Drawing the Line at Being Your Sister’s Keeper

I first realized Jodi Picoult was a writer of surprising power and depth when I read her novel Nineteen Minutes, which chronicles a school shooting, both from the point of view of the school shooter and those around him who are affected by the tragedy. Her crafting of authentic voices for the myriad of characters and her tackling of a topic as controversial as violence in schools would have put her on my “to be watched” list, but she went further and explored the events that motivated a young man to commit such a heinous crime. The novel shook me to the core and made me think about the casual cruelty heaped on people who are different and can’t blend in, and how those cruelties affect them psychologically.

So, when I heard of another book by the same author, My Sister’s Keeper, which was recently turned into what I hear is a fabulous film, I immediately grabbed it. This one is so deep and multilayered that I have been hesitant for a long time to speak about it and the ethical questions it raises. At its most basic level, the burning question addressed by the novel is: When do you draw the line at saving a child? When do you say enough is enough and allow that child to die? The novel doesn’t give an answer, except to say that there are no easy ones.  

The story itself is framed around the Fitzgerald family; Bryan, Sarah, Anna, Jessie and Kate. When Kate is three, she is diagnosed with a rare and deadly form of leukemia. Her mother, Sarah, is absolutely determined to save her child, as any mother would be, I think. When many of the traditional therapies do not work, the family decides to conceive a designer baby, Anna, who will be a perfect genetic match for Kate. Their initial intention was to give Kate some of Anna’s cord blood cells, which would hopefully put her back into remission.

Unfortunately, the blood cells did not put Kate into remission, and the ethical slope of just what Anna could reasonably be expected to do for her sister got very slippery. It became very easy to justify Anna giving bone marrow to Kate. If Anna were in pain, well, it was only slight pain compared to her sister’s. And after Kate came out of remission engendered by Anna’s bone marrow, it was easy to justify other procedures, because Anna wouldn’t want Kate to die.  

I remember one especially poignant moment just before Anna went in for another of her procedures to help Kate. She told her mother, Sarah, that she was scared. Sarah replied that Anna didn’t have to do it, but that she was sure Kate and Bryan and herself were counting on her. So, Anna got locked into this vicious cycle of negative feedback where if she refused to do something for her sister, she was the “bad guy.” Even when she was accepted to hockey camp on scholarship, she couldn’t go because Kate might need something while Anna was gone.

This all comes to a head in the novel when Anna, now twelve, sues her family for medical emancipation when they demand that she give Kate a kidney. And it would be so easy to paint the family as “bad guys” and leave it at that as Anna’s lawyer attempts to do in court. But it isn’t that simple. Anna loves Kate, and wants to see her alive and happy. Yes, she wants to have her own life, but not at the expense of her sister’s.  

And Sarah, who wanted all her children healthy and happy, was so focused on achieving that goal that she let other things slip away. Anna’s brother, Jessie, for instance becomes a juvenile delinquent because he simply can’t get attention any other way, and when he is committing a crime, he finally feels in control of his careening life. Sarah does try, with Jess. But every time she sits down to devote a moment to him, some sort of emergency crops up with Kate, and eventually, he stops asking for her attention because he feels he is taking it away from the greater problem, namely saving Kate.

When you see flashbacks of Sarah holding Kate’s head while she vomits or shaving her own head after Kate’s radiation therapy, you know how much she cherishes this child. And yet, she cherishes Anna and Jessie, too. It hurts her that Anna is barred from doing so many things because of Kate, and she simply doesn’t know what to do about Jess. And Bryan, her husband, is so utterly exhausted from caring for Kate and trying to hold down a firefighter’s job that he’s simply at his wit’s end.

There are a thousand interweaving threads in this novel, and space doesn’t permit me to go into all of them. There is Anna’s attorney, who lost his first love a long time ago because of something mysterious, which is only revealed at the end of the book. There is Julia, the love of the attorney, who was simply left in the cold when he never contacted her after their high school graduation. All these threads eventually interweave with the story of the Fitzgerald’s, and the recurring theme is choice.
 
Julia wanted the choice to weather whatever the storm was with her lover and only gets it toward the end. Her lover, Anna’s attorney, made a choice to exclude people from his life because of what he considers a humiliating handicap. It is only towards the end that he comes to regret this choice, and realizes there were other ways to live his life. And finally, there is Anna, who wants the choice of when and why to have her body used for the benefit of her sister. It isn’t that she doesn’t want to help; it is that, for once, she wants to be asked, and have her answers and concerns heard.  

The action in this book is framed around a sensational court battle, but it is so much more than that. It is a fascinating character study of a family pushed to the breaking point and poignant social commentary. I encourage you to pick it up, because it will definitely be worth your time.