In Picoults (Leaving Time, 2014, etc.) latest novel, Ruth Jefferson, a labor and delivery nurse, struggles to survive claims of murdering a patient while keeping her own family intact.Picoult has made a name for herself crafting novels of depth and insight, peopled with rich characters and relationships. Here, she explores the intersection of racial bias, medicine, and the law. African-American Ruth Jefferson has been a labor and delivery nurse for more than 20 years, and she's the kind of professional every patient dreams of: she genuinely cares for her patients and takes joy in seeking out ways she can help themwhether it be a back rub or an epidural. But Ruth is completely thrown when a newborn babys parents, both white supremacists, demand that she be removed from their care team because they don't want a black person touching their child. In a moment of deliberate plot maneuvering, Ruth is left as the sole nurse on the childs floor, and the baby goes into cardiac arrest and dies. Ruth, accused of hesitating before performing CPR, is charged with murder. There's no question that Picoult is a talented writer. The plot is suspenseful, the structure and pacing exquisite. But there is also no question that writing a story from the perspective of a black woman requires more racial consciousness than she displays here. At times the plot feels more like an intellectual exercise to understand racism than an organic exploration of a real person's life. The voice is that of a nonblack person discovering all at once that racism exists rather than that of a black person who has lived with racism her whole life. Picoult has drawn upon every black stereotype available: here is the black single mother, the angry black woman, the mammy, the maid, the teenage "thug," the exceptional token, and the grandstanding preacher. Alternating among the points of view of Ruth; the white supremacist father, Turk Bauer; and Ruths lawyer, Kennedy McQuarrie, Picoult is at her best when she lets the novel solidify into Kennedys narrative, the tale of a white woman who thinks she's more liberal than she actually is. It's Kennedy's journey of coming to terms with her own racist relatives and white privilege, as she realizes, for the first time, the pervasiveness of American racism, that is the real story hereand the novel would have been stronger if it had been written from this perspective throughout. After she sets up a world in which racism thoroughly defines every aspect of character and plot, Picoult's conclusion occurs in a separate fairy-tale world where racism suddenly does not exist, resulting in a rather juvenile portrayal of racial politics in America. Copyright Kirkus Reviews, used with permission.

*Starred Review* Immensely popular novelist Picoult (Leaving Time, 2014) continues to tackle weighty subject matter in her twenty-fourth novel. Ruth Jefferson, a widow with a teenage son, is a labor and delivery nurse and the only African American in her department. When the infant son of two white supremacists, Turk and Brittany Bauer, who have specifically asked that Ruth not handle their child, dies suddenly, Ruth is blamed for the child's death by both the hospital and the child's parents. In quick succession, Ruth loses her license, is dragged from her home by the police in the middle of the night, and is charged with murder. Kennedy McQuarrie, a white female public defender, takes Ruth's case, but her refusal to bring up race in Ruth's defense doesn't sit right with Ruth, given that race is ingrained in the case's DNA, from the Bauers' hateful views to Ruth's supervisor's acquiescence to their demands to Ruth's experience once in the cogs of the justice system. Picoult's gripping tale is told from three points of view, that of Ruth, Kennedy, and Turk, and offers a thought-provoking examination of racism in America today, both overt and subtle. Her many readers will find much to discuss in the pages of this topical, moving book. HIGH-DEMAND BACK STORY: Picoult's gift for taking on sensitive and timely issues in page-turning novels will be duly and energetically celebrated in a many-platformed national publicity campaign.--Huntley, Kristine Copyright 2016 Booklist

Bestselling author Picoult's latest page-turner is inspired by a Flint, Mich., event in which a white supremacist father refused to allow an experienced African-American labor and delivery nurse to touch his newborn. In Picoult's story, a medical crisis results in an infant's death and a murder charge against a black nurse named Ruth Jefferson. The story unfolds from three viewpoints: Ruth's, the infant's father-a skinhead named Turk-and Ruth's public defender, Kennedy McQuarrie, a white professional woman questioning her own views about racism. The author's comprehensive research brings veracity to Ruth's story as a professional black woman trying to fit into white society, to Turk's inducement into the white-power movement, and to Kennedy's soul-searching about what it's like to be black in America. Unfortunately, the author undermines this richly drawn and compelling story with a manipulative final plot twist as well as a Pollyannaish ending. Some may be put off by the moralistic undertone of Picoult's tale, while others will appreciate the inspiration it provides for a much-needed conversation about race and prejudice in America. (Oct.) © Copyright PWxyz, LLC. All rights reserved.

