Literature Annotations


Carver, Raymond
A Small, Good Thing


Genre Short Story (29 pp.)
KeywordsArt of Medicine, Caregivers, Catastrophe, Communication, Death and Dying, Empathy, Grief, Hospitalization, Illness and the Family, Medical Mistakes, Mourning, Parenthood, Professionalism
Summary

This story concerns the death of a child and failures of communication. Scotty, an eight year old, is hit by a car on his birthday. His mother had ordered a birthday cake but "there were no pleasantries between" her and the baker. Scotty is hospitalized, unconscious, and the cake is forgotten. Dr. Francis reassures the anxious parents that all will be well when the boy wakes up.

The baker phones the parents’ home in the dead of night (when he does his baking) because the cake hasn’t been picked up, but they can’t figure out who he is or what he wants. At the same time the doctors and staff can’t and won’t answer their questions about why Scotty isn’t waking up. Dr. Francis comes to the hospital to check the child, looking tanned, meticulously dressed, as if he has just been out for the evening- he has a life outside of the hospital, but the parents have none. When they do run home, separately, to take a break, the baker torments them with his mysterious late-night calls. Their confusion and isolation deepen. The child dies-"a one-in-a-million circumstance."

The mother finally realizes that it is the baker who has been calling and tracks him down, enraged. She unleashes all of the anger which she had been unable to express to the doctors. The baker is stunned to learn about the child’s death; he begs forgiveness and offers them warm delicious cinnamon rolls. "Eating is a small, good thing in a time like this" and they are comforted.

Commentary

Carver’s story captures the excruciating anguish of a parental vigil with a sick child, the sense of helplessness and isolation, and the interplay with the professionals who themselves don’t understand the medical course that this particular case is taking. The baker is also isolated, cut off from daily human contact, but he is able to meet the parents’ most elemental need for nourishment and comfort. (One is reminded of the role that food plays at the end of a funeral.)

Could the staff have behaved or communicated differently? Does professionalism preclude a role as comforter? Should the doctor have admitted his own uncertainty? How much information (bad news) can a patient/family tolerate, and how does a physician make this judgment?

SourceWhere I'm Calling From
PublisherRandom House: Vintage
Edition1989 (paperback)
Place PublishedNew York
Annotated by Aull, Felice
Date of Entry 01/12/95
Last Revised 01/31/97