In her second historical novel, Frances Ward turns to a new subject: the nineteenth-century origin of a School of Nursing at Harvard. What, she wonders, would have happened at a critical moment in American history if healthcare had been envisioned as something other than disease management? And what would have happened had nursing led the way to a new future in which health maintenance and disease prevention were at the center of the nation’s fastest growing industry?Emerging from the ashes of Civil War, the United States was fast immersing into a gilded age, with hospitals a shining symbol of science.

Fueling what many called the hospitalization of America was a silent infrastructure training schools of nursing, owned by hospitals. Pupil nurses had become a caste unto themselves, working long hours, caring for patients, and undertaking domestic tasks within hospitals.

Their education was inconsistent, always secondary to patient care. For Charles W.

Eliot, this situation simply would not do. As Harvard's 21st president, he was determined to modernize higher education through diverse curricula, including the finest education for physicians, nurses, and dentists.

To achieve having them all at their best, he turned to Alfred Worcester, an alumnus of Harvard’s Medical School, to establish a School of Nursing as the new century began. And Worcester turned to someone so unlikely that she seems herself invented: Annette Fiske, a Radcliffe College graduate of Latin and Greek languages.

Brilliant, resolute, efficient, and determined, Annette galvanizes a dedicated team politically guided by Eliot that forges their goal forward, dismissive of biased nurse leaders’ acrimonious vitriol and capitalizing on themes of national women’s organizations. Becoming a nurse herself, Annette recognizes that education is the foundation of knowledge-based nursing practice—and that knowledge can be provided in any setting, whether in hospitals, communities, homes, or industry.

As Annette becomes the founding dean of the Harvard School of Nursing, we witness the origin of what might have been universal care for all citizens. Ward shows us a future that might have resulted in an American health care system that might have become the envy of the world.

And, if we listen carefully to the lessons of history, might yet be. .