THE PULL OF THE STARS
By Emma Donoghue
In Emma Donoghue’s arresting new page-turner of a novel, “The Pull of the Stars,” an urban hospital is overwhelmed by victims of a cruel new disease. The sounds of wracking coughs cut through the air as medical supplies run short, and face masks become commonplace in the streets. Meanwhile, the government touts false cures and contends that the epidemic is under control.
The parallels to 2020 are uncanny, but this is history, not prescience. The year is 1918, and the illness, of course, is influenza. As Donoghue writes in an author’s note, “‘The Pull of the Stars’ is fiction pinned together with facts.”
When the novel opens, the pandemic has left one Dublin hospital with “more than twice as many patients as usual and a quarter the staff.” Julia Power, a 29-year-old midwife, suddenly finds herself the only nurse on duty overnight in the “fever/maternity” ward, the makeshift section of the hospital set aside for influenza patients who also happen to be pregnant.
Readers familiar with Donoghue’s masterly 2010 best seller, “Room,” will recall the focused intensity she can bring to bear on constricted spaces. Like “Room,” “The Pull of the Stars” takes place almost entirely in a single room and unfolds at the pace of a thriller. Over the course of three harrowing days in this “small square of the plague-ridden, war-weary world,” Julia dashes from patient to patient administering what little treatment there is: mostly whiskey and chloroform. A good day is one when nobody dies.
So desperate is the hospital for doctors that the higher-ups soon call in Dr. Kathleen Lynn, a rare female physician (and real historical figure) who is considered a wanted criminal by the Dublin police, for her role in Sinn Fein’s 1916 uprising. Brilliant and iconoclastic, Dr. Lynn eventually inspires a kind of political awakening in the practically minded Julia.
Joining Julia and Dr. Lynn is a young volunteer, Bridie Sweeney, the product of an orphanage so neglectful that she does not even know her exact age. What Bridie lacks in medical experience she makes up for in tenderness and good judgment.
Together, these capable women leap from crisis to crisis: life-threatening hemorrhages, skyrocketing fevers that lead to convulsions, a horrifyingly rapid case of influenza that progresses to cyanosis (a bluish discoloration of the skin) in mere hours, and multiple premature labors, an apparent side effect of the 1918 influenza strain. Their lives are intertwined in the constant struggle against the “bone man” — Julia’s childhood nickname for death.
The narrow aperture of the maternity ward allows Donoghue to focus on one of the novel’s most compelling preoccupations: the lives and bodies of women. Donoghue goes into great physical detail as women labor and deliver, as their skin tears and bleeds, as they vomit and urinate and breast-feed — and, in some cases, as they die. Even in Julia’s slightly euphemistic voice, the sheer attention devoted to these descriptions functions as a kind of unadorned reverence for the work and pain and strength of women — and how the paths of their lives are so often defined by the workings of their bodies.
The scenes in the “fever/maternity” ward are so enthralling that the novel loses a bit of its fire — and realism — whenever it leaves that room, but these departures are thankfully rare. Donoghue seems most interested in the dramas of this one space — with which she manages to make clear the broader constrictions and injustices of an entire Irish society.
Among the ward’s patients is an unwed mother from a “mother/baby home,” whose baby will be confiscated by Ireland’s system of Catholic orphanages as soon as he is weaned. Another patient, delirious from fever, is pregnant with her 12th child, which reminds Julia of an apparently common saying: “She doesn’t love him unless she gives him 12.” The ward’s youngest patient is 17 and lost her own mother in childbirth; this girl arrives eight months pregnant but so uneducated about the female reproductive system that she expects her baby to emerge from her navel.
At one point, Dr. Lynn notes that the word “influenza” comes from the Italian phrase “influenza delle stelle,” the influence of the stars. But this affecting novel suggests that the courses of these women’s lives are ruled not so much by the heavens but by poverty, misogyny and abuse — and a culture that forces women to bear burdens that should be shared by men, with children left to suffer the consequences.
Julia describes one of her doomed patients this way: “Mother of five by the age of 24, an underfed daughter of underfed generations, white as paper, red-rimmed eyes, flat bosom, fallen arches, twig limbs with veins that were tangles of blue twine. Eileen Devine had walked along a cliff edge all her grown life, and this flu had only tipped her over.”
At one point in “The Pull of the Stars,” as Dr. Lynn criticizes the government for Dublin’s high rates of poverty and infant mortality, an exhausted Julia insists that she doesn’t have time for politics. But Dr. Lynn shoots back with a sentiment that seems as relevant to our own time as to hers: “Oh, but everything’s politics, don’t you know?”
What she means is what we also know: that bad health outcomes are not simply parceled out by the stars. Instead they fall most heavily on the groups that a society has mistreated and neglected. America’s disproportionate rates of death from Covid-19 in the Black and Latinx communities come to mind. As we are being reminded now, a pandemic can expose the political order and the political choices that have marked many of the sick or dying long before the disease arrived.