Context In 2004, Picoult published My Sisters Keeper. Like most
of her works, the novel takes on a range of morally complex issues,
from the ethics of genetic engineering, to the right of
terminally-ill patients to elect to die, to a minors right to
control her own body. Genetic engineering alone has been the
subject of controversy since its very first uses to help infertile
couples conceive via in vitro fertilization. As the potential uses
of the method have grown, so have the moral questions that such
genetic manipulation raises. Notably, the ethics of using science
to create a so-called designer baby, meaning one whose physical
traits are selected by the parents, has become the object of
frequent and heated debates. These quandaries, and those regarding
the rights of terminally ill patients and minors to determine what
happens to their bodies, all intertwine in My Sisters Keeper, which
tells the story of one family devastated by their eldest daugther
Kates battle with acute promyelocytic leukemia, an extremely
aggressive form of cancer
Slide 3
Background Info With My Sisters Keeper, Picoult drew on her
experiences with her middle son, who at the age of five needed ten
surgeries over three years to treat a tumour in his ear. Picoult
says the desperation she felt sitting in the hospital beside her
anesthetized son and knowing she could do nothing to help him
informed her depiction of Sara, the mother in the Fitzgerald family
of My Sisters Keeper. That emotion, combined with the knowledge
Picoult gathered in her research, imbues the book with a sense of
realism.
Slide 4
In a nutshell... NARRATOR Multiple narrators alternate
throughout the book. These narrators are Anna, Jesse, Kate, Brian,
and Sara Fitzgerald, Campbell Alexander, and Julia Romano. The
chapters narrated by Sara largely take place in the past, while the
rest of the narration occurs in present day. The prologue and
epilogue take place several years after the main action has
occurred. POINT OF VIEW Each narrator speaks in first person,
allowing the reader to see the world from each narrators point of
view. TONE Each narrator speaks in a different tone. Anna is
observant, thoughtful, and inquisitive. Jesse is sarcastic and
angry. Brian is often discursive, wandering into musings on
astronomy. Sara is practical and concise. Campbell is sarcastic and
sometimes regretful. Julia is open and watchful of the characters
around her. SETTING ( TIME ) The setting alternates between present
action and events from the past fourteen years. SETTING ( PLACE )
Rhode Island CENTRAL PROTAGONIST Anna Fitzgerald
Slide 5
Slide 6
Prologue Summary The prologue begins with an epigraph from Carl
von Clausewitzs Von Kriege. The epigraph states that no one in his
right mind starts a war unless they are absolutely clear on two
things: what he wants to achieve, and how he plans to achieve it.
An unidentified person narrates the second part of the prologue
from a first-person point of view. This narrator recalls the time
she was three years old and attempted to kill her sister. Her
father stopped her and implied she pretend the incident never
happened. The narrator confesses that as she grew older she didnt
seem to exist except in relation to her sister. She thought of many
different ways she could kill her, but ultimately the narrator says
she didnt do anything after all, because her sister did it on her
own.
Slide 7
Monday Anna Summary Thirteen-year-old Anna Fitzgerald begins
narrating the story. She talks about the different reasons babies
come into being and admits that she was born for a very specific
purpose. Scientists used her mothers eggs and fathers sperm to
create a specific combination of genes. They created her in this
way so she would be able to save her sister, Kate. Anna talks about
visiting a pawnshop to sell a locket. She has a difficult time
parting from the locket because her father gave it to her as a gift
after she donated bone marrow to Kate. Anna goes on to describe
herself as skinny and a freak. She talks about her family, how her
sister Kate has leukemia, and how she has had to undergo medical
procedures to help Kate whenever Kate has gotten sick. Her mother,
meanwhile, obsessively shops online, and her older brother, Jesse,
behaves like a delinquent because their parents dont have time to
care about him.
Slide 8
cntd. Anna shows Jesse a newspaper clipping about a lawyer
named Campbell Alexander. Jesse warns her not to mess with the
system and the roles everyone in the family has, but he still
agrees to drive her to Campbells office. Anna meets Campbell and
notices he has a service dog, which Campbell sarcastically tells
Anna prevents him from getting too close to magnets, because he has
an iron lung. Campbell tries to send Anna away, and she explains
that she wants Campbell to help her sue her parents for the right
to her own body.
Slide 9
Campbell Summary Campbell gives his account of his meeting with
Anna. He talks with her about her case and notices how angry she
seems. He agrees to represent her because he thinks the case will
be easy to win and great publicity. He doesnt think they will even
need to go to trial, because Annas parents will give in before
that. Anna leaves after Campbell tells her he will file a petition
in family court for her medical emancipation. Campbells assistant,
Kerri, expresses her shock that Campbell is representing Anna. She
wonders where Anna will live during the trial, but Campbell hasnt
thought about it. Campbells dog, Judge, pushes against him,
apparently alerting Campbell to something. Campbell goes back into
his office and locks the door.
Slide 10
Sara Summary Saras narration jumps back in time to 1990. While
bathing Kate and Jesse, Sara talks to Brian, her husband and a
career firefighter, and she recalls her decision to give up her
career as an attorney to become a stay-at-home mother. Sara notices
a bruise on two-year-old Kates shoulder blade. The next morning,
bruises have spread up and down Kates spine. Sara takes Kate to the
hospital where Kate undergoes a series of tests. The hospital
refers Sara to an oncologist who, after further tests, diagnoses
Kate with acute promyelocytic leukemia (APL), a rare and aggressive
form of blood cancer. The doctor tells Sara and Brian that APL has
a twenty to thirty percent survival rate and they should begin
treating Kate immediately. At home Sara and Brian deal with the
fallout of the diagnosis and the realization that their daughter
may not survive. Sara refuses to let Kate die.
Slide 11
Brian Summary In the present day again, Brian Fitzgerald
describes a fire at a medical school. The fire started because a
body got stuck in the cremation incinerator. He turns the story to
earlier that night, while he ate dinner with his family. Kate
upsets Sara because she wears a t-shirt with a picture of a crab
and the word Cancer across it. Jesse walks in reeking of pot.