IN A VERY earnest author's note at the end of her latest novel, "Small Great Things," Jodi Picoult says that she has long wanted to write about American racism. Picoult is savvy enough to make her position as "white and class-privileged" known from the start. She details the rigorous research she did, the people she talked to, including women of color and skinheads. Of the former, she said: "I hoped to invite these women into a process, and in return they gave me a gift: They shared their experiences of what it really feels like to be black." There is also a lot of introspection about her presumed audience (white people) and her own racism. She ends the note acknowledging that talking about racism is difficult but that "we who are white need to have this discussion among ourselves. Because then, even more of us will overhear and - I hope - the conversation will spread." Picoult certainly seems to have the best of intentions. The question is whether good intentions translate into a good novel. "Small Great Things" is, in most ways, a classic Jodi Picoult novel - tackling contemporary social issues, creating interesting, relatable characters and presenting a gripping courtroom drama. Ruth Jefferson, a black woman with a teenage son, has been a labor and delivery nurse for more than 20 years when the white supremacists Turk and Brittany Bauer come to her maternity ward for the delivery of Brittany's first child, a boy named Davis. Turk demands that Ruth have no interaction with the baby - but when the ward is short-handed, Ruth finds herself alone with Davis just as he stops breathing. In that moment, Ruth has to decide whether she should heed her humanity and her oath as a nurse or follow the orders she has received to stay away from the Bauer baby. In the end, Ruth does both, but cannot prevent serious consequences. The parents, as you might expect, need someone to blame. In short order, Ruth's nursing license is suspended. She is charged with felony crimes, and her fate lies in the hands of the public defender Kennedy McQuarrie, a white woman. Picoult knows how to tell an interesting story, and the novel moves briskly. 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. "Small Great Things" particularly shines when Picoult writes from Turk Bauer's point of view. She makes this man with loathsome ideologies flawed but human. He is a white supremacist, but he is also a husband and father. We see his anger and impotence, and as the story unfolds, we see how he learned to hate, how he met and fell in love with Brittany, how avenging his son becomes his singular motivation. At times, Turk's story feels like a history of the modern white supremacy movement, but given the current political climate it is quite prescient and worthwhile. Then there is Kennedy, Ruth's public defender, married to a surgeon who (of course) seems to be the perfect man. They have one child, a daughter who is (of course) adorable and precocious. Kennedy is harried, but (of course) a loving and well-loved wife and mother. By the end of the novel, she becomes a proxy for well-meaning white folk who don't realize the extent of their racism until they are forced to confront it. Kennedy's evolution quickly becomes too contrived and convenient. There is even a moment in her closing arguments during which Kennedy says: "When I started working on this case, ladies and gentlemen, I didn't see myself as a racist. Now I realize I am." Girl, I guess. When it comes to race itself, the novel stumbles. Its least believable character is Ruth. Her blackness is clinical, over-articulated. I certainly appreciate the research Picoult did and the conversations she had, but research does not necessarily translate to authenticity. Ruth and her sister, Adisa, were raised in Harlem by a single mother who works as a maid for a wealthy white family. Ruth is light-skinned and Adisa darker. (Nee Rachel, Adisa had an awakening in her 20s and changed her name to get in touch with her African roots.) Now Adisa is the militant one while Ruth is more open to integration. The more we see of Ruth and her family, the more their characterization feels like black-people bingo - as if Picoult is working through a checklist of issues in an attempt to say everything about race in one book. Colorism, professional discrimination, segregation, the challenges of black ambition, microaggressions, the welfare system, negotiating predominantly white spaces, the boundaries of authentic blackness and, of course, race and the justice system: Bingo! There are references to Trayvon Martin's killing and the tennis player James Blake's mistaken arrest (though Blake, inexplicably, becomes "Malik Thaddon"). There is a stand-in for Al Sharpton, one Wallace Mercy: "His wild white hair stands on end, like he's been electrocuted. His fist is raised in solidarity with whatever apparent injustice he's currently championing." Bingo! 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. During Ruth's trial, it's clear that the courtroom is where Picoult feels most comfortable. We are treated to pages and pages of legal discovery and testimony. At times, it starts to feel like reading court transcripts - but to be fair, they are very interesting court transcripts. Turk and Brittany Bauer show up, and Brittany, racked with grief, makes the occasional outburst from the gallery. Ruth's son starts to struggle with his mother's precarious position and the revelations of the trial. There are more legal maneuvers. And then there is the ending, with a twist that is so unexpected and so over-the-top that it undermines what is, on the whole, a compelling and well-intended novel. Truly, the twist still has me shaking my head because I understand the why of it while recognizing that Picoult has crossed a bridge too far. From there, the ending is breathlessly rushed, with revelations, resolutions and epiphanies. It is, in the end, the author's note that leaves me feeling generous toward "Small Great Things" despite its shortcomings. Picoult wanted to write about race in contemporary America, and she does. The novel is messy, but so is our racial climate. 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. 'I didn't see myself as a racist,' a character says. 'Now I realize I am.' ROXANE GAY'S new story collection, "Difficult Women," will be published in January.

Ruth Jefferson is great at her job. She's an experienced labor and delivery nurse who not only knows how to guide women through labor, but also understands postdelivery needs such as a shoulder to cry on and lipstick. But her career and life change forever when she hesitates before helping a baby in cardiac arrest. Why would a nurse pause to help a patient? Ruth is African American and the baby's white supremacist parents don't want her touching their child. The hospital tells Ruth to comply with the parents' wishes, but when she's the only available nurse, should she follow orders or try to save the newborn's life? Told from the points of view of Ruth, her white public defender, and the white supremacist father, the novel digs into the issue of race. Picoult (Leaving Time; The Storyteller) delivers what her fans expect with a controversial topic that includes plenty of courtroom drama and a surprise twist. The novel is well researched, although it raises the question: can a person of one race write authentically about being another race? VERDICT Recommended for Picoult fans and book clubs that don't shy away from serious discussions. [See Prepub Alert, 4/25/16; 15-city tour.]-Amy Stenftenagel, Washington Cty. Lib., Woodbury, MN © Copyright 2016. Library Journals LLC, a wholly owned subsidiary of Media Source, Inc. No redistribution permitted.