Cover of My Sister’s Keeper
    LiteraryLiterary FictionRelationshipYoung Adult

    My Sister’s Keeper

    by Picoult, Jodie
    “My Sister’s Keeper” by Jodie Picoult follows 13-year-old Anna Fitzgerald, who was conceived as a genetic match to donate organs and blood to her older sister Kate, who suffers from leukemia. When Anna is asked to donate a kidney, she sues her parents for medical emancipation, challenging the ethical boundaries of family obligation and bodily autonomy. The novel explores themes of sacrifice, moral dilemmas, and the complexities of love through multiple perspectives. Picoult’s narrative delves into the emotional and legal turmoil faced by the Fitzgerald family, raising profound questions about medical ethics and personal choice. The story is inspired by the real-life case of Anissa and Marissa Ayala.

    The chap­ter opens with Anna, a ten-year-old girl, ask­ing her par­ents, Bri­an and Sara, for $614.96 to pur­chase hock­ey goal­tender leg pads from eBay. Ini­tial­ly hes­i­tant, her par­ents press for details, lead­ing Anna to reveal she has secret­ly been prac­tic­ing as a goalie for a boys’ hock­ey team after fill­ing in for a sick play­er. Despite their sur­prise, Anna’s pas­sion and tal­ent for the sport become evi­dent, though her par­ents need time to con­sid­er the cost­ly equip­ment. The scene high­lights Anna’s deter­mi­na­tion and the par­ents’ cau­tious yet sup­port­ive dynam­ic.

    Mean­while, Kate, Anna’s old­er sis­ter, strug­gles with graft-ver­sus-host dis­ease, a com­pli­ca­tion from her bone mar­row trans­plant. When the fam­i­ly pre­pares to attend Anna’s hock­ey game, Kate refus­es to go due to a severe flare-up of her con­di­tion, which caus­es a rash and swelling. Sara insists Kate come along, dis­guis­ing her with gloves, a hat, and a scarf to pro­tect her self-esteem. This sub­plot under­scores Kate’s ongo­ing health bat­tles and the fam­i­ly’s bal­anc­ing act between her needs and Anna’s mile­stones.

    At the hock­ey game, Anna shines as the team’s goalie, impress­ing her fam­i­ly with her nat­ur­al tal­ent. Bri­an and Sara watch in awe as Anna makes remark­able saves, while even reluc­tant Kate gets caught up in the excite­ment. The game becomes a rare moment of nor­mal­cy and pride for the fam­i­ly, con­trast­ing sharply with their usu­al med­ical crises. Anna’s suc­cess on the ice serves as a brief respite from the heav­ier themes of ill­ness and sac­ri­fice.

    The chap­ter takes a dark turn when Kate suf­fers a severe hem­or­rhage lat­er that night, requir­ing emer­gency hos­pi­tal­iza­tion. Dr. Chance presents arsenic ther­a­py as a last-resort treat­ment, though its suc­cess is uncer­tain. Sara imme­di­ate­ly agrees, while Bri­an remains silent, reflect­ing their dif­fer­ing cop­ing mech­a­nisms. The chap­ter ends on a cliffhang­er, empha­siz­ing the fam­i­ly’s relent­less strug­gle with Kate’s ill­ness and the emo­tion­al toll it takes on them all.

    FAQs

    • 1. How does Anna’s request for money reveal both her personality and the family dynamics at play?

      Answer:
      Anna’s bold request for $614.96 upfront in exchange for future lawn-mowing demonstrates her determination and unconventional problem-solving approach. Her defensive reaction (“I knew you’d be like this”) suggests she anticipates resistance, highlighting a teen-parent dynamic where negotiations are tense. The parents’ insistence on transparency (“we’re not forking over six hundred bucks without knowing”) reveals their responsible parenting style, while Anna’s eventual confession about hockey equipment shows she trusts them enough to share her passion—once cornered. This interaction underscores Anna’s independent spirit and the family’s balance between skepticism and support.

