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Authors: Jodi Picoult

BOOK: Small Great Things
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My sister likes to play the victim. We've had some pretty heated exchanges about that before. If you don't want to be seen as a stereotype, then the way I see it, don't
be
one. But to my sister, that means playing a white man's game, and being who
they
want her to be, instead of being unapologetically herself. Adisa says the word
assimilation
with so much venom that you'd think anyone who chooses it—like I did—is swallowing poison.

It's also very like my sister to take a problem
I
have and turn it into her own rant.

“None of what happened at the hospital is your fault,” my sister says, surprising me. I figured she'd say I had this coming to me, because I've been pretending to be someone I'm not and somewhere along the pretending, I forgot the truth. “It's their world, Ruth. We just live in it. It's like if you up and moved to Japan. You could choose to ignore the customs and never learn the language, but you're going to get along a lot easier if you do, right? Same thing here. Every time you turn on the TV or the radio you see and hear about white people going to high school and college, eating dinner, getting engaged, drinking their pinot noir. You learn how they live their lives, and you speak their language well enough to blend in with them. But how many white people you know who go out of their way to see Tyler Perry movies so they can learn how to act around Black people?”

“That's not the point—”

“No, the point is you can
do as the Romans do
all you want, but it don't mean the Emperor will let you into his palace.”

“White people do not run the world, Adisa,” I argue. “There are plenty of successful people of color.” I name the first three that pop into my head. “Colin Powell, Cory Booker, Beyoncé—”

“—and ain't none of them dark, like me,” Adisa counters. “You know what they say: the deeper you go into the projects, the darker the skin.”

“Clarence Thomas,” I pronounce. “He's darker than you and he's on the Supreme Court.”

My sister laughs. “Ruth, he's so conservative he probably
bleeds
white.”

My phone dings, and I carefully extract it from my purse so I don't mess up my nails.

“Edison?” Adisa asks immediately. Say what you will about her, but she loves my son as much as I do.

“No. It's Lucille from work.” Just seeing her name pop up on my phone makes my mouth go dry; she was the nurse during the delivery of Davis Bauer. But this isn't about that family at all. Lucille's got a stomach bug; she needs someone to fill in for her tonight. She's willing to trade me, so that instead of working all day Saturday, I can leave at eleven. It means pulling a double shift, but I'm already thinking of what I could do with that time on Saturday. Edison needs a new winter coat this year—I swear he's grown four inches over the summer. I could treat him to lunch, after shopping. Maybe there's even a movie coming out that Edison and I could go see. It's been hitting me hard lately—the realization that getting my son to a point where he's accepted to college also means that I will be left alone. “They want me to come in to work tonight.”

“Who's they? The Nazis?”

“No, another nurse who's sick.”

“Another
white
nurse,” Adisa clarifies.

I don't even respond.

Adisa leans back in her chair. “Seems to me they're not in a position to be asking you for favors.”

I am about to defend Lucille, who had absolutely nothing to do with Marie's decision to put a Post-it note on the baby's file, when the nail technician interrupts us, checking our fingers to see if the polish is dry. “Okay,” she says. “All done.”

Adisa waggles her fingers, a shocking shade of hot pink. “Why do we keep coming here? I hate this salon,” she says, her voice low. “They don't look me in the eye and they won't put my change right in my hand. It's like they think my Black is gonna rub off on them.”

“They're Korean,” I point out. “Did you ever think that maybe, in their culture, neither of those things are polite?”

Adisa raises a brow. “All right, Ruth,” she says. “You just keep telling yourself it's not about you.”

—

N
OT TEN MINUTES
into my unscheduled shift, I'm already sorry I said yes. There's a storm crackling outside, one the weathermen didn't see coming, and the barometric pressure's tanked—which leads to early ruptured membranes, to women going into premature labor, to patients who are writhing in the halls because we don't have enough space for them. I'm running around like a chicken with its head cut off, which is a good thing, because it keeps me from thinking about Turk and Brittany Bauer and their baby.

