My Sister's Keeper (Picoult)

My Sister's Keeper 
Jodi Picoult, 2004 
Simon & Schuster
448 pp.
ISBN-13: 9781439157381


Summary 
New York Times bestselling author Jodi Picoult is widely acclaimed for her keen insights into the hearts and minds of real people. Now she tells the emotionally riveting story of a family torn apart by conflicting needs and a passionate love that triumphs over human weakness.

Anna is not sick, but she might as well be. By age thirteen, she has undergone countless surgeries, transfusions, and shots so that her older sister, Kate, can somehow fight the leukemia that has plagued her since childhood.

The product of preimplantation genetic diagnosis, Anna was conceived as a bone marrow match for Kate—a life and a role that she has never challenged...until now. Like most teenagers, Anna is beginning to question who she truly is. But unlike most teenagers, she has always been defined in terms of her sister—and so Anna makes a decision that for most would be unthinkable, a decision that will tear her family apart and have perhaps fatal consequences for the sister she loves.

My Sister's Keeper examines what it means to be a good parent, a good sister, a good person. Is it morally correct to do whatever it takes to save a child's life, even if that means infringing upon the rights of another? Is it worth trying to discover who you really are, if that quest makes you like yourself less? Should you follow your own heart, or let others lead you? Once again, in My Sister's Keeper, Jodi Picoult tackles a controversial real-life subject with grace, wisdom, and sensitivity. (From the publisher.)

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Author Bio
• Birth—May 19, 1966
• Where—Nesconset (Long Island), New York, USA
• Education—B.A., Princeton University; M.Ed., Harvard University
• Currently—lives in Hanover, New Hampshire


Jodi Lynn Picoult is an American author. She was awarded the New England Bookseller Award for fiction in 2003. Picoult currently has approximately 14 million copies of her books in print worldwide.

Early life and education
Picoult was born and raised in Nesconset on Long Island in New York State; when she was 13, her family moved to New Hampshire. Even as a child, Picoult had a penchant for writing stories: she wrote her first story— "The Lobster Which Misunderstood"—when she was five.

While still in college—she studied writing at Princeton University—Picoult published two short stories in Seventeen magazine. To pay the bills, after graduation she worked at a variety of jobs, including copy writing and editing textbooks; she even taught eighth-grade English and attained a Masters in Education from Harvard University.

In 1989, Picoult married Timothy Warren Van Leer, whom she met in college, and while pregnant with their first child, wrote her first book. Song of the Humpbacked Whale, her literary debut, came out in 1992. Two more children followed, as did a string of bestseller novels. All told, Picoult has more than 20 books to her name.

Writing
At an earlier time in her life, Picoult believed the tranquility of family life in small-town New England offered little fodder for writing; the truly interesting stuff of fiction happened elsewhere. Ironically, it is small-town life that has ended up providing the settings for Picoult's novels. Within the cozy surroundings of family and friends, Picoult weaves complex webs of relationships that strain, even tear apart, under stress. She excels at portraying ordinary people who find themselves in extraordinary circumstances. Disoriented by some accident of chance, they stumble, whirl, and attempt to regain a footing in what was once their calm, ordered world.

Nor has Picoult ever shied from tackling difficult, controversial issues: school shooting, domestic violence, sexual abuse, teen suicide, and racism. She approaches painful topics with sympathy—and her characters with respect—while shining a light on individual struggles. Her legions of readers have loved and rewarded her for that compassion—and her novels have been consistent bestsellers.

Personal life
Picoult and her husband Timothy live in Hanover, New Hampshire. They have three children and a handful of pets. (Adapted from a 2003 Barnes and Noble interview and from Wikipedia. Retrieved 9/28/2016.)

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Book Reviews 
Picoult is at her best, and most moving, when writing from the perspective of Anna's mother, Sara. Exhausted by Kate's recurrent illness, Sara is often on edge and overwhelmed. But she is also focused: Her tenacity, her vigilance and her support during Kate's aggressive cancer treatments all give Kate a reason to live. Mothering takes on new meaning, and the mundane becomes surreal: Kate's goldfish, according to the oceanologist Sara consults in a desperate effort to save the pet's life, requires bottled water, and the mere thought of buying Jesse a new pair of soccer cleats after Kate relapses seems "downright obscene."
Katherine Arie - The Washington Post

