The first, historical strand is based on the real-life Hungarian-born Ignaz Philipp Semmelweis, a doctor working in 19th-century Vienna, who realised that the spread of child-bed or puerperal fever could be prevented if doctors would wash their hands between patients.
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This section clearly pastiches a tradition of dystopian dialogue, from William Morris through H G Wells, to Marge Piercy, as well as the classic sci-fi interrogation scene.
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Kavenna's third novel, Come to the Edge (2012) is a satire, set in a fictionalised version of the Duddon Valley, Cumbria.
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