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Film / My Sister's Keeper

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Anna Fitzgerald has gone through countless surgeries, transfusions and shots by the age of thirteen. Is she sick? No. She's forced by her parents to do it for her older sister Kate, who has suffered from severe leukemia since the age of three. Anna was born to be a perfect match for Kate. Kate now needs a kidney and Anna decides she's had enough. So she sues her parents for medical emancipation.

My Sister's Keeper is a 2009 American drama film adapted from the novel of the same name, directed by Nick Cassavetes and starring Cameron Diaz as Sara, Abigail Breslin as Anna, Sofia Vassilieva as Kate, Alec Baldwin as Campbell, and Joan Cusack as Judge De Salvo.

Tropes for the movie:

  • Adaptational Alternate Ending: In the novel, Anna dies in a car accident with her usable organs being donated to Kate who remains in remission for 8 years. In the film, Kate dies from her leukemia and Anna lives.
  • Adaptational Context Change: In both the book and the film, Kate is revealed to have talked Anna into suing her parents, but the reasoning is different; while the book says that Kate feels guilty that Anna's life is being taken from her, here it's because Kate is ready to die and doesn't want the transplant in the first place; furthermore, in the book Anna accepts to go on with Kate's request especially to have voice regarding herself for once, but at the same time she does want to donate her kidney and save Kate's life, while in the movie she goes on only because she wants to help Kate to stop suffering.
  • Adaptation Dye-Job: Sara is brunette in the book but blonde in the film.
  • Adaptation Explanation Extrication: "Jesse turned his life around" sounds a bit odd considering the most the film shows Jesse doing is spending nights in troubled neighborhoods - in contrast to his rampant pyromania in the book.
  • Adaptational Heroism:
    • Sara is considerably more sympathetic in the film than she is in the book. Notably it cuts some of her crueller moments from the book: yelling at Anna for wanting to go to a friend's birthday party, and her abuse causing Jesse to pull his braces out with a fork. Likewise since Kate dies instead of Anna, Sara and Anna rebuild their relationship. The film has also has several happy moments between the family, establishing that Sara does indeed love her other children too.
    • Jesse’s pyromania from the book is absent in the film.
  • Adaptational Modesty: Inverted. In the book Kate and Taylor just kiss at the prom. In the film they passionately make out and Kate claims they had sex - though quickly says they just did "some stuff".
  • Adaptation Name Change: Aunt Suzanne is renamed Aunt Kelly.
  • Adapted Out: Julia Romano, Anna’s guardian ad litem and Campbell’s Old Flame in the novel is absent from the film. By extension, this also includes her sister and roommate Isobel
  • Age Lift: Kate and Anna are respectively sixteen and thirteen in the book but fifteen and eleven in the film.
  • Anachronic Order: The film bounces around from the current timeline where Anna's suing her parents, to various times in Kate's teen years and back to Kate's childhood from when she was first diagnosed.
  • Artistic License: When Sara gets news that Kate is dying, she's asked to contact the Make-a-Wish Foundation, suggesting that the organisation prioritises dying children. Kate would realistically have been offered a wish as soon as she was diagnosed, since the organisation and similar ones specialise in children with any life-threatening condition.
  • Artistic License – Geography: The ending shows the family in Montana, with Anna's narration stating that they go there on Kate's birthday every year, which is said to be August 22nd. Everyone is shown in coats and scarves, but summer temperatures in Montana are often in the 70s at least.
  • Artistic License – Law:
    • Campbell Alexander's commercial states that he has a "90% success rate", which violates Rule 7.1 of ABA Model Rules of Professional Conduct, offering "unjustified expectations" without reference to the specific factual or legal circumstances.
    • Anna's lawsuit starts with cross examination from Sara, who is both the defendant and lawyer in this situation. Anna is the plaintiff and therefore should present her claims first, before being cross examined.
  • Artistic License – Medicine: Doctors don't usually break major bad news to family members in the waiting room.
  • Baldness Means Sickness: Chronically ill leukemia patient Kate is most often in a hospital gown and a cap to hide her baldness. Later in the film, her mother Sara shaves her head in solidarity.
  • Big Sister Instinct: The ultimate kind, Anna is willing to continue with the invasive treatments to keep Kate alive, but Kate knows the torture both physically and emotionally that Anna endures. Kate pressures Anna to sue for Medical Emancipation, knowing full well she will die, but her little sister will finally get to have a normal life.
  • Bittersweet Ending: Sick of watching her parents torture Anna just to keep her alive, Kate helps Anna win her lawsuit and lets herself die. Kate may be gone, but she dies at peace with herself, knowing Anna can finally live.
  • Blonde, Brunette, Redhead: Fulfilled for the prom scene. With Kate donning a red wig, this puts her alongside blonde Sara and brunette Anna.
  • Bookends: The film starts with Anna going to a lawyer then jumps back in time then moves forward again to end just after the court case.
