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Literature / My Sister's Keeper

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My Sister's Keeper is a 2003 novel by Jodi Picoult. Anna Fitzgerald has gone through countless surgeries, transfusions and shots by the age of thirteen. Is she sick? No. She's doing 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. This book has a high Tear Jerker warning, and is the 7th most challenged book in schools and libraries for 2009.

Made into a movie starring Abigail Breslin as Anna and Sofia Vassilieva as Kate in June 2009.

This book contains examples of:

  • Aerith and Bob: Anna Fitzgerald's legal name is Andromeda, as opposed to her siblings who are simply called Katherine and Jesse.
  • Abusive Parents: Sara is the emotional abuse type, though she isn't doing it because she hates Anna; rather, it's because her single-minded devotion to Kate blinds her to the needs of her other children. When Anna was five, Kate needed bone marrow from her so Sara had doctors restrain Anna while they extracted the bone marrow. Whenever Anna questions her, Sara always blackmails her saying "why won't you help your sister?"
  • The Alcoholic: Brian becomes addicted to alcohol after Anna's death, although he gets better.
  • Ambiguous Disorder: Campbell Alexander (as he is a seemingly healthy man who requires a service dog to be around him at all times). Averted near the end of the book, when we figure out that he's epileptic.
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  • Amicable Exes: Campbell and Julia attempt to be this as they work together on Anna Fitzgerald's medical emancipation, but it becomes apparent that neither of them can make it work.
  • Anyone Can Die: Though the entire Fitzgerald family has made some sort of peace with the fact that Kate is going to die, Anna's death at the end of the book is something nobody predicted.
  • Artistic License – Medicine: The book portrays savior siblings as being born specifically to be life long donors to their siblings and with no legal ability to refuse. In reality, the only thing taken from most savior siblings is their umbilical cord, which contain stem cells that can have major rejuvenating properties for the sick siblings. After that, parents cannot force their children donate organs or bone marrow against their will. And even if the child gives their consent, most hospitals won't accept organ donations from anyone under 18. Moreover, considering Kate's state of health, hardly any hospital or transplant board would have forced Anna to donate, because every transplanted organ, unless from a homozygous twin, is eventually rejected: the fact that Anna is a saviour sister only means that her organs will be less likely to be rejected from the start, and if the transplant is successful, they will be rejected after a longer than average period of time, but they will still be rejected sooner or later. So it's quite unrealistic to force a thirteen year old to donate an organ that will have so few chances, especially on the long term, of saving the reciever's life.
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  • Billy Needs an Organ: The story centers around Kate's need for a kidney and Anna's reluctance (actually encouraged by Kate) to donate one.
  • Bittersweet Ending: Anna wins the lawsuit. On her way to the hospital to see Kate she is in a car accident that leaves her brain dead. Alexander decides her kidney should be donated to Kate which saves Kate's life. So Sara gets what she wanted — Kate gets to live — but it comes at the cost of her younger daughter's life, and there are no guarantees Kate will stay in remission.
  • The Caretaker: Sarah of cancer-struck daughter Kate.
  • Consummate Professional: For better or worse, Julia Romano is this, which leads her to take on a case working alongside the only man who truly broke her heart.
  • Debate and Switch: Due to her sudden death in a car crash shortly afterward, the outcome of Anna's lawsuit is meaningless, so no-one finds out what the ramifications of her decision would have actually been. Even before that, after the lawsuit was decided, when her lawyer asked what she was going to do, her reply was "Ten years from now, I'd like to be Kate's sister", implying she was planning to go through with the donation despite having just fought (and won) a lawsuit over her right to refuse that very procedure.
  • Designer Babies: Anna is probably a more realistic example of this trope.
  • Diabolus ex Machina: Anna wins legal emancipation so her mother will stop using her as a living organ farm — then dies in a car crash and her organs are used anyway.
  • Disabled Love Interest: Kate is this briefly to a boy she meets at the hospital, but he dies shortly after they meet.
  • Downer Ending: The book ends with Anna dying in a car crash and her organs being harvested for Kate, while Sara gets her way yet again.
  • Expository Hairstyle Change: In the present Sara's hair is long and straight. When it shows Kate, Anna and Jesse as children it is longer and curly. In the ending scenes it is cut short.
  • The Hero Dies: At the end of the story, Anna passes away in a car accident.
  • False Rape Accusation: Briefly discussed. In lieu of something to do with his new client, Campbell considers talking to Anna in her room, but then decides that no lawyer in his right mind would follow a thirteen-year-old girl upstairs without supervision.
  • The Idealist: Averted with Anna Fitzgerald, who has a pretty realistic outlook on the both court case and her sister's imminent death, particularly for a thirteen-year-old.
  • Ill Girl: Of course, Kate. She eventually becomes a Disabled Love Interest to Taylor, a boy with cancer she meets at the hospital, until he dies as a result of remission.
