Thirteen-year-old Anna Fitzgerald has carried the burden of her sibling’s survival on her shoulders for her entire life. Conceived as a genetic match to her sister, Kate, who suffers from leukemia, Anna has submitted to numerous procedures since birth for Kate’s medical benefit. It’s basically a given that if Kate ends up in the hospital, so will Anna. Only this unquestioned arrangement has allowed the Fitzgerald family to function in the face of Kate’s life-threatening illness.
In spite of these extenuating circumstances, Anna has tried her best to be a normal teenager—among other things, she is good at ice hockey and has gone on a date with a boy in her class. But unlike her peers, Anna’s life and body have always been intimately intertwined with her sister’s needs: “Kate and I are Siamese twins; you just can’t see the spot where we’re connected. Which makes separation that much more difficult.” Though their deep bonds of love and friendship are obvious, Picoult puts forth two important questions: how much of herself can Anna be expected to give to Kate? More importantly, who gets to decide “how much is too much?”
In a desperate bid to gain control over her own body, Anna sues her parents for medical emancipation—a decision that throws her family into tumult. While her parents are forced to question their past decisions, Anna must confront the inevitable consequences of her actions, and must weigh the emptiness of a future without her best friend with the freedom of a life without medical obligations. Most of all, each must try to decide what is “right” when the options are neither desirable nor fair.
The narrative alternates between the main characters’ points of view, and Picoult seamlessly interweaves the present action with memories of the past. This multifaceted style of storytelling shows the ripple effect that Anna’s decision has on her family and gives insight into the individual struggles of each character. The subplot of past romance and betrayal between Anna’s lawyer, Campbell Alexander, and her court-appointed guardian ad litem, Julie, provides periodic respite from the more emotionally charged central plotline.
My biggest complaint about the book is that Anna’s voice often seems a bit mature, even for a very grown-up 13-year-old, but this quality detracts very little from the text as Picoult is able to master the mentality and tone of a teenager, if not the lingo. However, all the characters are convincingly portrayed, and accessing the mind and poignant memories of each is perhaps the biggest treat of the novel.
In My Sister’s Keeper, Picoult sensitively handles a vexed moral dilemma of our time without being pedantic or providing easy answers. Questions of medical ethics are inextricably tied to family dynamics in the book, so no matter where the reader’s own opinion falls on issues such as genetic testing, My Sister’s Keeper will provide a thought-provoking view of how the human element always complicates modern scientific and technological advances.
Though easy to read, this book is not the fluff that perfectly compliments an afternoon of sunbathing on the quad. But if you’re in the mood for more serious fare, or are interested in current legal and medical issues, My Sister’s Keeper is the perfect read for a quiet afternoon spent snuggled under the bedcovers.