My Sister's Keeper by Jodi Picoult

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My Sister's Keeper by Jodi Picoult

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Category: General Fiction
Rating: 4/5
Reviewer: Sue Magee
Reviewed by Sue Magee
Summary: A well-written and tightly-plotted story which explores one of today's ethical dilemmas - that of the designer baby produced to prolong the life of another child. The background has been well-researched and the issues are dealt with sensitively.
Buy? Yes Borrow? Yes
Pages: 448 Date: January 2005
Publisher: Hodder & Stoughton Ltd
ISBN: 034083546X

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I've been guilty of judging a book by its cover. I'd skipped over it so many times because of the delicate pastel colouring, glittery stars and sweet-faced child on the front. There's little indication that inside there's a tightly-plotted, well-written story which explores one of today's ethical dilemmas.

When she was two Kate Fitzgerald was diagnosed with a rare form of leukaemia. Without blood, bone marrow, lymphocytes, granulocytes from a matched donor her life is likely to be short. The best match is likely to be from a brother or sister but Kate's brother, Jesse, isn't the perfect match that's required. Kate's parents, Brian and Sara, decide to have another child to be a donor for Kate. This baby isn't pot luck though. This is a designer baby - the foetus selected because it's a perfect genetic match for Kate. That's how Anna came to be born. Within minutes of her birth she donated blood from her umbilical cord and this put Kate into remission for some years. Some thirteen years and various donations later Anna has had enough and sues her parents for the rights to her own body.

This may be fiction but it's also a book from which you'll learn. Primarily it's about the feelings of a child who is brought into the world to save another. At first sight it seems innocuous: the blood from Anna's umbilical cord put Kate into remission. The cord would have been thrown away and there was no effect on Anna. That's not the end of it though. When Kate becomes ill again more donations are required and these are invasive. Each time the extent of the invasion escalates and we join the story when Anna is required to donate one of her kidneys. Is it reasonable that she should be expected to do so? How will she deal with the consequences if she gains the right to refuse?

It's a story too about parenting and about the effect on the whole family when one member is seriously ill. Kate is the centre of attention. She's the one who is thought about first and life revolves around her needs. Her elder brother, Jesse, reacts with bad behaviour, escalating to the point where he will put life at risk just to get attention from his parents. Anna feels that she's invisible, that she's nothing more than a donor for Kate. Her life has to revolve around Kate even more than the rest of the family. She can't even go away in case she's needed to give another bit of her body for Kate. Sara, the mother, is single-minded, but had she not been, Kate would have been dead for many years. She sees Kate's needs as being paramount. Brian, her husband, is torn between the two points of view.

What is obvious though is that neither parent has any idea what is going on in Jesse and Anna's lives. This is an extreme example and thankfully not a common one, but I suspect we're all guilty of, or subject to, this discrimination on occasion and it's made me rethink my attitudes in a couple of areas. Not many novels do that. It made me think too about the ethics of using a child as a donor. The child is not in a position to make an informed decision about what's happening as they're unlikely to be able to understand the long-term implications. If they refuse how will they deal with the guilt? If they agree do they understand the medical implications for themselves? On the other hand if the parent making the decision is also the parent of the recipient it's difficult to see how the decision can be unbiased and in the donor's interests.

It's also a book about illness. The forms of leukaemia have been carefully and thoroughly researched but in many ways this is irrelevant. It could have been any life-threatening and debilitating disease. It raises questions about when it's right to continue invasive treatment and when it's right to let go. It's about the risks that are taken in the hope rather than certainty of getting a little more time. Ultimately it's about the "when" not the "if" of terminal illness.

The characters are well drawn. They came out as balanced people rather than caricatures. The story is told in a series of snapshots, each narrated in the first person by different people. Anna's sassy, intelligent but unsure of herself. Sara has an iron will where Kate's concerned and Kate herself, despite never taking part in the narration, comes across as having some of the less-considerate traits of an invalid but still being something more than her illness. There is a less-sure touch with the men in the story. I was never quite certain that the character of Campbell, the lawyer, made sense and Brian, the father, didn't seem consistent. These are minor quibbles and didn't spoil the story for me.

The story is well-plotted and tightly drawn. There's little there that's superfluous and once started I finished the book within a couple of days. I found the ending shocking but a little disappointing. It was a little bit too convenient, but still didn't spoil the book for me.

Whilst reading I was put in mind of "The Lovely Bones" by Alice Sebold although there's much less sentimentality in this book. If you enjoyed that book you'll certainly enjoy this one.

The book's recommended. I don't reread many books but this might be one of the ones that I do.

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