Small Great Things

by

Jodi Picoult

Small Great Things: Chapter 4, Ruth Summary & Analysis

Summary
Analysis
After Marie sends Ruth out of the Bauers' room, Ruth and Corinne joke about how Turk is a real winner. Ruth knows that Turk isn't just silly; he's racist, judging by his Confederate flag tattoo. Corinne suggests that Marie will be able to fix it, but Ruth thinks that she'll only be able to do that by making her white. Ruth runs to the cafeteria for coffee. She thinks about how she doesn't have a problem with the white people she lives and works with, but they're not overtly prejudiced. Ruth notices an old lady struggling with the cream pitcher. When she sees Ruth approaching she grabs her purse, even though she smiles at Ruth when Ruth helps her with the pitcher. Ruth tries to shake it off, reminding herself that it's her sister Adisa who sees the worst in everyone, not her.
Because Ruth is black, Turk's racism and his tattoo are much scarier and more dangerous for her than they are for Corinne, who is white and therefore not at as high of a risk of experiencing hate crimes or discrimination. Ruth's comment that she doesn't have a problem with her white friends suggests that she's doing her best to fit in to her community, as doing so is the easiest way to deal with the possibility that Marie might make a racist decision here.
Themes
Racism: Hate, Fear, and Grief Theme Icon
Institutional Racism Theme Icon
Belonging and Community Theme Icon
Ruth checks Brit and Davis's charts when she gets back but finds a sticky note in Davis's folder reading that no African-American staff are to care for him. Ruth angrily finds Marie and confronts her about it. Marie encourages her to think of it like a religious preference and to be happy that she doesn't have to deal with Turk, but Ruth notes that she's the only person who's being discriminated against.
Again, Marie saw that discriminating against Ruth was easier than fighting Turk on this, which suggests that it's often more difficult to be not racist than to be racist—the system is biased, and it’s always easier to go along with the system than struggle against it. This indicates to Ruth as well that she shouldn't trust her white community as much.
Themes
Racism: Hate, Fear, and Grief Theme Icon
Institutional Racism Theme Icon
Belonging and Community Theme Icon
Ruth says that once, a Muslim couple came to the hospital to have their baby. The father explained that he needed to be the first one to speak to the baby. Ruth promised to try, but in an emergency, she'd need to speak to save the baby's life. The parents consented and after the baby was born, Ruth handed him to the father. The man whispered to the baby in Arabic, handed him to his wife, and the silence ended. Later, Ruth asked the man what he whispered to his son. The man explained that Islamic tradition states that the first thing a baby should hear is a prayer. Ruth thinks that the difference between the man and Turk is the difference between love and hate.
This story very clearly draws out the differences between religious preferences and overt racism—and notably, this father was willing to concede that in an emergency, his child's life was more important than his religious beliefs. This shows that this man, unlike Turk, recognizes that love, kindness, and making sure that his child can receive care is of the utmost importance. Davis will now be at risk because one of the nurses on the floor can't care for him.
Themes
Family and Shared Humanity Theme Icon
As Ruth and Corinne prepare to leave that afternoon, Corinne asks what happened with the Bauers. When Ruth says that Marie took her off because she's black, Corinne insists that there must be more to it and that Marie wouldn't do that. Ruth feels as though it's unfair to be angry with Corinne, but Corinne will never understand. She turns down Corinne's invitation to get a glass of wine and, when the elevator opens and reveals a sea of white faces, Ruth thinks she's tired of being the only black nurse. She takes the stairs.
Corinne's unwillingness to take Ruth at her word suggests that she doesn't see herself or Marie as racist—like Marie, she's trying to make it seem like this isn't racially motivated. However, when she does this, she effectively tells Ruth that what Ruth experiences and knows to be true isn't interesting or worth listening to, which in turn alienates Ruth.
Themes
Institutional Racism Theme Icon
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Mama taught Ruth to read before she turned five. At that point, Ruth and Rachel got accepted to a prestigious public school on the Upper West Side, but the bus ride was draining for everyone and Rachel didn't like school. The girls returned to their Harlem school for a year and then Ms. Mina got Ruth an interview at Dalton, Christina's private school. Ruth earned a full scholarship and though she did well, she didn't fit in at Dalton or in Harlem. She later got accepted to Cornell, and people whispered that it was because she was black. Ruth took the full ride to SUNY Plattsburgh because she couldn't afford Cornell, and listened to Mama's advice to show everyone that she's Ruth, not just a black girl.
The whispers that followed Ruth throughout her childhood and young adulthood show how black people are unfairly thought to be less smart or less worthy than their white counterparts. The comment about Ruth's admission to Cornell is a direct reference to Affirmative Action policies, which some white people believe unfairly give spots to minority students in the name of diversity when those students aren't actually deserving.