But not so much that I don't casually check the chart when I first come on duty. I tell myself that I just want to make sure that someone—someone
white
—has scheduled that consult with a pediatric cardiologist before the baby is discharged. And yes, there it is in the schedule, along with a record of Corinne doing the baby's heel stick on Friday afternoon to draw blood for the state newborn screening. But then someone calls my name and I find myself pulled into the orbit of a laboring woman, who is being wheeled up from Emergency. Her partner looks terrified, the kind of man who is used to being able to fix things who has come to the sudden realization that this is outside his wheelhouse. “I'm Ruth,” I say to the woman, who seems to have telescoped further into herself with each subsequent contraction. “I'm going to be here with you the whole time.”

Her name is Eliza and her contractions are four minutes apart, according to her husband, George. This is their first pregnancy. I get my patient settled in the last birthing room we have available and take a urine sample, then hook her up to the monitor, scanning the gravestone printout. I grab her vitals and start asking questions:
How strong are the contractions? Where are you feeling them—the front or the back? Are you leaking any fluid? Are you bleeding? How's the baby moving?

“If you're ready, Eliza,” I say, “I'm going to check your cervix.” I put on a pair of gloves and move to the foot of the bed, touch her knee.

An expression flickers across her face that gives me pause.

Now, most laboring women will do anything to get that baby out of them. There's fear about getting through childbirth, yes, but that's different from the fear of being touched. And that's what I'm reading all over Eliza's face.

A dozen questions jockey their way to the tip of my tongue. Eliza changed in the bathroom with her husband's help, so I didn't see if she had any bruises that might flag an abusive relationship. I glance at George. He looks like an ordinary father-to-be—nervous, out of place—not like a guy with anger management issues.

Then again, Turk Bauer looked pretty normal to me until he rolled up his sleeves.

Shaking my head to clear it, I turn to George and pin a smile over my instincts. “Would you mind going to the kitchenette and getting some ice chips for Eliza?” I say. “It'd be a tremendous help.”

Never mind that's a nurse's job—George looks supremely relieved to be given a task. The minute he's out of the room I turn to Eliza. “Is everything all right?” I ask, looking her in the eye. “Is there something you need to tell me that you couldn't say with George in the room?”

She shakes her head, and then bursts into tears.

I strip off my gloves—the cervical exam can wait—and reach for her hand. “Eliza, you can talk to me.”

“The reason I got pregnant is because I was raped,” she sobs. “George doesn't even know it happened. He's so happy about this baby…I couldn't tell him it might not be his.”

The story comes out, whispered, in the middle of the night, when Eliza has stalled at seven centimeters dilated, and George has gone to get to a snack from the cafeteria. Labor is like that—a shared trauma bond, an accelerant that makes relationships stronger. And so even though I am little more than a stranger to Eliza, she pours out her soul to me, as if she has fallen overboard and I am the only glimpse of land on the horizon. She was on a business trip, celebrating the close of a deal with an important, elusive client. The client invited her out to dinner with some others and bought her a drink, and the next thing Eliza remembered was waking up in his hotel room, and feeling sore all over.

When she finishes, we both sit, letting the words settle. “I couldn't tell George,” Eliza says, her hands bunched on the rough hospital linens. “He would have gone to my boss, and believe me, they wouldn't risk losing this deal just because of something that happened to me. The best-case scenario is that I would have been given a severance package to keep my mouth shut.”

“So nobody knows?”


You
do,” she says. Eliza looks at me. “What if I can't love the baby? What if every time I look at her, I see what happened?”

“Maybe you should get DNA testing,” I tell her.

“What good would it do?”

“Well,” I say, “you'd
know
.”

She shakes her head. “And then what?”

It is a good question, one that I feel all the way to my own core. Is it better not knowing the ugly truth, and pretending it doesn't exist? Or is it better to confront it, even though that knowledge may be a weight you carry around forever?

I am about to give her my opinion when Eliza is seized by another contraction. Suddenly, we are both in the trenches again, fighting for a life.

It takes three hours, and then Eliza pushes her daughter into the world. Eliza starts crying, like many new mothers do, but I know it's not for the same reasons. The OB hands the newborn to me, and I stare down into the angry ocean of that baby's eyes. It doesn't matter how she was conceived. It just matters that she made it here.

