What a marvel of a novel this is. Emma Donoghue has written a story that explores profound human issues – hope, survival, struggle – within the minutiae of three days in a tiny hospital ward, allowing glimpses of the social, religious, political and health influences swirling around the small cast of characters. I can absolutely see this story brought to life as a stage play or movie.

The timing of The Pull of the Stars is uncanny. Published in mid 2020 during a world pandemic, it is set during another pandemic, the global influenza outbreak a century ago. Reading it now, as we struggle with Covid-19, I was struck by so many similarities between then and now.

The story takes place over three days, in a short-staffed Dublin hospital. Julia is a nurse, working long days in the maternity/fever ward, where there are three patients about to give birth who are also suffering from influenza.

The author pays tribute to the struggles of people from all levels of Irish society at the time. The poverty, religious conservatism and bigotry of early nineteenth century Ireland imposed added burdens for many, but middle class women were not immune to influenza or its effects on pregnant women, which could have dire consequences for mothers and babies.

If you are squeamish about the icky parts of the body’s functioning during childbirth or illness, you might find some scenes in this book challenging. Personally, I loved the way the author honoured the crucial role of nurses during what are profound and dramatic moments: the work and risk of bringing new life into the world, and the struggle against an illness that could strike from nowhere and kill in a matter of days, even hours. The research that went into the book was evidently deep but sits lightly in the narrative.

The characters – nurse Julia; young, poor Bridie, a volunteer helper in Julia’s ward; and the three sick, labouring women they care for – form the nucleus of the story, though the other characters are well drawn and entirely believable. We meet Dr Kathleen Lynn, rumoured to be a Rebel on the run from police, but whose calm and compassionate approach prompts Julia to question her own assumptions and beliefs. Dr Lynn is based on a real figure, a Sinn Féin rebel who later established a hospital for impoverished mothers and babies.

The intense work of the hospital is set against the background of an Ireland at war: internally in the aftermath of the 1916 Rebellion, and externally as the Great War is still being waged throughout Europe. As Julia realises:

It occurred to me that in the case of this flu, there could be no signing a pact with it. What we waged in hospitals was a war of attrition, a battle over each and every body.

The Pull of the Stars.

One aspect of the novel that I particularly enjoyed was that the business of childbirth – those giving birth and those helping labouring women – was front and centre, much as in another book I have reviewed this year, The German Midwife. Perhaps it is no coincidence that both novels juxtapose the battles of women in the process of giving life, against the battles of war, which are all about taking it.

There is so much to love about The Pull of the Stars. I listened to the Audible audiobook version, where the narration by Emma Lowe added another layer of enjoyment. It’s a wonderful book with timeless themes and compelling characters.

The Pull of the Stars was published by Allen & Unwin Australia in July 2020.