1. When the novel opens, we learn that Jo and her fellow nurses --- women in their 20s --- have gone gray and lost teeth due to malnutrition as they’ve been deployed all over Europe and Africa. Were the nurses’ hardships surprising to you? How do you compare them to the hardships of the soldiers they care for?

2. When Kay and the other nurses hide extra vials of morphine into their curls, we learn why: “they thought of the Rape of Nanking, and what happened to those hundreds, thousands of women and girls, young girls, at the hands of the Japanese --- and they fastened in another hairpin.” This despite the fact that many believe suicide to be a sin. What did you think about this last resort?

3. Kay thinks “I should have stayed with you, Jo, we were stronger together…We could face anything together.” How do the nurses’ relationships with other nurses sustain them during the war? How does Jo draw on those relationships for sustenance, even though she is utterly isolated in France? How does this compare to the “band of brothers” formed by soldiers during World War II?

4. “Nothing was sad anymore. [Jo] had shut herself off --- or the part of herself that had been lovable, that had been her, she had shut that off. This woman might have cheated death, but had not won life in the process.” Is this emotional shutdown necessary for survival? Do Jo and Kay eventually recover?

5. Kay sees an emaciated nurse at Santo Tomas carefully apply lipstick, and thinks “How had she made the grubby thing last all this time? Who cared how she looked?” Why do you think the nurse continues to apply lipstick while she is starving in an internment camp?

6. How are the usual roles of chaplain and soldier reversed when Jo hears Father Hook’s story? What do you make of her thought afterwards that “the only thing she was sure of was that she had just acted as a nurse. That had been important.”?

7. Why does Jo react so strongly when Clark brings in the dead body of the German soldier whose wound she had dressed, and who had kissed her? What do you make of Clark? Is he a villain even though he is a fellow American?

8. The epigraph of the novel is from the Book of Exodus, and Kay recites it as her ordeal in Santo Tomas is about to end: “The Lord was going before them...in a pillar of fire by night to give them light, that they might travel by day and night.” Why does Kay think of that passage? What does the pillar of fire refer to in that moment? Why did the author choose the title of this novel from those lines?

9. Why does Jo choose to work in the laundry room of a hotel after the war? How does it help her reckon with everything she experienced?

10. When so many other nurses go back to civilian life after the war, Kay chooses to become a career army nurse. Why does Kay double down on the military and patriotic service when Jo chooses an entirely different post-war life? Which would you have chosen?

11. What do you think happens to Kay and Jo in the years after this novel?