small great things by jodi picoult

SMALL GREAT THINGS by Jodi Picoult [Book Thoughts]

I received this book for review consideration from the publisher, via Shelf Awareness for Readers. All opinions are my own.

Small Great Things
Written by Jodi Picoult
Published by Ballantine Books on October 11th 2016
ISBN: 9781444788013
Genres: Fiction, Literary, Adult Fiction
Format: ARC
Pages: 480
Source: publisher, via Shelf Awareness for Readers

Ruth Jefferson is a labor and delivery nurse at a Connecticut hospital with more than twenty years' experience. During her shift, Ruth begins a routine checkup on a newborn, only to be told a few minutes later that she's been reassigned to another patient. The parents are white supremacists and don't want Ruth, who is African American, to touch their child. The hospital complies with their request, but the next day, the baby goes into cardiac distress while Ruth is alone in the nursery. Does she obey orders or does she intervene?
Ruth hesitates before performing CPR and, as a result, is charged with a serious crime. Kennedy McQuarrie, a white public defender, takes her case but gives unexpected advice: Kennedy insists that mentioning race in the courtroom is not a winning strategy. Conflicted by Kennedy's counsel, Ruth tries to keep life as normal as possible for her family—especially her teenage son—as the case becomes a media sensation. As the trial moves forward, Ruth and Kennedy must gain each other's trust, and come to see that what they've been taught their whole lives about others—and themselves—might be wrong.
With incredible empathy, intelligence, and candor, Jodi Picoult tackles race, privilege, prejudice, justice, and compassion—and doesn't offer easy answers. Small Great Things is a remarkable achievement from a writer at the top of her game.

SMALL GREAT THINGS by Jodi Picoult: Book Thoughts

A version of this discussion was previously published as a compensated review in Shelf Awareness for Readers (October 21, 2016). All opinions are my own.

Jodi Picoult is best known for fiction that blends courtroom and human drama around a controversial topic. While some of her recent work has deviated from that template, she returns to it in Small Great Things. This very timely novel filters the trial of a nurse accused of the wrongful death of a patient through the lens of the Black Lives Matter movement.

Ruth Jefferson is the only Black labor-and-delivery nurse at a small Connecticut hospital.  When two white supremacists demand that she be kept away from their newborn son, she’s stunned…and despite those orders, she is in the middle of things when the infant goes into cardiac arrest. When he doesn’t survive, the parents’ grief and need to place blame lead to criminal charges against her. To Ruth, the matter is literally black and white–that is, she’s been accused of killing a white baby because she is Black. And while the case attracts the attention of prominent Black activists, her attorney’s insistence on building a defense that addresses race as little as possible confounds her.

Small Great Things is narrated in the voices of Ruth, the accused nurse; Turk, the baby’s father; and Kennedy, Ruth’s (white) public defender. While Turk’s presentation of the white-supremacist worldview is deeply unsettling, the relationship between Ruth and Kennedy evokes a more complicated discomfort as it becomes an ongoing dialogue about race, consciousness, and intention. Small Great Things is in the tradition of Picoult’s best topical fiction (My Sister’s Keeper, Nineteen Minutes)–engrossing, provocative, and timely, it’s sure to spur discussions that mirror those taking place between her characters.

SMALL GREAT THINGS: Other Discussions

Jodi Picoult on NPR , speaking on inspiration and authorial intent:

“I’d wanted to write about racism. I’ve wanted to do that for a very long time. Twenty years ago, I started a book after reading a news story about an African-American undercover cop who was shot four times in the back on the subway by his white colleagues. And I started that book, and I tried very hard to write it, and ultimately I failed. I just couldn’t write an authentic story. And I really second-guessed myself. I thought, you know, do I even have the right to write this story? I am a white woman. I have not lived this life. This is not my story to tell.

And then in 2012, I read a news story that came out of Flint, Mich., and there was an African-American nurse there with 20 years of labor and delivery experience who helped deliver a baby. And in the aftermath, the father called her supervisor into the room and asked that she not touch the baby nor anyone who looked like her. He pulled up his sleeve to reveal a swastika tattoo. There was a Post-it note left on the baby’s file that said no African-American personnel to touch this infant. And the nurse wound up suing the hospital. She settled out of court. I hope she got a very large payout.

