The Pull of the Stars by Emma Donoghue

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This book’s received a lot of attention, because it’s about the Spanish flu pandemic and, although the author began writing it in 2018, to mark the centenary of the pandemic, it ended up being published in early 2020, just as the Covid pandemic hit.  A book about a pandemic will be the last thing that some people want to read: others will find it intriguing.  It also seemed like a good book to review during Pride month, as it includes a same sex romance – rainbow pic instead of my usual pic to show support for Pride.  I’m afraid that I automatically assumed that this was going to be between the doctor and the nurse, but it was actually between the nurse and the orderly.  When I say “romance”, it’s only very brief, because they only know each other for a few days.  There are no happy endings in this book, but, if you can take all the misery, it’s well worth a read.

I don’t care for the style of writing – it annoys me very greatly when people write speech without using speech marks – but the intensity of it’s fascinating: the entire book only covers three days, and almost all of it’s set within one very small room.  The main character is Julia Power, a nurse in charge of a maternity/Spanish flu ward at a Dublin hospital, and the other two prominent characters are Bridie Sweeney, an orderly, and Kathleen Lynn, a doctor who was a real person and was well-known as a republican activist and suffragist as well as for her medical work.

There are a lot of talking points about the book – the Spanish flu and any parallels that readers may draw between that and the Covid pandemic are the obvious ones, but also everything that the book shows about what went on in institutions run by the Catholic Church in Ireland at the time.  It was nothing I hadn’t heard before, but it didn’t pull any punches, it portrayed nuns extremely negatively, and I’d be interested to know how the book’s been received in the Republic of Ireland.

During the course of the book, we’re told that the Catholic Church mistreats orphans in its care, allowing priests, nuns and lay staff to abuse them, putting them to work at an early age and taking their wages, and even sending young girls to stay with “holiday fathers” (a euphemism for paedophiles).   Disabled and illegitimate children in its institutions are neglected, and unmarried mothers are virtually imprisoned and forced to work to pay for their “care” whilst they were expecting.  And it takes adolescent daughters away from widowed fathers on the grounds that it’s immodest for girls to live with a man with no adult female present.   It’s also blamed for Ireland having a far higher rate of death in childbirth than the rest of the UK, by making the use of contraception taboo and encouraging women to have at least twelve children, and for women suffering a difficult labour being forced to undergo horrific processes such as the sawing in half of their pubic bone, as the priority is to avoid damage to the womb and never mind any other bits.

All of this is based on evidence given by people who were in the institutions concerned, so it’s not been made up, but I’d be interested to know how the book’s been received in the Republic of Ireland, because it really is very heavy on all this.

Also, those who participated in the Easter Rising are repeatedly described as terrorists who were responsible for the deaths of hundreds of people, and those who supported it but weren’t arrested as being cruel for tormenting injured Great War veterans.  I’m not saying that this isn’t a valid viewpoint, just that I wouldn’t have expected to “hear” it from Irish characters created by an Irish author.  Kathleen Lynn is presented positively, but her role in the Easter Rising – she was the chief medical officer for the “Irish Citizens’ Army” –  is rather vaguely explained away as being because she thought it might bring about improved conditions for women: she mentions her plans to set up a hospital for women and children, with her friend (and probably her partner), the gloriously named Madeleine ffrench-Mullen – something that did actually happen.  When she’s arrested, the emphasis is on the fact that men are arresting a female doctor: the fact that this is about the Easter Rising is rather skimmed over.  That’s not what I was expecting.

To get back to the Spanish flu, If you’re looking for happy endings, or just any sort of happiness, this is not the book for you!  Of the five expectant mothers admitted to Julia’s ward, three die of the Spanish flu, one survives but her baby is stillborn, and the only one who goes home with her baby has got a violent husband waiting for her.   Julia’s brother has been invalided out of the Army due to shell shock (which doesn’t actually sound right to me – shell shock wasn’t a reason for being discharged during the Great War) and refuses to speak.  Dr Lynn is arrested and imprisoned.  The only person in the book who’s ever cheerful is a hospital porter, and we eventually learn that his singing and joking are just his way of trying to cope with his grief at losing his wife and children in a typhus epidemic.

