In 1918, both World War I and the deadly 1918 influenza pandemic are raging. Death is everywhere. This is especially true for Julia, a nurse at a major hospital in Dublin. She sees signs of sickness and death even as she commutes to work on the tram, such as people covering their faces and closed-up storefronts. Julia describes Dublin as “a great mouth holed with missing teeth” (7). At the hospital, Julia sees bodies on stretchers as they’re carried to the morgue, and people share frightening stories about the flu. One of Julia’s patients, Mary O’Rahilly, tells her, “People are afraid to go near each other, it can pounce so fast! The other day, the peelers smashed down a door in the tenement behind ours and found a whole family expired on the mattress” (64). Over the three days that the novel covers, Julia sees the deaths of patients Ita Noonan and Honor White as well as her volunteer helper, Bridie Sweeney. Julia marks the deaths of her patients with etchings on the back of her watch. She admits, “[I]n this hospital we prided ourselves on losing as few mothers as possible, so there really weren’t that many circles marked on my watch.