It's the tale of two men. Dr. Wilbur Larch is truly an unforgettable character. He was forged by his first sexual experience: with a prostitute his father bought him as a going-away-to-college gift, whose daughter came in at the end and sat in a chair by the bed, smoking a cigar. He contracted gonhorrea from the prostitute, then years later, he would treat both mother and daughter in a Boston ER. Both would die, the daughter from a back-alley abortion that Dr. Larch had refused to perform. After that, Dr. Larch began performing them. He also became the head of an orphanage in rural Maine. For decades, he provided a safe choice to women: they could come to him to have either an orphan or an abortion.
Homer Wells was a 'failed orphan'. He was adopted four times. None of them took, for various reasons. He remained at the orphanage as the heir apparent to Dr. Larch, and as the only son Larch would ever know.
The book chronicles Dr. Larch's entire life, and most of Homer Wells'. It's set in the first half of the twentieth century throughout rural Maine and has a huge cast of memorable characters. Melony, Homer Wells' first girlfriend, also a failed orphan and a large, rough woman who finds her place as an electrician. The two nurses, Dr. Larch's platonic wives, who worship him. Candy, the woman Homer leaves with and has a doomed, decades-long affair with. Fuzzy Stone, an orphan who succumbs to poor lungs but is reborn in Dr. Larch's mind. Many, many more, including the migrant apple-picker denizens of the Cider House, for whom the rules of the title are written. I enjoyed this one a lot, and plan to try more Irving in the future.