By the start of the 20th century many Irish people were living in squalor: the country's infant mortality rate was the highest in Europe and tuberculosis was rampant. The daunting and tireless Lady Ishbel Aberdeen, wife of the British Viceroy to Ireland, devoted herself to social changes that could save lives. But she often faced ridicule because of the contrast between her own high status and her concern for the common man. Arthur Griffith, future president of Ireland, publicly nicknamed her The Viceregal Microbe.

This book tells the story of the friction between the struggle for Irish independence and the 'good works' of the Anglo-Irish elite. The mainly Protestant and upper-class women who gathered around Lady Aberdeen through the Women's National Health Association she founded were all fine people with good hearts. But Irish Nationalists treated them with suspicion, and progress in the war against tuberculosis was the casualty.

Lady Abderdeen became ever more radical in her campaign for better living conditions for Ireland's poor. The Chief Medical Officer of the Guinness Brewery, John Lumsden, was one of her close allies. By the end of her decades of work (most intensely 1906-1915) in Ireland, Ishbel Aberdeen became as out-spoken as the trade union rebel 'Big Jim' Larkin. She was a strong woman and often alienated people by her relentlessness. She drove herself to exhaustion and her family almost to bankruptcy in her campaign for a better life for Ireland's poor. But in the end she was doomed to be viewed as part of the system of British rule over Ireland. And history belongs to the victor. The contribution of Lady Aberdeen and her volunteers to the welfare of Ireland's poor and sick was largely forgotten in the wake of the country's independence and its nationalist fervour.