Finally Anna arrives, and Brian immediately notices something is
wrong. Anna remains quiet and withdrawn through the meal, and she
does not have her locket on. She leaves the table without saying a
word. After dinner, Brian and Sara discuss their daughters. Sara
talks about Kate, but Brian worries about Anna. Sara mentions that
she has to take Kate to dialysis the next day. Later that night,
Anna visits Brian at the station. She doesnt want to talk, but
together they watch the stars from the stations roof.
Slide 12
Tuesday Anna summary Anna and Sara sit with Kate at the
hospital during her dialysis session. Sara talks about kidney
donation while Anna thinks about all of the risks associated with
the procedure. Vern Stackhouse, a sheriff, comes to Kates room. He
awkwardly serves Sara papers for the lawsuit Anna has filed for
medical emancipation. Sara responds angrily, but before she can
talk to Anna about the lawsuit, Kate cries out in pain. Sara goes
to Kates bedside while Anna runs out of the hospital room. Jesse
drives to the hospital to pick Anna up, and they go home.
Slide 13
cntd. When Sara and Kate arrive home, Kate runs to her room,
and Sara demands to know what Anna is doing. Anna refuses to drop
the lawsuit, and despite Brians protests, Sara grows even angrier
until she slaps Anna. Later, Kate talks to Anna. Kate says that
even if she has to lose Anna as a sister she cant bear the thought
of losing her as a friend. Anna doesnt respond, but in her thoughts
admits she couldnt stand to lose Kate either. Sara and Brian walk
into Annas and Kates room at night. Anna overhears her father
saying that maybe Annas actions arent crazy. He leaves, and Sara
sits on Annas bed. Anna thinks Sara hates her, but Sara insists she
could never hate her. Sara holds Anna and assures her they can fix
everything by talking to the judge. Anna only nods.
Slide 14
Sara Summary In 1990, Sara and Brian see an oncologist named
Dr. Chance, who will be in charge of Kates treatments. Sara calls
her older sister, Zanne, whom she has fallen out of touch with, and
later Zanne arrives to help the family out. Sara and Brian feel
overwhelmed with the list of details and questions facing them
about Kates cancer and treatment. Since Kates form of cancer often
resists treatment, the doctors admit they can only do so much. Sara
asks what it will be like if Kate dies and wonders how she would
survive it. Kate starts chemotherapy and gets extremely sick. The
doctors test Jesse to see if he is a genetic match for Kate, since
she might need bone marrow if she relapses, but he is not. Dr.
Chance tells Sara that if she and Brian have more children, one
sibling could be a match. After chemo, Kate develops an infection
and has to be rushed to the hospital. While at the hospital, Sara
tells Brian she is thinking of having another child. Brian thinks
Sara wants to be able to replace Kate if she dies, but Sara assures
him she wants to have another child to see if the child would be a
genetic match for Kate.
Slide 15
Wednesday Campbell Summary Campbell, while on the phone with
his mother, wonders how much people are beholden to their parents.
Campbell stops for coffee and gives his waiter a new sarcastic
explanation of his service dog, Judge. He returns to his office and
finds Anna there. Sara calls while Anna is in the room with
Campbell. Sara tells Campbell that Anna has changed her mind, but
Anna tells Campbell she has not. Campbell recalls a memory of his
father. They competed in a sailing competition, and Campbell ended
up embarrassing and disappointing his father. Campbell goes to the
courthouse where he meets Sara, who decides to act as counsel for
herself and Brian. Sara and Campbell speak with Judge DeSalvo, the
judge for the case. They argue about what Anna really wants until
Judge DeSalvo decides he needs to speak with Anna.
Slide 16
Anna Summary Anna wonders what her funeral would be like. She
doesnt think many people would come, unlike Kates funeral, which
would be crowded. At the courthouse, Anna speaks with Judge DeSalvo
alone. They discuss the trial, and Anna tries to remain composed.
But she recalls a time when she and Kate pulled a prank on a nurse
at the hospital and starts to cry. She tells Judge DeSalvo she cant
give a kidney to her sister. He assures her no hospital would take
a kidney from an unwilling donor, but she says being a donor has
never been her choice. She says she never wanted to stop the
lawsuit and only told her mother she would because she loves her.
Judge DeSalvo decides to appoint Anna a guardian ad litem who can
decide what is best for her. The hearing, he says, will take place
the following week.
Slide 17
cntd. Anna goes home with her parents, even though Campbell
wants to speak with her. Brian pleads with Sara to calm down, but
Sara shouts that Anna practically signed Kates death sentence. Kate
runs upstairs. Anna leaves the house to go to a laundromat, a place
she feels safe. She tries to picture a future without Kate but
cant. They are as connected, she thinks, as Siamese twins.
Slide 18
Jesse Summary Jesse thinks about when he was a child and would
light bath soap on fire to show Anna. He reflects that Anna is the
only proof he has that he belongs in the family. While driving down
the highway, he imagines crashing his car because he would be worth
more dead and used as parts. He meets a homeless man named Dan.
Jesse has a deal with Dan where he brings Dan food if Dan will
watch Jesses things, including stolen acid and sawdust. Jesse goes
to an abandoned warehouse and sets a fire. He admits he has done it
before. He watches the fire from far away until he sees his father
arrive. Jesse goes home to find Sara frantic. Kate is vomiting
blood. Jesse drives Kate to the ER.
Slide 19
cntd. At the hospital, Dr. Chance tells Sara and Jesse that
Kate is in the end stages of kidney failure. Sara asks if a
transplant is possible, and Dr. Chance tells her that the odds are
not good. Sara asks if they would do the transplant if a donor were
available. Jesse offers his kidney, but Dr. Chance tells him it
must be an exact match. Jesse wonders why he thought he might
suddenly be worth something and why he thought he could save his
sister when he cant save himself. Kate tries to tell Jesse
something, but all he can understand is tell Anna.
