Jodi Picoult: Small Great Things

I understand the need people have to put a certain face on for the rest of the world. Which is why-when I first arrive for my shift at 6:40 A.M.-I don’t even go into the staff room, where we will shortly receive the night’s update from the charge nurse. Instead I slip down the hall to the patient I’d been with yesterday, before my shift ended. Her name was Jessie; she was a tiny little thing who had come into the pavilion looking more like a campaigning First Lady than a woman in active labor: her hair was perfectly coiffed, her face airbrushed with makeup, even her maternity clothes were fitted and stylish. That’s a dead giveaway, since by forty weeks of pregnancy most mothers-to-be would be happy to wear a pup tent. I scanned her chart-G1, now P1-and grinned. The last thing I’d said to Jessie before I turned her care over to a colleague and went home for the night was that the next time I saw her, she’d have a baby, and sure enough, I have a new patient. While I’ve been sleeping, Jessie’s delivered a healthy seven-pound, six-ounce girl.

I open the door to find Jessie dozing. The baby lies swaddled in the bassinet beside the bed; Jessie’s husband is sprawled in a chair, snoring. Jessie stirs when I walk in, and I immediately put a finger to my lips. Quiet .

From my purse, I pull a compact mirror and a red lipstick.

Part of labor is conversation; it’s the distraction that makes the pain ebb and it’s the glue that bonds a nurse to her patient. What other situation can you think of where one medical professional spends up to twelve hours consulting with a single person? As a result, the connection we build with these women is fierce and fast. I know things about them, in a mere matter of hours, that their own closest friends don’t always know: how she met her partner at a bar when she’d had too much to drink; how her father didn’t live long enough to see this grandchild; how she worries about being a mom because she hated babysitting as a teenager. Last night, in the dragon hours of Jessie’s labor, when she was teary and exhausted and snapping at her husband, I’d suggested that he go to the cafeteria to get a cup of coffee. As soon as he left, the air in the room was easier to breathe, and she fell back against those awful plastic pillows we have in the birthing pavilion. “What if this baby changes everything?” she sobbed. She confessed that she never went anywhere without her “game face” on, that her husband had never even seen her without mascara; and now here he was watching her body contort itself inside out, and how would he ever look at her the same way again?

Listen, I had told her. You let me worry about that.

I’d like to think my taking that one straw off her back was what gave her the strength to make it to transition.

It’s funny. When I tell people I’ve been a labor and delivery nurse for more than twenty years, they’re impressed by the fact that I have assisted in cesareans, that I can start an IV in my sleep, that I can tell the difference between a decel in the fetal heart rate that is normal and one that requires intervention. But for me, being an L & D nurse is all about knowing your patient, and what she needs. A back rub. An epidural. A little Maybelline.

Jessie glances at her husband, still dead to the world. Then she takes the lipstick from my hand. “Thank you,” she whispers, and our eyes connect. I hold the mirror as she once again reinvents herself.

–

ON THURSDAYS, MY shift goes from 7:00 A.M. till 7:00 P.M. At Mercy-West Haven, during the day, we usually have two nurses on the birthing pavilion-three if we’re swimming in human resources that day. As I walk through the pavilion, I note idly how many of our delivery suites are occupied-it’s three, right now, a nice slow start to the day. Marie, the charge nurse, is already in the room where we have our morning meeting when I come inside, but Corinne-the second nurse on shift with me-is missing. “What’s it going to be today?” Marie asks, as she flips through the morning paper.

“Flat tire,” I reply. This guessing game is a routine: What excuse will Corinne use today for being late? It’s a beautiful fall day in October, so she can’t blame the weather.

“That was last week. I’m going with the flu.”

“Speaking of which,” I say. “How’s Ella?” Marie’s eight-year-old had caught the stomach bug that’s been going around.

“Back in school today, thank God,” Marie replies. “Now Dave’s got it. I figure I have twenty-four hours before I’m down for the count.” She looks up from the Regional section of the paper. “I saw Edison’s name in here again,” she says.

My son has made the Highest Honors list for every semester of his high school career. But just like I tell him, that’s no reason to boast. “There are a lot of bright kids in this town,” I demur.

“Still,” Marie says. “For a boy like Edison to be so successful…well. You should be proud, is all. I can only hope Ella turns out to be that good a student.”

A boy like Edison . I know what she is saying, even if she’s careful not to spell it out. There are not many Black kids in the high school, and as far as I know, Edison is the only one on the Highest Honors list. Comments like this feel like paper cuts, but I’ve worked with Marie for over ten years now, so I try to ignore the sting. I know she doesn’t really mean anything by it. She’s a friend, after all-she came to my house with her family for Easter supper last year, along with some of the other nurses, and we’ve gone out for cocktails or movie nights and once a girls’ weekend at a spa. Still, Marie has no idea how often I have to just take a deep breath, and move on. White people don’t mean half the offensive things that come out of their mouths, and so I try not to let myself get rubbed the wrong way.

“Maybe you should hope that Ella makes it through the school day without going to the nurse’s office again,” I reply, and Marie laughs.

“You’re right. First things first.”

Corinne explodes into the room. “Sorry I’m late,” she says, and Marie and I exchange a look. Corinne’s fifteen years younger than I am, and there’s always some emergency-a carburetor that’s dead, a fight with her boyfriend, a crash on 95N. Corinne is one of those people for whom life is just the space between crises. She takes off her coat and manages to knock over a potted plant that died months ago, which no one has bothered to replace. “Dammit,” she mutters, righting the pot and sweeping the soil back inside. She dusts off her palms on her scrubs, and then sits down with her hands folded. “I’m really sorry, Marie. The stupid tire I replaced last week has a leak or something; I had to drive here the whole way going thirty.”

Marie reaches into her pocket and pulls out a dollar, which she flicks across the table at me. I laugh.

“All right,” Marie says. “Floor report. Room two is a couplet. Jessica Myers, G one P one at forty weeks and two days. She had a vaginal delivery this morning at three A.M., uncomplicated, without pain meds. Baby girl is breast-feeding well; she’s peed but hasn’t pooped yet.”

“I’ll take her,” Corinne and I say in unison.

Everyone wants the patient who’s already delivered; it’s the easier job. “I had her during active labor,” I point out.

“Right,” Marie says. “Ruth, she’s yours.” She pushes her reading glasses up on her nose. “Room three is Thea McVaughn, G one P zero at forty-one weeks and three days, she’s in active labor at four centimeters dilated, membranes intact. Fetal heart rate tracing looks good on the monitor, the baby’s active. She’s requested an epidural and her IV fluid bolus is infusing.”