Small Great Things” is the most important novel Jodi Picoult has ever written. Frank, uncomfortably introspective and right on the day’s headlines, it will challenge her readers.

(Ballantine)

The protagonist, Ruth Jefferson, has been a labor and delivery nurse for more than 20 years. She’s a widow — her husband was killed while serving in Afghanistan — and her son, Edison, is an honor student. She’s also an African American living in a very white area of Connecticut and is the only black staff member in the maternity ward of the hospital where she works.

To survive in that white world, Ruth has convinced herself that race doesn’t matter. “I treat people the way I want to be treated,” she says, “based on their individual merits as human beings, not on their skin tone.” So when white supremacists Turk and Brittany Bauer refuse to allow Ruth to care for their newborn and the hospital acquiesces, she is shocked.

She obeys, but when the baby stops breathing, Ruth is the only person in the room, and she is charged with the child’s death.

That crisis rips the scales from Ruth’s eyes, and suddenly she recognizes the racism and microaggressions she previously accommodated or ignored: the woman who moves her purse when Ruth comes close, a co-worker who marvels at Edison’s academic success, the patient who assumes a young white nursing student is Ruth’s supervisor. “Have I really never noticed these things before?” Ruth wonders. “Or have I been very studiously keeping my eyes shut?”

Ruth’s attorney, Kennedy, is a stand-in for Picoult and many of her regular readers: a well-intentioned white woman who had never been challenged to face her own internalized prejudice. Of the several narrators in this novel, she’s the least engaging, but her conversations with her husband provide occasional comic relief in a story that can feel unrelentingly bleak.

Ruth moves from colorblind to racial-awareness advocate rather too quickly. Two-thirds of the way through the novel, she’s earnestly correcting a friend: “Slavery isn’t Black history. It’s everyone’s history,” then assures him, “In your defense, you probably don’t talk about it quite as much as I do.” But such heavy-handedness never diminishes the story’s greater truth.

In an earlier novel, “Sing You Home” (2011), which dealt with gay rights, Picoult was called out for her cartoonish portraits of the religious right, the book’s villains. But here, she draws a believable and often sympathetic portrait of Turk Bauer, despite his abhorrent racist views. After his brother was killed in a car accident, Turk blamed the other driver, an African American, for both his brother’s death and the ensuing collapse of his family. Flamed by a member of a white-power group, Turk’s anger grew into indiscriminate prejudice and hatred, though he wrestles with the absolutism of his beliefs.

Author Jodi Picoult (Deborah Feingold)

The care that Picoult bestows on Turk’s backstory is a thoughtful exploration of the idea that even the most reprehensible beliefs can have roots in powerful emotions such as fear or anger, which have no obvious cure. But the emotion that drives Turk and Brittany for the bulk of the story is not hatred but wrenching grief. Having spent their lives confronting every obstacle with anger and violence, they are helpless after the death of their child. Even their blaming of Ruth feels pro forma. Turk’s despondency over the loss of his son, combined with his fear of losing his wife as she slides into near-catatonic grief, provides some of the novel’s most powerful moments. His plight is so human, his mourning so understandable, that it is startling when he reminds us of his belief in the superiority of the white race.

In a forthright author’s note, Picoult says this novel represents her grappling, as someone “white and class-privileged,” with issues of racism, both individual and institutional. “I was writing to my own community — white people — who can very easily point to a neo-Nazi skinhead and say he’s a racist . . . but who can’t recognize racism in themselves.” That difficult self-awareness is what sustains the book when the story sags, forcing engaged readers to meditate on their own beliefs and actions along with these characters.

Yes, “Small Great Things” is overly long, with a meandering middle, a tendency toward melodrama and a rushed ending that feels glib. And Picoult will be fairly criticized for choices she’s made in her representations of people of color and an oversimplification of complex issues. But it’s also exciting to have a high-profile writer like Picoult take an earnest risk to expand our cultural conversation about race and prejudice.

Eleanor Brown’s most recent novel is “The Light of Paris.”

On Oct. 26 at 6:45 p.m., Jodi Picoult will be at the National Museum of Natural History in conversation with NPR’s Lynn Neary. For tickets, call 202-633-3030 or visit smithsonianassociates.org.

Small Great Things

By Jodi Picoult

Ballantine. 467 pp. $28.99