Small Great Things – Jodi Picoult (2016)

Small Great Things by Jodi Picoult, published in 2016, is a contemporary legal and social drama that delves into the intricacies of race, privilege, and justice in modern-day America. The novel follows a Black labor and delivery nurse, Ruth Jefferson, who is barred from caring for the newborn son of white supremacist parents. When the baby dies under her colleagues’ watch, Ruth is held responsible, leading to a gripping courtroom trial that tests the boundaries of ethics, identity, and personal conviction. Picoult uses alternating perspectives to explore prejudice from multiple angles, challenging the reader to confront uncomfortable truths about systemic racism.

Plot Summary

On an ordinary shift at the Mercy–West Haven Hospital in Connecticut, Ruth Jefferson arrives early, professional and composed as always. She’s been a labor and delivery nurse for over twenty years, committed to her patients and beloved by her colleagues. As the day unfolds, she’s assigned to care for a newborn named Davis, born just hours ago to Brittany and Turk Bauer. But the father, a hulking man with stormy eyes and Confederate ink across his arm, demands that Ruth be removed from their case. The reason is unspoken but unmistakable – Ruth is Black, and the Bauers are white supremacists.

Hospital administration complies without argument. Ruth is quietly removed from the room. The next day, when Davis stops breathing and Ruth is the only medical staff present, she hesitates. Just long enough. Another nurse takes over, but it’s too late. Davis dies.

An internal investigation is conducted. Then a charge is filed. Ruth is arrested for negligent homicide. The charge rocks her already fragile world. Her teenage son Edison, a brilliant student, watches his mother be dragged into the system like a criminal. Ruth is placed on leave. Her reputation tarnished, her savings drained. The silence of her mostly white coworkers is deafening.

Kennedy McQuarrie, a white public defender, is assigned Ruth’s case. Confident, polished, and liberal in the way people often are when distant from injustice, Kennedy assures Ruth she’ll fight the charges. But she makes one thing clear – race should not be mentioned in court. Talking about racism, she insists, will alienate the jury. The strategy is silence.

The courtroom becomes the stage where personal pain, prejudice, and buried histories come to light. Ruth, once cautious and deferential, finds herself battling not only the criminal charges but the demand to erase her experience as a Black woman. Kennedy, at first convinced her colorblind approach is correct, slowly begins to recognize the privilege embedded in her own worldview. The more time she spends with Ruth, the more the façade cracks. Kennedy starts to see that silence can be its own kind of violence.

Turk Bauer watches the trial unfold with bitterness and fury. Ruth, in his mind, is not a nurse who might have done her best. She is the face of everything he’s been taught to hate. But even he isn’t immune to change. Grief carves strange paths through the human soul. Memories of his brother’s death at the hands of a Black man – an accident, but one that shaped his hatred – blend with the agony of losing his child. His world begins to shift. He grows distant from his former comrades. The firebrand who once shouted slurs at protests now stands quietly in a courtroom, uncertain of what justice even looks like anymore.

Ruth’s son, Edison, becomes a silent pillar of strength. The trial is his first close encounter with the kind of raw, institutionalized racism his mother always shielded him from. He is harassed at school. He is pulled into a police car for walking through his own neighborhood. These experiences sharpen the edges of his innocence. They bring Ruth to the breaking point.

When Ruth finally takes the stand, it’s not just her defense that’s at stake. It’s her voice. She chooses to speak the truth – about being the only Black nurse on her floor, about being mistaken for janitorial staff, about being invisible until something goes wrong. She speaks of the moment she hesitated, not because she didn’t care, but because years of knowing she was unwelcome had conditioned her to freeze. Her words land heavily. Not just in the courtroom, but in the heart of Kennedy, who realizes that acknowledging race isn’t divisive – it’s honest.

The prosecution paints Ruth as reckless. But Kennedy, now fully awakened to her role in perpetuating silence, dismantles their argument by pulling back the veil on implicit bias and institutional failure. She draws a picture not of a nurse failing a child, but of a system failing everyone.

