Jodi Picoult - MY SISTER'S KEEPER

MY SISTER'S KEEPER

About the book
A conversation with Jodi about MY SISTER'S KEEPER
Book club discussion questions
Interviews
Reviews
Buy the book

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About the book

THE ONLY WAY TO SAVE YOUR DAUGHTER
IS TO SACRIFICE HER SISTER.
WHAT WOULD YOU DO?

Sara Fitzgerald’s daughter Kate is just two years old when she is diagnosed with a rare form of leukaemia. Reeling with the helpless shock of it, Sara knows she will do anything – whatever it takes - to save her child.

Then the tests results come back time and again to show that no one in their family is a match for Kate. If they are to find a donor for the crucial bone marrow transplant she needs, there is only one option: creating another baby, specifically designed to save her sister. For Sara, it seems the ideal solution. Not only does Kate live, but she gets a beautiful new daughter, Anna, too.

Until the moment Anna hands Sara the papers that will rock her whole world. Because, aged thirteen, Anna has decided that she doesn’t want to help Kate live any more. She is suing her parents for the rights to her own body.

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A CONVERSATION WITH JODI PICOULT ABOUT MY SISTER’S KEEPER

Your novels are incredibly relevant because they deal with topics that are a part of the national dialogue. Stem cell research and “designer babies” are issues that the medical community (and the political community) seem to be torn about. Why did you choose this subject for My Sister's Keeper? Did writing this novel change any of your views in this area?
JP: I came about the idea for this novel through the back door of a previous one, Second Glance. While researching eugenics for that book, I learned that the American Eugenics Society - the one whose funding dried up in the 1930s when the Nazis began to explore racial hygeine too - used to be housed in Cold Spring Harbor, NY. Guess who occupies the same space, today? The Human Genome Project… which many consider "today's eugenics". This was just too much of a coincidence for me, and I started to consider the way this massive, cutting edge science we're on the brink of exploding into was similar… and different from… the eugenics programs and sterilization laws in America in the 1930s. Once again, you've got science that is only as ethical as the people who are researching and implementing it - and once again, in the wake of such intense scientific advancement, what's falling by the wayside are the emotions involved in the case by case scenarios. I heard about a couple in America that successfully conceived a sibling that was a bone marrow match for his older sister, a girl suffering from a rare form of leukemia. His cord blood cells were given to the sister, who is still (several years later) in remission. But I started to wonder… what if she ever, sadly, goes out of remission? Will the boy feel responsible? Will he wonder if the only reason he was born was because his sister was sick? When I started to look more deeply at the family dynamics and how stem cell research might cause an impact, I came up with the story of the Fitzgeralds. I personally am pro stem-cell research - there's too much good it can to do simply dismiss it. However, clearly, it's a slippery slope… and sometimes researchers and political candidates get so bogged down in the ethics behind it and the details of the science that they forget completely we're talking about humans with feelings and emotions and hopes and fears… like Anna and her family. I believe that we're all going to be forced to think about these issues within a few years… so why not first in fiction?

In Jesse, you've done an amazing job of bringing the voice of the "angry young man" alive with irreverent originality. Your ability to transcend gender lines in your writing is seemingly effortless. Is this actually the case, or is writing from a male perspective a difficult thing for you to do?
JP: I have to tell you - writing Jesse is the most fun I've had in a long time. Maybe at heart I've always wanted to be a 17 year old juvenile delinquent… but for whatever reason, it was just an absolute lark to take someone with so much anger and hurt inside him and give him voice. It's always more fun to pretend to be someone you aren't, for whatever reason - whether that means male, or thirteen, or neurotic, or suicidal, or any of a dozen other first person narrators I've created. Whenever I try on a male voice - like Jesse's or Campbell's or Brian's - it feels like slipping into a big overcoat. It's comfortable there, and easy to get accustomed to wearing… but if I'm not careful, I'll slip and show what I've got on underneath.

On page 190, Jesse observes, while reminiscing on his planned attempt to dig to China, that, "Darkness, you know, is relative." What does this sentiment mean and why did you choose to express it through Jesse, who in some ways is one of the least reflective characters in the novel?
JP: Well, that's exactly why it has to be Jesse who says it! To Jesse, whatever injustices he thinks he's suffered growing up will always pale to the Great Injustice of his sister being sick. He can't win, plain and simple… so he doesn't bother to try. When you read Jesse, you think you see exactly what you're getting: a kid who's gone rotten to the core. But I'd argue that in his case, you're dealing with an onion… someone whose reality is several layers away from what's on the surface. The question isn't whether Jesse's bad… it's what made him that way in the first place… and whether that's really who he is, or just a facade he uses to protect a softer self from greater disappointment.

