Score: 90/100 (9.0 out of 10)
Nurse Florence, What is Endometriosis? is yet another ambitious medical-themed children's book by Michael Dow. This specific book tackles the subject of endometriosis, something which can be a touchy, uncomfortable, or even scary subject to young people enduring or experiencing puberty, specifically girls and young women. However, like asthma (the subject of Dow's previous book), endometriosis isn't a foreign, alien, mysterious thing that only affects a few unfortunate people, it's actually a common condition that affects millions of women around the world—about 10% of the female population! So, realistically, this is a very important subject to a whole lot of people! This book follows Jean, Condi, and Sonia, three curious (some would say precocious) students who frequently appear in this series in one iteration or another. Similarly, Nurse Florence appears, as she does in every book in the series, however, she takes the form of middle-aged Caucasian woman (in the previous books, she was a woman of color). This indicates to us that Nurse Florence isn't necessarily one person but an amalgamation of people who represent and embody Florence Nightingale, the mother of nursing. This version of Nurse Florence addresses a prompt that the girls present her about a problem that only affects women. The nurse is then able to provide a lot of enlightening and invaluable information about endometriosis, a condition in which, during the process of menstruation, tissue like the lining of the uterus leaves the uterus and grows outside of it as scar tissue, causing pressure and pain. The nurse is able to go over six causes of endometriosis: retrograde menstruation, hormones and immune factors causing endometrial-like cells to form outside the uterus, embryonic cells transforming into endometrial-like cells outside the uterus, surgery in the reproductive area, an endometrial cell being transported through a vessel outside of the uterus, or an immune system disorder. She is also able to explain which populations are more likely to get it (such as women who've never given birth, heredity, or people being exposed to estrogen for a prolonged time), different ways doctors test for endometriosis, and some ways to alleviate its symptoms like pain medication and a warm bath. There are also some scary consequences to endometriosis. The one that stood out to us is never being able to have kids. We'd say that this book is decent and provides a lot of important information. It has some issues, however, that have existed since the first Nurse Florence book we read (Nurse Florence, How Do We Grow?). First, the author seems to struggle with storytelling, dialogue, and establishing proper character motivations. Characters need motivations. There needs to be a reason why the characters are so interested about a particular topic. It's awkward and weird when some kids walk up to some lady and ask her to talk to them about an issue that only affects women. Wouldn't it make more sense if one of the girls was just starting to menstruate and was experiencing cramping, so the girls—being good, caring friends—ask the nurse about it? Now, in Nurse Florence, What is Asthma?, the central character, Jean, had a motivation to ask the nurse about asthma, it's because she was suffering from it. In fact, it was affecting her ability to keep up with her friends in physical education and sports. So, we could understand why she would ask the nurse about it. What motivation did these girls have to just randomly sprout this “women's issue” prompt on Nurse Florence? Doesn't that seem forced, contrived, and unnatural? Did they all just have nothing better to do? Kids love to play video games, ride bikes, and compete in sports. Some of them love to read. Most kids don't walk up to a school nurse and ask them to take time out their day to talk to them (presumably for 30-60 minutes) about a condition we have no idea they suffer from or not. There's a quick and easy fix: have a restroom scene, cropping the private parts out (of course), in which one of the characters is menstruating and experiencing pain, perhaps even calling to a friend in another stall about it. That solves this core issue. Another issue is that most people who read this book will be young women who may be experiencing endometriosis and want a solution to help alleviate their pain (and possibly panic). Well, the solutions are relegated to the very end of the book, and they're quite sparse. It might have been better if the nurse had identified the problem one of the girls was having EARLY in the book (perhaps in the first 10 pages) and then was able to get permission from the girl's parents to give her ibuprofen. That's another quick fix. Doesn't that make more sense? A third issue with this book is that the dialogue is still clunky and strange. It isn't formatted properly. When multiple people are talking in dialogue, you're supposed to create a new paragraph for each new line of dialogue. Well, in this book (like the other Dow books we read), all of the dialogue is clumped together in one block of text. This can make it difficult to distinguish between who is saying what. The framing of each of these books is also a bit weird. Instead of us being naturally introduced to characters doing stuff, the author always introduces them like they're in a stage play (and not prose) with a “Background” page that sets the scene. We'd advise against doing this because it's not really a way to endear us to the characters. Instead of having a “Background” page, just introduce us to the characters as they appear and as the action is happening. Nurse Florence, What is Asthma? worked, despite its far inferior illustrations, because it kicked off with the central character actually doing stuff, trying to perform well in P.E. despite a condition affecting her breathing and energy levels. Why couldn't this book have started out in a similar way? Maybe with Sonia experiencing cramps during dodge ball or something. Maybe she doesn't get to first base or home because the cramps are so bad. Isn't that so much more exciting and interesting than three girls finishing class and randomly deciding to ask a nurse a seemingly random question? We talked about the illustrations, and these might be the best in a Nurse Florence book in terms of quality. However, we would argue that the illustrations don't seem to fit the subject and feel of the book. This style would fit more in a more sophisticated book about traveling to Paris or protesting for human rights, but this is a children's book. It's supposed to be soft and smooth. This book is supposed to be covering a rather painful, uncomfortable, and scary subject for girls. However, we're presented with the least comforting, least appealing, and most scary-looking Nurse Florence yet. The other Nurse Florences had soft, inviting, welcoming, and comforting features. This one has wild, red, wiry hair and a million-yard stare that pierces your soul. Most disturbing of all, she has this really creepy, unsettling smile that never goes away, even when she's talking about the frightening consequences of endometriosis. Shouldn't she look a little sad or have a frown while talking about never being able to bear children? At least the three other characters look great, but it's just the same image of them used throughout the book. With that said, again, these are probably the best illustrations in a Nurse Florence book. Lindsay Roberts, the illustrator, is far and away the most experienced (and arguably skilled) artist in the series so far. However, we're not sure if the style really fits the target demographic. It also brings up another issue: there is so much inconsistency and lack of continuity in this series. Every book in this series features a different Nurse Florence, a different Jean, a different Sonia, and a different Coni. Every book in this series features a different artist with a completely different style, usually one that's jarring or clashes with the style of the previous book. Could you image a 23-episode animated series that changed its animation style every episode? Wouldn't that drive you nuts? There is such great information in every book in this series, and the concept is great, but the execution is hit or miss. There are so many ways in which books in this series could be easily improved: have characters with continuity and motivations rather than changing them every time, hire one illustrator with one style to illustrate the whole series, and either write in proper prose or have a skilled, professional ghost writer do it. In film-making, there are people who produce, people who do the screenwriting, and people who direct. Similarly, in publishing, there are writers, editors, and illustrators. It seems to us like this author may be a producer—someone with an awesome idea and concept but who should really put the execution of that idea and those concepts into the hands of people who can make them work. We want to see this series succeed because it covers topics that are important to the health, safety, and education of young people. Check it out on Amazon!
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