Ruminating on why the 1918 flu pandemic wasn’t better remembered, the African historian Terence Ranger concluded in the early 2000s that the story wasn’t being told right. The vast majority of the victims—50 million of them at a conservative count—perished in a mere 13 weeks at the tail end of 1918, all over the globe. It was a planetary convulsion that was over in the blink of an eye, but whose impact reverberated through human societies for decades to come.
That kind of story doesn’t fit a linear narrative, Ranger thought. You need something rounder, more concentric; something close to the way he’d heard women in southern Africa rehearse an event that mattered to them. “They describe it and then circle around it,” he wrote, “constantly returning to it, widening it out and bringing into it past memories and future anticipations.” They take the weft of the event and draw it through the warp of their communal memory, until the two are woven together.
There is another way in which gender shapes our memory of the 1918 flu. Though more men than women died in that pandemic, women generally nursed the ill—and given the state of medical science at the time, their efforts were often what determined whether a patient lived or died. It was the women who registered the sights, sounds, and smells of the sickroom. Crucial eyewitnesses, they were the ones who connected the personal tragedies with the public memory; but with relatively few exceptions, their voices haven’t properly been heard. In her new novel, The Pull of the Stars, Irish-Canadian writer Emma Donoghue imagines what they would say if they could speak to us. She takes us into the sickroom, at whose door—out of respect or disgust or fear—the narrator usually stops.
The task couldn’t have fallen to a better-qualified artist. In a previous novel, Room (2010), Donoghue examined the relationship between a mother and her child who live in what is essentially a 3-meter-square prison cell. “I wanted to focus on how a woman could create normal love in a box,” she told a visiting journalist when it was published. In The Pull of the Stars, too, she conjures up a claustrophobic space—an overflow “Maternity/Fever” ward at a Dublin hospital, a converted supply room that just about accommodates three cots. And into it she brings the world.
The world, as is its wont, comes in different shapes and sizes. There are the occupants of the cots—a shifting cast of women who have contracted the “grip” at an advanced stage of pregnancy. One hails from the slums, another from Dublin’s posh Southside, a third who carries an honorary “Mrs.” and doesn’t wish to say where she hails from. There is Bridie Sweeney, the novice nursing assistant who grew up in a Church-run mother-and-baby home, and her nemesis Sister Luke, the night nurse from the same home who cuts a menacing figure in her whimple and eye patch—legacy of a shrapnel wound she sustained at the front. (Yes, nuns were there.) And there is Julia Power, the very capable acting ward sister, who presides over this tiny universe and narrates what happens in it.
Physicians being “as rare as four-leaved clovers” in this time of war and pandemic, Nurse Power does most of the doctoring—aided at critical moments by Kathleen Lynn. Drawn from a real person of the same name, Lynn is a talented medic and rebel who is wanted by the police for her part in the 1916 Easter Rising. Masculinity makes only fleeting appearances on this ward, in the form of a couple of high-handed doctors, a priest, and the singing orderly Groyne, a war veteran himself. But for all its femininity, Maternity/Fever is unmistakably a battlefield. First and last breaths are taken here; the interior decor is continually being stripped and replaced, and Bridie sent to the laundry chute with blood-stained bundles. Two visitors erupt into the ward by means other than the door—two infants, one born alive and the other dead.
This is the flask in which Donoghue distills the drama of the 1918 pandemic. It’s a good choice. Adults in the prime of life were particularly vulnerable to that flu, and pregnant women were among the most vulnerable of all. They suffered miscarriages and died in shockingly high numbers. The reasons aren’t clear, but it seems likely that for a body already under the physiological stress of pregnancy, the extra demands of fighting the illness—and in particular of the exuberant immune response that, like Covid-19, the flu provoked—were sometimes more than it could meet. In 1918, doctors and nurses were working with less knowledge and fewer tools than their modern counterparts—they had no ventilators, for example, and no antibiotics for fighting the potentially lethal complication of bacterial pneumonia—but Donoghue’s characters do their best with what they have. And even in 2020, medics can feel impotent when faced with patients in severe respiratory distress.
The Pull of the Stars refers to the original meaning of the name influenza, which 14th-century Italians gave to the disease, believing it to be the outcome of astronomical influence. Our understanding of flu has changed since then, and even since 1918, when most doctors thought it was caused by a bacterium rather than by a virus. Donoghue’s characters make sense of it with the concepts at their disposal. She knows that her readers hold a different set of concepts—that they may take away a different message, for example, from her description of an exhausted, working-class mother of seven who expires in the hospital with her unborn eighth, while the well-heeled Southside resident, whose baby was stillborn, returns home to her two surviving children and a private nurse. In 1918, eugenic thinking had not yet been discredited by the Nazis, and such disparities were regularly put down to constitutional weakness on the part of the poor; now we know that socioeconomic status powerfully shapes the outcome of infection, through access to health care, employment, nutrition, accommodation, and education.
The author also observes, astutely, that human beings in any era are capable of holding conflicting beliefs. Even Dr. Lynn, who keeps up with the science and has fully embraced germ theory, makes room in her mind for an explanation of the pandemic that has older roots: noxious gases rising from corpses on the battlefields of Flanders have floated over the world and sickened humanity. Today we live in a more scientifically literate world, yet conspiracy theories about the origins of Covid-19 still rampage through the internet.
Eventually, Lynn’s rebel past catches up with her. There is nothing more she can do for Nurse Power’s patients, and the Irish Question now jostles in the stuffy air above the three cots alongside socialism and women’s suffrage. As if we needed reminding, in 2020, a pandemic is social and political as well as biological. In the end, for Julia Power, it becomes personal too. Her history gets tangled up with the history of the world. The warp and the weft are knit, the story is told.