Slide 20
Sara Summary The time is 19901991 and Sara is pregnant with
Anna. Sara knows everything about the baby, from the sex to the
specific combination of genes that will allow Anna to be a donor
for Kate. She admits that she has thought of Anna only in terms of
what she will be able to do for Kate. Sara reveals that three
months after chemo, Kate went into molecular relapse. Sara recalls
the television interview she and Brian did. They explain why they
went to a geneticist and deny wanting a designer baby. They only
wanted a child who would save Kates life. Sara goes into labor on
New Years Eve. Anna is born, and the doctors take her umbilical
cord to harvest the cord blood. Kate begins a pre-transplant
regimen of radiation and chemotherapy, which makes her violently
ill. The doctors put her in isolation, then give her Annas cord
blood.
Slide 21
Wednesday Julia Summary Julia argues with her twin sister,
Izzy, until Judge DeSalvo calls. The judge asks Julia if she will
be the guardian ad litem in Annas case. Julia agrees and goes to
the Fitzgerald house where she meets Anna. Julia takes Anna to the
zoo to talk, hoping it might loosen her up. Julia cant determine
why exactly Anna filed the lawsuit, but she realizes that Anna will
either lose her sister or herself. At the house Julia meets Sara.
Julia tries to speak with Sara, but Sara brushes her off. Julia
realizes that it will be difficult for Anna to live there during
the course of the legal proceedings without being swayed by her
mother. Afterward Julia goes to Campbells office. It emerges that
they have had a romance in the past and that they havent spoken in
years.
Slide 22
Campbell Summary Campbell works in his office when Julia walks
in. He feels shocked to see her for the first time in fifteen
years. After some awkward conversation, the two discuss Anna.
Campbell suggests removing Sara from the house, but Julia thinks it
is the wrong course of action. The two argue and the dog, Judge,
becomes increasingly agitated. Finally, Campbell leaves Julia alone
in his office. In a flashback to their high-school years, Campbell
remembers when Julia arrived at their prep school. She looked
different than the other girls and kept to herself. One day
Campbell followed her to a cemetery and asked for help with his
homework. In the present, Campbell straightens himself up in a
bathroom. When he goes back to his office, Julia has gone. In
another flashback, we see Campbell and Julia as teenagers sharing
their first kiss.
Slide 23
cntd. Back in the present, Campbell goes to see Anna at her
house. Initially, he feels awkward around Anna and admits that he
usually doesnt spend time with his clients. Later that night,
Campbell visits Julia. At first he confuses her with her twin
sister, Izzy, who acts angrily toward Campbell. Campbell and Julia
talk and catch up. Julia admits to Campbell that it is hard to be
around him after everything that happened between them.
Slide 24
Anna Summary Anna asks Jesse to drive her to the hospital.
Jesse tells Anna that she is not doing the wrong thing, but she
tells him that shes not doing the right thing either. Jesse agrees
to help Anna see Kate by distracting their mother. In a flashback,
Kate wants to talk to Anna about death and the best way to die, but
Anna refuses. In the present, Jesse pretends to be drunk in order
to get Sara away from Kates hospital room. Anna goes into Kates
room, and we see another flashback in which the entire family plays
football on Thanksgiving. Jesse accidentally knocks Kate down, and
Brian gets angry at him. Jesse says he forgot, and Kate smiles.
Shes thrilled that, for a moment, Jesse forgot she had cancer. In
the present, Anna climbs into Kates bed with her. In her thoughts
she acknowledges that she didnt come to see Kate to feel better,
but because without Kate, she cant remember who she is.
Slide 25
Thursday Brian Summary Julia meets Brian at the fire station
and helps him cook breakfast. They discuss Anna, and Brian
hesitates to state his opinion. He thinks about an incident where
he saved a child from a burning building. Brian admits he became a
firefighter to save people but wishes he could have been more
specific about who to save. He asks Julia if he can take her to
meet someone but doesnt say who the person is.
Slide 26
Julia Summary Julia rides with Brian in his car. In flashbacks,
we see Julia at her apartment sobbing the previous night after
Campbell left, then going to a bar where she drinks heavily. She
remembers how Campbell felt attracted to her because she was
different from everyone else at their school. They would meet after
school in the cemetery and talk. Their relationship blossomed from
there. In Brians car, he tells Julia they named Anna after the
galaxy, Andromeda. They find Anna at the house and decide to all go
to the hospital together. Anna confesses to Julia that she fears
Kate will hate her. Outside the hospital room, Sara begs Julia not
to tell Kate that Anna has not dropped the lawsuit. She also
insists to Julia that she loves both of her daughters. Julia and
Kate talk alone. Julia asks about Jesse, and Kate says that he gets
into a lot of trouble because its his only way of being noticed.
Kate talks about a year where she got sick on almost every single
holiday and how hard that was for Anna.
Slide 27
Sara Summary In 1996, Sara throws Kate a party for her eighth
birthday. Kate has been in remission for five years, but soon after
the party Kate relapses. She starts on a new medication in an
attempt to put her in remission. In the midst of this, Jesse
reminds Sara she promised to take him to get new cleats after his
orthodontist appointment. Sara tells him they cant do either, so
Jesse attempts to pry his braces off his teeth with a fork. The new
medication works at first, but Kate develops a resistance. Dr.
Chance recommends a donor lymphocyte infusion from Anna. Brian
suggests it might not be a good idea to make Anna donate blood,
since he and Sara only agreed she would act as a donor for Kate
once. Concerned about Kate, Sara dismisses the concern. Anna
arrives at the hospital to give blood and screams and cries during
the procedure. Later, when the doctors need to take more blood,
Sara forces Anna to leave a birthday party early. A month later,
Anna has to donate blood a third time. Sara also talks about
finding Kates goldfish nearly dead. Desperate to save it, she calls
a marine biologist who helps her revive the fish.
