Ruth was delighted when she was accepted into the nursing school at Kingston General Hospital. But she didn’t realize how challenging it would be. She quickly finds her skills aren’t up to snuff and is sent to build them up as an aide at the local tuberculosis sanitarium.
It’s 1946, and when Ruth arrives, she is immediately surrounded by crowds of wounded and infected soldiers, women, and children. 
Ruth must find her way among the dying, depressed, and too-friendly patients, managing demanding doctors and a jealous mentor, without being sent home or infected. Can she impress her seniors and be readmitted to the nursing program she so wants?

Thanks to LibraryThing ,  author DA Brown, and Somewhat Grumpy Press for this advanced reviewer’s copy!

SPIT AND POLISH is a captivating historical fiction novel that transports readers to Canada in 1946, where aspiring nurse Ruth dreams of escaping her small-town life and making a difference. Accepted into Kingston General Hospital’s nursing school, her initial excitement crumbles as she struggles with the demanding coursework. Sent to gain experience at a local tuberculosis sanatorium, Ruth is confronted with the harsh realities of illness, death, and prejudice. Surrounded by wounded soldiers, desperate families, and a complex medical environment, she must navigate challenges while honing her skills. Ruth needs to find her strength, compassion, and the resilience to succeed.

The sanatorium, teeming with wounded soldiers and civilians battling the debilitating disease, paints a stark picture of the era’s healthcare realities. The facility fairly overflows with wounded soldiers, women, and children battling the debilitating disease. Ruth grapples with the emotional and physical demands of caring for, and witnessing firsthand, the suffering and resilience of her patients. Ruth must also navigate navigate dormitory life, avoid flirting soldiers, and handle the draining emotional complexities of her family back home. The author skillfully portrays the harsh realities of the medical setting, balancing it with moments of tenderness and compassion. It is easy to empathize with Ruth’s internal struggles as she confronts her own limitations and prejudices. Her journey is one of personal and professional development, and it is satisfying to see her initial naiveté transform into empathy, strength, and self-assuredness as she faces challenges head-on.

Brown immerses the reader in the post-war atmosphere of Canada, capturing the social anxieties, medical advancements (and limitations), and evolving societal roles of women. The struggles of returning soldiers and the stigma surrounding tuberculosis are woven seamlessly into the narrative.

Ruth’s growth is relatable and engaging, and the supporting cast, from other nursing students to her domineering father, adds depth and nuance. The initial chapters do move a bit slowly as the setting and characters are established. I would have liked to see some of the secondary characters (such as Patricia, Mrs. Graham, and Mary) fleshed out some more. This information might have given some more backstory and understanding of their behavioral quirks and motivation.

One thing that was a bit jarring to me were the short paragraphs of medical notes that began each chapter. One was a quote from 1947, quite a few were from Florence Nightingale’s NOTES ON NURSING, and there was one from 2018 quite early on in the book. While I appreciated the “insider information”, I spent a few minutes trying to figure out if the quote was supposed to reflect the tone of the chapter or not. Some were relevant, while others seemed random to me. I did like the idea of headers to each chapter, but I think they would work a lot better if the words tied in with each chapter’s vignette. Another option would be to let the reader know that the paragraphs at the beginning of each chapter are taken from  either various authors who are sharing their thoughts on nursing, or excerpts from textbooks that will give the reader background on how TB was treated back then, etc. That would set an expectation for the reader, allowing them to absorb the information, then move seamlessly into the storyline.

SPIT AND POLISH offers a captivating journey through a unique historical setting. Brown’s well-researched narrative sheds light on the challenges and triumphs of mid-century healthcare, while Ruth’s personal growth resonates with themes of ambition and compassion. The novel delves into the emotional toll of caring for the sick and dying, yet the harsh realities of the sanatorium are balanced with moments of tenderness and hope, creating a nuanced portrayal of human resilience. Throughout the book, the importance of human connection in the face of adversity is underscored – a lesson we can all learn from in today’s world.

Readers interested in historical fiction with strong female protagonists and a touch of medical drama will find this book satisfying. One caveat: be aware of the potential for emotional intensity due to the setting and subject matter.

Want your own copy? You can pick it up here.