Julia Alvarez is the author of five works of fiction, among them In the Time of the Butterflies and How the Garcia Girls Lost Their Accents; a book of essays; five collections of poetry; and five books for children.

About this book, in Julia Alvarez's words:

As the Seamus Heaney poem says, hope and history can sometimes be made to "rhyme."

This novel is about two women, one contemporary and one historical, who want desperately for this rhyme to happen. A footnote in a history book I was reading caught my eye: due to the occupation of the colony of Santo Domingo by the French, the 1804 Spanish smallpox expedition going around the world with the newly discovered vaccine did not make a stop there. This was the first world-wide effort to eradicate a deadly disease. Back then, travel was slow, on ships. There was no refrigeration, so the only way to keep the vaccine alive was through carriers, sequentially vaccinated. The carriers were, for the most part, orphan boys. The first group of 22 boys, between the ages of three and nine, came from an orphanage in Spain, and here's an incredible detail for a novelist to come upon: the rectoress of the orphanage went along to take care of them. Nothing is known about her except her name, Doña Isabel, her surname variously misspelled. She is the subject of the first story in the novel.

The second story in the novel is about Alma, a contemporary writer undergoing her own dark night of the soul. Alma has lost faith in writing, lost faith in most things. She is married to a wonderful man, whom she dearly loves, and that saves her from total despair. Her husband, who has a job at an international aid consulting firm, finds himself mixed up with an AIDS clinic (our 21st-century epidemic) in a third-world country where a pharmaceutical company is testing a new vaccine. These two stories, seemingly so different, begin to "speak" to each other, and I hope there is, if not a full rhyme, then a sort of half rhyme: a hope that stories can make a difference in a world that increasingly seems beyond any kind of redemption.