The novel makes heavy use of annotations, marginalia, and false documents to support its premise;[2] Goldberg has stated that Vladimir Nabokov's Pale Fire was a major influence on her in this respect.
When Henry, and most of her relatives, die of the "Spanish flu", Lydia becomes a nurse, and works to help find a cure by assisting in medical experiments on convicted Navy deserters.
[5] In The New York Times, Andrea Barrett described it as "ambitious", "thoroughly researched", and "admirable", with "a set of nightmarish, wonderfully well-written chapters that would have made a strong short novel all on their own", but felt that it was a "somewhat uneasy mixture" of emotional fiction and historical fact; as well, Barrett considered that the novel's sheer scope and "kaleidoscopic narrative" worked to its detriment.
[6] The Seattle Times considered the book "well-researched" but "somewhat elusive and not entirely satisfying", comparing it unfavorably to Goldberg's earlier work Bee Season.
[7] Salon described it as "historically credible," and stated that "the real reason to read" the novel is "the chance to spend a few hours" with Lydia.