Themes
Institutional Racism Theme Icon
Ruth decided early on to try to save Edison from the troubles she faced, so she and her husband Wesley moved to an affluent white neighborhood in time to enroll Edison in preschool. Edison is now a National Merit Scholar. When Ruth gets home from work, she greets Edison and teases him about leaving his jacket lying around. Edison explodes and runs to his room. Ruth takes a deep breath and has a glass of sour wine from a bottle Marie gave her. She gives Edison some time to cool down, and then knocks on his door.
The fact that the wine from Marie is sour and unpleasant casts it as a symbolic representation of Ruth and Marie's relationship: supposedly positive, but actually unpleasant. Ruth and Wesley's choice to move to a white neighborhood shows they believe that Edison feeling a part of his community is extremely important.
Themes
Institutional Racism Theme Icon
Belonging and Community Theme Icon
Quotes
Edison explains that he got into an argument with his best friend Bryce. Edison has been on vacation to Greece with Bryce's family; this is unusual. Ruth notices that Edison is crying. He finally explains that when he approached Bryce about helping him orchestrate an elaborate ask to homecoming for Bryce's sister, Bryce said that their parents wouldn't be pleased if she dated a black guy. Ruth tries to comfort Edison and thinks of Wesley, who died in Afghanistan.
What Edison experienced is the line that black people run up against: he was accepted by Bryce's family as a friend, but if he were their daughter's boyfriend, they'd have to accept that he's actually a real person with feelings and emotions. Refusing to let him be more than a friend is a way to keep Edison down and ignore his humanity.
Themes
Racism: Hate, Fear, and Grief Theme Icon
Institutional Racism Theme Icon
Family and Shared Humanity Theme Icon
Ruth asks Edison if he remembers a preschool classmate who insisted that Edison looked like black toast. Then, she'd told him that he just has more melanin, which means he's better protected against sun damage. She reminds Edison of this, but Edison says he doesn't feel lucky.
Ruth's pep talk tries to convince Edison that racism doesn't hurt as much as it clearly does, but Edison's answer suggests that he's becoming aware that the world isn't as welcoming to him as Ruth wants him to think.
Themes
Racism: Hate, Fear, and Grief Theme Icon
Institutional Racism Theme Icon
Ruth says that she and her sister look nothing alike. Rachel is dark like Mama, but Ruth is much lighter. This meant that strangers were nicer to her, which drove Rachel crazy. Rachel once tried to convince Ruth that her father was white, which isn't true. In her twenties, Rachel embraced her "ethnic roots," and changed her name to Adisa. She now lives in a shady neighborhood in New Haven, has five kids, and works a minimum wage job. Ruth can't understand Adisa's choices and wonders if Rachel turned herself into Adisa to feel as though she had a chance.
While Ruth's proverbial chance came thanks to her education, she implies that Rachel's chance came to her when she decided to embrace her identity as an African-American woman of slave descent. When Ruth insists that Adisa chose to embrace these stereotypes, it suggests that she doesn't fully appreciate how black people who aren't so focused on academics aren't afforded advantages like Ruth was.
Themes
Belonging and Community Theme Icon
Friday is Ruth's day off, so she meets Adisa at the nail salon. Adisa gives Ruth a hard time for choosing the "whitest" color, an orange called Juice Bar Hopping. She insists that being taken off of Davis's case is what black people deal with every day and says that Ruth's forgotten that she's black. Adisa surprises Ruth by saying that what happened wasn't her fault, but says that white people still rule the world. Ruth lists several successful black people and then names Clarence Thomas, whose skin is darker than Adisa's. Adisa jokes that he probably bleeds white, given how conservative he is.
Though Ruth is able to list several successful black people, the number of successful and well-known movie stars, politicians, and singers who are black still doesn't come to close to the number of white people filling similar roles. To take the example of Clarence Thomas, though he's a successful Supreme Court justice, at the time of the novel's writing he's still the only black man to hold such a high position.
Themes
Institutional Racism Theme Icon
Ruth gets a phone call from Lucille, asking if she'd trade shifts with her and work a double shift tonight rather than working all day Saturday. Ruth agrees, excited to have Saturday to spend with Edison. Adisa insists that they shouldn't be asking Ruth for favors, but the nail technician interrupts.
Adisa's desire to see that Lucille is taking advantage of Ruth suggests that she is on high alert for instances of racism, though Ruth's narration doesn't betray any overt racism in their exchange.
Themes
Racism: Hate, Fear, and Grief Theme Icon
Institutional Racism Theme Icon
Ruth is sorry she switched with Lucille within minutes of getting to work. A storm means that women are going into labor early, and the hospital is busy. Ruth does check Davis's chart to make sure that he's going to see the pediatric cardiologist and then gets whisked away to a new patient, Eliza. Ruth gets her settled and as she begins an exam, notices that Eliza seems afraid to be touched. Ruth sends Eliza's husband on an errand and throughout the night, Eliza confides in Ruth that she's pregnant because she was raped. Her husband doesn't know. Hours later, Eliza gives birth to a tiny girl. Eliza cries and won't look at the baby until Ruth makes her. The baby looks like a clone of Eliza's husband, and Eliza visibly relaxes.
