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  Small Great Things is a work of fiction. Names, characters, places, and incidents are the products of the author's imagination or are used fictitiously. Any resemblance to actual events, locales, or persons, living or dead, is entirely coincidental.

  Because language is a significant mediator of power, status, and privilege, the author has made deliberate choices in the treatment of certain identity-related terms in this book. Variation in capitalization of words like "Black" and "White" is intentional.

  Copyright (c) 2016 by Jodi Picoult

  All rights reserved.

  Published in the United States by Ballantine Books, an imprint of Random House, a division of Penguin Random House LLC, New York.

  BALLANTINE and the HOUSE colophon are registered trademarks of Penguin Random House LLC.

  Library of Congress Cataloging-in-Publication Data Names: Picoult, Jodi, author.

  Title: Small great things : a novel / Jodi Picoult.

  Description: First edition. | New York : Ballantine Books, 2016.

  Identifiers: LCCN 2016023120 (print) | LCCN 2016028842 (ebook) | ISBN 9780345544957 (hardcover : acid-free paper) | ISBN 9780345544964 (ebook) Subjects: LCSH: African American nurses--Fiction. | Criminal defense lawyers--Fiction. | Race relations--Fiction. | Racism--Fiction. | BISAC: FICTION / Contemporary Women. | FICTION Literary. | FICTION Sagas. GSAFD: Legal stories.

  Classification: LCC PS3566.I372 S63 2016 (print) | LCC PS3566.I372 (ebook) | DDC 813/.54--dc23 LC record available at https://lccn.loc.gov/ 2016023120

  Hardcover ISBN 9780345544957

  International edition ISBN 9780425286012

  Ebook ISBN 9780345544964

  randomhousebooks.com

  Book design by Susan Turner, adapted for ebook

  Cover design: Laura Klynstra

  Cover images: Shutterstock

  v4.1

  ep

  Contents

  Cover

  Title Page

  Copyright

  Stage One: Early Labor

  Ruth

  Stage One: Active Labor

  Ruth

  Turk

  Ruth

  Kennedy

  Turk

  Ruth

  Stage One: Transition

  Kennedy

  Turk

  Ruth

  Kennedy

  Ruth

  Kennedy

  Ruth

  Turk

  Kennedy

  Ruth

  Kennedy

  Stage Two: Pushing

  Ruth

  Turk

  Kennedy

  Ruth

  Turk

  Kennedy

  Ruth

  Kennedy

  Ruth

  Turk

  Kennedy

  Ruth

  Stage Three: Afterbirth

  Turk

  Author's Note

  Dedication

  Acknowledgments

  Bibliography

  By Jodi Picoult

  About the Author

  Justice will not be served until those who are unaffected are as outraged as those who are.

  --BENJAMIN FRANKLIN

  THE MIRACLE HAPPENED ON WEST Seventy-fourth Street, in the home where Mama worked. It was a big brownstone encircled by a wrought-iron fence, and overlooking either side of the ornate door were gargoyles, their granite faces carved from my nightmares. They terrified me, so I didn't mind the fact that we always entered through the less-impressive side door, whose keys Mama kept on a ribbon in her purse.

  Mama had been working for Sam Hallowell and his family since before my sister and I were born. You may not have recognized his name, but you would have known him the minute he said hello. He had been the unmistakable voice in the mid-1960s who announced before every show: The following program is brought to you in living color on NBC! In 1976, when the miracle happened, he was the network's head of programming. The doorbell beneath those gargoyles was the famously pitched three-note chime everyone associates with NBC. Sometimes, when I came to work with my mother, I'd sneak outside and push the button and hum along.

  The reason we were with Mama that day was because it was a snow day. School was canceled, but we were too little to stay alone in our apartment while Mama went to work--which she did, through snow and sleet and probably also earthquakes and Armageddon. She muttered, stuffing us into our snowsuits and boots, that it didn't matter if she had to cross a blizzard to do it, but God forbid Ms. Mina had to spread the peanut butter on her own sandwich bread. In fact the only time I remember Mama taking time off work was twenty-five years later, when she had a double hip replacement, generously paid for by the Hallowells. She stayed home for a week, and even after that, when it didn't quite heal right and she insisted on returning to work, Mina found her tasks to do that kept her off her feet. But when I was little, during school vacations and bouts of fever and snow days like this one, Mama would take us with her on the B train downtown.

  Mr. Hallowell was away in California that week, which happened often, and which meant that Ms. Mina and Christina needed Mama even more. So did Rachel and I, but we were better at taking care of ourselves, I suppose, than Ms. Mina was.

  When we finally emerged at Seventy-second Street, the world was white. It was not just that Central Park was caught in a snow globe. The faces of the men and women shuddering through the storm to get to work looked nothing like mine, or like my cousins' or neighbors'.

  I had not been into any Manhattan homes except for the Hallowells', so I didn't know how extraordinary it was for one family to live, alone, in this huge building. But I remember thinking it made no sense that Rachel and I had to put our snowsuits and boots into the tiny, cramped closet in the kitchen, when there were plenty of empty hooks and open spaces in the main entry, where Christina's and Ms. Mina's coats were hanging. Mama tucked away her coat, too, and her lucky scarf--the soft one that smelled like her, and that Rachel and I fought to wear around our house because it felt like petting a guinea pig or a bunny under your fingers. I waited for Mama to move through the dark rooms like Tinker Bell, alighting on a switch or a handle or a knob so that the sleeping beast of a house was gradually brought to life.

  "You two be quiet," Mama told us, "and I'll make you some of Ms. Mina's hot chocolate."

  It was imported from Paris, and it tasted like heaven. So as Mama tied on her white apron, I took a piece of paper from a kitchen drawer and a packet of crayons I'd brought from home and silently started to sketch. I made a house as big as this one. I put a family inside: me, Mama, Rachel. I tried to draw snow, but I couldn't. The flakes I'd made with the white crayon were invisible on the paper. The only way to see them was to tilt the paper sideways toward the chandelier light, so I could make out the shimmer where the crayon had been.

  "Can we play with Christina?" Rachel asked. Christina was six, falling neatly between the ages of Rachel and me. Christina had the biggest bedroom I had ever seen and more toys than anyone I knew. When she was home and we came to work with our mother, we played school with her and her teddy bears, drank water out of real miniature china teacups, and braided the corn-silk hair of her dolls. Unless she had a friend over, in which case we stayed in the kitchen and colored.

  But before Mama could answer, there was a scream so piercing and so ragged that it stabbed me in the chest. I knew it did the same to Mama, because she nearly dropped the pot of water she was carrying to the sink. "Stay here," she said, her voice already trailing behind her as she ran upstairs.

  Rachel was the first one out of her chair; she wasn't one to follow instructions. I was drawn in her wake, a balloon tied to her wrist. My hand skimmed over the banister of the curved staircase, not touching.

  Ms. Mina's bedroom door was wid