Slide 28
Thursday Anna Summary Anna recalls imagining what life would be
like if Kate died. It would be painful, but she also thinks of the
exciting things she could do if Kate werent alive. In the present,
Anna sits with her parents in the hospital cafeteria. Vern
Stackhouse serves Sara with a temporary restraining order requiring
her not to have contact with Anna. Anna says she never asked for
that but Sara is furious. Sara and Brian fight in the car about
hiring a real lawyer. Reporters have gathered at the courthouse,
and Anna and Brian wait outside while Sara and Campbell talk to the
judge. Julia arrives and asks if Anna wants Sara to leave the
house. Anna says thats not what she wants. She also says shes
changed her mind and doesnt want to go through with the lawsuit
anymore. After Julia leaves, Brian asks Anna if she wants to stay
with him at the fire station to give her distance from Sara. They
leave together.
Slide 29
Campbell Summary Outside the courthouse, Campbell speaks to the
reporters. He recognizes that he wants to draw attention to the
case to capitalize on it. Sara and Campbell speak to Judge DeSalvo.
Julia arrives, tells the judge that Anna is confused, and it would
be a mistake to remove Sara from the house. Judge DeSalvo refuses
to grant the restraining order, but he orders Sara not to say one
more word to Anna about the case. Julia, Campbell, and Sara go
outside to see Anna only to discover she has left with Brian. Julia
tries to talk to Campbell but he avoids her. Once again, his dog,
Judge, clearly tries to alert Campbell to something. Julia yells at
Campbell while he tries to get away from her. She informs Campbell
that Anna said she changed her mind about the petition. Finally,
Campbell escapes into an empty room and locks the door.
Slide 30
Jesse Summary Jesse arrives home to find Julia on his doorstep.
He tries to flirt with her. She asks for Anna, but Jesse says no
one is home. Julia brushes off Jesses continued flirtations and
asks him about his family. He tells her a story about a Christmas
Eve when he was 12 and Kate was in the hospital. Anna had to be
taken in to give white blood cells, and Jesse was sent to a
neighbors house. He left and chopped down a tree from his familys
front yard, then set it up in the living room and decorated it. The
next day when he opened his gifts he realized they were all from
the hospital gift shop. Brian and Sara never even noticed the tree.
Jesse says that the story explains what it has been like to grow up
in his family. He says at least Anna is on their parents
radar.
Slide 31
Brian Summary Brian takes Anna to the fire station. He recalls
his visit to the hospital earlier that afternoon. Kate slept, and
Brian talked to Sara. He told her Anna was going to stay with him
at the station. They argued when Brian told Sara he was worried
about Anna. Sara said that, unlike him, she worries about both of
their daughters. Later that night, the fire station receives a call
to a nursing home where a woman has hit her head. Anna goes along
and helps. They take the woman to the hospital, and Brian loses
track of Anna. He finds her in Kates room, curled up on Saras lap.
He takes her back to the station. Later, Anna and Brian watch a
meteor shower from the stations roof. Anna wonders aloud if it
would be possible to find a fallen star.
Slide 32
Campbell Summary In flashbacks, Campbell recalls more scenes
from his high-school relationship with Julia. Campbells friends
teased him about Julia, but he would not defend her. Campbell also
avoided telling his parents about Julia, which Julia suspected.
When he finally took her to meet them, his parents behaved rudely
and refused to invite her to a party the rest of the family was
attending. Afterward, Campbell began ignoring Julia. One day they
met at the cemetery, and Campbell told Julia their relationship was
over.
Slide 33
cntd. In the present, Campbell goes to the hospital to speak to
Dr. Bergen, the head of the ethics committee. Dr. Bergen says the
committee never met to discuss Anna, despite the fact that Anna had
been a patient at the hospital eight times. After his meeting,
Campbell runs into Julia. He convinces her to talk with him about
the case, and they go to an Italian restaurant. Campbell avoids
answering questions about his service dog and why he took the case.
He receives a phone call from Anna asking him to meet her at the
police station. When he and Julia arrive, Anna tells them Jesse has
been arrested for stealing a judges car. She asks for Campbells
help. Reluctantly, he manages to get Jesse released on probation.
In the car on the way home, Campbell tries to get Anna to tell him
what she really wants. She explodes in anger and says shes sick but
never sick enough for her family. Campbell is pleased at her anger
but also worried that she will sound unsympathetic on the witness
stand.
Slide 34
Brian Summary Campbell arrives at the firehouse with Anna. When
he and Brian talk alone, Brian admits he agrees with Anna and says
he is willing to say so to the judge. Brian remembers an incident
from the night before in which he shouted at a kid whose girlfriend
overdosed on drugs. Another firefighter told Brian he could take
time off, but Brian says that means he would have to be at home
instead. Back in the present, as Campbell leaves he mentions Jesses
arrest
Slide 35
Sara Summary In 1997, Sara finds Kate with blood streaming down
her legs. Kate has relapsed and needs a bone marrow transplant. The
familys insurance company refuses to cover the transplant. To
prepare Anna for the bone marrow donation, Sara gives her
growth-factor shots. Six-year-old Anna tells Sara she hates her.
Saras sister, Zanne, offers to pay for the transplant, but Brian
tells Sara the men at the fire-station raised enough money. Sara
takes Kate to the hospital to begin her pre-transplant regimen of
chemotherapy. Before she leaves the house, Kate cleans her room in
case she doesnt come back. Again, the chemo makes Kate violently
ill. The time arrives for Annas bone-marrow extraction, and Sara
tells her she doesnt have to do it but that everyone is counting on
her. Sara goes to be with Kate. Brian arrives after Annas procedure
and says Anna has been asking for Sara. Sara feels torn but goes to
see Anna. Anna says she hurts, so Sara finds a nurse to give her
medication. When Sara goes back to Annas room, she sees Brian
putting the locket on Annas neck.
Slide 36
cntd. A few weeks later, Brian takes Sara out to dinner. They
have nothing to talk about other than Kate and feel like strangers.
