The Pull of the Stars – Emma Donoghue (2020)

The Pull of the Stars by Emma Donoghue, published in 2020, is a gripping historical novel set in Dublin during the harrowing days of the 1918 influenza pandemic. Written by the author of Room, this story immerses the reader in the suffocating walls of a makeshift maternity ward where life and death coexist precariously. The novel unfolds over just three days, but within that narrow span, it captures the vast emotional, societal, and moral landscapes of early 20th-century Ireland.

Plot Summary

In the dark and rain-slicked streets of 1918 Dublin, a city ravaged by war and gripped by influenza, Nurse Julia Power rides her bicycle through a waking world of mourning and fear. The flu – the grippe, the blue death – seeps into every alley and doorway. Julia, turning thirty the next day, arrives at her post at a Dublin hospital, her breath clouding in the frigid dawn. She reports to a makeshift ward hastily assembled for expectant mothers infected with the flu. The usual staff is depleted – Matron is down with the illness, many others have vanished into fever and death. Julia finds herself in charge.

The maternity-fever ward is little more than a storage room repurposed to cradle three iron cots. Her patients are fragile and flickering: Delia Garrett, a well-bred woman with high blood pressure and growing agitation over her confinement; Ita Noonan, a factory worker and mother of many, lost in fever-dreams; and Eileen Devine, already slipping away, lungs surrendering to fluid and silence. The first morning brings Eileen’s death, swift and quiet, her cot left a blunt reminder of the thinness between survival and stillness.

Help arrives in the unlikely form of Bridie Sweeney, a young volunteer from a Catholic orphanage. She is awkward and untrained, but willing, and soon proves invaluable. Her brightness brings breath to the stagnant air. Bridie has known hardship, the kind too long endured to name easily, and her innocence is both shield and scar. Together, she and Julia scrub, lift, soothe, and feed – caretakers in a corner of the world spinning too fast.

Outside, the city stumbles under the weight of its burdens. Men collapse in streets. Children are orphaned overnight. Shops are shuttered. Horses pull endless funerals past shuttered windows. Inside the ward, time compresses. Each moment brings decision, discomfort, tenderness, and blood. Delia frets for her daughters and demands release, certain she is well enough to go home. Julia sees the danger in her blood pressure, the shadowy threat of eclampsia. She calms Delia with quiet, measured tones, gives her castor oil, distracts her with small kindnesses.

Ita, meanwhile, tumbles deeper into fever. Her breath shortens. Her eyes blur. She speaks to phantoms, gestures to things unseen. Her body is swollen with a child due months from now, but labor comes like a thief. There is no doctor. No midwife. Julia, trained in the ways of childbirth but never alone in its crucible, must act. With Bridie’s trembling hands as her only support, Julia delivers a premature baby into a world with little mercy.

The infant is impossibly small, slick and silent. For a long moment, Julia believes it dead. But the child breathes – faintly, a moth-wing flicker. They name her Honor. She is set in a sterilized shoebox by the heater, monitored with watchful hope. Ita, however, is fading. Her pulse races. Her skin flushes deep with fever. Aspirin offers little. There is no magic left to offer. She dies in the cot that once belonged to Eileen Devine, her new daughter still warm and blinking.

Delia’s turn comes suddenly. In the middle of the night, her complaints intensify. She seizes, body stiff as iron, and begins to bleed. Julia recognizes the signs too late – a placental abruption, swift and catastrophic. Bridie and Julia act fast, delivering a baby boy into blood and panic. The infant, larger than Honor but still frail, lives. Delia does not.

In these moments, Julia changes. Her duty becomes a deeper thing – not simply the task of care, but the stewardship of fragile, flickering lives against a devouring dark. The hospital grows quieter, not from relief but from loss. Dr. Kathleen Lynn arrives, brisk and brilliant, offering both political fire and medical clarity. She confirms what Julia suspected: the hospital is collapsing under the weight of its duties and the absence of its staff. Yet, Julia’s work matters. Her small ward, barely sanctioned, is a haven.

With Bridie, Julia begins to imagine something beyond the corridors of illness. The two women find, in their long days and quiet nights, a bond that deepens into affection, a companionship untouched by convention. Bridie, who had known nothing but institutional coldness and unnamed violations, discovers gentleness. Julia, who had kept her life narrow and tidy, dares to feel something more.