How did you choose which quotes would go at the beginning of each section? Milton, Shakespeare, D.H. Lawrence - are these some of your favorite authors, or did you have other reasons for choosing them?
JP: I suppose I could say that all I ever read are the Masters… and that these quotes just popped out of my memory… but I'd be lying! The bits I used at the beginning of the sections are ones that I searched for, diligently. I was looking for allusions to fire, flashes, stars - all imagery that might connect a family which is figuratively burning itself out.

Sisterhood, and siblinghood for that matter, is a central concept in this work. Why did you make Isobel and Julia twins? Does this plot point somehow correspond with the co-dependence between Kate and Anna? What did you hope to reveal about sisterhood through this story?
JP: I think there is a relationship between sisters that is unlike other sibling bonds. It's a combination of competition and fierce loyalty, which is certainly evident in both sets of sisters in this book. The reason Izzy and Julia are twins is because they started out as one embryo, before splitting in utero… and as they grew their differences became more pronounced. Kate and Anna, too, have genetic connections… but unlike Izzy and Julia, aren't able to separate from each other to grow into distinct individuals. I wanted to hold up both examples to the reader, so that they could see the difference between two sisters who started out as one and diverged; and two sisters who started out distinct from each other, and somehow became inextricably tangled.

Anyone who has watched a loved one die (and anyone with a heart in their chest) would be moved by the heartfelt, realistic and moving depiction of sickness and death that is presented in this story. Was it difficult to imagine that scenario? How did you generate the realistic details?
JP: It's always hard to imagine a scenario where a family is dealing with intense grief, because naturally, you can't help but think of your own family going through that sort of hell. When researching the book, I spoke to children who had cancer, as well as their parents - to better capture what it felt like to live day by day, and maintain a positive attitude in spite of the overwhelming specter of what might be just around the corner. To a lesser extent, I also drew on my own experience, as a parent with a child who faced a series of surgeries: when my middle son Jake was 5, he was diagnosed with bilateral cholesteatomas in his ears - benign tumors that will eventually burrow into your brain and kill you, if you don't manage to catch them. He had ten surgeries in three years, and he's tumor free now. Clearly, I wasn't facing the same urgent fears that the mom of a cancer patient faces… but it's not hard to remember how trying those hospitalizations were. Every single time I walked beside his gurney into the OR, where I would stay with him while he was anesthetized, I'd think, "Okay, just take my ear; if that keeps him from going through this again." That utter desperation and desire to make him healthy again became the heart of Sara's monologues… and is the reason that I cannot hate her for making the decisions she did.

Sara is a complicated character, and readers will probably both criticize and empathize with her. How do you see her role in the story?
JP: Like Nina Frost in Perfect Match, Sara's going to generate a bit of controversy, I think. And yet, I adore Nina… and I really admire Sara too. I think that she's the easy culprit to blame in this nightmare… and yet I would caution the reader not to rush to judgment. As Sara says at the end of the book, it was never a case of choosing one child over the other - it was a case of wanting BOTH. I don't think she meant for Anna to be at the mercy of her sister… I think she was only intent on doing what had to be done to keep that family intact. Now… that said… I don't think she's a perfect mom. She lets Jesse down - although she certainly was focused on more pressing emergencies, it's hard for me to imagine giving up so completely on a child, no matter what. And she's so busy fixating on Kate's shaky future that she loses sight of her family in the here and now - an oversight, of course, that she will wind up regretting forever at the end of the book.

The point of view of young people is integral in your novels. In fact, more wisdom, humor and compassion often comes from them than anywhere else. What do you think adults could stand to learn from children? What is it about children that allows them to get to the truth of things so easily?
JP: Kids are the consummate radar devices for screening lies. They instinctively know when someone isn't being honest, or truthful, and one of the really hard parts about growing up is learning the value of a white lie… for them, it's artifice that has to be acquired… remember how upset Holden Caulfield got at all the Phonies? Anna sees things the way they are because mentally she's still a kid - in spite of the fact that she's pretty much lost her childhood. The remarkable thing about adolescents, though, that keeps me coming back to them in fiction… is that even when they're on the brink of realizing that growing up means compromising and letting go of those ideals, they still hold fast to hope. They may not want to admit to it (witness Jesse!) but they've got it tucked into their back pockets, just in case. It's why teens make such great and complicated narrators.

