With the fine instincts of an investigative reporter and intuitive storyteller, Jodi Picoult, already critically acclaimed for her previous best selling novels, zeroes in on the issue of genetically engineered children who are born to save their siblings lives. In the process, she creates a moving saga of a family faced with the inevitable loss of one of their own.
My Sisterís Keeper is a poignant, uplifting, emotional, sad, triumphant, passionate, heartwrenching and extremely powerful story about the Fitzgeralds, a family united in their love for each other but divided on exactly where the boundaries of family obligations, love and sacrifice should end. But it is, ultimately, a story of two sisters, the unbreakable bond they share and how totally entwined they have been all their lives until a crucial decision threatens to tear them apart and ends up changing all the lives forever.
The Fitzgeralds - Brian, a firefighter and avid amateur astronomer, and Sara, a stay-at-home mother and ex-lawyer - have the perfect suburban family, but life changes irreversibly when Kate, now sixteen, is diagnosed at age two with leukemia. She develops what looks like "a line of small blue jewels" down her spine, and her mother knows immediately that she is not seeing normal bruises. The family doctor wants the tests repeated in the hospital hematology/oncology department. There, after a series of painful and invasive procedures, they learn that Kate suffers from "APL Ö a subgroup of myeloid leukemia. The rate of survival Ö is twenty to thirty percent, if treatment starts immediately." The treatments keep the disease at bay for about five years, until Kate's body explodes with runaway cancer cells. She desperately needs a bone marrow transplant or she will die. Her determined mother, on the advice of the doctor, persuades her husband to try for the "perfectly engineered baby."
Their other child, Jesse, is not a match, but now at thirteen, Anna has always been aware that she was "born for a specific purposeÖa scientist managed to hook up [her] motherís eggs" and her fatherís sperm "to create a specific combination of precious genetic material," so that could she could be a bone marrow match for her sister Kate. When Kate needs leukocytes or stem cells or bone marrow "to fool her body into thinking itís healthy," Anna has obediently stepped in. Everytime Kate is hospitalized so is she, which means Anna can never go away to soccer camp or even to college.
Until now, Anna has never questioned her role in life. But she says that "lately I have been having nightmares, where Iím cut into so many pieces that there isnít enough of me to be put back together." The strain has been heavy on them all, especially Anna who says so bluntly - "I was never really a kid. To be honest, neither were Kate and JesseÖ" And it is hard because they "practically set a place for Death at the dinner table." It does different things to them. Jesse is the wild kid who does drugs and plays with matches, gets arrested for stealing a judgeís car and is generally hopeless. But he is acting out is because he feels he is worthless, unable to help Kate. He calls himself "a lost cause."
After the countless surgeries, transfusions and shots, Anna is now required to give a kidney, which her mother Sara, so intent on saving Kate, doesnít think is a big deal. Kidney donation us considered a relatively safe surgery. But the pamphlet that Anna reads explains that "when you donate a kidney, you spend the night before the operation fasting and taking laxatives. Youíre given anesthesia, the risks of which can include stroke, heart attack and lung problems. The four-hour surgery isnít a walk in the park either --- you have a 1 in 3,000 chance of dying on the operating table, if you donít, you are hospitalized for four to seven days, although it takes four to six weeks to recoverÖ"
She has had enough. She loves her sister fiercely but she canít go through with the kidney donation, so she sues her parents for the right to make her own medical decisions.
When you reach the end of the book after following Anna through her journey, you realize that there are no easy or even right answers. There isnít one person who can be judged for what they think is moral or ethical, or even justifiable. Sometimes you donít know what the right thing is but as a mother, as a doctor and even as a sibling, you do what you think is right for you and for everyone else.
Picoult has done an amazing job of presenting the dilemma. She takes this conflicting issue and handles it with compassion, sensitivity and an infinite amount of grace. For the first time in her career, she draws on her own experience with her son Jake, who thankfully was never in a life-threatening situation. It may be cliched to say that this is "a must read," but itís true. Read this book and you will never again consider stem cell research and other news topics indifferently.
Jodi Picoult received a BA in creative writing from Princeton and a master's degree in education from Harvard. The recipient of the 2003 New England Book Award for her entire body of work, she is the author of ten previous novels, including Perfect Match and SALEM FALLS. She lives in New Hampshire with her husband and three children. Visit her website at