As usual, I ran out of novels to read while on holiday in Sicily. I scoured the English shelves of the local bookstore and this time I found a winner: a novel by Emma Donoghue. The title, The Pull of the Stars did nothing for me but the back cover sounded promising: ‘Dublin1918 . . . unfamiliar flu . . . Best Novels of 2020 Daily Telegraph’.

According to the inside back cover, Emma Donoghue was born in Dublin in 1969 and was an Irish emigrant twice over, having spent eight years in Cambridge, England before moving to London, Ontario. She is best known for her novels, which range from the historical to the contemporary. Her international best seller Room, was the New York Times Best Book of 2010 and was shortlisted for the Booker, Commonwealth and Orange Prizes.

Nurse Julia Power, age 30, single, who lives with her younger brother, a shell-shocked casualty of the trenches of World War I, is the principal character. Through staff illness she has been assigned a tiny, three bed ward which is occupied by women in the late stages of pregnancy, and who have the fearsome disease which is taking so many lives. (The virus which causes the disease was not discovered until there was an electron microscope in 1935, and a vaccine was not developed until 1938.) There are two other supporting characters: a young volunteer, Bridie Sweeney, from a Dickensian home for orphaned children, and Doctor Kathleen Lynn, a real person, who violently opposed British rule, was Sinn Fein’s director of public health and founder of a free clinic on Charlemont Street. There is a constant flow of new patients onto the tiny ward. Julia and Bridie face seemingly every complication of pregnancy with the occasional help of Dr Lynn. Nurse and volunteer become attached under the continual life and death struggles they face. Bridie becomes ill with the flu and dies. Her loss for Julia (and the reader) is compensated partially by Julia’s spontaneous adoption of the newborn son of an impoverished woman who died of the flu.

This book is a magnificent piece of fiction. Julia, Bridie, Dr Lynn and all of their patients are real in their humanity and their flaws. One feels nearly suffocated in the tiny ward with it’s primitive medications and treatments. My hat is off to Ms Donohue for her compelling descriptions of early 20th century medication, the hospital culture, and the Dublin environment with its grinding poverty. From about page 30, the tension is unremitting and un-contrived. The reader becomes completely absorbed in this altogether different world a century ago, and its strange yet familiar problems.

I have just two comments about the book. The scene-setting which consumes the first thirty pages of the book lacks the powerful tension which engulfs the rest of the book. It is still very interesting reading; perhaps some foreshadowing would have helped increase the tension. When Bridie becomes ill during the last twenty pages, her death becomes a foregone conclusion and some of the tension disappears. It might have been better to introduce Bridie’s illness earlier with some doubtful symptoms and some denials. This could have intensified Bridie’s loss.