The influenza pandemic of 1918 killed more people than the First World War—an estimated 3 to 6 percent of the human race. This quote from the author’s note about her novel The Pull of the Stars set the scene for this gripping and beautiful  book. Many of you will know about Emma Donoghue because of her novel, Room, which was made into a movie. I was very impressed with that novel, but honestly have found other of her novels even more impressive. Donoghue is a writer of immense talent and a huge heart.  There are three main characters in this novel: a young nurse, Julia Powers, who works in a severely understaffed hospital in Dublin, where for three days she finds herself in charge of a unit for pregnant women who have come down with the dreaded flu, and thus have to be isolated from the other pregnant women. Bridie Sweeny, who is an even younger volunteer helper, and who finds herself quite suddenly in the middle of a rather chaotic scene with no training, but a deep need to be of service. And, finally, a rarity for the times, a woman Dr. Kathleen Lynn who is rumored to be a Sinn Fein rebel on the run from the police. Nurse Powers can serve in the ward because she has already had the flu and is therefore immune.  The novel begins with her on her way to work, part way by bike and then by tram. Children carrying suitcases were filing into the train station as we swung past, being sent down the country in hopes they’d be safe. But from what I could gather, the plague was general all over Ireland. The spectre had a dozen names: the great flu, khaki flu, blue flu, black flu, the grippe, or the grip…(That word always made me think of a heavy hand landing on one’s shoulder  and gripping it hard). The malady, some called it euphemistically. Or the war sickness, on the assumption that it must somehow be a side effect of four years of slaughter, a poison brewed in the trenches or spread by all this hurly-burly and milling about across the globe.  The chapters of the book are related to the course of the disease, Red, Brown, Blue, Black. Well, I said, it starts with a light red you might mistake for a healthy flush. If the patient gets worse, her cheeks go rather mahogany. (I thought of the turning of the leaves in autumn.) In a more severe case, the brown might be followed by lavender in the lips. Cheeks and ears and even fingertips can become quite blue as the patient’s starved of air….Bridie Sweeny asked, Is blue as far as it goes?I shook my head. I’ve seen it darken to violet, purple, until they’re quite black in the face. Most of the book is taken up with the particular stories of the three or four pregnant women who are isolated together in the small makeshift ward.  While the nurses deal immediately with the pain and suffering of the patients, they have very little power, unable to administer  pain medications without the direct order of a physician, and not even allowed to use the medical equipment at hand. Dr. Lyon is a rare exception in that she tells Nurse Powers that she can use her own judgment in administering aspirin  and even opiates. Although this is not a political novel, the asides on  the Sinn Feiners are perceptive and clearly show Donoghue’s  sympathies.  Dr. Kathleen Lynn’s character is based on a real life doctor, described by one of the the cynical orderlies as  “a vicar’s daughter from Mayo gone astray—a socialist, suffragette, anarchist firebrand.” In spite of the severe shortage of doctors in the hospital, during one of the times of greatest need and chaos, she is summarily arrested and taken in chains from the hospital. I learned a lot about maternity from this superbly crafted work and a lot about the sexism in the medical profession which, while somewhat improved  these days, is still very much with us.. Nurse Powers notes the ridiculous methods of prevention and alleged cures by the ignorant, not so unlike certain idiot’s responses to today’