The difficult choices a family must make when a child is diagnosed with a serious disease are explored with pathos and understanding in this 11th novel by Picoult (Second Glance, etc.). The author, who has taken on such controversial subjects as euthanasia (Mercy), teen suicide (The Pact) and sterilization laws (Second Glance), turns her gaze on genetic planning, the prospect of creating babies for health purposes and the ethical and moral fallout that results. Kate Fitzgerald has a rare form of leukemia. Her sister, Anna, was conceived to provide a donor match for procedures that become increasingly invasive. At 13, Anna hires a lawyer so that she can sue her parents for the right to make her own decisions about how her body is used when a kidney transplant is planned. Meanwhile, Jesse, the neglected oldest child of the family, is out setting fires, which his firefighter father, Brian, inevitably puts out. Picoult uses multiple viewpoints to reveal each character's intentions and observations, but she doesn't manage her transitions as gracefully as usual; a series of flashbacks are abrupt. Nor is Sara, the children's mother, as well developed and three-dimensional as previous Picoult protagonists. Her devotion to Kate is understandable, but her complete lack of sympathy for Anna's predicament until the trial does not ring true, nor can we buy that Sara would dust off her law degree and represent herself in such a complicated case. Nevertheless, Picoult ably explores a complex subject with bravado and clarity, and comes up with a heart-wrenching, unexpected plot twist at the book's conclusion.
Publishers Weekly

Imagine that you were conceived to be the donor of bone marrow and platelets for your older sister, who has a rare form of cancer. Imagine what it would be like to grow up in a family where everyone is constantly aware of one child's deadly illness, so that all decisions must be filtered through what will work for her treatment or her most recent medical emergency. How can a 12-year-old decide against donating a kidney to her older sister? By having this story narrated by each character in turn, Picoult (Second Glance) shows readers the dilemmas facing everyone involved: from Anna, the child who sues her parents for medical emancipation; to Sara, the mother who loves all three of her children but must devote continual attention to the daughter with cancer; and to Jesse, the son who has abandoned hope of ever being noticed by his parents. Picoult's timely and compelling novel will appeal to anyone who has thought about the morality of medical decision making and any parent who must balance the needs of different children. Highly recommended. —Kim Uden Rutter, Lake Villa Dist. Lib., IL
Library Journal

Picoult's latest chronicle of family travail (Second Glance, 2003, etc.) highlights the consequences of deliberately conceiving a child genetically compatible with a mortally ill sibling. The author vividly evokes the physical and psychic toll a desperately sick child imposes on a family, even a close and loving one like the Fitzgeralds. Picoult's plotting, though, is less sure, as an inherently somber tale morphs into a melodrama with a too-neat twist. Anna Fitzgerald, the 13-year-old who begins the story, was conceived in vitro, and her embryo's genetic makeup closely matched that of her sister Kate. Now 16, Kate was diagnosed at 2 with acute promyelocytic leukemia. In the years that followed she has suffered numerous relapses, despite the infusion of Anna's platelets and bone marrow, even stem cells from her sister's umbilical cord. Their parents, Sara and Brian, now want Anna to give Kate one of her kidneys; compromised by her drastic treatments, Kate's organs are shutting down. Instead, Anna contacts attorney Campbell Alexander and asks him to represent her; she wants her parents to stop using her body to help Kate. Like elder brother Jesse, who's turned his angst into arson and general bad-boy behavior, she has spent her life in the shadow of her sister's illness-one year Kate had to be hospitalized on every holiday. Sara, who has made keeping Kate alive her life's mission, is very angry, but Brian initially takes Anna's side, feeling too much has been asked of her. A hearing is scheduled, though Anna is torn between her affection for Kate and what she feels must be done. As the hearing begins Kate is hospitalized, Jesse's arson is discovered, and Anna initially refuses to testify.There can be no easy outcomes in a tale about individual autonomy clashing with a sibling's right to life, but Picoult thwarts our expectations in unexpected ways. Despite overplotting, then, a telling portrait of a profoundly stressed family.
Kirkus Reviews

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Discussion Questions 
1. One of this novel's strengths is the way it skillfully demonstrates the subjectivity people bring to their interactions with others. The motivations of individual characters, the emotions that pull them one way or another, and the personal feelings that they inject into professional situations becomes achingly clear as we explore many different viewpoints. For example, despite Julia and Campbell's attempts to remain calm, unemotional and businesslike when they deal with one another, the past keeps seeping in, clouding their interaction. The same goes for the interaction between Sara and Anna during the trial. Is there such a thing as an objective decision in the world of this story? Is anyone capable of being totally rational, or do emotions always come into play?

2. What do you think of this story's representation of the justice system? What was your opinion of the final outcome of the trial?

3. What is your opinion of Sara? With her life focused on saving Kate, she sometimes neglects her other children. Jesse is rapidly becoming a juvenile delinquent, and Anna is invisible — a fact that the little girl knows only too well. What does this say about Sara's role as a mother? What would you have done in her shoes? Has she unwittingly forgotten Jesse and Anna, or do you think she has consciously chosen to neglect them — either as an attempt to save a little energy for herself, or as some kind of punishment? Does Sara resent her other children for being healthy? Did you find yourself criticizing Sara, empathizing with her, or both?