The ending of My Sister's Keeper is surprising and terribly sad. Without giving too much away, can you share why you choose to end the novel this way? Was it your plan from the beginning, or did this develop later on, as you were writing?
JP: My Sister's Keeper is the first book one of my own kids has read. Kyle, who's twelve, picked it up and immediately got engrossed in it. The day he finished the book, I found him weeping on the couch. He pushed me away and went up to his room and told me that he really didn't want to see me or talk to me for a while - he was THAT upset. Eventually, when we did sit down to discuss it, he kept asking, "Why? Why did it have to end like that?" The answer I gave him (and you) is this: because this isn't an easy book, and you know from the first page, that there are no easy answers. Medically, this ending was a realistic scenario for the family - and thematically, it was the only way to hammer home to all the characters what's truly important in life. Do I wish it could have had a happy ending? You bet - I even gave a 23rd hour call to a oncology nurse to ask if there was some other way to end the book - but finally, I came to see that if I wanted to be true to the story, this was the right conclusion.

All of your books to date have garnered wonderful press. In what ways, if any, does this change your writing experience?
JP: Um, are you reading the same reviews that I am?!? I'm kidding - well, a little. I've had overwhelmingly good reviews, but I think the bad reviews always stick with you longer, because they sting so much (no matter how many times I tell myself I'm going to ignore them, I read them anyway). I am fortunate to write commercially marketed books that still manage to get review coverage - too often in this industry books are divided by what's reviewed and literary, or what's advertised and commercial. It's incredibly fun to have a starred review in a magazine - photographers come out and take fancy pictures of you, and people are forever seeing your face and a description of your novel when they hang out in doctor's and dentist's waiting rooms. But the best thing about good press is that it makes people who might not otherwise have a clue who you are want to go and pick up your book. I never write a book thinking of reviewers (in fact, if I did, I'd probably just hide under my desk and never type another letter!) but I certainly think about whether it will hold the interest of a reader as well as it's holding my own

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Book club discussion questions

Reread the prologue to My Sister's Keeper. Who is the speaker? Is it the same person you thought it was the first time you read it?
What is the metaphorical relevance of Brian's profession as a fire chief?
Why is Jesse's behavior so aberrant, while until now, Anna has been so compliant?
What might be a possible reason for Brian's fascination with astronomy?
On page 98, Kate is being admitted to the hospital in very serious condition. She mouths to Jesse, "tell Anna," but is unable to finish. What do you think she was trying to say?
On page 122, Julia says, "Even if the law says that no one is responsible for anyone else, helping someone who needs it is the right thing to do." Who understood better how to "help" Kate, Sara or Anna?
Did Anna do the right thing, honoring Kate's wishes?
Do you feel it was unfair of Kate to ask Anna to refuse to donate a kidney, even though this seemed to be the only way for her to avoid the lifesaving transplant?
On page 142, Brian says that when rescuing someone from a fire, that "the safety of the rescuer is of a higher priority than the safety of the victim. Always." How does this apply to his role in his own family?
On page 144, Brian says, "Like anything that's been confined, fire has a natural instinct to escape." How does this truth apply to Kate? to Brian himself?
On page 149, Brian is talking to Julia about astronomy and says, "Dark matter has a gravitational effect on other objects. You can't see it, you can't feel it, but you can watch something being pulled in its direction." How is this symbolic of Kate's illness?
For what reason(s) did Brian offer Anna a place to stay at the firehouse while the legal proceedings were underway?
How does Anna's decision to pursue medical emancipation parallel Campbell's decision to end his relationship with Julia after his accident?
Do you agree with Brian's decision not to turn Jesse in to the authorities for setting the fires?
Do you feel that it's ethical to conceive a child that meets specific genetic requirements?
If not, do you believe that there should be specific exceptions, such as the purpose of saving another person's life, or is this just a "slippery slope?"

Interviews

Jodi Picoult spreads her wings and catches an updraft’

The New York Times Book Review

Picoult's son Jake had undergone 11 operations to address an exceptionally rare condition. She glosses over any traumatic memories, but acknowledges their percolating effect. "With something like that, I won't write about it while it's happening, because I'm too close to it; but years afterwards I'm able to let some of my own experiences bleed through into the fiction. It was only when I started writing My Sister's Keeper that that whole experience of having a chronically ill child from my own life began to inform the writing."

