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Year : 2021  |  Volume : 1  |  Issue : 2  |  Page : 156-157

My sister's keeper

Department of Paediatrics, Max Super-Specialty Hospital, Gurgaon, Haryana, India

Date of Submission07-Mar-2021
Date of Decision18-Apr-2021
Date of Acceptance30-Apr-2021
Date of Web Publication31-May-2021

Correspondence Address:
Dr. Megha Consul
703/Tower 5, Unitech the Palms, South City 1, Gurgaon-1, Haryana
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ipcares.ipcares_83_21

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How to cite this article:
Consul M. My sister's keeper. Indian Pediatr Case Rep 2021;1:156-7

How to cite this URL:
Consul M. My sister's keeper. Indian Pediatr Case Rep [serial online] 2021 [cited 2021 Sep 21];1:156-7. Available from: http://www.ipcares.org/text.asp?2021/1/2/156/317372

  About the Author Top

Jodi Lynn Picoult is an American writer. Picoult has published 26 novels, accompanying short stories, and has also been awarded the New England Bookseller Award for fiction in 2003. Her brand of fiction is characterized by the fact that she usually portrays moral dilemmas which pit family members against each another. She has not shied away from controversy, many of her books having as their theme contentious current issues such as abortion, assisted suicide, race relations, eugenics, and school shootings. She is also, as one discovers, the mother of a child who needed 10 surgeries for cholesteatoma-a circumstance she credits as being the reason she holds the medical profession in such high regard.

  About the Book Top

”My Sister's Keeper” is set against the backdrop of the gut-wrenching diagnosis of Acute Promyelocytic Leukemia and how the family copes in the shadow of the interventions needed to keep their second born, Kate, alive. The story is written in first person, a master stroke as one gets an intimate look at the inner workings and motivations of each character.

The primary protagonist is Anna, the third and youngest child. Anna initially comes across as a disgruntled teenager who like all adolescents is looking to find her own identity. In her case though, there is a unique situation, in that Anna was genetically designed to be her older sister Kate's bone marrow match-a fact that seems to have contributed to her sense that she did not really belong in this family. All of thirteen, she decides at the start of the novel that she has had enough of subsuming her needs and life to the needs of the older sibling and decides to take her parents to court to medically emancipate herself.

This decision changes everyone and everything that come into her path and the ensuing drama has been masterfully, sensitively recounted. The passages sharing the view of the world and its happenings from the perspective of the kids as they are growing up are particularly appealing. Anna is portrayed sensitively, showcasing all the inevitable confusion and yet passion of the teenage years. Her need to be seen and validated as also the growing realization that her parents are unable to understand things from her perspective, is moving and emotionally charged.

Anna's father, Brian, is a fire fighter, an intensely metaphorical profession, given that in many ways that's what his role is in the family. His interest in astronomy (Anna is short for Andromeda) seems to have started as a hobby and is now an attempt to maintain perspective through the shambles of his life and marriage. His perspective is that of a sincere father and husband who is trying his best to keep his family afloat amidst the catastrophe his family is going through. His life seems to be a balancing act between managing medical and financial issues, as well as the emotional needs of his wife and kids. He is particularly concerned about Anna, who he considers to be the stable one as compared to the rest of his brood.

Brians wife, Sara, is a lawyer who has given up practicing Law to take care of her three children. The story of her life is recounted in flashbacks interspersed with present day rendition. Her story is that of a young mother intent on saving the life of her daughter since the age of 2 years, when she was first diagnosed. Picoult lets the reader gradually uncover the making of a woman who is pushed emotionally to the limit, time and again. Sara seems to have lost herself through the 14 demanding years since her daughter's diagnosis was made. She is the backbone, and also paradoxically also the weakest link in the family's structure. In the present, she finds herself defending all the decisions she has ever made, in a court of law against her own daughter. A process that forces her to see herself and her life's work from the perspective of all her children.

Anna's teenage brother, Jesse, is a druggie teenager bordering on delinquency. Jesse's angst seems a manifestation of all the unacknowledged pain that the other members of the family are experiencing. His use of substances and predilection for causing mayhem hides feelings of worthlessness stemming from a childhood spent in the shadow of his younger sister's disease.

Perhaps the most poignant passages are assigned to Kate, the victim of the devastating disease and harrowing treatments. In addition to being a survivor of leukemia and now chemotherapy-induced chronic renal failure, she is also a teenager who desperately longs to lead a “normal” life. The parts of the book that deal with Kate would appeal the most to the “pediatrician” within our readers. Picoult describes, in sometimes excruciating detail, the nontherapeutic effects of life-saving interventions that are used in children with leukemia, This perspective is almost never factored in the vision of the treating medical personnel, who are completely focused on saving lives, preventing relapses and decreasing morbidity.

Picoult succeeds in making the reader feel torn. One veers to feel support toward Anna, and other times Sara, the poor mother in this situation. The courtroom scenes are full of conflict and yet since one has been made aware of each character's unique points of view, there is a much deeper conflict to have a straight-forward verdict. The book ends in a rather emotionally unsatisfying way, but given the fact that by the end, one has developed an attachment to all the main characters, perhaps that was intentional on part of the author.

The greatest strength of this novel is in the descriptions of the inner workings of each character. Each of the protagonists, in their own way, is looking for redemption and the author manages the tall task of fleshing out their individual voices beautifully. The medical portions have been dealt with robust research and the emotion with depth, yet scant sentimentality. The medical themes that keep one engrossed are ethical dilemmas at the very cusp of life and death. The author manages to bring alive the complex and contradictory world of this family and make it entirely relatable to all readers, but especially pediatricians. The gray areas of Medicine, the controversial subjects, as also the sheer pace of the book, make it difficult to put down. Do keep aside time (and a box of tissues!) before picking up this gem.

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There are no conflicts of interest.


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