Hospital ward during the 1918 influenza pandemic
historical fiction

The DO Book Club, March 2021: The Pull of the Stars

The DO Book Club’s first fictional selection is a novel about the 1918 flu pandemic that provides a valuable look at how health care workers weathered the storm over 100 years ago.

Welcome back to The DO Book Club! For March, I read The Pull of the Stars by Emma Donoghue. If you’ve read this one, please share your thoughts in the comments below. And if you’d like to write a book review for a future month, please email Rose Raymond at rraymond@osteopathic.org.

Plot summary

This historical novel spans three days in a “maternity/fever” ward of a hospital overrun by the 1918 influenza pandemic in Dublin, Ireland. The story is told from the perspective of a fictional nurse named Julia Power, who works alongside a volunteer helper and an overworked physician to deliver babies whose mothers are struggling to survive this mysterious respiratory virus.

Obviously, the parallels between this story and the last year of the COVID-19 pandemic make it a timely read. It provides a valuable retrospective look at how health care workers weathered the storm over 100 years ago.

Interestingly enough, Donoghue mentions in the novel’s afterword that she started writing it in late 2018, to commemorate the 100-year anniversary of the flu pandemic, and submitted her final draft to her publisher in early March 2020. As our current pandemic picked up steam, the publishing process was fast-tracked and the book was released last July.

Keeping that timeframe in mind, it is all the more fascinating to see how many ways history has repeated itself this time around when compared to Donoghue’s descriptions of 1918. Allusions to public health messaging about the importance of masks, restrictions on gatherings, confusion about the origins of a virulent disease, and the protagonist’s observation that “the whole world was a machine grinding to a halt” (p. 12) will all resonate with readers for years to come.

The story itself is gripping. At times it is optimistic and at times it is tragic, as one might expect in the genre. Overall, it is steeped in a unique intensity many health care workers have unfortunately grown familiar with over the last year, but it ends on an unexpected note of hope, which was a welcome conclusion after a stressful read.

Interesting tidbits for DOs

Donoghue did extensive research on the common medical practices of the early 20th century, down to extremely minute details about childbirth and fever control. There are some that DOs will note are clearly outdated, like this scene, in which a physician prescribes alcohol for a woman in labor:

“‘The high doses [of aspirin] seem to be poisoning some patients, and quinine and calomel are just as bad. Try whiskey instead, as much as she can take.’ ‘Whiskey?’ I asked, confused. ‘To reduce fever?’ He shook his head. ‘For soothing discomfort and anxiety and promoting sleep’” (p. 41-42).

On the other hand, some methods of fighting respiratory viruses have stood the test of time, including one in particular that a number of DOs were proponents of during the 1918 pandemic:

“There was a printed [information] sheet underneath the [hospital cafeteria] plates: … EARLY TO SLEEP AND KEEP WINDOWS WIDE [OPEN], WHILE TAKING CARE TO AVOID DRAUGHTS. VENTILATION AND SANITATION WILL BE OUR NATION’S SALVATION” (p. 108).

Notable quotes

One particularly prescient observation Donoghue makes about pandemics calls to mind one of the central theories of November’s Book Club selection, On Immunity. That book focused on the interconnectedness of society and how global immunity is a shared “garden” we all play a part in maintaining.

“Strangers’ bodies weighed against mine [on the tram]. I pictured trams grinding along their lines across Dublin like blood through veins. We live in an unwalled city, that was it … a web of human traffic that connected all nations into one great suffering body” (p. 151).

Donoghue also references a phenomenon many physicians experienced during the flu pandemic, and that many may have experienced again over the last year. In the following quote, a physician tries to see the glass half full in the midst of a taxing situation.

“‘You and I are lucky, Nurse Power.’ I frowned. ‘Lucky? To be alive and well, you mean?’ ‘To be here, in the middle of this. We’ll never learn more or faster’” (p. 147-148).

Takeaways

I enjoyed this book for the most part, though I think anyone would be forgiven for waiting until COVID-19 is behind us to pick it up and read it. The historical parallels were a little too close to reality for my taste at the moment.

Nonetheless, physicians (or their friends and family) may find it useful as a resource to put our current moment in history into context. The story is anxiety-inducing, but it ultimately offers a hopeful message that a brighter post-pandemic world awaits us down the road, just as it did in 1918.

April’s book

For April, The DO Book Club will be reading When Breath Becomes Air by Paul Kalanithi, MD. We encourage all who are interested to read along (this book club can be followed at any pace)! If you are unable to get out to a local library or bookstore due to COVID-19, we recommend checking out eBook options.

As a reminder, if you read The Pull of the Stars or any previous Book Club selection and want your reflections to be shared in future posts, or want to write your own book review for a future month, please leave a comment below or email rraymond@osteopathic.org.

Happy reading!

Related reading:

The DO Book Club, February 2021: Womb With a View: Tales from the Delivery, Emergency and Operating Rooms

The DO Book Club, January 2021: The Man Who Mistook his Wife for a Hat and Other Clinical Tales

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