Context In her career as a novelist, Jodi Picoult has published at an extraordinary pace, releasing seventeen books in about as many years. Though panned by some critics for the commercial nature of her writing, she has earned a large and devoted following of readers. Nearly 14 million copies of her books are in print in the U. S. alone, and her work has been translated into thirty-four languages in thirty-five countries. Her novels cover a range of topics, from school shootings to teen suicide to death row inmates, yet many share a single theme: ordinary people in extraordinary and often morally complicated situations.
All manner of horrific things happen in the lives of Picoult’s characters, and the choices her characters make in response typically form the crux of her plots. Her books often explore the psychological consequences of wrenching incidents and decisions, and they deal largely in moral gray areas, where the ethics of medicine, law, and society come into conflict with one another. Rarely, if ever, do her novels offer easy resolutions. Born in 1966, Picoult attended Princeton University for her undergraduate studies.
Seventeen magazine published two of her short stories while she was still a student. After graduation, Picoult took on a series of different jobs to earn her living. She worked as a technical writer for a brokerage firm, wrote copy for an advertising agency, served as an editor at a textbook publisher, and taught English to 8th graders. Eventually she enrolled in Harvard, where she received her Masters in Education. She married Tim Van Leer, and while pregnant with her first child she published her first novel, Songs of the Humpback Whale, which was released in 1992.
But not until the release of her 1998 novel, The Pact, about the apparent murder of a seventeen-year-old girl by a boy she had known all her life, did Picoult begin to achieve wide-scale commercial success. conducting numerous interviews with experts related to the issue at hand and spending time with real individuals and families who have been affected. The writing of her novel House Rules, for instance, about a teenage boy with the autism-spectrum disorder called Asperger’s Syndrome, involved several conversations with autistic children and their parents.
For My Sister’s Keeper, Picoult spent time with pediatric oncologists who treat children with cancer. Picoult also brings her personal experiences to her books. House Rules came about in part because her cousin has autism, so she knew first-hand how autism can affect a family. With My Sister’s Keeper, Picoult drew on her experiences with her middle son, who at the age of five needed ten surgeries over three years to treat a tumor in his ear.
Picoult says the desperation she felt sitting in the hospital beside her anesthetized son and knowing she could do nothing to help him informed her depiction of Sara, the mother in the Fitzgerald family of My Sister’s Keeper. That emotion, combined with the knowledge Picoult gathered in her research, imbues the book with a sense of realism. Plot Overview The narrative of My Sister’s Keeper alternates between first-person accounts by the novel’s different characters. The bulk of the story takes place in the present, in a one-and-a-half week stretch of time.
Sara Fitzgerald, a former attorney and current stay-at-home mom, narrates the remainder of the story from different points in the past but moving gradually toward the present. One final chapter, the epilogue, occurs in the future. In 1990, doctors diagnose Sara’s two-year-old daughter, Kate, with a rare and aggressive form of leukemia. The news that their child might die shocks Sara and her firefighter husband, Brian, but Sara immediately resolves to begin Kate on treatment. Kate starts chemotherapy, and her oncologist, Dr. Chance, suggests she might eventually need a bone marrow transplant, preferably from a related donor.
The Fitzgeralds test their four-year-old son, Jesse, but he is not a match. Dr. Chance mentions that another unborn sibling could be a match, and Sara suggests to Brian that they have another child. Sara’s passages, told at different points over the next fourteen years, focus largely on Kate’s struggles. She describes how scientists help them conceive another daughter, Anna, who is a perfect genetic match for Kate. Over the course of the next few years, Anna undergoes several procedures, including frequent blood withdrawals and a painful bone marrow extraction, to help keep Kate alive.
Sara describes in great detail the pain and suffering Kate endures. Chemotherapy and radiation make her violently ill, and an emergency trip to the hospital heralds each new relapse. Sara and Brian’s marriage suffers as a result, to the point where they begin to feel like strangers. In different ways, both Jesse and Anna act out at Sara because of her single-minded focus on Kate. The present action of the story begins on a Monday. Thirteen-year-old Anna goes to see a lawyer named Campbell Alexander and asks him to represent her. Anna tells Campbell that she wants to sue her parents for medical emancipation.
