Although Lib has nursed professionally for several years, she does not truly become a nurse until the end of the novel. Having been trained by Florence Nightingale in the wartime conditions of Scutari during the Crimean War, Lib views almost all nursing simply as a means to either help a patient recover physically or, alternatively, to make death as physically painless as possible. Because nurses at Scutari were responsible for so many patients, Lib's perspective on nursing does not allow for any sort of personal or emotional relationship with her patients. When Lib first meets Anna she is concerned almost exclusively with her physical health, and one of the first things that she does upon meeting Anna is write down her measurements because those numbers are a concrete representation of Anna's physical state. Significantly, Lib is acutely distrustful of anything having to do with emotions; each time she thinks something positive about Anna, she forces herself to think of something negative as well. On Lib's second day with Anna, the narrator says, "The girl was charming, in her unworldly way. Lib found it hard to keep in mind that Anna was a trickster, a great liar in a country famous for them."
Significantly, as the novel continues, Lib realizes that if she is to arrive at the truth behind Anna's decision to stop eating she must also learn to understand Anna's emotional needs. This realization catalyzes her quest to understand the motivations behind Anna's decision not to eat. During her first night shift, while Anna sleeps, Lib thinks about Anna's comment that she was living on "manna from Heaven": "It came to Lib then that the question to ask was not HOW a child might commit such a fraud, but WHY." In thinking about Anna, Lib speculates that she does not seem like someone who is being forced to do anything, so in order to find the truth about Anna, she must find out how her mind works. After this realization, Lib Over the course of the novel, Lib gains a much deeper understanding of Anna's thought processes and of the events behind her refusal to eat. Only then can Lib move beyond the physical to care for Anna as a whole person rather than simply as a body.
When Sister Michael refuses to join her in asking Dr. McBrearty to call off the watch because she is "only a nurse,"f Lib snaps at her, "'I was taught the full meaning of that word,'...'[w]eren't you?'" Lib realizes that in order to truly be a nurse in the fullest sense of the word, she must go beyond the parameters of the job for which she was hired and find a way to save Anna.
