“My mother stands over me. “You went to a lawyer and made him think this is all about you— and it’s not. It’s about us. All of us—””

Note: This review is based on the book alone. If you have not read the book and you have any intention of doing so in the future, beware that there will be spoilers below. There are major differences between the book and the movie. By comparison to the book, the movie is downright light-hearted.

Even if you have not read any of Jodi Picoult’s books, there is a good chance that you would recognise the name “My Sister’s Keeper” and would most likely know at least a little bit about the story. It just goes to show the impact this story has had on its audience. Anyone who has ever read this story will feel emotionally invested and drawn to it.

How could any reader not be? We are drawn to thirteen-year-old Anna Fitzgerald in the same way we might be drawn to a crying child or an orphan. The claim her mother: Sara (and it is mostly her mother) has placed on her body goes beyond moral grayness. It is clearly unethical.

Anna was conceived specifically so that she could donate parts of herself to her sister who is dying from acute leukemia. While it may have started with her umbilical cord, it gradually evolved to bone marrow until she was eventually told to donate a kidney. This was the point at which Anna decided to sue her own parents. The very fact that it even had to go this far is horrifying.

How could anyone, least of all a mother, possibly think that it is okay to force her thirteen-year-old daughter to constantly donate different parts of her body to a sister who may never get better? To even ask for a kidney should be enough for her to lose custody due to gross neglect and abuse.

And I know that some people may be inclined to sympathise with the mother’s plight. She is, after all, at risk of losing a child but that does not ever justify her sacrificing another child. Not only that but she neglects her son in the process of trying to keep her oldest daughter safe.

The Fitzgerald family is not only dysfunctional but also abusive.

Anna Only Has Value In Regards To How She Can Help Her Sister

“Although I am nine months pregnant, although I have had plenty of time to dream, I have not really considered the specifics of this child. I have thought of this daughter only in terms of what she will be able to do for the daughter I already have.”

Sara Fitzgerald

The above quote perfectly summarises everything wrong with Sara’s relationship with her youngest daughter: Anna. Due to the fact that she merely conceived Anna in order to save her oldest daughter, she never went through the same bonding with Anna that she would have done with Kate. Anna’s only value is in her ability to save her sister.

“”The umbilical cord,” I remind him. “Be careful.” He cuts it, beautiful blood, and hurries it out of the room to a place where it will be cryogenically preserved until Kate is ready for it.””

Sara Fitzgerald

Instead of cooing over her new baby and really taking the effort to bond with her brand new daughter, Sara is more concerned with the baby’s umbilical cord. Kate’s illness has made her unable to truly see Anna as her daughter as well. It has given her tunnel vision. This is a coping mechanism. If Sara ever stopped to see Anna as her child. If she ever stopped to consider that Anna has inherent value as a human being, I doubt she would be able to carry on treating her like a miniature organ donor.

“I spoke to Anna, and she assured me she really doesn’t want to do this. She had a bad day, and wanted a little extra attention … You know how thirteen-year-olds can be.”

Sara Fitzgerald

People have a right to decide whether or not they want their organs donated, even after death. Yet Anna, a living breathing child, is being denied this right by her own mother. If that was not bad enough, Sara has the audacity to accuse her child’s plea for bodily autonomy as a plea for attention. If Sara had begged Anna to donate her kidney to save her sister, it would still be morally wrong but to go so far as to see her as a mischievous child really shows she has no value for Anna.

Sara is willing to force Anna into giving up her kidney to her sister despite her clear refusal and her filing for a lawsuit. She has very little interest in Anna’s life (she barely even notices any of her children other than Kate and openly dismisses her husband’s suggestion that something is wrong with Anna). She is not able to even consider the impact that giving up a kidney will have on Anna.

The fact of the matter is, that with a mother like this, Anna could give up her life and Sara will always prefer it to Kate dying. She will certainly grieve. I’m not doubting that one bit but nowhere near as much as she would if Kate died. Sara has spent too long trying to keep her oldest daughter alive to let anything, even her youngest daughter’s health and life, to stop. She is too far gone to ever be a good mother to either of her two remaining children.

“”Dr Chance doesn’t think Kate’s strong enough [for a kidney transplant].”

“And Sara Fitzgerald’s pushing for it,” I say.

“When you think about it, Campbell, you can’t blame her logic. If Kate’s going to die without the transplant anyway, why not go for it?”

…

“Because the transplant involves major surgery for her other daughter … And putting Anna’s health at risk for a procedure that’s not necessary for her seems a little cavalier.””

Campbell Alexander

I love the inclusion of Campbell’s point of view since it really shows just how messed up this whole situation is. To the Fitzgeralds, the only thing that seems to matter is that Kate survives, whatever the cost. While I may have been inclined to feel sympathy for the parents in an ordinary situation, I can bring myself to feel nothing but disgust for a set of parents who would sacrifice their own healthy daughter for a child whose chance of surviving is minimal even in the most ideal circumstances.

Donating a kidney comes with both short and long term health issues. Anna would have to be careful for the rest of her life and may not even be able to safely have kids of her own. It is a risky medical procedure for a healthy adult, let alone an actual child. And the fact that this might not even help Kate makes it even more disgusting that Sara would push for this with no hesitation. Sara does not even spend a minute of her time to consider the implications of the procedure on her youngest daughter. She is presented with a lawsuit and she still cannot see how she is endangering her own child.

