Fever tells the torrid tale of the life of Mary Mallon, an Irish-American immigrant who became the first known healthy carrier of the pathogen that causes typhoid fever, and the only one to be imprisoned long-term for her condition. She is better known to American history as the infamous “Typhoid Mary.” But readers will feel compelled to qualify that epithet after finishing Mary Beth Keane’s sympathetic portrayal of this woman scorned by circumstance.

Keane credits Judith Walzer Leavitt’s book Typhoid Mary: Captive to the Public’s Health as her “starting point and . . . touchstone” during the four years she spent writing the novel. Thankfully, Keane takes a few liberties that bring Mary to life beyond the historical account, like the wonderfully drawn friends and fellow immigrant-occupants of her 33rd Street tenement building. Most prominent among them is her lover and companion of nearly 30 years, Alfred Breihof. Their relationship is Mary’s thread to the world as she is whisked away and isolated, in truly Kafkaesque fashion, on North Brother Island in the middle of the East River. And it is the thread running wildly through the narrative, threatening always to tangle or to snap. It’s a faltering, ultimately tragic love story that leaves just the narrowest gap for the light of hope—hope that a strong woman, who bravely refused to concede her inalienable rights but who could never shake the love of a hapless cad, could in the end find some peace within herself.

The history lesson alone is worthwhile: the rich portrait of New York City during the early 20th century, an era of sweeping change. Its class divisions and immigrant life, its awkwardly young public health awareness, its teeming growth, all create a veracious space in which Keane’s characters move. Their dilemmas are never easy and their decisions are often questionable, making for a read that is as morally challenging as it is quickly paced. Fans of The Immortal Life of Henrietta Lacks will find stirring parallels in Fever. Ultimately, this is a story that provokes a deeper understanding of the tenuous relationship between love, personal liberty and the common good.

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