The main character of The Pull of the Stars is Julia Power, a nurse midwife, about to turn 30, who shares a flat with her shell-shocked younger brother. Julia works in a supply room that's been turned into a three-bed maternity ward/delivery room for fever victims. Julia's patients, among them a newly married teenage girl and a delirious woman who has seven children already waiting at home for her, are in various stages of agony.
The mortality rate for flu victims during and after labor is sky high, but Julia also observes there's another contributing cause that's never listed on the charts. After one of her patients dies, Julia is tempted to put down as cause of death:
Worn down to the bone. Mother of five by the age of twenty-four, an underfed daughter of underfed generations, ...
Always on their feet, these Dublin mothers ... living off the scraps left on plates and gallons of weak black tea. The slums in which they somehow managed to stay alive were as pertinent as pulse or respiratory rate, it seemed to me, but only medical observations were permitted on a chart. So instead of poverty, I'd write malnourishment or debility. As code for too many pregnancies, I might put anaemia, ... low spirits, ... torn cervix, or uterine prolapse.
Two other women squeeze into that improvised ward to work alongside Julia: Bridie Sweeney, an orphan sent over by the nuns to do grunt work, and Dr. Kathleen Lynn, an actual historical figure.
Dr. Lynn took part in the Uprising, was jailed by the British and founded a free clinic in Dublin. There's a risk that both these characters could turn out to be a bit precious, but Donoghue swerves away from contrivance: She's such a deft, lyrical and sometimes even cheeky writer.
For instance, during a quick break, a male orderly comes in and opines about women voting, which he dismisses because women don't serve, don't pay what he calls the "blood tax." Donoghue knows to just let the irony of that remark lie. Hours before, Julia has had to manually remove the afterbirth from a hemorrhaging new mother. She's only practiced on an orange but gamely reaches into, what she describes as, "a cave behind a waterfall; hot red past the gloves all the way up my arm."Hours later, another woman in labor almost dies in "a sea of red." And, not to forget, all these laboring women—certainly paying a "blood tax"—also have the flu, which they will pass on to some of their caregivers.
I suggested earlier that perhaps Donoghue has given us one of our first pandemic novels, but that's not quite right. Instead, I'd say she's given us our first pandemic caregiver novel—an engrossing and inadvertently topical story about health care workers inside small rooms fighting to preserve life.
Copyright 2020 Fresh Air. To see more, visit Fresh Air.