Eliza's history shows that building a family isn't always something positive and desired—in her case, she believes it was forced upon her. This shows that there are many ways to corrupt Ruth's initial assertion that family and childbirth exposes everyone's shared humanity; Turk's racism isn't the only way. Eliza's willingness to accept her daughter when her paternity seems confirmed offers hope that, despite rough starts, it is possible to recover from this kind of corruption.
Themes
Family and Shared Humanity Theme Icon
Ruth is so busy that she doesn't see Corinne until nine the next morning. Ruth is in the nursery eating a snack when Corinne wheels in Davis for his circumcision. She says that his sugar is still low, but he hasn't nursed in preparation for his procedure. Dr. Atkins, the pediatrician, arrives and asks Ruth if she prepped Davis. Ruth stiffly says she isn't caring for him anymore. Dr. Atkins notices the note in Davis's file and gives Ruth a sympathetic look. Ruth jokes that Dr. Atkins could sterilize Davis as well.
As Davis's file makes the rounds and is seen by more staff, Ruth is made increasingly aware of her liminal position as the only black nurse on the labor and delivery floor. That her discomfort manifests as her sterilization comment is understandable, but it will come back to haunt her later.
Themes
Institutional Racism Theme Icon
Belonging and Community Theme Icon
Twenty minutes later, Corinne is called away from monitoring Davis to go with another patient for an emergency C-section. She asks Ruth to watch him while she's gone, which should only be 20 minutes. Ruth stares at Davis, thinking that babies are blank slates and will take comfort from anyone. Ruth looks up and when she looks back, Davis isn't breathing. Ruth tries to wake him up before remembering that she's not supposed to touch him. She wonders if she'll lose her job, and if it'll even matter if he starts breathing again.
Ruth's thought process shows that with the sticky note, Marie put Ruth in a difficult position: her job and her livelihood are at risk on one hand, while Davis's life is at risk on the other. Her fears of being fired show the ability of racism to sow fear and make Ruth question everything she knows about herself and her job, as it's implied that Ruth wouldn't have hesitated had she not been afraid.
Themes
Institutional Racism Theme Icon
Belonging and Community Theme Icon
Family and Shared Humanity Theme Icon
Quotes
Davis doesn't start breathing. Ruth hastily wraps him up and seconds later Marie comes up behind Ruth. Marie tells Ruth to get an Ambu bag (a breathing aid), call the code, and start chest compressions. Other doctors rush into the nursery and try to resuscitate Davis. Ruth is asked to stop and restart compressions several times. Suddenly, Brit screams—she and Turk are in the nursery, watching. Dr. Atkins arrives and within seconds, Davis's heart stops. As she calls time of death, Turk desperately tries to pull the Ambu bag out of the trash. Corinne arrives as Marie hands Davis's body to Brit. Ruth rushes to the bathroom, vomits, and thinks that if she hadn't hesitated, Davis might still be alive.
It's important to note that when Ruth is told to do her job and join the crash team, she does so without question. She follows orders and is no less invested in saving Davis's life than the other doctors are. When compared with her hesitation minutes ago, this shows how dangerous it can be to tell a nurse like Ruth to not do their job. Racism aside, it means that Ruth's patients are at risk. Davis's death then becomes representative of what can happen when one's racism keeps someone else from doing their job.
Themes
Racism: Hate, Fear, and Grief Theme Icon
Institutional Racism Theme Icon
Ruth recalls a teenage patient whose baby was stillborn. The mother nearly died too. Twelve hours later, the patient's grandmother arrived and wanted to hold the baby. Ruth went to the morgue to get the body, but couldn't bear the thought of giving the grandmother an ice-cold baby. She warmed the baby up with heated blankets, swaddled him, and the grandmother held him for an afternoon. When she was finished, Ruth took the baby back to the morgue. She says the hardest part is removing the swaddling and putting the baby back in the refrigerator.
The description of this great-grandmother and the baby drives home for the reader how compassionate Ruth is, especially when it comes to infant loss. She understands that this can be the worst time of a parent or grandparent's life, and it's her job to ease the pain as much as she can. This then offers a counterpoint to how Ruth would've behaved had she been able to touch Davis.
Themes
Family and Shared Humanity Theme Icon
An hour later, as Ruth prepares to leave, Marie catches her in the staff room. Marie asks for Ruth's version of events for hospital protocol. Ruth says she was covering for Corinne and lies that she noticed Davis wasn't breathing right before Marie arrived. When Marie notes that Ruth wasn't doing anything, Ruth spits that she was doing exactly what she was told to do. Ruth goes to the morgue before she leaves. She holds Davis, prays for him, and says goodbye.
Ruth's decision to go to the morgue and say goodbye to Davis again shows her humanity and her compassion, as she doesn't hold his parents' beliefs against him and believes he's still worthy of love and respect in death. Marie's incredulity suggests that she had no idea her order would have such dire consequences.
Themes
Institutional Racism Theme Icon
Family and Shared Humanity Theme Icon