Life turned sour

Note: This article is based on the film, rather than the book, and contains some plot spoilers.

In My Sister’s Keeper, Kate Fitzgerald (Sofia Vassilieva) is diagnosed with acute promyelocytic leukemia when she is two years old, and the prognosis is not positive. Her parents, Sara (Cameron Diaz) and Brian (Jason Patric), and her brother Jesse (Evan Ellingson) are not genetic matches. Sara, at least, will do anything to save Kate, and Dr Wayne (Jeffrey Markle) suggests, off the record, that producing another child in a test-tube would provide a perfectly matched donor. Anna (Abigail Breslin) is the result. The initial expectation is that only the blood from the umbilical cord will be used, but by the time Anna is 11, she’s undergone a number of medical procedures, including bone marrow transplants, and the latest call is for a kidney.

The idea of donating a kidney appears to be a step too far for Anna, who hires slick lawyer (success rate 92%!) Campbell Alexander (Alec Baldwin) to help sue her parents for medical emancipation, allowing her the right to decide how her body will be used. Having spent all her life defined as ‘Kate’s sister’, is Anna, like many teenagers, questioning who she is? As Anna says in the film, ‘I just want to live a normal life!’ This is much clearer in Jodi Picoult’s novel, where she loves (and is brilliant at) ice-hockey, which she’ll have to give up if she donates her kidney. It’s obvious that Kate will die if Anna persists in withholding her kidney, so the film follows the inter-relationships of the family as it is torn apart by this decision.

Sara has been the driving force behind the decision to do almost anything to save Kate, having given up her law career, and pursued every avenue to give Kate a chance of physical survival. She believed that the whole family was united in this cause, and can’t understand why Anna would choose to withhold her body when it could help Kate. Sara believes that she loves all of her children in equal measure, but it is clear that both Anna and Jesse feel neglected, and that what they need is often sacrificed for what Kate needs.

A close relationship between Kate, Anna and Jesse is evidenced throughout the film. Kate and Anna, unsurprisingly, have a particularly close relationship, and as the film progresses we see how much they mean to each other. Jesse’s place is the family is less evident, which is clearly how he feels. In the book he appears to be a kid who is completely off the rails (pyromania, taking drugs, stealing cars), although he secretly donates large quantities of blood for Kate. In the film, he’s a much less wayward character, more of a typical teenager, with a number of scenes in which he aimlessly wanders round, which don’t really seem to contribute to the plot.

The film deals sensitively, but unflinchingly, with the realities of living a life with cancer, never knowing when ‘normal life’ will come to a crashing halt, and the hospital routine start up again. Vassilieva's Kate is excellent and clearly portrays the desire of her character to be more than ‘the cancer’. The scenes built around Kate’s scrapbook, created for Sara, tie together a number of haunting themes, and demonstrate those times at which Kate has come somewhere close to normality. In the hospital, Kate meets Taylor Ambrose (Thomas Dekker) as both receive chemotherapy:

Taylor: I'm Taylor. ACL. 
Kate: I'm Kate. APL. 
Taylor: Oh, a rarity. 

The romance quickly develops, with Sara’s approval: she’s so excited she struggles to get pen and paper out of her bag so Taylor can note down Kate's phone number. The two head to the hospital prom together, a high point in Kate’s life. Kate and Taylor end up sleeping together, which seems a rather unnecessary addition to the more chaste relationship in the book, especially as Kate is 16 in the book and 14 in the film. The relationship is very sensitively portrayed, but disturbingly, Taylor looks a lot older. Both Vassilieva and Dekker shaved their heads and eyebrows for their roles, with Vassilieva describing it as being the least she could do to understand Kate's pain.

William J. Stuntz, a Professor at Harvard Law School and a cancer sufferer, notes ‘Cancer kills, but cancer treatment steals – it takes a portion of cancer patients’ lives, as though one were dying in stages.’[1] Under pressure in the courtroom Anna admits that she initiated the lawsuit as Kate was tired of being sick and wanted to die, putting a stop to her endless suffering. Anna loves Kate so much that she will do anything for her.

In the courtroom Sara reclaims her lawyerly status, representing herself against Anna, which causes all kinds of legal complications, especially as in the film the key character of Julia Romano (guardian ad litem in the book), who seems to hold the book together, is missing. Julia and Campbell had previously had a relationship and she had never understood why he had left her. The resulting sub-plot regarding Campbell’s mysterious ‘Service Dog’, Judge, is considerably weaker, but demonstrates why he was prepared to take on Anna’s case largely pro bono. As the result of a car accident, Campbell has epilepsy and the dog can sense when an attack is coming on. The dog is going frantic in the courtroom, but the case is at a crucial point, so Campbell is left feeling that he has no control over his own body. The other powerful figure in the courtroom is Judge de Salvo (Joan Cusack), who is returning to preside over her first case since her twelve-year-old daughter was killed in a car crash six months ago, something which Sara forgets when talking about Anna: ‘You know what thirteen-year-olds are like’.

Those who haven’t read the book will think it’s a powerful film, and certain elements are brilliantly portrayed, particularly Kate’s role. But for many – including Jodi Picoult, who had no control over how the story was changed for the film – the missing twist leaves a tinge of disappointment as we walk out of the cinema (many clutching tissues to eyes). My Sister’s Keeper is the first of Jodi Picoult’s series of successful, thought-provoking books to be filmed for the cinema, with The Pact, Plain Truth and The Tenth Circle all going straight to TV.

Stuntz notes that ‘the question we are most prone to ask when hardship strikes — why me? — makes no sense. That question presupposes that pain, disease, and death are distributed according to moral merit. They aren’t. We live in a world in which innocent children starve while moral monsters prosper. We may see justice in the next life, but we see little of it in this one.’ It has been noted that ‘suffering either makes you bitter or better’, and Kate is an inspiration as she laughs her way through many scenes. This, Stuntz notes, is God’s trademark: ‘He takes lemons and makes lemonade.’

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