The only bit of good cheer is that Julia takes the baby of one of the women who died.  This is after the doctor says that he probably won’t survive more than a few months as he’ll be handed over to Evil Nuns, who’ll neglect him as he’s illegitimate and has a hare lip.  An Evil Nun kidnaps him whilst Julia’s briefly out of the room, but Julia manages to rescue him.  The Evil Nun tells her that people will probably assume he’s the result of an incestuous relationship between her and her brother.

Oh, and be prepared for extremely graphic descriptions of difficult childbirth.   The medical information is fascinating, though, as are the general observations about the Spanish flu, including the public notices.  There’s a lot of talk about wearing masks and avoiding close contact, and the book repeatedly makes the point that saying that people should stay at home, and rest in bed if feeling unwell, isn’t very practical when people have got to work.  Some of the blame game stuff going on is very reminiscent of the patronising comments about the “hard work” of people in areas where Covid infection rates are low – mainly rural areas with low population density, and or areas where most people are able to work from home.

Don’t read this if you’re feeling down, because it’ll make you feel a million times worse!  But, if you can cope with all the misery, it’s a very interesting read.

Star by Star by Sheena Wilkinson (Facebook group reading challenge)

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I read this book because the blurb said that it was “a bold tale of suffragettes”; but it was actually more about the Spanish flu.  Strangely few books cover the Spanish flu, and, under the present circumstances, it was particularly interesting to read one that did.  The women’s suffrage movement did come into it, though, as did the granting of universal male suffrage, the mental health impact of the First World War, and the complex political situation in Northern Ireland.  As one of the characters said, it was an awful lot for everyone to try to process at once – the war, the Spanish flu, the general election so soon after the Armistice, it being the first time that all men and any women could vote, and the issue of Irish independence.  I don’t think I’ve ever seen a character in a book say that before, and it was a very, very good point.

This is 180 page book for children, so obviously it didn’t go into the depths than an adult book on the same subjects would, but it packed a lot in, and all in quite a quirky way, with Our Heroine keeping imagining that she was at the centre of big dramas and playing out scenarios in her head.  She was about 16.  I still do that now!

This was late 1918 – the Armistice was announced towards the end of the book – and our heroine Stella was moving from Manchester to live at her auntie’s boarding house in a seaside resort in Ulster, following the death of her mother from the Spanish flu.  Very impressed that the book had a Manchester connection 🙂 .  Suffragette City!   I do love reminding people, for the millionth time, that I went to the same school as the Pankhurst sisters.  Who apparently didn’t like the place very much, but the school doesn’t tell pupils that!

Anyway, back to the book.  She’d lived in “Eupatoria Street”.  I wonder if that’s near Inkerman Street and Balaclava Terrace 🙂 . We learnt that she was illegitimate and that that was why her mother had left home, and that her mother had been very involved with the suffragette movement.  She was very keen on the idea of women’s rights, but, although we saw her accompanying her late mother’s best friend to the polling station on the day of the 1918 election, there wasn’t much active politics going on …. but then there wasn’t anyway, because campaigning had been suspended due to the war.

Another of the people staying at the boarding house was a soldier who’d been invalided out of the Army and was struggling to cope psychologically – and that again was something which so many books about the First World War don’t cover, and it was good to see that as a major theme here.  The complex political situation in the north of Ireland was also a central theme, with opposing views expressed by different characters.  If it hadn’t been for the House of Lords, the whole of Ireland would have had Home Rule in Gladstone’s time and a lot of bloodshed would probably have been avoided, but you can’t rewrite history.

However, it was really the Spanish flu pandemic that dominated events. Or maybe that’s just how it seemed to me, and I’d have felt differently had I been reading the book a year ago.  I usually get annoyed when people talk about historical events in the context of current events, but it’s impossible to read about the Spanish flu pandemic at the moment and not look at it in the context of the coronavirus pandemic.  We think things are bad now, but at least we haven’t got healthy people suddenly taking ill in the street and dying within hours, funeral parlours struggling to cope, homes of infected people being viewed by frightened neighbours as houses of contagion, and little in the way of effective treatment for those worst affected.  The death toll was just horrendous, and this in a world already reeling from all the deaths and long-term injuries resulting from the war.