      2. Analyze how the chapter contrasts Anna’s and Kate’s struggles through their physical experiences.

      Answer:
      The chapter juxtaposes Anna’s athletic triumph with Kate’s medical crisis to emphasize their divergent challenges. Anna’s hockey gear (“stuffed and trussed”) symbolizes her growing agency and physical competence, while Kate’s steroid-induced “moon face” and rash reflect her body’s betrayal. Where Anna’s movements are precise (“knees bent in, elbows pointed out”), Kate’s body hemorrhages uncontrollably. This contrast heightens the emotional tension: Anna’s visible success occurs alongside Kate’s invisible deterioration, illustrating how illness isolates while sports unite (shown through the cheering crowd vs. Kate’s solitary hospital bed).

      3. Why does the author include the detail about Kate’s reluctance to attend the hockey game, and how does this moment develop her character?

      Answer:
      Kate’s refusal to go (“Not when I look like this”) underscores the psychological toll of graft-versus-host disease on a teenager’s self-image. Her rash and “moon face” from steroids make her withdraw socially, contrasting with Anna’s public confidence in goalie gear. When Sara forcibly bundles Kate in winter accessories, it shows both maternal insistence on family support and Kate’s vulnerability—her eventual engagement with the game (“getting into the game”) hints at resilience beneath her frustration. This moment humanizes Kate, emphasizing that chronic illness steals not just health but also ordinary adolescent experiences.

      4. How does Dr. Chance’s explanation of arsenic therapy reflect the broader themes of hope and desperation in the chapter?

      Answer:
      Dr. Chance’s candid discussion of arsenic—a poison repurposed as a last-resort treatment—mirrors the family’s oscillation between hope and despair. His admission that they “haven’t effected a cure” yet contrasts with Sara’s immediate “Do it,” showing how medical limbo breeds radical faith. The growth chart mural (“How Big Can I Grow?”) ironically underscores Kate’s stunted development, while the experimental treatment symbolizes clinging to progress despite statistical odds. This scene crystallizes the chapter’s tension between scientific realism and parental love’s irrational persistence.

      5. Interpret the significance of the line “Anna saves, every time” in the context of the chapter’s events.

      Answer:
      This phrase operates literally and metaphorically. As a goalie, Anna physically blocks hockey pucks with “natural talent,” but the line also foreshadows her role in the family’s emotional survival. While Kate’s body fails to “save” itself from hemorrhaging, Anna’s vitality offers the parents a reprieve from medical trauma—her athletic success becomes a rare win in their fraught lives. The double meaning reflects how siblings in crisis households often unconsciously provide hope; Anna’s saves on the ice momentarily deflect attention from the unsaveable nature of Kate’s decline.

    Quotes

    • 1. “The good news is that if that happens, all the cancer cells are under siege, too—something Dr. Chance calls graft-versus-leukemia disease. The bad news is the symptomology: the chronic diarrhea, the jaundice, the loss of range of motion in her joints.”

      This quote captures the cruel duality of Kate’s medical condition—her body’s rejection of the bone marrow transplant both fights her cancer and causes debilitating symptoms. It illustrates the painful trade-offs inherent in her treatment.

      2. “I respect her vanity, because there is so little of it.”

      This poignant observation about Kate’s rare moments of self-consciousness reveals how her illness has stripped away normal teenage concerns, making her occasional vanity both understandable and precious.

      3. “Anna saves, every time.”

      This simple yet powerful statement works both literally (describing Anna’s hockey skills) and metaphorically (hinting at her role in the family dynamic). It highlights Anna’s resilience amid her sister’s illness.

      4. “She’s lived ten years past what any of us would have expected.”

      Dr. Chance’s remark underscores both Kate’s remarkable survival against odds and the grim reality that her treatments are running out. It marks a turning point where hope becomes increasingly difficult to maintain.

      5. “Did I tell Kate I loved her before I put her to bed last night?”

      This heartbreaking internal monologue reveals the narrator’s sudden awareness of mortality and the small, precious moments that take on immense significance in crisis. It shows how medical emergencies amplify parental fears and regrets.

    Quotes

    1. “The good news is that if that happens, all the cancer cells are under siege, too—something Dr. Chance calls graft-versus-leukemia disease. The bad news is the symptomology: the chronic diarrhea, the jaundice, the loss of range of motion in her joints.”

    This quote captures the cruel duality of Kate’s medical condition—her body’s rejection of the bone marrow transplant both fights her cancer and causes debilitating symptoms. It illustrates the painful trade-offs inherent in her treatment.

    2. “I respect her vanity, because there is so little of it.”

