This book vividly describes the horrors of war faced by Americans Ruth, a surgical nurse in a field hospital in Belgium, and her sister, Elise, an ambulance driver between the hospital and the front lines in WWI. One had to admire these American sisters facing the horrible conditions that they lived and worked in for several years but I wished the author would have added some more characters. I think some readers will be turned off by some of the blood and gore parts of the book. I have a medical background and even so, I tired of reading so much about the harsh situations in the surgical units. The trials of the ambulance drivers, mostly women, though also horrible, was most interesting. The author did a good job telling of the prejudices, both personal and job wise facing the women of that era. I did like the book.