Despite all the serious subjects, there was quite a light touch to it, told in the first person by a teenage girl who, as you do at that age, took herself very seriously!   As I said, it’s a children’s book, not an adult book, but, as a children’s book, it was very good, and I would have loved to have had something like this to read when I was in the intended reading age group.

 

The Flu That Killed 50 Million – BBC 2

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We all know that Manchester does things better than London, but, in this tragic case, it’s not really a reason to smile. When Spanish flu swept across the country in 1918, the medical authorities in Manchester took steps to try to stop it from spreading.  Whilst still affected, our city therefore suffered considerably less than other cities did.  Meanwhile, the idiots in Westminster did very little, for fear of affecting munitions production and causing a panic that would affect morale.  What, and letting a highly contagious pandemic rage unchecked didn’t cause any problems?!  228,000 people died in the UK alone.  Maybe that number would have been far less had something been done about it.  I expected this programme to make me feel sad.  It did, but it also made me feel angry.

The Spanish flu pandemic of 1918 killed an estimated 50 million people. It could have killed as many as 100 million people: no-one really knows.  It’s thought that around 500 million people caught the flu – and, due to the interaction between the virus that caused it and the immune system, healthy young to middle-aged adults were the most likely to die.  It first seems to have broken out in Kansas, in late January 1918, with a second wave then beginning in Massachusetts (Wikipedia says, although the programme didn’t, that the second, even more severe, strain also appeared in Brittany and Sierra Leone at around the same time) in September 1918.  Nobody’s sure where the virus actually originated: there are various theories.  And it spread pretty much right across the world, even to remote areas.  Then it seems to have mutated into normal flu, and the pandemic ended fairly quickly.  But so many people had died, and so many survivors had lost loved ones.

Of course, this coincided with the final year of the Great War. People thought that, finally, it’s over, we’ve survived, we can try to get on with their lives – and then this happened.  Celebrations of the Armistice were breeding grounds for the flu, all those people in close proximity.  And one of the main reasons it spread so quickly was that so many people were on the move because of the war.

Many British (including, at that time, Irish) troops falling ill were brought home to be treated. Did it not occur to anyone just what a bad idea that was?  This was 1918, not 1348: people understood about infection.  Little was known about viruses at that time, so doctors and scientists weren’t able to isolate the cause of the flu and find anything to try to counter it – keeping people warm and giving them Bovril was mentioned, sadly not really much help – but how can it have been considered a good idea to move people around when they had a highly contagious disease?  Healthy troops coming home on leave also carried the virus with them.  A map showed how it spread from the Channel ports across the country.  As with most contagious diseases, densely-populated, overcrowded areas were hit worst.

On 29 September 2018, USS Leviathan, carrying 11,000 people, left New York for France. By the time she reached Brest, around 2,000 people were ill, with the deadly second strain of the flu, and 80 had died. Patients were carried on shore: there are reports of a convoy four miles long.  The programme was done partly as a docu-drama, and the representation of conditions on the ship was just horrific – talk about a plague ship.

Why was the ship allowed to dock? Why wasn’t it put into quarantine?  Why weren’t arrangements made to try to treat people on board?   I don’t know: maybe leaving healthy people on there would have been cruel – but couldn’t some sort of arrangements for isolation have been made?  Maybe it just wasn’t practical.  Or maybe they wanted to get the healthy soldiers off the ship and to the Front – that’s the one explanation that does make some sort of sense, I suppose.  Ships travelling all over the place carried the disease with them.

Going back to the first wave of infection, the flu reached Manchester in June 2018. James Niven, the local Medical Officer of Health, kept detailed records and statistics of the spread of the flu.  It was worse on the north side of the city, my side, more densely populated and more industrialised.  A graphic showed the flu moving from the city centre, where it’d arrived at the railway stations, into the outskirts and suburbs.  It was very strange and frightening seeing it moving across North Manchester, my home turf, right through the areas where most of the older people I knew as a kid would have been living in 1918.

