Author: Amanda SkenandoreRating: Four out of Four antiseptic bandagesEase Of Reading: 352 pages. Relax because you’re in the hands of a master narrator. Plenty of narrative balls to juggle with no risk of dropping any of them.When To read: After watching several episodes of Grey’s Anatomy and realizing that the history of medicine and women’s role wasn’t simply groping in one of the many supply closets in the hospital.The Nurse’s Secret is one of those novels that reignites the title and subtitle debate. The title, The Nurse’s Secret, alludes to a medical story or even a romance novel. In reality, the novel is both and so much more. The Nurse’s Secret is indeed a medical tale with a romantic piece. But it is also a sharp commentary on the gross inequality of 1880s America in big cities like New York City.Moreover, the novel pokes its stick at male dominance, female submission, medical ignorance, and the birth of a new medical profession.Author Amanda Skenandore is a historical fiction writer by trade and a registered nurse. Her practical expertise and historical chops steer the novel toward dramatic mastery with a ‘pay no attention to the man behind the curtain” skill.Kensington, the book’s publisher, summarizes the book this way: “Based on Florence Nightingale’s nursing principles, Bellevue is the first school of its kind in the country. Where once nurses were assumed to be ignorant and unskilled, Bellevue prizes discipline, intellect, and moral character, and only young women of good breeding need apply. At first, Una balks at her prim classmates and the doctors’ endless commands. Yet life on the streets has prepared her for the horrors of injury and disease found on the wards, and she slowly gains friendship and self-respect.“Just as she finds her footing, Una’s suspicions about a patient’s death put her at risk of exposure, and will force her to choose between her instinct for self-preservation, and exposing her identity in order to save others.”The narrative pacing is deliberate and descriptively dense, yet the author needs to pace the story carefully because the novel operates on so many levels simultaneously.First, the novel introduces the class struggle of the impoverished in the dark recesses of the Gilded Age in New York City in the 1880s. That stark inequality and outward disgust toward the “street people” infects the entire narrative and the mystery.Second, there are the medical components of the story, and they multiply seamlessly. The reader learns about the Florence Nightingale-inspired nursing school at Bellevue Hospital, where only proper woman with distinguished backgrounds can apply. Again, the class warfare invades. Then the reader watches the subjugation of the female nurses and trainees by the doctors, administrators, and society. In that time and place, doctors are incapable of mistakes and never second-guessed.The author slickly injects Joseph Lister and his germ theory, as the English doctor’s theory of antiseptic care was just beginning to take root in the medical profession after years of being ridiculed and rejected.The author then uses his nursing training with great skill to educate the reader as well as Una and her roommate-nurse trainee Dru. That medical knowledge was then used skillfully to advance the medical mystery and ultimately criminal acts.Third, the novel slow churns a budding romance between a young doctor at the hospital and Una, with the suitor unaware of Una’s true, sordid past. That simmering romance links to the oppression of the lower classes and to male domination in society and in relationships at that time.Finally, there is the journey of the main character, Una. Here, Skenandore paints her brushstrokes of Una with painstaking care, compositional excellence and three-dimensional depth. It’s Una’s voice we hear throughout the novel, and the reader is so meticulously drawn into her world that it’s literary immersion at its best.The Nurse’s Secret enabled me to enjoy a medical history tome, a criminal mystery, a romance novel, a socio-economic tract, a female empowerment tale, and the personal growth of a young woman destined like so many others in 1883 to a short, brutish life. The novel is a showcase for a talented author like Amanda Skenandore, and would be fun for readers in either print, ebook or audiobook versions.