Only four Nebula winners left to read now, Rite of Passage by Alexei Panshin, A Time of Changes by Robert Silverberg, Stations of the Tide by Michael Swanwick, and The Terminal Experiment by Robert J Sawyer. I checked the 1989 shortlist to see what this book beat: I must have read both Prentice Alvin and Ivory shortly after they were published, and remember the latter as particularly engaging, though I think that The Healer's War is better. (The others were Boat of a Million Years by Poul Anderson, Good News From Outer Space by John Kessel and Sister Light, Sister Dark by Jane Yolen; this was the equivalent year that Hyperion won the Hugo for Best novel, with the Card and Anderson books on both shortlists.)
This was one of those years when the Nebula system managed to recognise an exceptional novel that would never win a Hugo. The Healer's War is a somewhat autobiographical account of the Vietnam war as seen by an American military nurse, with precisely one sfnal element: a magic amulet, with slightly healing powers, which gives the narrator the power of empathy with the Vietnamese of all sides and of none (and indeed with her fellow Americans as well). It is a fair comment that the magic amulet is a literary device that enables the author to tell the story she wants (Scarborough herself says so in an afterword). But I think it's still entirely legitimate to count the book within the genre, and to acknowledge its merits accordingly.
It's a stark contrast with other war stories I have read, which tend to concentrate on the view of the individual soldier (eg, Catch-22 and War and Peace; see also my reviews here, here, here and rather notoriously here). The Healer's War concentrates on the non-soldiers involved in war, and indeed its military characters tend to be pretty unpleasant, whether Americans or Vietnamese of either side. But I felt that none of them slipped into caricature; the narrator's commitment to empathy helped to avoid that trap. It was a gripping and moving read.
Vietnam is coming somewhat indirectly into my life at the moment in a way I had never expected. I hadn't expected it in this book either - it arrived from a second hand dealer the day before we left on holiday, and I packed it without looking at it beyond checking that the title and author were correct. I shall be learning a lot more about Vietnam in years to come, but this was a surprisingly thought-provoking starting point.