Nursing Book Club

The Winter Station: A Novel by Jody Shields

A fictional tale set during the Great Manchurian Plague of 1910

The Winter Station is a historical novel about harrowing real events. In 1910, the city of Kharbin, Manchuria, was Chinese territory, but it was divided into districts occupied by Imperial Russian and Japanese forces, each hoping to eventually take control of this outpost city. Kharbin was a station on the Russian-controlled Chinese Eastern Railway, an important hub of commerce and trade.

In October of that year, the pneumonic plague struck Kharbin. Pneumonic plague is a highly virulent, extremely lethal bacterial lung infection that affects both humans and animals. Since cities along the railway line were trading posts for furs and skins, the epidemic may have come from traders who had handled sick animals or been bitten by infected fleas. However, the disease can also be spread by coughing and sneezing, and it incubates very rapidly.

During the Ebola outbreak a few years ago, I worked in a multinational clinic that treated many patients from African countries. I was the Ebola point nurse, meaning that I was required to don the crash suit and work (or try to work) wearing many layers of waterproof clothing, double gloves, a plastic mask and so on.

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After that experience, I could easily imagine the horror the people of Kharbin must have experienced when they began to find bodies in the snow.

Fictional Characters in a Real Historical Epidemic

Shields’ protagonist is the Russian chief medical examiner, Rozher Alexandrovich von Budberg, a Russian aristocrat married to a Chinese woman. When the epidemic begins, Von Budberg must contend not only with the disease, but also with language barriers, cultural conflicts, deep mistrust between the rival factions, a political cover-up and the ambivalence of officials concerned only with their own citizens. Those factors allow the disease to spread unchecked through the community.

Even today, the World Health Organization warns that pneumonic plague “is always fatal … when left untreated.” In 1910–11, without antibiotics, it was devastating. The eventual death toll in Kharbin was at least 43,000 and may have been even higher. Only one person is known to have survived after being infected.

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During the winter, the frozen ground made burials impossible, so “plague wagons” picked up bodies to be burned. Commandeered buildings became hospitals where no one was saved. Even some doctors caring for the afflicted succumbed to the plague.

Shields sets up interesting characters and relationships to follow and her descriptions of the deep cold and the lifestyle of Czarist Russians are evocative. However, as a nurse, I found myself more fascinated by what the novel reveals about the politics of public health.

Today, we have extensive tools to limit and prevent epidemics. Even so, familiar diseases like influenza still kill thousands of people every year. I shudder to imagine what it was like in a world that didn’t even have disposable masks.

The Winter Station is a compelling novel, but if, like me, you’re more interested in the real-world details, you might want to investigate nonfiction histories of the same events, like William C. Summers’ The Great Manchurian Plague of 1910–1911, published in 2012 by Yale University Press.

The Winter Station: A Novel, by Jody Shields (Little, Brown, 2018)

Christine Contillo, RN, BSN, PHN, is a public health nurse with more than 40 years of experience, ranging from infants to geriatrics. She enjoys volunteering for medical missions.

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