Thanks to Dr Niven, steps were taken in Manchester to try to reduce the spread of the disease. Leaflets were distributed, posters put up, and a film called “Dr Wise” shown at cinemas, advising people how to reduce the risk of infection.  Schools, Sunday schools and some places of entertainment were closed.  OK, there were still many cases and many deaths locally. The programme followed the story of a young girl called Ada Berry.  Her entire family caught the flu.  She survived – and lived to be 99 – but her parents and brother both died.  Many others died too – to the extent that there was a backlog of funerals, because there weren’t enough coffins or enough gravediggers to keep up with the number of deaths.  But the pandemic was definitely much less severe here than it was in other cities.  Had even those steps been taken everywhere, things wouldn’t have been nearly as bad as they were.

But the powers that be in London – and, whilst public health matters were still dealt with at local level at the time, orders from the central government would have applied nationwide – decided that no steps should be taken to try to stop the flu spreading, on the grounds that suspending public transport, closing factories etc would have affected the war effort (and the spread of the flu didn’t??), and wouldn’t even go as far as Niven did, closing schools and places of entertainment, and even just advising people on what precautions might help them, because of concerns about the effect on morale. Apparently (although this wasn’t mentioned in the programme) the Cabinet didn’t even discuss it until Lloyd George himself caught it, in the September, and it wasn’t brought up in Parliament until the end of October.  There had actually been plans in place for dealing with an epidemic, but they weren’t brought into force.  I understand that difficult choices have to be made in wartime, but it’s hard not to think that the authorities got this one very badly wrong indeed.

And it wasn’t just the British authorities. The reason for the name “Spanish flu”, when the pandemic actually started in Kansas and affected many other countries before it reached Spain – killing, amongst others, King Alfonso XIII – was that the press in neutral Spain were able to report in detail on what was going on, whereas the press in combatant countries, on both sides, said very little.  And, when the second, and far more deadly, strain of the flu broke out, in an American army camp, a doctor who wanted to seal the camp off to stop the disease from spreading was shouted down by his superior.  The Australian authorities, by contrast, refused to allow any ships at all to dock in their country until the pandemic was over.  OK, it wasn’t really practical for every country in the world to try to seal itself off, but surely more could have been done.

Sadly Dr Niven’s story didn’t end happily. He did a huge amount to improve public health in Manchester: the death rate per 1,000 population almost halved during his term of office.  And he was recognised for his work, during his lifetime.  But he suffered from depression after he retired, and ended up taking his own life.  What a tragedy.

The Ministry of Health, now the Department of Health and Social Care was set up as a result of the pandemic. It was also mentioned that female doctors came to the fore whilst all this was going on.  We didn’t hear about the long-term effects of the pandemic in other countries, but there’s only so much you can say in an hour.  Quite a bit of that hour, especially at the end, was spent talking about what lessons can be learnt from the events of 1918, and what might happen if a similar virus took hold today.  Without wishing to sound complacent, I’m not quite sure what the point of that was, seeing as medical science today is so much more advanced as to make comparisons with 1918 rather inappropriate.  Having said which, as the programme – which seemed determined to scare the hell out of viewers, telling us that 200,000 people would be killed in the UK if a virus with a similar infection rate and similar fatality rate took hold – pointed out, new viruses do seem to appear from nowhere, and then mutate.

I could really have done without that bit. Those killed by the 1918 pandemic deserve to be remembered, without either scaremongering or trying to make their experience relevant to the present day.  Whilst it’s important to learn from the past, there’s no need to try to make everything about today – like that bizarre programme last year which tried to turn the 500th anniversary of Martin Luther’s 95 theses into a discussion about the wretched European Union.  As we mark the centenary of the end of the Great War, let’s also spare some thoughts for those killed by the Spanish flu.

There’s a book called Song of Songs, by the late Beverley Hughesdon (also from North Manchester!), about a Great War nurse.  It’s not the best book ever – some of it’s very odd – but there’s a section in it in which the main character says that she feels as if vengeance thinks it’s been cheated by the end of the war, so it’s played its trump card – the flu pandemic.  That’s how it must have felt.  What a horrible, horrible time – and how frustrating to think that the government could have taken steps to ameliorate it, and chose not to do so.