Kate, her sister, is in the end stages of kidney failure, and Anna wants to file the lawsuit so she will not have to donate a kidney to Kate. Campbell, who has a service dog but gives a sarcastic explanation whenever someone asks why, agrees to represent Anna for free. When she is served with the papers for the lawsuit, Sara becomes furious with Anna as she cannot understand Anna’s decision. Brian, however, understands Anna’s point of view to a degree and recognizes that she would not have brought a lawsuit unless she were genuinely unhappy.
Judge Desalvo, the judge for Anna’s case, decides to appoint a woman named Julia Romano as Anna’s In 2004, Picoult published My Sister’s Keeper. Like most of her works, the novel takes on a range of morally complex issues, from the ethics of genetic engineering, to the right of terminally-ill patients to elect to die, to a minor’s right to control her own body. Genetic engineering alone has been the subject of controversy since its very first uses to help infertile couples conceive via in vitro fertilization.
As the potential uses of the method have grown, so have the moral questions that such genetic manipulation raises. Notably, the ethics of using science to create a so-called “designer baby,” meaning one whose physical traits are selected by the parents, has become the object of frequent and heated debates. These quandaries, and those regarding the rights of terminally ill patients and minors to determine what happens to their bodies, all intertwine in My Sister’s Keeper, which tells the story of one family devastated by their child’s battle with acute promyelocytic leukemia, an extremely aggressive form of cancer.
As in many of her novels, Picoult distills these conflicts to their most controversial aspects, places ordinary people in the midst of them, and challenges readers to confront their own preconceptions about the subject. The world of My Sister’s Keeperitalic brims with realistic medical and legal jargon. In fact, Picoult is renowned for diligently researching the topics she writes about, and she has said that her research can at times take even longer than the actual writing of the book. Her regular routine entails guardian ad litem, a person whose job is to objectively decide what is in Anna’s best interests.
When Julia goes to see Campbell, it becomes clear they have a romantic past and have not seen each other in many years. Throughout all of these events, Jesse has been setting different abandoned buildings on fire. Jesse acts like a delinquent in other ways as well, such as drinking alcohol excessively, but much of this behavior stems from anger over his inability to save Kate and his feelings of being ignored by his parents. Kate becomes seriously ill and must be hospitalized. Dr. Chance says she will die within a week. Anna refuses to change her mind about the lawsuit, however.
At the hearing, Sara decides she will represent herself and Brian. Consequently, Brian takes Anna to stay with him at the fire station to give Anna some distance from her mother. He believes if they remain in the same house together, Anna may unwillingly cave to her mother’s wish that she donate her kidney. Meanwhile, through flashbacks Campbell and Julia alternately recall scenes from their high-school relationship. They both attend a prep school populated by children from wealthy families. Julia feels and acts like the outsider, and Campbell falls in love with her despite the reservations of his friends and parents.
Their relationship ends abruptly, however, when Campbell breaks it off without explanation. In the present, Campbell and Julia initially bicker with each other, but they end up sleeping together the night before the trial begins. At the trial, both Sara and Campbell question witnesses, including one of the doctors familiar with Kate’s medical history, and both are effective at different times. Reluctantly, Anna takes the stand and admits that she filed the lawsuit because Kate told her to. At the very moment she makes this announcement, Campbell has an epileptic seizure and collapses.
When his seizure ends, he admits he has been having seizures ever since a car accident in high school. He broke up with Julia because he didn’t want his seizures, which limit him greatly, to limit Julia as well. He also explains that the seizures are the reason he has a service dog, which can tell when another seizure is coming on. Julia and Campbell reconcile. Back on the stand, Anna explains that Kate asked Anna not to donate her kidney because she was tired of being sick and waiting to die. Anna also admits that while she loves her sister, part of
her wanted Kate to die, too, so that she could have more freedom with her life. Judge DeSalvo decides to grant Anna medical emancipation and gives Campbell medical power of attorney over her. On the way to the hospital, Campbell and Anna get into a serious car accident. At the hospital, the doctors tell the family that Anna has irreversible brain damage. Campbell tells the doctors to give Anna’s kidney to Kate. Kate narrates the epilogue, set in 2010. She discusses the grief her family went through after Anna’s death, and the fact that she blames herself. She knows, however, that she will always carry Anna with her.
My Sister’s Keeper Character List Anna Fitzgerald – The youngest Fitzgerald child and the protagonist of the novel. Described by her father as their family’s constant, thirteen-year-old Anna is smart, funny, and observant. Anna’s actions drive the plot, as she struggles to reconcile her knowledge that only she can provide Kate, whom she loves dearly, with the organs she needs to survive and her desire to live without this extraordinary burden. While the rest of the family has often been left to sit idly by in Kate’s fight against cancer, Anna, because her genes match Kate’s, has been an active participant.
