What if HIV started spreading in the early 1500s rather than the late 1900s? Without modern medicine, anybody who catches HIV is going to die. A patriarchal society reacts to this devastating disease in the only way it knows how: it sequesters women as much as possible, limiting contacts between the sexes except for married couples. While imperfect, such drastic actions do limit the spread of the disease.

The 'Wasting' (HIV) has caused devasting destruction throughout the known world and severely limited the development of technology as well, creating a mid-nineteenth century England and London almost unrecognizable to us. This is the world Viola is born into. Extremely intelligent and growing up in a house full of medical books which she reads, she dreams of travelling to far-off places, something she can only do via books since her actions and movements are severely restricted by both law custom.

Meticulously researched and exquisitely detailed in a way only a master like Harry Turtledove can do, this book is a tour-de-force from one of the best historical and alternate history writers ever to write in the genre.