MY SISTER’S KEEPER

Picoult’s latest chronicle of family travail (Second Glance, 2003, etc.) highlights the consequences of deliberately conceiving a child genetically compatible with a mortally ill sibling.

The author vividly evokes the physical and psychic toll a desperately sick child imposes on a family, even a close and loving one like the Fitzgeralds. Picoult’s plotting, though, is less sure, as an inherently somber tale morphs into a melodrama with a too-neat twist. Anna Fitzgerald, the 13-year-old who begins the story, was conceived in vitro, and her embryo’s genetic makeup closely matched that of her sister Kate. Now 16, Kate was diagnosed at 2 with acute promyelocytic leukemia. In the years that followed she has suffered numerous relapses, despite the infusion of Anna’s platelets and bone marrow, even stem cells from her sister’s umbilical cord. Their parents, Sara and Brian, now want Anna to give Kate one of her kidneys; compromised by her drastic treatments, Kate’s organs are shutting down. Instead, Anna contacts attorney Campbell Alexander and asks him to represent her; she wants her parents to stop using her body to help Kate. Like elder brother Jesse, who’s turned his angst into arson and general bad-boy behavior, she has spent her life in the shadow of her sister’s illness—one year Kate had to be hospitalized on every holiday. Sara, who has made keeping Kate alive her life’s mission, is very angry, but Brian initially takes Anna’s side, feeling too much has been asked of her. A hearing is scheduled, though Anna is torn between her affection for Kate and what she feels must be done. As the hearing begins Kate is hospitalized, Jesse’s arson is discovered, and Anna initially refuses to testify. There can 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.

Despite overplotting, then, a telling portrait of a profoundly stressed family.