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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 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. 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.
  • 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:
    • Savior siblings are portrayed as being born specifically to be lifelong donors to their siblings and with no legal ability to refuse while underage. In reality, the only thing taken from most savior siblings is their umbilical cord, which contains stem cells that can have major rejuvenating properties for the sick siblings.
    • In real life, a patient like Kate would have no chance of receiving an organ transplant, even from an adult relative or cadaver. For a transplant to take place, the new organ must last long enough to have a good chance of not needing another transplant for at least a decade, more or less, and the condition that caused the original organ to be irreparably damaged must no longer be present, or at least not present in such a way that the new organ will be damaged in a short time. In Kate's case, the latter condition is not met because the cause of her kidney failure is PML, which the transplant would not have cured, so the chances of immediate damage to the new kidney are too high to make the procedure worthwhile. If the transplant had been done anyway, Kate would have been in the same situation as before, while Anna would have been left with only one kidney.
  • Balancing Death's Books: While it's never explicitly stated to be true (given that the book has no supernatural elements), Kate states in the book's epilogue that she and the rest of the family believe that this trope is the real reason Kate survived against all the odds — that when Anna died, she took the "place" that was meant to be Kate's.
  • 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 remissionnote .
  • 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 was engineered to be a perfect genetic match for Kate, to increase the odds of donations working successfully.
  • 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.
  • Heel–Face Turn: Campbell. Though not outright evil, he originally undertakes Anna's case solely because he sees it as a slam-dunk that will boost his reputation. As he starts working with Anna, he feels more sympathetic to her situation, and takes the case more seriously.
  • 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.
  • High-School Sweethearts: Campbell and Julia met and fell in love in high school, despite being polar opposites to each other. Things came to an abrupt end when Campbell became epileptic following a car accident, and he broke things off with Julia without explanation.
  • 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 
  • Jerkass Has a Point: Brusque as he is about it, Campbell rightfully tells Anna that if she wants a chance at winning the case, she's going to have to be more straightforward with him—this coming after being told by Julia and Sara alike that Anna was considering dropping the case, when Anna tells him otherwise.
  • Karma Houdini: Sara, in the novel, is the only character to have evaded substantial Character Development. She ends the book in much the same place she started and never has to reconcile with any of her choices and even gets what she wanted begin with since Anna dies and her organs save Kate's life, the entire reason she even had Anna. The film gives her Adaptational Karma by avoiding the Cruel Twist Ending. By having Kate die, instead of Anna, Sara must give up being the "martyr mother" and let her go. Having Anna live also means that Sara needs to actually build and repair that relationship. The closing narration implies that's still in progress several years later.
  • 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).
  • Parental Favoritism: Kate's terminal illness has caused Sara to neglect her other two children over time, dismissing Anna's desire not to be Kate's personal on-call donor any longer, and all but considering Jesse a lost cause after ignoring him for years. Whenever Jesse and Anna object, Sara typically snaps at them and feels guilty for doing so later. Although Sara does love them, she always has and will put Kate's needs over theirs.
  • 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 Kate herself talked her into it (in the book it's because she feels guilty that her own illness is essentially sucking away Anna's life; in the movie it's because she's ready to die).
  • Pyromaniac: The unnamed criminal who Brian and the rest of the firemen have nicknamed "The Arsonist". It later turns out to be Jesse, who started doing it to both finally get some attention after being neglected of it by his parents, and to unleash his anger at being unable to help Kate in any medical capacity.
  • 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: 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. Not only does she die without ever becoming an independent person, but her literal last act in life is once again being Kate's donor.
  • Third Line, Some Waiting: Every few chapters with the Fitzgeralds will switch to focus on the relationship between Campbell and Julia.
  • Title Drop: When Julia turns up at the Fitzgeralds' and asks Jesse where Anna is, he replies "Am I my sister's keeper?"
  • Tragically Disabled Love Interest: Kate is this briefly to a boy she meets at the hospital, but he dies shortly after they meet.
  • The Unfavorite: Anna and Jesse, though more extreme in the latter's case. Kate's terminal illness has caused her parents to neglect their other children in favor of her. In Anna's case, even if her parents love her, she is always considered first and foremost Kate's donor. In Jesse's case, as he cannot offer anything medically to Kate, years and years of being dismissed entirely have turned him into a delinquent.
  • Useless Bystander Parent: Brian. While not happy with Anna's Walking Transplant status, he pretty much lets Sara get her way all the time. While Sara's Parental Favoritism of Kate is more blatant, Brian's neglect of his other children is more attributed to a lifetime of exhaustion and burnout from Kate's illness.
  • 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 and acting like a regular thirteen-year-old girl. Although years of being Kate's donor have made her knowledgeable in matters like law and medicine, she also crushes on cute boys and steals some of her sister's things, like music.
  • Working with the Ex: Campbell and Julia are aghast to learn that their first time reuniting after their bitter high school breakup will be in serving as Anna's lawyer and guardian ad litem, respectively.