4. During a conversation about Kate, Zanne tells Sara, "No one has to be a martyr 24/7." When she mistakenly hears the word "mother" not "martyr" and is corrected by Zanne, Sara smiles and asks, "Is there a difference?" In what ways does this moment provide insight into Sara's state of mind? Do you think it strange that she sees no difference between motherhood and martyrhood?

5. Campbell is certainly a fascinating character: guarded, intelligent, caring and yet selfish at the same time. Due to these seemingly contradictory traits, it can be difficult to figure him out. As he himself admits, "motivations are not what they seem to be." At one point he states, "Out of necessity -- medical and emotional -- I have gotten rather skilled at being an escape artist." Why do you think Campbell feels that he needs to hide his illness? Is it significant that Anna is the first to break down his barriers and hear the truth? Why, for example, does he flippantly dismiss all questions regarding Judge with sarcastic remarks?

6. At one point, Campbell thinks to himself: "There are two reasons not to tell the truth -- because lying will get you what you want, and because lying will keep someone from getting hurt." With this kind of thinking, Campbell gives himself an amazingly wide berth; he effectively frees himself from speaking any semblance of the truth as long as the lie will somehow benefit himself or anyone else. Did it concern you that a lawyer would express an opinion like this? Do you think, by the end of the story, that Campbell still thinks this moral flexibility is okay? In what ways might this kind of thinking actually wind up hurting Campbell?

7. It is interesting that Campbell suffers seizures that only his dog can foresee. How might this unique relationship mirror some of the relationships between humans in this novel? In what ways does Judge introduce important ideas about loyalty and instinct?

8. On page 149, Brian is talking to Julia about astronomy and says, "Dark matter has a gravitational effect on other objects. You can't see it, you can't feel it, but you can watch something being pulled in its direction." How is this symbolic of Kate's illness? What might be a possible reason for Brian's fascination with astronomy?

9. Near the end of the novel, Anna describes "Ifspeak" — the language that all children know, but abandon as they grow older — remarking that "Kids think with their brains cracked wide open; becoming an adult, I've decided, is only a slow sewing shut." Do you believe this to be true? What might children teach the adults in this novel? Which adults need lessons most?

10. "It's more like we're astronauts, each wearing a separate helmet, each sustained by our own source of air." This quote comes from Anna, as she and her parents sit in silence in the hospital cafeteria. Besides being a powerful image of the family members' isolation, this observation shows Anna to be one of the wisest, most perceptive characters in this novel. Discuss the alienation affecting these characters. While it is obvious that Anna's decision to sue her parents increases that sense of alienation throughout the novel (especially for Anna herself), do you think that she has permanently harmed the family dynamic?

11. During the trial, when Dr. Campbell takes the stand, he describes the rules by which the medical ethics committee, of which he is a part, rules their cases. Out of these six principles (autonomy, veracity, fidelity, beneficence, non-maleficence, and justice), which apply to Anna's lawsuit? Moreover, which of these should be applied to Anna's home situation? In other words, do you think a parent might have anything to learn from the guidelines that the doctors follow? Are there family ethics that ought to be put into place to ensure positive family dynamics? I so, what should they be?

12. Early in the legal proceedings, Anna makes a striking observation as she watches her mother slip back into her lawyer role, noting, "It is hard to believe that my mother used to do this for a living. She used to be someone else, once. I suppose we all were." Discuss the concept of change as it is presented in this story. While most of the characters seem to undergo a metamorphosis of sorts -- either emotionally or even physically (in the case of Kate), some seem more adept at it than others. Who do you think is ultimately the most capable of undergoing change and why?

13. Discuss the symbolic role that Jesse's pyromania plays in this novel, keeping in mind the following quote from Brian: "How does someone go from thinking that if he cannot rescue, he must destroy?" Why is it significant that Jesse has, in many respects, become the polar opposite of his father? But despite this, why is Jesse often finding himself in the reluctant hero position (saving Rat, delivering the baby at boot camp)? Brian himself comes to realize, in the scene where he confronts Jesse, that he and his son aren't so different. Talk about the traits that they share and the new understanding that they gain for each other by the end of the story.

14. My Sister's Keeper explores the moral, practical and emotional complications of putting one human being in pain or in danger for the well being of another. Discuss the different kinds of ethical problems that Anna, as the "designer baby," presents in this story? Did your view change as the story progressed? Why or why not? Has this novel changed any of your opinions about other conflicts in bioethics like stem cell research or genetically manipulated offspring?
(Questions issued by publisher.)

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