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The author of multiple novels, including 'Room' and 'Akin', Emma Donoghue spoke from her home in London, Ont.Una Roulstoun/Handout

Set during the 1918 pandemic, as the Great War still rages in Europe, Emma Donoghue’s novel The Pull of the Stars is told from the perspective of a nurse in a Dublin hospital, Julia Power, struggling to help the women in her understaffed, undersupplied maternity/fever ward. The author of multiple novels, including Room and Akin, Donoghue spoke to The Globe and Mail from her home in London, Ont.

You finished this book just before the current pandemic hit. Did writing and researching it affect your view of our current straits?

Having just written a Great Flu novel, I certainly took COVID-19 seriously from early March and I’m our family’s “have you got your masks?” nag. But also I’m so grateful that scientists know a lot more about what this virus is, how not to catch it and how to treat it than they did back in 1918 when they didn’t even known what a virus was and didn’t have our ventilators, dialysis machines, steroids and antibiotics. We have far less of an excuse for letting bad politicians in certain countries allow it to run wild this time.

And yet, it must have felt a little surreal?

It has been rather surreal, living through two pandemics at once, the historical one in my head and the present one all around me. But I’ve nothing to complain of, because my lockdown experience hasn’t been notably different from my usual writerly life: get up and make stuff up, cook meals, watch good TV. It’s been strange not to have that rhythm broken by travels – we had to cancel a trip to see my 91-year-old dad in the [United] States – and I really miss not being able to go out to plays, films and concerts.

Can you explain the meaning of the novel’s four sections: Red, Brown, Blue, Black?

One of the first details that jumped out at me from my research was that Great Flu victims often went weird colours, from lack of oxygen in the blood. I seized on that as a very concrete and vivid way to mark the rapid decline of a patient – a sort of “code red” alarm system that would pulse its way through the chapters. As a novelist you’re always looking for ways to take abstract ideas or cold facts and flesh them out, somehow; make readers register them with their senses, in their bodies. So The Pull of the Stars includes very few statistics and a great many vivid details.

COVID-19 is testing social and political systems the world over. Were there challenges specific to the Irish context in 1918?

I don’t think the pandemic was any worse in Ireland – in fact many parts of Asia and Africa had much higher death rates. What drew me to my homeland as a setting was that there was so much else going on, politically. Between 1916, when the tiny and abortive Easter Rising took most of the population by surprise, and 1919, when most of the population voted in a Sinn Fein republican government, there was a massive collective change of heart, and I wanted my protagonist, nurse Julia Power, to share in that. She starts to realize that health isn’t outside of politics, it’s inherently political – who lives, who dies, who tells their story.

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Religion and poverty, specifically the treatment of young unwed mothers and female orphans by the religious institutions that housed them, add to the terrible circumstances some of these characters have to endure...

In many countries in recent decades we’ve been digging up and reckoning with the hideous history of the residential institutions in which vulnerable people used to be stashed against their will. Here in Canada it was a specifically genocidal phenomenon, but in Ireland the same kind of thing happened – a huge percentage of the population was locked up in orphanages, reformatories, Magdalene Laundries and unwed-mother-and-baby homes – motivated not by racism but by middle-class judgment of impoverished people or “fallen women.” So when I wanted to invent a background for my fictional nursing volunteer, Bridie Sweeney, I decided to have her be a survivor of that dank pipeline; I thought it would be fascinating and poignant if, after an upbringing that should have left her only bitter, this young woman still had a wealth of energy and generosity. Also, given that The Pull of Our Stars is set in a hospital run mostly by nuns, who are doing their best to save lives, I thought it would complicate the story interestingly to raise the spectre of other Catholic institutions where so many lives were stunted or destroyed.

What led you to include the real-life character of Dr Kathleen Lynn?

I was looking for interesting details about Irish doctors during the pandemic and Lynn – being a medical innovator, as well as a socialist, feminist and revolutionary – was an irresistible character for this story. In the first draft I veiled her under a fictional name, but then I decided I might as well give her the shout-out, as she’s still not half as well-known as she should be. She spent her whole adult life with another woman, too; I couldn’t have made this stuff up.

Yes, if she weren’t real it might be hard to convince people she ever existed! What were some of her innovations?

During the flu pandemic, she ran a free clinic and tried giving patients the vaccines that were available, which, though we now know couldn’t do anything for the virus itself, may have offered some protection against secondary infections. When she was arrested, as chief medical officer of Sinn Fein, the revolutionary party campaigning for Irish independence, the Lord Mayor of Dublin personally intervened to get her let out because her work against the pandemic was so crucial; she was let out on a promise to refrain from political activities, which she broke immediately. In 1919 she and her life partner, Madeleine ffrench-Mullen, set up their own children’s hospital – with no help from the Catholic Church, which refused to get involved unless it would be a specifically Catholic institution. In 1937, she spearheaded the campaign to vaccinate the Irish against tuberculosis.

The novel's drama takes place in a single room – a maternity/fever ward in a Dublin hospital. Was that a conscious nod to your novel Room, or just circumstances calling for it?

It’s a literary choice: I’m repeatedly drawn to single rooms because they intensify the human emotions and create an atmosphere of high tension. I seem to thrive best on a small scale – what Jane Austen called her “little bit [two-inches wide] of ivory on which I work with so fine a brush.” By the way, I was named after her novel Emma, because my father, the literary critic Denis Donoghue, was writing about it at the time. With a subject as vast as a pandemic during a world war, I felt I had to keep my focus tight to avoid a sort of dutiful surveying-the-world effect. I hate when people praise fiction set in the past for being “educational,” rather than thrilling!

The medical situations you depict are remarkably detailed; you obviously did a heap of research.

I always do a lot of research, but this time it felt even more important – to get the facts right, and also to be fair to health-care workers in 1918, who were doing their best with the knowledge and equipment – moss for bandages! – they had. Between the Great Flu and all its horrifying symptoms, and child birth with all its complications, this research was more graphic and gory than usual; some of the illustrations in my copy of Practical Obstetrics from 1910 make me gag.

Oh yes, the moss – that certainly seems like a local, Irish-specific innovation! The birth scenes are thrilling for their combination of human and medical drama. Was that line difficult to tread?

Yes, I never wanted it to feel like line after line of incomprehensible medical jargon. I’m a loyal watcher of Grey’s Anatomy but I still don’t understand any of the technical dialogue during surgical scenes! The great thing about child birth as a fictional subject is that it’s not an illness, it’s more like running a marathon. Delivery can go wonderfully smoothly or dramatically wrong; its timing is mysterious – too slow, too fast? Stop and start? – and happiness can give way to tragedy or vice versa in a heartbeat.

You do know this novel will launch a thousand birth stories. Are you ready to hear them?

Eager to hear them! Much as I like to meet and hold a cute newborn, what I really long for is the story – and not just the birth mother’s experience, but that of the other parent if there is one. So many men have told me how witnessing their child be born blew their mind. It’s grand drama, potentially the most dangerous and wonderful day of several lives, and there’s nothing anodyne and Hallmark-card about it.

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