When its time to take Kate home from the hospital, Sara notices how
different Kate looks. Later, Sara learns that Brian lied about the
firefighters having raised enough money to cover Kates bone marrow
transplant. When Sara confronts him, he says he used the money from
Kates college fund to help pay for it, because Kate wont live long
enough for college. Time passes and Sara tries to get Kate to leave
the house, but Kate feels self-conscious about her appearance. Sara
shaves her own head, and then Anna asks to have her head shaved,
too. All bald, they go to the mall.
Slide 37
Weekend Jesse Summary Jesse steals a dump truck and picks up
Dan. In flashbacks, Jesse recalls when he was eleven and received a
skateboard as a guilt gift, meaning a gift his parents gave him
whenever Kate became seriously ill. Brian promised him he would
take him to a parking lot where he could ride it, but Kates nose
started to bleed. When Jesse reminded Brian of his promise, Brian
looked at Jesse like he didnt see him. That day, Jesse walked into
the middle of traffic, hoping to get noticed. In the present, Jesse
takes Dan to a shed. Jesse lights it on fire and admires his work,
until Dan tells him that a homeless man named Rat lives in there.
Jesse runs in to the burning shed, saves Rat, and runs away just as
the fire trucks arrive.
Slide 38
Anna Summary Anna waits at the hospital with Kate and Sara.
Kate feels alert, but Dr. Chance cautions that Kates lucid moments
will occur less and less frequently because she is in end- stage
renal failure. Kate asks Dr. Chance how long it will be before she
dies, and he tells her maybe a week. Sara begins crying. When Anna
tells her to stop, Sara looks at Anna and tells her to stop. Later
at the fire station, Anna talks to Julia about her crush, Kyle, and
Julia asks Anna what it will be like when Kate dies. Anna cant
answer. Sara calls to apologize to Anna and say goodnight. On the
roof that night, Anna and Brian talks about the stars and celestial
navigation.
Slide 39
Brian Summary Brian goes to the hospital to see Sara. He talks
to her about a trip they took to Nevada years ago. They saw a
fortune teller who told Sara her life wouldnt be good enough and
told Brian to save himself. Sara doesnt remember the trip and only
wants to talk about Anna. Brian tells her he plans to speak on
Annas behalf. Sara cant understand this. She asks Brian to remember
what it used to be like between them. But Brian knows Sara is not
the same woman she used to be. He also knows he is not the same man
he used to be, a man who believed Sara when she told him she would
always love him.
Slide 40
Sara Summary In 2001, Anna asks for money for goaltender pads.
She has started playing ice hockey. Four years have passed since
Kates bone marrow transplant. One night, the family goes to watch
Anna play hockey. Later, Kate wakes up bleeding badly. She has
relapsed and her body is failing. Dr. Chance suggests a new and
untested arsenic therapy. That night, Sara finds Brian writing
Kates eulogy. He wants to bring Kate home to die in her own bed. He
tells Sara the arsenic will just postpone what is coming. Sara
tells him its not time.
Slide 41
cntd. Kate slips into a coma. Sara receives a call from Jesses
school. He blew up a septic tank and has been expelled. Sara picks
him up from the school and notices needle marks on his arms. She
suspects drug use, but Jesse reveals he has been donating platelets
for Kate every three days. Anna gets accepted to a prestigious
hockey camp, but Sara tells her she wont be able to go because they
might need her for Kate. Anna says the camp is a year away,
implying that Kate wont be alive then anyway. Kate develops an
infection and becomes seriously ill. Jesse and Anna say their
good-byes to Kate. Brian tells Sara that Kate needs her permission
to leave. As Sara tells Kate that its okay for her to go, Kate
grips her hand and begins to claw her way back to life.
Slide 42
Anna Summary Anna ponders what heaven will be like. She wonders
what age people are in heaven, and how anyone recognizes each
other. Sara calls a meeting at Campbells office. She tells Anna
that if Anna gives Kate a kidney she will never ask Anna for
anything again. Anna hugs her mother but tells her she cant do it.
Without a word, Sara tries to smile and then leaves.
Slide 43
Julia Summary Julia admits to Izzy that she still has feelings
for Campbell. Just then, Campbell arrives and asks Julia out to
dinner to discuss Saras plea bargain. He takes her out on his boat,
and though theyre having a good time, Julia suspects Campbell wants
to sway her decision. Julia gets angry and wonders if Campbell ever
says anything that isnt a lie, but Campbell kisses her. She remarks
that it feels like the most natural thing in the world.
Slide 44
Monday Campbell Summary Campbell wakes up in his boat after
spending the night with Julia. He thinks that he loved Julia
because she was an independent spirit and he couldnt bear to take
that away from her. He leaves while Julia sleeps and goes to the
courthouse. Neither Sara nor Brian knows where Anna is. Campbell
finds her in Kates hospital room and drives her back to the
courthouse. On the way, Campbell pulls over and asks Anna why
theyre going to court. Anna counters by asking him about his dog.
Campbell says that the dog is for a hearing problem. Anna says shes
sick of things always being about Kate. Campbell points out that
Anna is lying, and Anna says Campbell is also lying about the
dog.
Slide 45
cntd. Campbell and Anna arrive at the courthouse, and everyone
moves into the courtroom. Anna asks Campbell if shell have to
speak. He lies and says she probably wont. Campbell speaks first
and says in the justice system what is legal differs from what is
moral. Sometimes is hard to tell them apart, but the court is there
to help. Campbell calls Sara to the stand. She talks about Annas
conception, and Campbell asks her about all the times Anna has
undergone a medical procedure to help Kate. He also asks if Anna
had a choice in any of these cases. Sara says Campbell can see
things in black and white because he only represents one of her
daughters, but Sara represents both of her daughters.
Slide 46
Anna Summary During a recess in the trial, Campbell and Anna
speak alone. Anna says even if they win they still lose. When the
trial resumes, Campbell calls Dr. Bergen as his second witness. Dr.
