Small Great Things

About Small Great Things

Ruth Jefferson has been a labor and delivery nurse for more than twenty years, and she is good at her job. When a white supremacist couple—Turk and Brittany Bauer—arrive at the Connecticut hospital where she works, they request that no Black nurses touch their baby. The hospital complies and posts a note on the chart. The next day, Ruth is alone in the room when the newborn goes into cardiac distress. She hesitates—remembering the note—and the baby dies. Ruth is charged with a crime.

Small Great Things is told in three voices: Ruth, her public defender Kennedy McQuarrie (a white liberal woman who has never had to think very hard about race), and Turk Bauer. Picoult's decision to give Turk a fully-rendered interior—his history, his ideology, his grief—is one of the novel's most deliberate and most discussed choices. He is not a symbol; he is a person whose beliefs the reader is forced to sit inside, which is more uncomfortable than a caricature would be.

Published in 2016, the novel examines systemic racism not as a theoretical category but as a series of specific, institutional decisions that accumulate into something Ruth has no good options for navigating. Kennedy's gradual recognition of her own blind spots is one of the book's central arcs—and its argument about what white allyship actually requires.

Race, Privilege, and the Stories We Tell Ourselves

Picoult has been both praised and criticized for writing a novel about race from a white author's perspective. She addresses this directly in an author's note, acknowledging the limitations of her vantage point and describing the extensive research and consultation that shaped the book. The conversation around that question—who gets to tell which stories, and how—is itself the kind of discussion the novel is designed to generate.

What the book does unusually well is show how racism operates through institutional structures—hospital policy, courtroom procedure, jury selection—rather than only through individual bad actors. Ruth is not failed by one villain; she is failed by a system that was not built with her in mind. That distinction matters for how readers understand the novel's conclusion.

Why Small Great Things Has Been Challenged

Small Great Things has been challenged in 1 state and 1 district tracked in this catalog. The challenges come from multiple directions: some object to the book's frank engagement with white supremacy and its language; others feel the novel centers a white character's racial awakening at the expense of its Black protagonist. Picoult has engaged with the second critique publicly and thoughtfully. Both critiques are worth discussing. Neither is a reason to remove the book from shelves.