  • Bungled Suicide: In one flashback, Kate attempts to kill herself by swallowing pills. Anna sees this and stops her, making her throw up the pills.
  • Calling the Old Man Out: Jesse does this to Sara when he reveals why they're in court in the first place.
    Jesse: Jesus Christ, Anna, just tell 'em.
    Anna: You shut up!
    Jesse: Tell 'em why we're here! What are we doing here in court? Tell 'em, Anna!
    Anna: You promised me that you wouldn't do this!
    Jesse: God, you people are so stupid!
    Anna: You promised!
    Jesse: Kate wants to die!
    Anna: Stop it!
    Jesse: She's making Anna do all this 'cause she knows that she's not gonna survive another operation.
    Sara: That's a lie, Jesse!
    Jesse: Mom, no, it's not! Kate's dying and everybody knows it! You just love her so much that you don't want to let her go! But it's time Mom. Kate's ready.
    Sara: That's not true. Kate would've told me!
    Jesse: Mom, she did tell you!
    Brian: She did. She told you a million times. You didn't want to hear it.
  • Composite Character: Aunt Kelly is a combination of Sara's sister and Julia in the book.
  • Compressed Adaptation: The movie takes out several other plotlines (such as Jesse's pyromania) and characters.
  • Convulsive Seizures: Campbell has one in the middle of the trial after leaving the courtroom and attempting to have it in the privacy of a restroom. He doesn't make it there in time.
  • Cruel Twist Ending: Thankfully averted, unlike the book. The film turns the ending into a mostly happy ending, instead.
  • Defrosting Ice Queen: Sara's moment of accepting Kate's imminent death is painful to watch.
  • Diabolus ex Machina: Gracefully averted, unlike the book.
  • Death by Adaptation: Kate in the movie takes the place of Anna.
  • Emo Teen: Kate turns into one after Tyler's death. Wearing dark clothes, short hair and makeup, playing loud rock music in her room and attempting suicide by swallowing a prescription bottle of pills.
  • Expository Hairstyle Change: Sara from the past has curly hair. Sara in the present has straight hair. Sara in the Distant Finale has short hair. Additionally Jesse's hair is longer and flatter in the finale to reflect the passage of time. Likewise Kate's hair is longer when she's in remission and at her happiest. Whenever she's depressed, her hair is shoulder length or gone completely.
  • Face Death with Dignity: Kate. She's just happy that Anna can live on.
  • Foreshadowing: Before the trial begins, Kate's oncologist, dr. Chance, attempts to make her have a meeting with an Make-A-Wish Foundation representative, but the they first have to tell it to Sara, who of course is not happy. While they are trying to reason with her, the representative tries to ask Sara if she knows what Kate wants but Sara immediately shushes her, refusing to listen. This shows how Sara is so adamant that Kate must survive that she hasn't even asked the latter her thoughts and feelings on the matter.
  • Gender Flip: The judge presiding over Anna's case is male in the book, but played by Joan Cusack in the movie.
  • Hair Reboot: Sara shaves her head to show support for Kate. The next scene cuts to much later when her hair is back to its original length.
  • Important Haircut: As mentioned above Sara shaves her head in solidarity with her sick daughter Kate.
  • Love Makes You Evil: Sara's abusive behaviour is a result of trying everything she can to get Kate a kidney. To a point where she lacks empathy with Anna and Jesse, who are also dealing with a tragedy that's out of their control.
  • Never My Fault: Lampshaded most blatantly with Sara by Anna's attorney:
    Alexander: Mrs Fitzgerald, did you ever think "Maybe I was wrong, maybe I took this too far"?
    Sara: *storms off* See you in court.
  • Never Trust a Trailer: The movie trailers looked to be a dramedy of accepting a sibling having possibly terminal cancer. Then the shock comes with the book synopsis.
  • Not His Sled: The film makes major changes to the book it is based on, actually changing the ending so that Kate dies instead of Anna. This seems to work better for the movie, though, as while the book focuses on the moral and legal ramifications of obligating a child to donate organs to a sibling, the movie focuses on how the family deals with pain and loss, which would not work as well with the original Twist Ending.
  • Pyrrhic Victory: In a literal view of the court case Anna wins, but her sister dies as a result.
  • Shirtless Scene:
    • Brian has two: The first one when he is talking with his wife in bed and the second one in the beach.
    • In one of the flashbacks there is one rare female example of little Kate during a medical checkup.
  • Spared by the Adaptation: Anna herself in the movie lives, while Kate dies instead.
  • Thanatos Gambit: The film has Kate arrange one of these because she wants to die and doesn't want Anna to suffer anymore.
  • The Unfavorite: Although it's the result of a tragic situation this dynamic is explored. Kate in her scrapbook apologizes to both Jesse and Anna for making them this through needing so much attention.
  • Wham Line: "Kate wants to die!" by Jesse Fitzgerald in the court-room scene.
  • Wham Shot: Anna and everyone else learns why the seemingly opportunistic Campbell Alexander wants to take on her case. It wasn't because of the publicity he would get from it, but a far more personal reason; he has epilepsy and proceeds to have a seizure in the courthouse hallway.