"The heart of the matter" interview, Independent on Sunday, May 11 2008

RICHARD AND JUDY BOOK CLUB WEBSITE:
Richard and Judy’s Book Club review unable to copy and paste. Website: http://www.channel4.com/entertainment/tv/microsites/R/richardandjudy/book_club_05/book_club_sister.html

Note from the Author: [Richard and Judy Website]
‘When I started writing I actually thought I would write the entire book from Anna's point of view, that 13-year-old voice, I loved Anna's voice. But one of my sons, who is now eleven was diagnosed with a benign tumour when he was five. It's a benign tumour so it won't kill you but it will eventually burrow into your brain and kill you that way so you need to get rid of it. Over the course of three years he wound up having ten surgeries. Somewhere in the middle of that it was discovered that he had these tumours in both ears. Because of that I learned very quickly what it was like to have a child go to hospital as a matter of routine. I learned what it was like for a hospital to be a comfortable place. And also had to admit to myself there were times as a mother when I had to tell my other children "no you cant go to your friends house" or "we are going to miss open school night because you brother is having surgery" and I began to realise as I wrote the book that it wasn't just Anna we needed to hear from, that her mother, her father and everyone else had a right to tell you why they made the choices they've made along the way.’

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Reviews

'Jodi Picoult spreads her wings and catches an updraft’

The New York Times Book Review

'Rarely have I read such an eloquent portrayal of the family in crisis. Every character: real. Every situation: true. Picoult defies you to put this novel down once you've begun it. I do the same.'

Elizabeth George

'Brilliantly told'

Daily Mirror

'Anna's conflict between love for her sister ('without her, it's hard to remember who I am') and the desire for her own freedom is well portrayed. And Picoult writes with an evident understanding of the damage serious illness can do to a family.'

Daily Mail

'The difficult choices a family must make when a child is diagnosed with a serious disease are explored with pathos and understanding in this 11th novel by Picoult (Second Glance, etc.). The author, who has taken on such controversial subjects as euthanasia (Mercy), teen suicide (The Pact) and sterilization laws (Second Glance), turns her gaze on genetic planning, the prospect of creating babies for health purposes and the ethical and moral fallout that results . . .Picoult ably explores a complex subject with bravado and clarity, and comes up with a heart-wrenching, unexpected plot twist at the book's conclusion.'

Publisher's Weekly

'Expect to be kept up all night by Picoult's latest novel, but it's much more than a page-turner; it's a fascinating character study framed by a complex, gripping story. Thirteen-year-old Anna Fitzgerald walks into the office of lawyer Campbell Alexander and announces she wants to sue her parents for the rights to her own body. Anna was conceived after her older sister, Kate, developed a rare form of leukemia at the age of two, and has donated bone marrow and blood to her sister. Now she has been asked to donate a kidney, and she intends to refuse. Campbell is a jaded young man who nevertheless decides to take her case pro bono. Anna's parents are shocked when they learn of her lawsuit, and her mother, a former civil defense attorney, decides to represent them. Anna refuse...'

Booklist

'Picoult's timely and compelling novel will appeal to anyone who has thought about the morality of medical decision making and any parent who must balance the needs of different children. Highly recommended.'

Library Journal

'This astonishing novel is beautifully and thoughtfully written, and focuses on difficult moral choices.'

Good Housekeeping

'[Jodi Picoult] vividly evokes the physical and psychic toll a desperately sick child imposes on a family, even a close and loving one like the Fitzgeralds... There may be no easy outcomes in a tale about individual autonomy clashing with a sibling's right to life, but Picoult thwarts our expectations in unexpected ways... a telling portrait of a profoundly stressed family.'

Kirkus Reviews

'It is not every day that I thank Richard and Judy but I am indebted to their book club for bringing to my attention MY SISTER'S KEEPER . . . Picoult's rich characterisation means the Fitzgeralds become more than a fictional family. The scientific debate gets personal . . . MY SISTER'S KEEPER is emotionally riveting and will test your tear ducts to the limit - particularly the final, gut-wrenching twist . . . Picoult tackles a controversial subject head on with a sense of wisdom and sensitivity. If there's only one book you read this year, make it this one.'

Daily Express

Very compelling.

Heat

'A real tear-jerker...It's an absolutely wonderful book.'

Sophie Anderson, Sunday Express

'I loved it, I read it in two nights . . . Absolutely no argument is left unturned'

Amanda Donahoe

'Fascinating and highly topical . . . I found it a real page turner . . . Every scene is powerful . . . A dramatic ending . . . shocking and made me cry'

Richard Madeley

'Picoult has become a master - almost a clairvoyant - at targeting hot issues and writing highly readable page-turners about them . . . [[I]t is impossible not to be held spellbound by the way she forces us to think, hard, about right and wrong.'

Washington Post

'This beautifully crafted novel will grab readers with its stunning topic . . . the tightly woven tale seamlessly bounces from past to present . . . Picoult's style borders on the poetic'

People Magazine