Any woman who has been a nurse knows that her sainted sisters in literature, movies and TV are idealized virtually beyond recognition. Saints they may be, but the lives of real nurses are not so much inspiring or uplifting as they are mean, exhausting and thankless.

It takes one to know one. So Carol Gino, a 40-year-old registered nurse with 16 years of experience, has written an autobiographical novel so candid and gritty that it may shatter the old stereotypes forever. The Nurse’s Story, Gino’s first book, has been grabbed as an alternate by both the Macmillan and Book-of-the-Month clubs and is heading toward the best-seller list, while Gino herself is finding that darting around the country on the personal-appearance circuit is easily as wearing as hospital work.

So steeped in reality is The Nurse’s Story (Linden Press/Simon and Schuster, $14.95) that to call it fiction seems scarcely adequate; the story bristles with details and case histories that only experience could have provided. Teri Daley, the narrator, is grossly underpaid and overworked, burdened with responsibility but little authority, yet often held accountable for the blundering of doctors. In harrowing, sometimes gruesome passages still fresh with pain, Teri ministers to patients so disfigured with cancer or burns that they barely resemble human beings, while other patients are so psychotic, tragically terminal or deformed that only sheer guts and bottomless compassion can see her through the long days and nights. Rocked by her own implosions of grief each time a patient dies, she finds the mundane quality of her own life mocking and barely tolerable.

Carol Gino led such a life. “There was a tornado of death and disease sweeping around me constantly,” she says of her years of nursing in a variety of Long Island hospitals. “I found myself living with fear all the time. I faced my own mortality every day. It’s like being in a war, having your buddies blown apart right next to you. I moved out of the mainstream of living and developed a wartime mentality. If something was not measured by life or death, I would refuse to consider it important.”

Her patients’ heroism and a support group of nurses pulled Gino through her dark periods and reinforced her belief that serious flaws exist in the medical profession. “I think there’s a whole cadre of nurses out there who feel the way I do and they’re just waiting for somebody to articulate it,” Gino says. “In 1980, I watched David Susskind and five nurses talking on TV about these problems. Most of the nurses were hidden in shadows and using filtered microphones to distort their voices. The conspiracy of silence, the omertà, does not only exist in the Mafia.”

To rid herself “of all these people tramping through my mind,” Gino started writing short stories in 1977, seated at night by her patients’ bedsides. After attending writers’ workshops, she sold pieces to New York magazine and the Chicago Tribune, among others. At the same time, Gino began doing private nursing. One of her patients, in 1978, was Erika Puzo, wife of Mario, the author of The Godfather. At age 57, Erika was dying of cancer, and Gino’s job was to see her through the terrible months to the end. After Erika died that year, Gino began showing her work to Mario. He was so impressed with her writing that he urged her to write a book. Puzo explains, “She’s a natural storyteller who looks upon her characters uncensoriously, and she’s able to find the humor in the most terrible situations.”

It was almost inevitable that Mario and Carol would become romantically involved. He introduced her to his literary agent and continued to encourage her. Still, Gino had a writer’s mind of her own. “The more she worked on the book, the less she listened to me,” he observes. “But I’m very proud of her. I think her book would be a hell of a movie if they did it right. It’s like those old Clark Gable and Spencer Tracy movies that are all about male bonding. I’d like to write the screenplay.” There may indeed be a film. Hollywood is nibbling at the possibilities, and if it bites, Puzo and Gino may work on the screenplay together.

It was not dreams of Hollywood but law and teaching that first beckoned Carol. The older of two daughters of a kitchen cabinet salesman father and floral designer mother, she was raised in conventional, middle-class Amityville, Long Island. In 1959, shortly after high school, she put aside career notions and married a baby food salesman. She provided two customers for his product before divorce sent her into nursing in 1966. A second marriage in 1975 to a psychology professor also ended in divorce. Her daughter, Teri, 22, who is married to a photographer, recently had a baby, and Gino’s son, Danny, 18, works as a printer’s apprentice and lives at home in an Amityville duplex with his mother and her divorced sister, Barbara.

When Gino began writing The Nurse’s Story in 1979, between private duty stints, Barbara assumed the household chores and retyped the 750-page manuscript through all its revisions. “Barbara took care of me. I was like the husband,” Gino laughs. “I’d write for 15 hours a day in two-week spurts. I smoked so many cigarettes and drank so much tea that I had heart palpitations and shook like somebody in The Exorcist.” She worried that Puzo might feel threatened if her book succeeded. “Mario got a big kick out of that,” she reports. “He’s at the age now when he is thrilled to death over a woman who is solvent and independent. I think he’s really a feminist hiding in an old Italian ginzo uniform.” Perhaps, but Puzo admits he sometimes envies Carol’s patients. “She is really terrific but you have to be seriously ill to get her attention,” he grouses. “If you just want a little tender, loving care or feel a little sick, forget it. You have to be terminal to get her sympathy.”

Gino now intends to tackle another book—and resume nursing. “Writing feeds the introvert in me and nursing feeds the extrovert,” she says. “Unless I’m doing both, I suffer from the loss of either one.” Her only other passions are Eastern philosophy and yoga. “It’s funny about goals. I worked so long as a nurse that I never plan for tomorrow. I don’t have any other burning desires. There’s nothing material I want—it all seems so transient. That’s not Buddhist philosophy. That’s a nurse’s philosophy.”