“Eliza,” I say, settling the baby on her chest, “here's your daughter.”

Even as George reaches over his wife's shoulder to stroke the newborn's mottled thigh, Eliza won't look at the baby. I lift the baby up, hold her closer to Eliza's face. “Eliza,” I say, more firmly. “Your daughter.”

She drags her gaze toward the baby in my hands. Sees what I see: the blue eyes of her husband. The identical nose. The cleft that matches the one in his chin. This baby might as well be a tiny clone of George.

All the tension fades from Eliza's shoulders. Her arms close around her daughter, holding the child so close there is no room for
but what if
. “Hello, baby,” she whispers.

This family, they'll make their own reality.

I just wish it were that easy for the rest of us.

—

B
Y NINE THE
next morning, it feels like the entirety of New Haven has come to the hospital to give birth. I have been mainlining coffee, running back and forth among three postpartum patients, and praying fervently in between that we don't get another woman in active labor before I leave here at eleven. In addition to Eliza's delivery, I had two more patients last night—a G3 P3 who, truth be told, could have had that baby on her own and nearly did—and a G4 P1 who had an emergency C-section. Her baby, only twenty-seven weeks, is in the NICU.

When Corinne comes on duty at seven, I'm in the OR with the emergency C-section, so we don't cross paths until it's 9:00
A.M.
and I'm in the nursery. “I heard you pulled a double,” she says, wheeling a bassinet into the room. “What are you doing in here?”

The nursery used to be where the babies were kept while mothers got a decent night's sleep, before they stayed twenty-four/seven in their mothers' hospital rooms. So now, it's used mostly for storage, and for routine procedures like circumcisions, which no parent wants to watch. “Hiding,” I tell Corinne, pulling a granola bar out of my pocket and devouring it in two bites.

She laughs. “What the
hell
is going on today? Did I miss the memo for the Apocalypse or something?”

“Tell me about it.” I glance at the infant for the first time, and feel a shudder run down my spine.
BABY BOY BAUER
, the card on the bassinet reads. Without even meaning to, I take a step backward.

“How's he doing?” I ask. “Is he eating any better?”

“His sugar's up but he's still logy,” Corinne answers. “He hasn't nursed for the past two hours because Atkins is going to do the circ.”

As if Corinne has conjured the pediatrician, Dr. Atkins comes into the nursery. “Right on schedule,” she says, seeing the bassinet. “The anesthesia's had enough time to kick in and I've already talked to the parents. Ruth, did you give the baby sweeties?”

Sweeties are a little bit of sugar water, rubbed on the babies' gums to soothe and distract them from the discomfort. I would have given the baby sweeties before a circ, if I were his nurse.

“I'm not taking care of this patient anymore,” I say stiffly.

Dr. Atkins raises a brow and opens the patient file. I see the Post-it note, and as she reads it, an uncomfortable silence swells, sucking up all the air in the room.

Corinne clears her throat. “I gave him sweeties about five minutes ago.”

“Great,” Dr. Atkins says. “Then let's get started.”

I stand for a moment, watching as Corinne unwraps the baby and prepares him for this routine procedure. Dr. Atkins turns to me. There's sympathy in her eyes, and that's the last thing I want to see. I don't need pity just because of a stupid decision Marie made. I don't need pity because of the color of my skin.

So I make a joke of it. “Maybe while you're at it,” I suggest, “you can sterilize him.”

—

T
HERE ARE FEW
things scarier than a stat C-section. The air becomes electric once the doctor makes that call, and conversation becomes parsed and vital:
I've got the IV; can you get the bed? Someone grab the med box and book the case
. You tell the patient that something is wrong, and that we have to move fast. A page gets sent from the hospital operator to anyone on the team who's outside the building, while you and the charge nurse take the patient to the OR. While the charge nurse rips the instruments from their sterilized paper bag and turns on the anesthesia equipment, you get the patient onto the table, prep the belly, get the drapes up and ready. The minute the doctor and the anesthesiologist run through the door, the cut is made, the baby's out. It takes less than twenty minutes. At big hospitals, like Yale–New Haven, they can do it in seven.

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