Bergen says the ethics committee has discussed whether Kate should
have a kidney transplant and that they arrived at a split decision.
Campbell asks if the committee discussed the risks to the donor,
and Dr. Bergen said it wasnt an issue since Anna wasnt a patient.
Campbell shows Dr. Bergen Annas hospital records, and the doctor
admits that Anna has had several invasive procedures. He also
admits he voted against the kidney donation since he did not
believe Kate would live through the procedure.
Slide 47
cntd. Anna recalls how Kate saved her when she was a baby. She
was in a walker and almost rolled onto the street before Kate
caught her. In the present, Sara questions Dr. Bergen and asks if
he has children. She then asks if he ever puts himself into a
patients shoes. She asks if, offered a course of action that could
save his childs life, would he question it or try it. He doesnt
answer. Another break follows. As Anna leaves the courtroom, she
tells her mother she did great.
Slide 48
Sara Summary In 2002, Kate meets a boy named Taylor while she
receives platelets and he receives chemo. Sara watches them flirt
and feels happy that her daughter likes a boy. Kate goes on a date
with Taylor. That night, Sara overhears Kate gushing about it to
Anna. Kate goes into relapse, and Sara has difficulty convincing
Kate, who does not want to be hospitalized again, to undergo a stem
cell transplant. The oncology team lets Kate begin chemo as an
outpatient. Taylor visits Kate during her chemo, helps her when she
throws up, and asks her to a dance for patients hosted by the
hospital.
Slide 49
cntd. Sara, Kate, and Anna shop for a dress for Kate. Kate
fells self conscious about her baldness, her chest catheter, and
all of the scars on her body from chemo. Sara tries to comfort her,
but Kate says she cant fix it every time. Anna drags Kate into a
hair salon and asks the hairstylist if she can give Kate, who has
no hair, an up-do or a perm. Anna and Kate laugh at the stunned
reaction they get. Kate attends the dance with Taylor, and Sara see
them kiss. Soon after the dance, Kate goes into the hospital for
her transplant. She worries because she hasnt heard from Taylor.
Sara finds out that Taylor died suddenly, but she waits to tell
Kate until a month after her transplant. When Kate finds out, she
says she loved him and doesnt speak to Sara for a week. Sara finds
Kate looking at old pictures, including one of Kate when she was a
baby, before cancer. Kate remarks that she was beautiful.
Slide 50
Monday Jesse Summary Jesse recalls the time he went to boot
camp on a farm as a fourteen-year-old. While there, he helped a
sheep give birth. The baby sheep almost died, and he thought that,
afterward, the sheep always looked like it had seen the other side.
In the present, Jesse sits with Kate at the hospital and sees a
similar look on her face. They talk about dying, and Jesse asks if
she feels afraid. She smiles and says she will let him know. In his
head, he tries bargaining to keep Kate alive. Kate tells Jesse how
much she will miss him. After she falls asleep, Jesse walks into
the hall and punches a wall.
Slide 51
Brian Summary In flashbacks to the morning of the hearing,
Brian goes home to look for Anna. He searches Jesses room and finds
materials that could be used to start a large fire. In the present,
Brian gets called to work and leaves the courthouse during the
hearing. He goes to the site of a recent arson fire at an abandoned
elementary school and finds a cigarette left by the arsonist. At
home, Brian accuses Jesse of starting the arson fires. Jesse tries
to deny it until Brian shows him the cigarette butt. Jesse breaks
down, saying he couldnt save her (he doesnt specify who), and asks
if Brian has told anyone. Brian hugs Jesse. He thinks he cant blame
Jesse and understands that Jesse chose to use fire for the same
reason Brian did: both wanted to control something uncontrollable.
Brian resolves not to tell anyone about what Jesse has done.
Slide 52
Campbell Summary At the courthouse, Campbell questions Dr.
Chance. He asks about Annas conception and about any risks to Anna
from the procedures shes undergone or will undergo. Dr. Chance
concedes there are some risks and complications, but most of them
are minor. Dr. Chance admits that having one kidney might affect
Anna later in life and could make it risky for her to play contact
sports, such as hockey. He states that up to that point she has not
experienced significant harm from any procedures, but she has
experienced the benefit of saving her sister.
Slide 53
cntd. During a recess, Julia asks Campbell if the previous
night was a joke to him, and Campbell tells her she doesnt want to
know the real answer. When the hearing adjourns for the day,
Campbell drives Anna to the fire station. Once there, Anna
confesses that sometimes she hates herself. Campbell says he
sometimes feels the same way. Anna asks about Campbells
relationship with his parents, and he tells her that somewhere
along the way he stopped wanting to be like them. Anna tells him
that she gets it, that Campbell was invisible, too.
Slide 54
Tuesday Campbell Summary Campbell questions Brian on the stand,
confident that Brian will help him win the case by disagreeing with
Saras position. Brian admits there have been times hes disagreed
with Sara, such as the time they needed Anna to donate lymphocytes.
However, he says that while he doesnt want to hurt Anna, he cant
lose Kate, and that when your child is dying you do not always have
a choice. He notes that he disagreed with Saras decision to start
Kate on arsenic therapy, but that Kate ended up surviving. Although
he hates to see Kate suffer, he says he doesnt want to make the
same mistake twice and agrees with Saras wish to have Anna continue
as a donor. Campbell feels stunned by Brians reversal. Brian
acknowledges he doesnt knowand has never knownthe right answer, and
begins to cry.
Slide 55
cntd. During a recess, Anna wonders whether she made Brian fall
apart. She says she had never seen him cry before. Campbell tells
her she will need to testify if they want to win. Anna declines,
despite Campbells insistence that they will lose. She yells at
Campbell that he needs to find another way to win the case.
Campbell assures Anna that, this time, when she speaks people will
listen. Anna refuses, but when Campbell asks why, she wont
say.