Turk, too, makes a choice. He takes the stand and, to the shock of all, testifies that Ruth wasn’t at fault. His former hate group disowns him. His wife, Brittany, broken by grief and consumed by fear, leaves him. He is alone. But for the first time, he is free of inherited rage.

The judge delivers a verdict – not guilty. Ruth is cleared. The courtroom exhales. But justice doesn’t bring celebration. It brings reflection. Ruth returns to nursing, but she is changed. She no longer hides parts of herself to make others comfortable. Kennedy quits her job and begins working on cases where race and justice intersect. Turk moves to a small apartment and volunteers at a community center. His tattoos remain, but he stops hiding them. They’re scars now, not symbols.

Time passes. Edison applies to Yale. Ruth visits her mother’s grave and tells her the truth – that sometimes, doing small great things means telling people what they don’t want to hear.

The world outside doesn’t change overnight. Racism still lingers like smog over everything. But in that small corner of Connecticut, three people learn that change begins with one breath, one word, one choice. And sometimes, it starts in the unlikeliest of places – with loss, with pain, with silence finally broken.

Main Characters

• Ruth Jefferson – A dedicated and experienced African American labor and delivery nurse. Ruth is intelligent, dignified, and devoted to her teenage son, Edison. Her character arc traces a journey from professional composure and quiet endurance to self-assertion, as she confronts a legal battle steeped in racism and must decide whether to play it safe or speak out against injustice.

• Turk Bauer – A militant white supremacist and the grieving father of baby Davis. Turk is deeply entrenched in racial hatred, shaped by personal trauma and the ideology instilled by his violent past. Over the course of the novel, his perspective evolves, revealing layers of grief, indoctrination, and ultimately, a potential for redemption born of overwhelming personal loss.

• Kennedy McQuarrie – Ruth’s public defender, a white lawyer who prides herself on being “color-blind.” Initially focused on winning the case by avoiding the subject of race, Kennedy undergoes a transformation as she recognizes the depth of her own privilege and the necessity of confronting systemic injustice head-on.

• Brittany Bauer – Turk’s wife and the mother of the deceased infant. Brittany is portrayed as emotionally fragile and heavily influenced by her husband’s ideology. Her grief and silence further complicate the moral and emotional landscape of the story.

Theme

• Racism and Privilege – At its core, the novel examines overt and covert forms of racism. Through courtroom drama and character introspection, it dissects how privilege operates invisibly for some and how racial bias is deeply embedded in social institutions and interpersonal dynamics.

• Justice and Morality – The legal proceedings raise complex questions about responsibility, ethics, and the pursuit of justice. The narrative probes whether the law serves everyone equally and how truth can be manipulated in a system skewed by prejudice.

• Identity and Transformation – Characters are challenged to reassess who they are and what they stand for. Kennedy confronts her complicity in systemic racism, Turk faces the collapse of his worldview, and Ruth finds empowerment in embracing her identity rather than suppressing it for acceptance.

• Motherhood and Loss – The emotional terrain of motherhood is central to the novel, from Ruth’s fierce protection of her son to Brittany’s devastating grief. These intimate portrayals underscore the human cost of social injustice and the universal depth of a parent’s love.

Writing Style and Tone

Jodi Picoult employs a rotating first-person narrative structure that allows readers to intimately experience the world through the eyes of her three primary characters – Ruth, Kennedy, and Turk. This technique enriches the emotional complexity of the story by presenting multiple sides of a contentious issue. Her prose is accessible yet thought-provoking, blending legal tension with emotional depth and social critique. She uses clear, vivid language and relies on realistic dialogue to make the characters’ voices distinct and authentic.

The tone shifts according to the narrator’s perspective – Ruth’s chapters are contemplative and restrained, marked by a quiet strength and deeply rooted sorrow. Kennedy’s tone starts pragmatic and clinical but gradually grows more impassioned as she awakens to her own limitations and biases. Turk’s voice is the most jarring, steeped in hostility and indoctrination, yet Picoult doesn’t shy away from portraying his humanity. Throughout, the tone is emotionally charged, earnest, and unafraid to confront difficult truths.