  • It's All About Me: Like many of Picoult's fictional mothers, Sara has this trait. For most of the book, she believes that Anna has filed the lawsuit to annoy her. She's genuinely surprised when Kate reveals how she actually feels, and her first thought when she is confronted with her daughter's fate — Anna's brain-dead, organ-harvested body is not "my poor baby" but "what do you call a parent who's lost a child?"
  • Ivy League for Everyone: Julia and Campbell both went to Harvard; Izzy is treated as less intelligent for having gone to Rhode Island School of Design. note 
  • Knight Templar Parent: Sara, who both creates and blights Anna's life in order to save Kate, while dismissing anyone who isn't of any use in the pursuit of that goal. Including her own son.
  • Likes Older Women: Played for Laughs. Jesse Fitzgerald is hopelessly attracted to Anna's guardian-ad-litem, Julia Romano, of which nothing good comes out.
  • Lipstick Lesbian: Downplayed. Izzy Romano is said to greatly resemble her twin sister, a non-masculine heterosexual woman who attracts the attention of Campbell and Jesse alike.
  • Littlest Cancer Patient: Kate, who has leukemia. Played with in that Kate is actually tired of fighting a losing battle against her own body and wants Anna to win the lawsuit so she can die in peace.
  • Living Emotional Crutch: Jesse lampshades Anna's role in the family as this. Sara sees herself as Kate's emotional crutch, but in reality it's the other way around (she defines herself by her child's illness, and her role as mother/martyr).
  • Love Makes You Evil: Everything Sara did was for Kate's survival. She was so focused on trying to save Kate that she inadvertently harmed her other two children in the process (Jesse by neglecting him, Anna by using her as a perpetual blood/tissue donor for years on end).
  • Middle Child Syndrome: Inverted; Kate is the middle child of the family, and gets all of the attention because of her cancer. The role Anna plays in her family, however, is pretty standard for that of a stereotypical middle child (even though she's the youngest).
  • Mixed Ancestry: Played straight in the book, as Sarah is black and Brian is white (making all three Fitzgerald children mixed race, though Anna admits she's the only one who really looks it). In the film version, the entire family is depicted as white.
  • Parental Favoritism: There are countless examples. The mother, Sara, mainly cares about Kate and Kate only. She only cares about Anna because she can help Kate. Here are the more depressing examples.
    • While pregnant with Anna, she hadn't even thought of a name, she was more happy with the thought that the baby would help Kate. It is only until the book progresses that Sara does learn to love the real Anna more.
    • Kate needs more lymphocytes from Anna. The appointment falls during her friend's birthday party and Anna is allowed to stay for half of the party. As Sara is taking Anna to the car, she asks why she had to leave. Sara is so angry because "[her] sister is more important than cake and ice cream", that she tells Anna to stop acting like a five-year-old. Anna was five at the time.
    • The oldest son Jesse is neglected after it is found out he is not a genetic match for Kate. Sara finds it hard to feel sorry when he, a 6-year-old, gets his blood tested to see if he is a match for Kate. As a result, he becomes a chain smoker and a Pyromaniac.
    • Another example with Jesse: at one point Sara is too depressed over Kate to take Jesse to shop for new cleats as she had promised, and tells him they won't be going. Jesse gets upset and points out that she isn't even doing anything, and Sara screams at him until he runs upstairs upset. When Sara later goes up to apologize to him, she discovers that Jesse has used a fork to pull out his braces, and he says to her, "Now you never have to take me anywhere."
  • Nice Girl: Anna is one, despite her persistence in filing for medical emancipation (knowing that her sister will die if she does so). In fact, the only reason she's going to court in the first place is that the suicidal Kate asked.
  • Pyromaniac: The unnamed criminal who Brian and the rest oft he firemen have nicknamed "The Arsonist". It later turns out to be Jesse.
  • Race Lift: Sarah and Suzanne Fitzgerald were black women in the book (and all of Sarah's children were mixed). In the movie, the entire Fitzgerald family is depicted as white.
  • Ripped from the Headlines: My Sister's Keeper was based on a real-life story of a family who had a child (unintentionally) that was an exact match for their daughter who had cancer.
  • Running Gag: Campbell never giving anyone a straight answer once they ask what his service dog is for, since he's not blind. But he is epileptic.
  • Scholarship Student:
    • Julia was this at the Wheeler School, where she and Campbell met.
    • Anna Fitzgerald earnt a scholarship to go to hockey camp, which she doesn't attend due to her sister's medical needs.
  • Shoot the Shaggy Dog: In the original novel, at least. Anna's battle for medical emancipation is proven pointless when she dies in a car accident and both her kidneys are harvested for her older sister.
  • Third Line, Some Waiting: Campbell (Anna's lawyer) and Julia's relationship.
  • Title Drop: When Julia turns up at the Fitzgeralds' and asks Jesse where Anna is, he replies "Am I my sister's keeper?"
  • The Unfavorite: Jesse, and to a lesser extent, Anna. See Parental Favoritism above.
  • Useless Bystander Parent: Brian. While not happy with Anna's Walking Transplant status, he pretty much lets Sara get her way all the time, resulting in this trope.
  • We Named the Monkey "Jack": Campbell's dog, Judge. This causes some confusion when Judge interrupts Campbell in the middle of court.
  • Walking Transplant: The entire reason behind Anna's conception was that she could be used as an organ donor for her sister Kate.
  • Wise Beyond Her Years: Zig-zagged with Anna Fitzgerald, who constantly alternates between this Trope and acting like a regular thirteen-year-old girl.


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