Thus, in the libretto (from the notable expressionist poet and playwright August Stramm), stage directions dominate over speech, which is highly fragmented through ellipses and incomplete phrases.

She is approached by a number of figures, the most prominent of whom is Sister Clementia, who states that Susanna is sick, and "scarcely live[s] on this earth any longer".

Susanna finds herself increasingly seduced and overpowered, initially by the sweet scents and sounds entering through the chapel window, but soon by the physical presence of her maid-servant, and her lover.

Susanna, no longer capable of abstaining, discards her veil, rips the loin cloth from the crucifix in front of her, and demands such punishment from the nuns, who have now congregated around her.

Fritz Busch, who had premiered the composer's earlier operas, and who was seen as both progressive, and a champion of Hindemith's work, refused to offer his services on moral grounds.