Elisa Speranza divides her time between New Orleans and the Vineyard, and in her latest novel, Triage, it is the Big Easy that takes center stage.

It’s 1951 and former US Army Nurse Corps Lieut. Laura Marino has received a horrible piece of news: her former colleague Frances has died by her own hand, as Laura learns in a letter from her friend’s mother.

Frances had initially been doing well after her return from the war, her mother reported, but gradually the shadows of her experiences had grown darker, until finally they were too much for her. 

The news, tragic enough in its own right, breaks into Laura’s life at a bad time. Her marriage to her husband Nicholas is childless and largely loveless, her job as a nurse at Charity Hospital is increasingly miserable, not only because a rival has been promoted to a job she wanted but also because her own standing there is soon threatened by the administration beginning to suspect her of swiping pills to feed her own private habit. She’s more miserable than she realizes, in other words, and the news about Frances pushes everything into crisis mode, no matter how she tries to calm herself.

“She puts two fingers on her wrist, counting off her pulse — the old habit: one one-thousand, two one-thousand, three one-thousand,” she thinks. “Breathe. You survived, she tells herself.”

Her memories are refreshed and sharpened as she reads through the old leather journal Frances kept of their shared time on the front lines in North Africa, taking orders from Captain McCarthy as they receive an abrupt introduction to the world of wartime medicine.

“We have to categorize them,” a veteran nurse tells them, speaking of wounded soldiers in a triage tent. “Red for heavy bleeding, open fractures, critical injuries. We send those to surgery. Yellow for serious but stable. Green for minor wounds and abrasions.”

And there’s also black – for the lost causes.

These were dark, heavy responsibilities for the young women who shouldered them (narrated in alternating chapters with those set a decade later), and although their time in North Africa and then Italy was also marked sometimes with wild nights and adventure, the trauma of their wartime experiences follows both Laura and Frances stateside to their civilian lives. Frances ends up taking her own life, while Laura’s destructive habits threaten to derail her entire life.

When Nicholas takes an assignment overseas, Laura falls into the company — and the bed — of a wounded veteran named Boyer who’s also sharing many of her inner demons. Ms. Speranza describes the development of their affair in the same clear, unsparing prose that fills the rest of the novel; these are two deeply troubled and unhappy people allowing themselves to think that matching weaknesses might somehow equal strength. Thanks to this author’s skill at shaping characters, readers will be furious with Laura even though they just “met” her 60 pages earlier. 

As she continues reading her dead friend’s journal, and as her work situation worsens (she’s put on leave when her drug pilfering is discovered), Laura fantasizes about somehow pulling her life back together when Nicholas returns.

“She’ll welcome her husband home, cut back on the drinking and the smoking. Stop the pills. Maybe they’ll try again for a baby. Boyer will be a fond, secret memory,” she thinks, and Ms. Speranza adds pointedly: “The end is obvious. What she can’t see his how she will get from here to there.”

As Ms. Speranza notes, although returning US nurses were allowed to use the benefits of the GI Bill for education, they were most often not seen as full-fledged veterans, nor were they eligible for VA medical benefits — so anything like compassionate therapy was out of the question, no matter how badly people like Laura needed it. These and other aspects of this story are seamlessly worked into the narrative by an author who knows exactly how to craft this kind of tale. Readers of Kristin Hannah’s bestselling novel The Women will very much appreciate a smart, empathetic addition to the fiction of women at war. 

Elisa Speranza will give an author talk on August 6 at 6 p.m. at the Vineyard Haven Library, in conversation with Robin Rivera.