Seasonal Vineyarder Elisa Speranza’s new historical fiction, “Triage,” is an intimate, beautifully nuanced portrait of a woman whose past makes her present-day existence dangerously precarious. Speranza skillfully draws us into Laura Marino’s journey, alternating between her challenging life as an Army nurse during World War II and her work at New Orleans’ Charity Hospital in 1951.
Having read “Triage” twice, first as a proofreader and now for this article, I was eager to interview Speranza, starting with a question about the book’s origins. “I had the seeds of the story in ‘The Italian Prisoner,’” she tells me. “The main character is Rose, who receives letters from her big sister, Laura. The more I learned while researching the nurses, the more I wanted to know about them, what they went through, and what it was like when they came home.”
Speranza did a deep dive, reading nurses’ journals, letters home, and memoirs. Because few addressed what it was like to return from war, Speranza researched more recent conflicts and interviewed nurses on the frontlines of the COVID-19 pandemic about their experiences during and after it: “I think there is a broader question in ‘Triage’ about any kind of trauma that goes untreated or unresolved, and the choices people make in coping with that.”
Speranza’s title suggests urgency. On one level, it applies to the grueling pressure Laura faces as an Army nurse to rapidly assess and prioritize patients by need for immediacy, severity, and likelihood of survival. This work, during her time in North Africa and then in Europe — including the horrific, relentless siege at Anzio, Italy — has left deep scars.
We sense the war’s legacy in the opening pages, when Laura wakes up in New Orleans: “Even awake … she’s back at the front. Her back is stiff, her hands like claws from gripping forceps and clamps … The terrifying, ceaseless clatter and boom of the artillery is so close the hospital tent quakes. The stench of the dead and dying. The sharp antiseptic tang of alcohol, the metallic smell of blood, the gut-wrenching odor of infected gas gangrene wounds. A boy’s desperate, clammy hand is clutching hers, its grip fierce, missing his family, his limbs, his mind. His youth.”
When Laura learns that Frances, her closest friend from the war, has taken her own life, Laura spins out of control, leaving us to question whether she can triage the situation and emerge a survivor. Speranza’s sharp, cinematic writing makes Laura’s life visceral, both as she struggles in the present and as she revisits the past by reading her wartime journal.
We follow Laura and Frances’ friendship from the start of their tour of duty. Frances, a Texan, is larger than life. Irreverent and audacious, she finds the intensity of war a welcome escape from the pain of her empty existence at home: “This is the first time in my life that I’ve mattered, that I’ve made a difference.” Laura comes from a close-knit Sicilian family in New Orleans, but she joined the Army to escape her mother’s expectations that she become a traditional wife and mother. She is particularly sustained by letters from her sister Rose, the protagonist of Speranza’s first novel, “The Italian Prisoner.”
Speranza’s ability to convey the intensity of the nurses’ harrowing work, their complete devotion to their patients, and the strong bonds that develop among the women transports us to the very feel of the time and place. All is not bleak, as there are beautiful moments of camaraderie, and romance enters the picture as well, with Laura and a married doctor, Nicholas, falling in love.
Although Laura and Nicholas are married in the present day, their relationship is fraught. She questions how much the war might have influenced their initially illicit affair, an escape from so much loss and death. Their life together, six years later, is fraying at the seams. Nicholas’ solution to the personal tragedy they faced after they married, as well as any remaining war trauma, is to run away. He tells Laura not to dwell, creating emotional and physical distance. When seeking help herself, Laura notes, “They told me nurses don’t get battle fatigue. That we weren’t in combat …They told the women to get over it. That women were strong.”
Laura knows that having made it home, she should be happy. Yet she is unable to put the war behind her, or to overcome the grief and guilt about Frances’ death. She is also at risk of being passed over for promotion at Charity Hospital, having lost seniority upon returning from duty. And for Laura, work is her identity: “Nursing isn’t just business to her. It’s her only source of pride, her whole life, really.”
In “Triage,” it is Laura’s life on the line, in the past and from 1951 to the present, not just the lives of the boys on the battlefield — leaving us turning pages to discover if she will find a way to heal.
Asked how she approached writing her braided timelines, Speranza explains, “I enjoy books that go back in time, because I think, if you do it well, you get to see the underpinnings of why the people are making the decisions they are in the current day. I wrote the war scenes alternating with the 1951 ones so that each section fed into the next.”
Speranza made what she refers to as the affirmative decision to self-publish, including establishing her own imprint, Burgundy Bend Press: “I had a great experience self-publishing ’The Italian Prisoner,’ which has found its way to thousands of readers. After over four years of work, I was anxious to get the next book out. Independent publishing gave me complete control over the timeline, and I assembled a terrific team to help with design and production. I enjoy being involved in every aspect, from writing to choosing cover art to distribution and publicity. Not all writers do. Luckily, I had a 30-something-year-long career in project management, marketing, and communications, so that part is actually fun for me.”
Asked what she would like readers to take away from her book, Speranza replies, “I hope people will consider the corrosive effect of unprocessed grief and trauma and grant grace to those who are wrestling with it. Another is the question of how to turn survivor’s guilt into the more positive emotion of gratitude, and find healthier strategies for coping with chaos. The third thing is embodied in the title. The essence of triage work is fixing your worst problem first. How can we accept that we can’t fix everything or everybody?”
Speranza adds, “This all sounds very heavy, but there are also lighter moments in the book, including female friendships and the ways camaraderie and humor can carry us through the toughest times. If someone asks what the book is ultimately about, I say it’s about the redemptive power of love, service, and friendship.”
“Triage: A Novel” by Elisa M. Speranza, is available at Edgartown Books and Bunch of Grapes. Speranza will speak with Robin Rivera at the Vineyard Haven library on August 6 at 6 pm.