But it became a seed for me that grew, and I began to push the envelope a little bit…And I began to think about trying to tell the story from three different points of view – the African-American nurse, the white public defender and the skinhead father – as they all confronted their beliefs about power and privilege and race.

…[Although every reviewer has mentioned] the timeliness of this novel, I would argue that any time in the past 200 years would have been timely. It’s not that racism hasn’t existed in our society. I think it’s that in today’s day and age with the 24/7 news cycle and with the internet, we see microaggressions and acts of racism being played out in real time. And that’s what makes this feel so incredibly immediate.”

From Roxane Gay’s review of Small Great Things in the New York Times, an (unintended) audience perspective:

This is a writer who understands her characters inside and out. She knows her story equally well. In terms of research, Picoult has put in the work — even too much work at times, as if she is saying, ‘Look at everything I know about everything I’m writing here.’ Still, this preparation and eagerness to please don’t really detract. I’d rather read a writer who knows too much about the story she is telling than a writer who knows not enough…

“When it comes to race itself, the novel stumbles. Its least believable character is Ruth. Her blackness is clinical, overarticulated. I certainly appreciate the research Picoult did and the conversations she had, but research does not necessarily translate to authenticity…It all starts to feel excessive and desperately didactic. This rises, I suspect, out of Picoult’s keen awareness that she is writing mostly for a white audience, which needs a more nuanced understanding of the black experience. And therein lies the true challenge of writing across difference, or of writing a political novel — if the politics overcomes the prose, then it becomes something other than a novel.

I give Picoult a lot of credit for trying, and for supporting her attempt with rigorous research, good intentions and an awareness of her fallibility. Picoult’s flawed novel will most likely be well received by her intended audience. I trust that the next time she writes about race — and I do hope there is a next time — she’ll write about it in ways that will also be compelling for the rest of us.”

SMALL GREAT THINGS by Jodi Picoult: An Excerpt


The most beautiful baby I ever saw was born without a face.

From the neck down, he was perfect: ten fingers, ten toes, chubby belly. But where his ear should have been, there was a twist of lips and a single tooth. Instead of a face there was a swirling eddy of skin with no features.

His mother—my patient—was a thirty-year-old gravida 1 para 1 who had received prenatal care including an ultrasound, but the baby had been positioned in a way that the facial deformity hadn’t been visible. The spine, the heart, the organs had all looked fine, so no one was expecting this. Maybe for that very reason, she chose to deliver at Mercy–West Haven, our little cottage hospital, and not Yale–New Haven, which is better equipped for emergencies. She came in full term, and labored for sixteen hours before she delivered. The doctor lifted the baby, and there was nothing but silence. Buzzy, white silence. “Is he all right?” the mother asked, panicking. “Why isn’t he crying?”

I had a student nurse shadowing me, and she screamed.

“Get out,” I said tightly, shoving her from the room. Then I took the newborn from the obstetrician and placed him on the warmer, wiping the vernix from his limbs. The OB did a quick exam, silently met my gaze, and turned back to the parents, who by now knew something was terribly wrong. In soft words, the doctor said their child had profound birth defects that were incompatible with life.

On a birth pavilion, Death is a more common patient than you’d think. When we have anencephalies or fetal deaths, we know that the parents still have to bond with and mourn for that baby. This infant— alive, for however long that might be—was still this couple’s son.

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  1. I’ve heard mixed things about this book but I’m sure it will spur great discussions. Picoult spoke about it at SIBA and got a standing ovation.

  2. I’ve definitely been interested in reading this one but I did wonder about a white author trying to write from the perspective of a black woman when the discussion really hinges on race. Gay’s comments are very interesting.

    1. I was a bit skeptical about that too, but Picoult almost never writes from just one narrative perspective and I think that’s an advantage here. I thought Roxane Gay added a lot to the conversation!