Slide 56
Sara Summary For the first time, Sara narrates in the present.
She prepares to question Brian and notices all of the qualities
that made her fall in love with him. She also notices how much he
has changed but doesnt necessarily for the worse. She begins
questioning him but finds herself talking about a family trip they
took. Suddenly Sara realizes they are no longer pushing each other
away but are fighting on the same side. She feels like none of the
past arguments matter. She thinks that they will have each other to
remember what their family used to be like, to share the fact that
they had Kate for sixteen years. Sara decides she doesnt need to
cross-examine Brian. She simply asks when he is coming home.
Slide 57
cntd. Brian and Anna move back home that night. After Brian and
Sara tuck Anna in, Sara tells Anna she is not a bad person because
she wants to be herself. She also says Anna reminds her of herself.
Later that night, Brian and Sara make love. Afterward, Sara tells
Brian that they are going to lose her, and she doesnt know which
daughter she is talking about.
Slide 58
Wednesday Julia Summary At their apartment, Julia and Izzy
talk, and Julia cries over Campbell. He did the exact same thing to
her that he did in high school. The next morning at the courthouse,
Julia hears Campbell and Anna fighting over Annas refusal to take
the stand. Julia confronts Campbell and tells him that both he and
Anna are cowards afraid of facing consequences. Julia also tells
Campbell he runs away every time someone gets close to him.
Campbell starts to tell Julia something about his dog, but Vern
Stackhouse interrupts to tell them the hearing needs to begin.
Slide 59
Campbell Summary In the courtroom, Sara questions a
psychiatrist named Dr. Neaux. She asks him about the potential harm
Anna will suffer if Kate dies. Dr. Neaux says that if Anna donates
her kidney and keeps Kate alive she will experience an immense
benefit. He also does not believe Anna capable of making her own
medical decisions. While Sara questions the doctor, Campbell jokes
with Anna about the names of Dr. Neaux and Dr. Chance. Campbell
then questions Dr. Neaux. He suggests Sara defines whether or not
she is a good mother by her ability to keep Kate healthy. Campbell
also suggests that Sara, who also stands to benefit by Kate staying
alive, cant make independent decisions any better than Anna.
Slide 60
Julia Summary Campbell questions Julia on the stand. Julia says
she can see how the Fitzgeralds want to do everything possible to
save Kate, but how medically it does not serve Annas best interests
to donate a kidney. Julia says that no one in Annas family has the
ability to make unbiased decisions regarding Annas health care, but
Anna also lacks the ability to make her own decisions.
Slide 61
Campbell Summary Campbell realizes Julia will not veto Annas
petition. He also recognizes how much the case has affected Julia,
the same way it has affected him. Julia, however, expresses those
feelings. Judge DeSalvo asks for Julias recommendation to the
court, but she says she hasnt been able to reach a decision. Anna
stands up and tells Judge DeSalvo she has something to say.
Slide 62
Anna Summary On the witness stand, Anna notices that Campbell
looks awful and sweats. Campbell walks up to Anna and cracks a
joke, giving Anna the courage to continue. She notices Campbells
dog behaving excitedly, and Judge DeSalvo asks Campbell to control
him. Campbell begins to question Anna and asks her why she wanted
to file the petition. In a flashback to two months before, Sara and
Brian sit Kate and Anna down to talk. They say Kate needs a kidney
transplant, and the kidney will have to come from Anna. Before Anna
can reply, Kate says she doesnt want the transplant. Sara snaps
that if Kate wont accept the kidney it will be just like suicide.
Kate says if shes already dying its not suicide.
Slide 63
cntd. In the present, Campbells dog barks and jumps, but
Campbell ignores him and continues with his questions. He asks Anna
if she decided to file the lawsuit herself. Anna tries to lie but
responds that someone else convinced her. Campbell asks Anna who,
and Anna tells him it was Kate. Just then, Campbell collapses to
the floor.
Slide 64
Wednesday Brian Summary Brian rushes to Campbell, who has had a
seizure. Julia asks if Campbell will be okay, and Brian assures her
that Campbell will be fine. In the Judges chambers, Campbell
regains consciousness. He doesnt remember what happened, but Brian
fills him in. Campbell apologizes to his dog for not listening.
Brian helps Campbell change into clean clothes, and Campbell admits
that hes been hiding his seizures since he was eighteen. He says
they started after a car crash. Julia enters the room, and Brian
leaves. Brian observes that things dont always look as they
seem.
Slide 65
Campbell Summary Campbell tells Julia he had a car accident the
night he took her home from his parents house. The seizures started
that night, and he has hidden them from everyone ever since. Judge,
he explains, is an epilepsy dog, and he broke up with Julia he
didnt think she should have to live with his seizures. Julia tells
Campbell that you dont love someone because theyre perfect but in
spite of their imperfection. She also tells Campbell that she will
never leave him.
Slide 66
Anna Summary Anna talks to Campbell alone. She asks him if he
took her case because he knows what its like not to have control
over his own body. He says maybe. They go back to the courtroom and
Anna takes the stand again. Campbell asks Anna to confirm that Kate
asked her to file the petition, and Anna says thats not exactly
true. She says Kate asked Anna to kill her. In a flashback, Anna
finds Kate drunk with a bottle of pills. Kate tells Anna shes sick
of waiting for something thats going to happen anyway, and shes
tired of ruining everyones lives. But she admits that she cant kill
herself. Anna realizes this means Kate has tried before. Back in
the courtroom in the present, Sara says Annas story isnt true. Anna
tells her mother that Kate didnt say anything because she knew
telling Sara would kill her, too. Anna also says she doesnt want
Kate to die, but Kate doesnt want to live the way shes been living.
Anna, as always, is the only one who can give her what she
wants.
