Book review by James King.
EMMA DONOGHUE. The Pull of the Stars, 2020 256 pp.
ISBN: 978 1 52904 6168
Since the publication of this novel in July this year, at the height of our first wave of the Australian COVID-19 epidemic, there have been many reviews, mostly very flattering, including one written by Frank O’Shea (a member of the Tinteán editorial team) for the Canberra Times-https://www.canberratimes.com.au/story/6862272/profound-timely-and-lasting-story-of-humanity
So what can I add to those reviews? Not much I feel, except that as I have a professional familiarity with the setting of the novel, perhaps a personal insight into certain aspects of this absorbing story might add something to complement other reviews.
Briefly, the story covers three days in 1918 (October 31 – November 1) in Dublin, at the height of the Spanish flu epidemic, and just ten days before Armistice day. The setting for most of the action is an unnamed major public maternity hospital on Dublin’s down-at-heel northside (but there is only one such hospital, then as now, so I’m puzzled why the author avoided naming it, and even gives it a false motto- perhaps there’s a story there). I’m confident that the hospital in the story is the world famous Dublin Lying-in Hospital, better known as the Rotunda Hospital (named for the copper cupola over its roof, not for the abdominal profile of its attendees). I undertook my obstetrical training there, from 1969-1973, so I know it well, and recognise many of the features described in the novel’s anonymous hospital as being peculiar to the Rotunda.
The novel’s narrator is an experienced dedicated midwife, Julia Power, turning thirty (‘have I left it too late?’ she muses), whom we follow through three utterly exhausting twelve-hour shifts, caring for several women who have contracted the Spanish flu while pregnant. Nurse Power has as her helper an untrained young volunteer named Bridie Sweeney, who had been taken on as a ‘runner’ to help with menial tasks in the chaotic milieu of overcrowded wards with understaffed, overworked midwives and doctors.
In each of the four chapters, the reader gets a minute-by-minute description of the progress of Nurse Power’s patients in the makeshift ‘Maternity/Fever’ ward. The chapters are named Red, Brown, Blue, Black, after the sequence of skin discolourations which occur as the influenza virus overwhelms the body’s capacity to maintain oxygenation, from initial cyanosis, until death.
The author has certainly done lots of homework. Nurse Power has the text ‘Jellett’s Midwifery’ at her elbow to help her manage her patients. Dr. Henry Jellett was Master of the Rotunda at the time of this story, and his textbook would have been the prescribed text for the hospital staff. It’s clear that Emma Donohue has studied it carefully (the book is still in print as a historical text), to glean arcane obstetrical terminology and to enable detailed descriptions of cataclysmic childbirth scenes.
The reader is spared nothing; no crisis, no matter how gory, is glossed over in the seemingly never-ending descriptions of the terrifying complications of childbirth in women with severe influenza, as if the author felt compelled to display all her new-found obstetrical knowledge before us.
In ‘Red’, we meet the first of her patients, Delia Garrett, a rather snooty south sider, with high fever from the flu and in premature labour, who eventually delivers a stillborn infant, followed by a catastrophic haemorrhage. There’s no obstetrician available, so Nurse Power has to undertake a manual removal of the placenta. ‘I went through the cervix way up my arm, as she wept and thrashed from side to side.. I was a fearful burglar, creeping around a lightless chamber’. This is followed by intra-uterine douching with carbolic acid, pumped in by a bulb syringe into a glass nozzle inserted through the cervix, then a rectal laceration needs suturing, with no anaesthesia, and Bridie restraining the patient’s legs.
In the next bed we meet Ita Noonan, forty-plus, who is in premature labour having her twelfth baby. Not only has she double pneumonia, coughing up ‘seaweed coloured sputum’, she also is doubly incontinent, delirious with fever and dehydration, befuddled by generous doses of medicinal whiskey, but in addition to all this collapses with hypoxic febrile convulsions. In vain, Nurse Power tries to revive her, and at the end of the shift assists with the post-mortem autopsy.
Nurse Power and the runner Bridie are too tired to go home, so they get some blankets and sleep on the roof under the stars, and decide they are sexually attracted and get up close and personal. The following morning, they attend to Mary O’Rahilly, a first time mother-to-be, bruised by a bashing from her husband, in labour, with a contracted pelvis. She has an excruciatingly protracted labour, and after Nurse Power has consulted Dr. Jellett’s textbook, she successfully manages the obstruction by putting the patient in Walcher’s position. Few currently practising midwives or obstetricians would have heard of this manoeuvre and I certainly had to look it up, and there it was, in Jellett’s Midwifery text.
The last patient is Honor White, pregnant ex-nuptia, who eventually gives birth to a beautiful baby boy, perfect in every way except he has a hare-lip, which meant he couldn’t even be ‘put out’ for adoption. Nurse Power decides to take him home…I shan’t go on.
Others have found this a riveting read, but I found it rather tedious, almost exhausting I felt the relentless descriptions of obstetrical calamities were somewhat gratuitous, and the lesbian love scene so irrelevant as to be almost ridiculous. Maybe I’m just a grumpy old obstetrician, but I’m giving The Pull of the Stars only two!
Dr James King is a retired obstetrician, with a long-standing interest in several Irish writers and their works.