Even before I read it, I sort of figured that Johnston found a publisher for her first novel because she's the Governor General's wife. And after reading it, I'm certain that's the case. Don't get me wrong, she has an interesting story to tell, but I didn't think the writing was fantastic (though not terrible either).
Apparently the story is loosely based on that of Johnston's grandmother (I think the Matron in the title, rather than the Madam). The story spans about 20 years from just before World War I until the mid-thirties. It focuses on two main characters. Clara Durling, a nurse, is widowed when her husband dies in the war. Shortly after that her son dies of influenza. Needing a fresh start she and her daughter Ivy immigrate to Canada where, on the recommendation of a Canadian doctor she worked with during the war, Clara becomes the new superintendent of the Lethbridge Hospital.
Lily is a teacher born in Nova Scotia to an unwed mother who was shipped to Canada by her embarrassed relations. Just before Lily's birth, her mother falls in love with and marries a pharmacist who Lily adores and who treats her as his own daughter. After teacher's college Lily weds a miner and they immigrate to Lethbridge for his job. Lily is unable to find a steady teaching job and when she falls upon hard times she decides to run a brothel to support herself and her young son, Teddy.
The book jacket talks about how the two women collaborate to establish the first venereal disease clinic in Alberta, and they do, but really this is a small part of the book. Far more time is spent on the women and their love relationships as well as their relationship to each other. I liked some of the male characters, especially the doctor, Barnaby, who was wounded in the war so must abandon surgery for psychiatry. I found Lily's husband Ed a bit hard to take - he was an immature, hothead. Johnston explains why in his back story but I still had a hard time sympathizing with him.
I probably had the most trouble with Clara. Her character was not consistently developed in my view. She could be compassionate at times (like when she befriends an unwed mother on the ship from England to Canada), but also rude and downright dictatorial in dealing not only with her employees, but also her daughter. I get that she had a hard life but the sorrow did not seem to explain the inconsistent behaviour. I also found her relationship with the mayor downright strange.
My other criticism of the writing is that there were too many coincidences. I know Canada may have been small at the time, but I still found it far-fetched how often the paths of various characters crossed. Along the same lines there were too many minor characters mentioned by name and then not developed sufficiently to be memorable so I often had to flip back to remind myself who was who. Finally, I think Johnston tried to fit too many incidents into the book so that lots happened but not a lot of the events were described in depth. I might have preferred fewer, well developed occurrences.
Despite the above criticisms, the book was an easy read and was fairly entertaining. It also examined an era in Canadian history that I didn't know a lot about so that was interesting. So I wouldn't say you should avoid this book. But I would say Johnston is probably lucky to have connections which helped her get published.