Slide 67
cntd. In another flashback, Kate asks Anna not to donate her
kidney. She acknowledges that there are so many things Anna could
do if she werent around. Anna feels ashamed to admit that she has
had the same thought. In the present, Campbell asks Anna if shes
willing to take an action that might kill her sister. Anna says
Kate wanted it, but admits that she wanted it, too. It would be the
worst and best thing to happen to her. Anna told Kate she was going
to be stop being a donor. Kate thanked her.
Slide 68
Sara Summary Judge DeSalvo moves the proceeding to the hospital
so he can talk to Kate. When they arrive, Kate is watching TV with
Jesse. Judge DeSalvo speaks with Kate alone. When he leaves Kates
room, he tells Sara, Brian, and Campbell that he will announce his
decision the following morning. Before Julia and Campbell leave,
Campbell tells Sara he is sorry. The entire family gathers in Kates
room. Anna tells Kate that she tried. Jesse jokes with Kate to
lighten the mood. Everyone leaves except for Sara. She climbs into
bed with Kate and tells her how sorry she is. Kate tells her not to
be, because she isnt.
Slide 69
Thursday Campbell Summary On a rainy morning, Campbell wakes up
with Julia at his apartment. Campbell thinks about Judge DeSalvos
decision and echoes what Anna says. No matter if they win or lose,
it wont be over. Julia tells Campbell she hates his apartment.
Slide 70
Jesse Summary In the rain, Jesse goes to a soccer field and
lies down. He recalls lying down in other storms, hoping to be
struck by lightning so he would feel alive.
Slide 71
Anna Summary Anna thinks about the rain and how it never really
stops moving. She notes that rain goes through a cycle, evaporates
like a soul into the clouds, and then like everything else, starts
over again.
Slide 72
Brian Summary Brian recalls another rainy day, the New Years
Eve when Anna was born. Brian remembers there were no stars that
night. He also remembers his decision to name Anna after Andromeda,
a princess in the sky between her mother and father.
Slide 73
Sara Summary Sara gives her closing arguments. She has note
cards but quickly abandons them. She tells Anna she loves her and
says that every day she wonders if shes doing the right thing. Sara
says that even if Anna and Kate dont agree with her, she wants to
be the one whos right ten years later, when they are all still
together. Sara says she knows the lawsuit was never really about
donating a kidney but about choice. She also knows that no one ever
really makes decisions by themselves. Sara makes an analogy to a
burning building. She says that in her life one child has been in a
burning building, and her other child has been the only one who
knew the way to save her. She acknowledges that she might be
risking the one child to save the other, and that it might be
unfair, but its the only way she can save both children. She doesnt
know if it was legal or moral, but she knows it was right.
Slide 74
Campbell Summary In his closing arguments, Campbell says the
case isnt about donating a kidney, but about a thirteen-year-old
girl who deserves the chance to figure out who she is going to be.
He says ultimately nothing else matters except what Anna thinks.
After a short recess, Judge Desalvo returns with a picture of his
daughter, who was killed by a drunk driver. He acknowledges that
they have entered into a debate about the quality of life versus
the sanctity of life. He says the sanctity of Kates life has become
intertwined with the quality of Annas. He admits there is no good
answer, because morals are more important than ethics, and love is
more important than law. But he decides that only Anna can decide
how to treat her body. He declares her medically emancipated and
gives Campbell medical power of attorney. Anna and her parents
hug.
Slide 75
Anna Summary Campbell drives Anna to the hospital in the
pouring rain. Anna asks Campbell what he thinks she should do, and
he says its her choice now. Campbell tells Anna he thinks she will
be amazing in ten years. Anna thinks about what she wants to be and
knows only that in ten years she wants to be Kates sister.
Slide 76
Brian Summary Responding to a call, Brian arrives at the scene
of a car crash. A large truck has crushed a small car. Campbells
dog comes whimpering out of the car just as Brian realizes that
Anna is one of the passengers. His fellow firefighters try and hold
him back, but he insists on pulling Campbell out of the car and
then Anna, who is unconscious. At the hospital, Sara finds Brian.
He doesnt know how to explain what happened. Campbell comes out
with his arm in a sling and asks about Anna. A doctor tells them
that Anna is brain dead and asks if they want to consider organ
donation. Brian thinks about twin stars and how the first one can
shine so bright that the other may be gone before you notice it.
Back in the present, Campbell tells the doctor that he has medical
power of attorney over Anna, and a girl upstairs needs Annas
kidney.
Slide 77
Sara Summary Sara observes that in the English language no word
exists for someone who loses a child. After doctors remove Annas
organs, they bring her back down to the family. Everyone is there,
and Sara and Brian sit beside Anna. Sara says she has spent years
anticipating the loss of a daughter, but she is still at a loss.
Brian reminds Sara that Anna is gone and that her body is just a
shell. Finally Brian turns off the respirator. Sara puts her hand
on Annas chest as her heart stops.
Slide 78
Epilogue Summary The year is 2010, and Kate narrates in the
first person. She discusses grief and how, after Annas death, Brian
believed he could see Anna in the night sky and Sara thought Anna
would come back to her. Kate says she began to hate herself. She
blamed herself for Annas death. Kate stayed sick for a long time
after the transplant, but suddenly got better. Dr. Chance had
medical explanations, but Kate believed it was because someone had
to go and Anna took her place. Kate talks about the immediate
stages of grief in her family, how much her mother cried and how
much her father kept away. But she said one day she laughed, and
the very act of living started to ease the pain.
Slide 79
Kate wonders if Anna keeps tabs on them, if she knows they
stayed close to Julia and Campbell and even went to their wedding,
and whether Anna saw Jesses graduation from the police academy or
witnessed Brians drinking problem and how he gradually got better.
She also wonders if Anna knows that she teaches dance to little
girls now. One year after Annas death, Sara came home with a roll
of developed film from Kates high school graduation. The last
picture on the roll showed Anna. Sara and Kate stared at the
picture until they memorized every detail. Kate fears a day will
come when it will be harder to remember Anna. But she knows she can
lift her shirt and feel the scar from where she received Annas
kidney. She says she takes Anna with her, wherever she goes.