Anna’s role in Kate’s survival has been a blessing and a curse for her, as it has made her Kate’s savior but has also made Anna unable to be her own person. Sara Fitzgerald – The mother of the Fitzgerald family. Sara is strong, stubborn, and intelligent, and her life centers on her efforts to keep Kate alive. She has extremely strong maternal instincts, but her single-minded focus on saving Kate sometimes exists at the expense of her marriage and her relationships with her two other children. Even so, she has a deep and abiding love for all her family, though she does not always know how to show that love.
Campbell Alexander – Anna’s lawyer. Initially arrogant and brusque, Campbell gradually emerges as a character with many layers. In many ways, he mirrors Anna. Both have found it difficult to be who their parents want them to be, and both have secrets they are unwilling to share. Campbell struggles between his urge to erect barriers around himself and his genuine desire to reach out to people. He ultimately experiences the most personal growth of any of the characters, and by the end of the story he has formed strong bonds with the people around him.
Brian Fitzgerald – The father of the Fitzgerald children and a career firefighter. Brian often serves as a foil to Sara. In contrast to her, he can view the situation from his children’s perspectives, making him both more perceptive and understanding than Sara at times. Yet Brian also escapes into his work to avoid dealing with the hardships surrounding his family. He can be kinder than Sara, but by the end of the story Sara proves to be the emotionally stronger of the two. Jesse Fitzgerald – The oldest of the Fitzgerald children and the most delinquent.
Despite his tough exterior, Jesse is in reality a vulnerable and sensitive character. He uses his destructive behavior to mask a fundamental feeling of inadequacy. Jesse cannot save Kate, and he has never been able to forgive himself for that. In addition, he has often felt ignored by his parents, who focus their attention almost exclusively on Kate, and he acts out in part to gain their attention. Kate Fitzgerald – The middle Fitzgerald child and the focal point of many of the novel’s events.
Kate’s cancer is at the heart of the story, but she only narrates the prologue and epilogue. She has struggled with cancer nearly her entire life, and she appears to have come to terms with the fact that she might die. The reader sees glimpses of the girl Kate could have been, but for the most part her battle with cancer defines her character. Julia Romano – Guardian ad litem to Anna and Campbell’s high-school girlfriend. Julia has a genuine desire to discover what is best for Anna and is one of the most open and caring characters in the story.
She possesses an independent personality that made her an outsider in high school but now makes her ideally suited for rendering an objective opinion on Anna’s case. Julia never truly Jodi Picoult < recovered from the way her and Campbell’s relationship ended, yet she still retains her ability to care deeply about people. Zanne – Sara’s older sister. Zanne, a high-powered career woman without children, provides a foil to Sara, who could have been a successful attorney but essentially gave up her law career to care for her children full-time.
Zanne often gives Brian and Sara comfort and support. For instance, she watches Anna and Jesse when Sara goes with Kate to the hospital and Brian has to work. Her relationship with Sara offers another example of the unique bond that exists between sisters. Dr. Chance – Kate’s oncologist. A warm but serious man, Dr. Chance represents the science and medicine keeping Kate alive. He speaks to Sara and Brian very honestly and directly about Kate’s condition, yet no matter how bleak Kate’s situation gets, Dr. Chance always offers hope that a treatment may work, even when the chances are slim.
Judge DeSalvo – The judge appointed to Anna’s case. Fair and kind, Judge DeSalvo genuinely cares for Anna’s well-being. As the father of a child killed by a drunk driver, he understands how desperately Sara and Brian want to keep Kate alive. Taylor Ambrose – Kate’s crush and fellow cancer patient. Kate and Taylor’s short relationship emphasizes that, at heart, Kate is a normal teenage girl. Yet Taylor’s sudden death underscores the fact that Kate’s condition remains extremely fragile and that she could die with little warning. Izzy Romano – Julia’s twin sister and roommate.
Izzy’s dislike of Campbell reflects how much he hurt Julia, and her presence in the story serves as another example of the extreme closeness that can exist between sisters. Judge (the dog) – Campbell’s service dog. Campbell does not reveal why he needs Judge for most of the book. Ultimately he reveals that Judge is an epilepsy service dog, meaning he alerts Campbell if a seizure is imminent so Campbell can move to a safe environment. control of her own body, allowing her to put her own interests before Kate’s; and since Kate will die without Anna’s kidney, Anna can fulfill Kate’s wish to die.
