November 23, 1998

There’s a disappointing moment in Anna Quindlen’s One True Thing—a novel, now a movie—about a young woman who leaves her magazine job to care for her dying mother. It’s when the bright, Harvard-educated daughter, who has witnessed the skill and empathy of a wonderful hospice visiting nurse, decides to become a physician. I was reading the book alone, and I gasped out loud in shock and frustration.

Ellen Gulden, the daughter, sees firsthand what an incredible difference a nurse, Teresa, makes in her family’s ability to cope with her mother’s impending death.

Teresa is everything a nurse should be. She’s direct, compassionate, smart, effective. In one breath she talks about the patency of the IV catheter site, side effects of codeine, and fatigue. And then she addresses the bigger issues. For instance, Ellen says to Teresa: "I wish I could just take your stethoscope and listen to [my mother’s] heart. Really her heart, not the beating, but inside."

Teresa takes the stethoscope from her bag, hands it to Ellen, and says: "Maybe it will help. Any intimacy will help. I can get another one."

Another time, when Ellen’s friend calls to talk and lend support, Ellen describes the nurse to her this way:

"She’s like a combination shrink-priest … She talks to me. She keeps me sane. Sometimes I wonder which of us is her patient, actually. You and she are my links to the outside world. Or maybe you’re my link to the outside world and she’s my link to the inside world."

Then Ellen decides to become a physician. A shrink, no less. And come to think of it, I know why.

It’s the same reason that I cannot find a 12-year-old anywhere who wants to be a nurse. It’s why there isn’t a nurse at my daughter’s middle school’s career fair. It’s why none of my son’s friends—male or female—are aspiring to a career in nursing: The bar’s too low.

Since all you need is an AA degree to become a nurse, and because this generation of 12-year-olds are being told they must go to college, they are aiming higher. Parents of kids who are doing well in school aren’t encouraging them to consider nursing. They’re talking medicine, law, business, and computer science.

The girls are being told that if they’re smart, they don’t have to settle for traditional careers. The sky’s the limit. As it should be. But the career counselors don’t talk about the incredible opportunities in nursing; all they know is the vast majority of nurses don’t have a bachelor’s degree.

I was thinking about calling Anna Quindlen to ask her why she didn’t have this Harvard grad who was so impressed by the nurse become one. And then I realized it just wouldn’t have been believable. After all, if fiction doesn’t seem real, it’s nothing. Quindlen chose to make Ellen do what we readers would most believe she’d do in real life. And that’s too bad.

What do you think?

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