Then comes the strike. The flu recedes slowly, but chaos surges. Authorities, eager to reassert control, issue new rules. Dr. Lynn is arrested, political tensions rise, and hospitals are ordered to evacuate. Julia and Bridie scramble to move their fragile infants. Honor is taken in a shoebox, her breath still uneven. The boy, nameless, is swaddled and hurried away. The future is uncertain.

Julia returns home, exhausted and altered. There, she finds her brother Tim, once a soldier, now silenced by trauma. The war took his voice, left him haunted. But he is present. She tells him, simply, what has happened – the deaths, the babies, the girl with shining eyes and brave hands.

In the final moment, Julia receives a telegram. Bridie, the girl who had held infants like glass and faced down death with nothing but hope, has died. Sent to help in another ward, she caught the flu and succumbed quickly. Julia is stunned, shattered in a way more complete than fatigue. She walks to the window. Outside, Dublin is still grey and damp. But the air smells faintly of rain, and life goes on, stubborn and strange.

She turns back to the room where the babies rest, their tiny bodies warm and breathing. She will care for them. She will go on. Because in a world unraveling, someone must hold the thread.

Main Characters

• Julia Power – A thirty-year-old nurse and the novel’s central figure. Quietly strong and deeply compassionate, Julia works in an improvised maternity ward for pregnant women with influenza. Her sense of duty is unwavering, but her interior world is rich with unspoken fears, suppressed hopes, and a growing desire for something beyond her constrained existence. Over the course of the novel, her emotional landscape evolves as she confronts loss, ethical dilemmas, and unexpected love.

• Bridie Sweeney – A volunteer from a Catholic orphanage, Bridie enters the ward as a temporary assistant. She is untrained but quick to learn, her innocence and wonder clashing poignantly with her tragic upbringing. Bridie’s character brings both vulnerability and resilience, and her relationship with Julia is one of the novel’s most tender and transformative threads.

• Dr. Kathleen Lynn – A real historical figure and a revolutionary turned physician. Dr. Lynn is brisk, intelligent, and deeply committed to public health reform. Her appearances in the novel, though brief, serve as moral and political anchor points. She represents science, feminism, and rebellion against oppressive systems.

• Delia Garrett and Ita Noonan – Two patients in Julia’s ward, each embodying a different aspect of maternal suffering. Delia, genteel and privileged, is deeply anxious about her children at home. Ita, a laboring-class woman and mother of seven, is consumed by physical and social exhaustion. Both women’s experiences illustrate the intersection of class, gender, and health.

Theme

• The Body and Its Burdens – The novel fixates on the physicality of childbirth and disease. Through raw, often graphic descriptions, it explores the female body as a site of endurance, suffering, and resilience. This is especially evident in the scenes of labor and death, which highlight the fragility and strength of human flesh.

• War and Pandemic as Parallel Catastrophes – Set against the backdrop of World War I’s final days and the Spanish flu, the novel juxtaposes global calamity with intimate personal tragedies. These dual crises frame the narrative, underscoring the randomness of death and the urgency of compassion in the face of institutional failure.

• Female Solidarity and Rebellion – At its heart, the novel is a testament to the power of women supporting women. In the ward, amidst desperation, a quiet revolution brews – one of empathy, resistance to authority, and quiet defiance. Characters like Dr. Lynn and Julia challenge the social norms of patriarchy and religion, asserting agency through care and competence.

• Institutional Oppression – The story critiques religious and state institutions, particularly in their treatment of women and the poor. Through Bridie’s backstory and the hospital’s resource-starved environment, Donoghue exposes the cruel indifference of systems that value order over humanity.

Writing Style and Tone

Emma Donoghue’s writing in The Pull of the Stars is urgent, immersive, and stripped of artifice. The narrative unfolds in a close third-person perspective, entirely within Julia Power’s consciousness, giving readers an unfiltered view of her observations, thoughts, and emotions. There are no quotation marks around dialogue, which adds to the novel’s breathless intensity, blurring the line between internal monologue and spoken word. This stylistic choice heightens the sense of disorientation and immediacy – echoing the chaos of a city and a hospital in crisis.

The tone of the novel is simultaneously clinical and poetic. Donoghue’s language captures the stark realities of medical care – antiseptic smells, bodily fluids, fever charts – while also finding lyricism in moments of quiet connection or reflection. The prose moves fluidly from harrowing to tender, often within the same paragraph. The rhythm of the writing mirrors Julia’s exhaustion and resolve, drawing the reader into the feverish pace of her world. At its most powerful, the novel pulses with compassion and a deep reverence for the often invisible labor of nurses, mothers, and marginalized women.