At one point, Sara even compares the situation to sending one child into a burning building to save another child. In my view, this is even more messed up since it actually shows an element of awareness about the dangers of forcing her younger daughter to go through with the transplant. No one can call themself a good parent if they are willing to risk the life of a child (of their child) to save another. The only thing this shows is that Sara clearly values the life of one child over the other.

“When you complain because someone’s sticking a needle into you for the tenth time, it’s considered standard operating procedure. All the adults look around with fake smiles and tell each other that no one voluntarily asks for more needles … The kidney-that’s just today. Tomorrow it’ll be something else. It’s always something else.”

Anna Fitzgerald

This is heartbreaking. Anna is stuck in this never ending cycle of having to give up parts of herself and being hospitalized in order to save her sister. She is almost forced to give up her own kidney. Her own family has made it her responsibility to ensure that her sister survives. She, a child, should never have been made responsible for an older sibling’s health, let alone their life.

And I know that anyone who read the book will know that Anna only went through the lawsuit because Kate asked for it but that is irrelevant because her parents don’t know that. They only know the legitimate reasons Anna has given for not wanting to donate a kidney. Sara is willing to use any means necessary to force her own child to give up her kidney. Brian, at best an enabler, is no better. He does not stand up for his own daughter and even betrays her trust in the end by switching sides during a court case with no warning.

The Forgotten Child: Jesse

While it may seem that in comparison to everything Anna has suffered at the hands of her family, Jesse escaped relatively unscathed, that could not be further from the truth. I would argue that the neglect that Jesse suffered at the hands of his parents is still worthy of being mentioned, especially in an evaluation of whether or not the Fitzgerald family is an abusive one.

I can understand that having a child with a terminal illness is a major setback and will often result in the occasional neglect of the other children. However, I would still argue that considering the extent of the neglect suffered by Jesse, he would have been better off being taken care of by another family. While that would still scar Jesse, at least his emotional and developmental needs could be met this way.

“I’d think that since you’re ten, you might be able to grow up enough to realise that the whole world doesn’t always revolve around you.”

Sara Fitzgerald

For context, the above statement is spoken by his mother when he asks to be taken to his orthodontist appointment to get his braces removed and to get new cleats so he can play sports. This results in him taking his braces out by himself (without any supervision whatsoever). While that may seem an extreme reaction, I am more inclined to blame Sara than I am to blame Jesse.

Having a terminally ill child may be heartbreaking but it does not justify taking the anger, grief and frustration out on a child. Sara could have just as easily tried to explain to her son why she couldn’t take him. She could have at least tried to explain to him that she has to prioritise his sister’s health and even though it’s unfair, he has to learn to accept it. Rather than doing that, she accuses him of being childish and entitled.

He is ten years old and much too young to fully understand the implications of his sister’s illness. While some may argue that Sara’s reaction was natural, I’d argue that as a mother, her responsibility to her children trump the anger she felt in the moment.

“My father looked right at me, but he didn’t answer. And his eyes were dazed and staring through me, like I was made of smoke. That was the first time I thought that maybe I was.”

Jesse Fitzgerald

It is one thing to feel as though you are not getting as much attention as your siblings and quite another to feel completely invisible. Jesse is very clearly neglected. If his parents had the foresight to have him be taken care of by another family, he would have been better off. While he might have grown up with abandonment issues, all of his needs would have been met. He would, arguably, be less of an emotional mess than he already is (this child becomes an actual arsonist as a way of coping in life).

I’m not saying that Sara and Brian should have completely cut him off. They should still see him regularly but they should have realised that with a terminally ill child, they would not be able to be parents to Jesse. They only met Jesse’s most basic of needs: sustenance and shelter. They could not even be there for his medical or educational needs. How could they possibly hope to be parents to him without severely neglecting him?

And if you don’t believe that he was severely neglected, here’s a quote for you.

“it isn’t that my parents don’t care about Jesse or whatever trouble he’s gotten himself mixed up in. It’s just that they don’t really have time to care about it, because it’s a problem somewhere lower on the totem pole.”

Anna Fitzgerald

In light of Kate’s condition, Jesse’s problems don’t even register to his parents. Keeping him only to severely neglect him was selfish and cruel. Jesse may be messed up but that’s more his parents fault than anything else. After all, no child can be expected to be a stable, functioning member of society if they are, at best, an afterthought, and at worst, a nuisance.

Final Thoughts

What did you think was the saddest part of the ending?

If you think it was her family grieving, then you’re very wrong.

The saddest thing is that Anna died at 13 right after suing her parents for medical emancipation (due to her mother doing everything she could to force her to give up her kidney). Her own father betrayed her. She spent 13 years feeling like her only purpose was to donate parts of her body (blood, bone marrow etc) to her sister. She didn’t get to have a normal childhood. She didn’t get to have friends or play hockey or graduate or go to college.

The ending may be cute but it’s worth nothing if they only truly showed how much she mattered to them after she died.

She never got to be a child. She never got to feel like a priority. Her going so far as to file for a lawsuit in order to not give up a kidney at 13 was seen as her seeking attention and acting out.

So if you’re feeling sorry for the parents? Don’t. They don’t deserve it.

The only family that truly loved her outside of her being able to save her sister were her siblings.

Yes, there was a sappy moment near the end but one moment of happiness, of being seen and cared for and prioritised does not erase a lifetime of pain and being put in the backseat over and over.

You should feel sad but not for these abusive parents. You should feel sad for a child who never even got to have a life of her own.