Anna also represents the point where science and humanity intersect. Her parents conceived her— with the aid of scientists—for a very specific reason: to provide Kate with a genetic match whose organs could help keep Kate alive. Sara even admits she could only think of the unborn Anna in terms of what she could do for Kate. Despite this scientific reason for Anna’s existence, she clearly amounts to more than just a donor, both to her family and to the reader. Anna is funny and thoughtful, described by Brian as the family’s constant and source of light.
She has contributed to the Fitzgerald family on far more than a medical level. Her emotional attributes have helped Kate just as often as her physical ones. Thus, Anna’s life suggests that no matter how far science advances in its ability to engineer humans for a purpose, those humans are still thinking, feeling people who will always mean more than just their scientific reason for being. Sara Fitzgerald Sara acts first and foremost as a mother throughout the novel, and her need to keep her daughter, Kate, alive motivates her more than any other impulse.
Whatever other problem she encounters, be it Jesse’s delinquency or Anna’s need for independence, the matter holds less importance for her than Kate’s survival. Paradoxically, by focusing so much on being a mother to Kate, Sara does not always fill the role of mother for her other children. For instance, Sara tends to disregard Jesse’s selfdestructive behavior, which Jesse uses to call out for attention, and she doesn’t stop to think that Anna might be genuinely unhappy when Anna files the lawsuit for medical emancipation.
Although Sara undoubtedly loves Jesse and Anna, she has difficulty considering them as people separate from Kate. Similarly, though Sara is a wife to Brian and a sister to Zanne, her relationships with these people also revolve around Kate. Sara struggles to talk to Brian about anything other than Kate, for instance, and the few times she sees her sister occur when Zanne comes to take care of Jesse and Anna because Sara is going with Kate to the hospital. Even with Kate, Sara focuses mostly on her physical, rather than emotional, health.
For example, when Anna reveals on the stand that Kate doesn’t want to live any longer, Sara does not believe it because she has never spoken to Kate about these feelings. Analysis of Major Characters Anna Fitzgerald Anna stands out as the book’s most conflicted character. Her connection with Kate, and her struggle to exist independently of that connection, both define her. She tells Campbell, for instance, that of all the things she might want to be in ten years, what she most wants to be is Kate’s sister.
At the same time, Anna desperately wants to exist independently of Kate, but she knows she cannot do so as long as her main purpose in life consists of keeping Kate alive. These contradictory feelings make up the tragic core of Anna’s character. She feels a tremendous sense of guilt for wanting to live separate from Kate and wonders if she is an awful person for feeling that way. As if trying to roleplay the part of an awful person, she even begins to indulge in self-destructive behaviors, such as smoking, with Jesse. But Anna also wants to do what’s best for her sister.
Kate, we learn, ultimately decides that she no longer wants to live, so Anna, although it hurts her deeply, brings a lawsuit against her parents for medical emancipation. The lawsuit satisfies both desires: it gives Anna Campbell Alexander Over the course of the novel, Campbell evolves from a sarcastic, emotionally aloof opportunist who fears intimacy into a person who—though still sarcastic—is more trusting, open, and truly cares about the wellbeing of Anna and her family. At the beginning of the story, Campbell has almost no friends, except for his service dog, Judge.
Instead, he keeps himself closed off from others, fearing his epilepsy will cause people to pity him or think him a burden, and he uses his sarcasm to hold people at a distance. He repeatedly tells bad jokes about why he needs a service dog, for instance, and he alternates between caring about Anna and using her case for publicity. Once he begins to care about Anna and to reconnect with Julia, however, Campbell begins opening himself up to new relationships. In fact, Campbell’s epilepsy and the resulting lack of control he feels over his own body
even help him to bond with Anna, who also feels, albeit in a different way, that she has no control over her body. Eventually Campbell starts being honest about his feelings, and less sarcasm appears in his conversations. By the end of the novel, he agrees to act with power of attorney for Anna’s medical decisions, proving the two have established a bond as the relationship means they would have to stay in touch at least through Anna’s eighteenth birthday. We also learn that Campbell and Julia eventually marry, and that they remained friends with the Fitzgeralds for a time. Themes, Motifs, and Symbols Themes