    This poignant observation about Kate’s rare moments of self-consciousness reveals how her illness has stripped away normal teenage concerns, making her occasional vanity both understandable and precious.

    3. “Anna saves, every time.”

    This simple yet powerful statement works both literally (describing Anna’s hockey skills) and metaphorically (hinting at her role in the family dynamic). It highlights Anna’s resilience amid her sister’s illness.

    4. “She’s lived ten years past what any of us would have expected.”

    Dr. Chance’s remark underscores both Kate’s remarkable survival against odds and the grim reality that her treatments are running out. It marks a turning point where hope becomes increasingly difficult to maintain.

    5. “Did I tell Kate I loved her before I put her to bed last night?”

    This heartbreaking internal monologue reveals the narrator’s sudden awareness of mortality and the small, precious moments that take on immense significance in crisis. It shows how medical emergencies amplify parental fears and regrets.

    FAQs

    1. How does Anna’s request for money reveal both her personality and the family dynamics at play?

    Answer:
    Anna’s bold request for $614.96 upfront in exchange for future lawn-mowing demonstrates her determination and unconventional problem-solving approach. Her defensive reaction (“I knew you’d be like this”) suggests she anticipates resistance, highlighting a teen-parent dynamic where negotiations are tense. The parents’ insistence on transparency (“we’re not forking over six hundred bucks without knowing”) reveals their responsible parenting style, while Anna’s eventual confession about hockey equipment shows she trusts them enough to share her passion—once cornered. This interaction underscores Anna’s independent spirit and the family’s balance between skepticism and support.

    2. Analyze how the chapter contrasts Anna’s and Kate’s struggles through their physical experiences.

    Answer:
    The chapter juxtaposes Anna’s athletic triumph with Kate’s medical crisis to emphasize their divergent challenges. Anna’s hockey gear (“stuffed and trussed”) symbolizes her growing agency and physical competence, while Kate’s steroid-induced “moon face” and rash reflect her body’s betrayal. Where Anna’s movements are precise (“knees bent in, elbows pointed out”), Kate’s body hemorrhages uncontrollably. This contrast heightens the emotional tension: Anna’s visible success occurs alongside Kate’s invisible deterioration, illustrating how illness isolates while sports unite (shown through the cheering crowd vs. Kate’s solitary hospital bed).

    3. Why does the author include the detail about Kate’s reluctance to attend the hockey game, and how does this moment develop her character?

    Answer:
    Kate’s refusal to go (“Not when I look like this”) underscores the psychological toll of graft-versus-host disease on a teenager’s self-image. Her rash and “moon face” from steroids make her withdraw socially, contrasting with Anna’s public confidence in goalie gear. When Sara forcibly bundles Kate in winter accessories, it shows both maternal insistence on family support and Kate’s vulnerability—her eventual engagement with the game (“getting into the game”) hints at resilience beneath her frustration. This moment humanizes Kate, emphasizing that chronic illness steals not just health but also ordinary adolescent experiences.

    4. How does Dr. Chance’s explanation of arsenic therapy reflect the broader themes of hope and desperation in the chapter?

    Answer:
    Dr. Chance’s candid discussion of arsenic—a poison repurposed as a last-resort treatment—mirrors the family’s oscillation between hope and despair. His admission that they “haven’t effected a cure” yet contrasts with Sara’s immediate “Do it,” showing how medical limbo breeds radical faith. The growth chart mural (“How Big Can I Grow?”) ironically underscores Kate’s stunted development, while the experimental treatment symbolizes clinging to progress despite statistical odds. This scene crystallizes the chapter’s tension between scientific realism and parental love’s irrational persistence.

    5. Interpret the significance of the line “Anna saves, every time” in the context of the chapter’s events.

    Answer:
    This phrase operates literally and metaphorically. As a goalie, Anna physically blocks hockey pucks with “natural talent,” but the line also foreshadows her role in the family’s emotional survival. While Kate’s body fails to “save” itself from hemorrhaging, Anna’s vitality offers the parents a reprieve from medical trauma—her athletic success becomes a rare win in their fraught lives. The double meaning reflects how siblings in crisis households often unconsciously provide hope; Anna’s saves on the ice momentarily deflect attention from the unsaveable nature of Kate’s decline.

    Note