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The Pull of the Stars by Emma Donoghue review – fighting the 1918 flu pandemic

This must be the only book this year whose publication date has moved forward, from autumn to midsummer, and that is because it’s set in a Dublin hospital during the 1918 flu pandemic. Reading it now offers a particularly eerie version of the time travel of historical fiction; one can’t stop thinking that it was written in 2018 for us to read in 2020, based on records from 1918 – dizzying swoops of both time and imagination. The novel’s Dublin is certainly uncannily familiar for this year’s readers, plastered with injunctions to “Stay out of public places … See only those persons one needs to see, refrain from shaking hands. If in doubt, don’t stir out.” Another poster announces that “The government has the situation well in hand,” and “There is no real risk except to the reckless.” Meanwhile, schools and shops are closed, and those forced by necessity on to crowded trams regard each other with a volatile mix of fear and camaraderie.

A defining strength in Emma Donoghue’s work is narrative voice, and here it is as strong and compelling as Jack in Room and Lib in The Wonder. Like The Wonder, The Pull of the Stars is narrated by a nurse, a woman necessarily involved in the defining moments of strangers’ lives, charged with both expertise and kindness, her professionalism and her femininity an unsettling combination for her era. Julia is working on the maternity fever ward of a city hospital, which is desperately short-staffed because of war and contagion, caring for pregnant women with severe flu, working beyond her training because there is no one else available. Patients stay long enough for Julia and the reader to learn to read their bodies and speech as more than symptoms, to recognise that class privilege is no protection from grief, that a half-starved 17-year-old doesn’t “bruise easily” unless someone bruises her, that poverty and overcrowding and malnutrition tell their final tales in hospital beds.

The friendship between the young women lifts an otherwise necessarily grim account of suffering and deprivation

Julia, whose own background is not very different from her patients’, is sadly inured to social injustice, but a new doctor in the hospital, Kathleen Lynn, never forgets to be angry. Babies born in the slums, she says, have less chance of surviving a year than men in the trenches. “Such hypocrisy, the way the authorities preach hygiene to people forced to subsist like rats in a sack.” Dr Lynn was a real figure, a suffragette, nationalist and activist for social justice who fought in the Easter Rising and was arrested and imprisoned. In Donoghue’s account, Lynn is tired but glamorous, especially in the eyes of Julia, whose sense of agency is limited to her home life caring for a brother with shellshock and her work on the ward.

On the first of this novel’s three days, Julia is left in sole charge of the ward but given a “runner”, a girl sent by the local convent, to help her. Bridie Sweeney is “the pale type of redhead, light blue eyes, brow almost invisible”, under-fed and scarred like most of the hospital’s patients. She proves uneducated but quick to learn and quick on her feet, caring by nature and pragmatic by experience, and the blooming friendship and admiration between the two young women lifts an otherwise necessarily grim account of suffering and deprivation. Patients die because the flu is untreatable and those with underlying conditions including malnutrition and poverty have little strength to resist it; all Julia can do is keep them warm, nourished and hydrated and try to preserve their last vestiges of strength needed to survive the disease.

Related: Emma Donoghue: the lockdown lessons she learned from writing Room

There is nothing cheerful about the situation, and so the novel depends on the voices and relationships of its three central women. They are all – as one would expect from Donoghue – complex, well-developed characters with distinctive voices and lives based on thorough research, vivid in ways that only excellent writing can offer. I found this novel admirable right up to the final chapters, when it veers into a disappointing cliche. I’m trying not to spoil anything, but if you’d like a haunting and finely balanced literary novel in which the plot isn’t suddenly taken over by depressing convention, stop 20 pages before the end.

• The Pull of the Stars is published by Picador (£16.99). To order a copy go to guardianbookshop.com. Delivery charges may apply.