My Sister’s Keeper
MONDAY CAMPBELL
by Picoult, JodieThe chapter depicts a tense courtroom scene where attorney Mr. Alexander cross-examines Dr. Chance about the medical treatments involving Anna Fitzgerald, who was conceived as a genetic match to donate to her cancer-stricken sister Kate. Dr. Chance, visibly impatient to return to his patients, defends the procedures as medically necessary, emphasizing that Kate’s survival to age sixteen is remarkable. The attorney highlights the ethical dilemma of Anna being used as a lifelong donor, questioning whether the Fitzgeralds were fully informed about the risks and long-term implications of these donations.
Mr. Alexander challenges Dr. Chance’s assertion that Anna has suffered no significant harm, presenting a consent form outlining serious anesthesia risks. The doctor downplays these risks as rare, but the attorney counters by pointing out Anna’s repeated exposure to dangerous procedures. The cross-examination reveals gaps in the doctor’s memory about Anna’s pain and recovery, suggesting a disregard for her experiences. The tension escalates as Mr. Alexander implies Anna’s autonomy has been overlooked in the pursuit of saving Kate.
The discussion shifts to the experimental nature of some treatments, particularly growth factor shots, which Dr. Chance admits have only been tested on animals. Mr. Alexander draws parallels to historical medical disasters like thalidomide, casting doubt on the safety of these procedures. The attorney then focuses on the proposed kidney donation, questioning its impact on Anna’s future health and activities. Dr. Chance initially claims minimal effects but is forced to acknowledge documented risks like hypertension and pregnancy complications when presented with evidence.
In the final exchange, Mr. Alexander underscores the hypocrisy of Dr. Chance’s position—claiming Anna faces no long-term harm while admitting the lack of human studies on some treatments. The chapter ends with the attorney highlighting Anna’s passion for hockey, a sport she may have to abandon if she donates a kidney. This confrontation exposes the moral complexities of using one child’s body to save another, leaving the reader to ponder the true cost of Kate’s survival.
FAQs
1. What is the main ethical dilemma presented in this courtroom scene regarding Anna’s medical donations to Kate?
Answer:
The ethical dilemma centers on whether Anna’s repeated medical donations (bone marrow, stem cells, and a potential kidney) for her sister Kate constitute justified medical treatment or exploitation. While Dr. Chance argues the procedures were medically necessary and low-risk, the attorney highlights the lack of long-term research on effects (e.g., growth factor shots), the anesthesia risks, and lifestyle limitations (e.g., Anna’s hockey participation conflicting with kidney donation guidelines). The chapter questions whether consent—given by Sara Fitzgerald, not Anna—truly considers Anna’s autonomy and well-being, especially since she was conceived as a donor match.2. How does Dr. Chance justify the ongoing medical procedures involving Anna, and what counterarguments does the attorney present?
Answer:
Dr. Chance defends the procedures by emphasizing Kate’s survival against odds, Anna’s role as a “perfect match,” and the absence of “significant long-term harm” to Anna. He frames consent forms as protective and downplays risks (e.g., calling marrow donation “simple”). The attorney counters by citing anesthesia consent forms listing life-threatening risks, the theoretical nature of growth factor research, and documented post-donation health restrictions (e.g., hypertension, pregnancy complications). He also implies moral hypocrisy by comparing extreme hypotheticals (e.g., “cutting off Anna’s head”) to the cumulative burden of her donations.3. Analyze the power dynamics in this scene. How do the characters’ motivations (Dr. Chance, Sara, the attorney) reflect their roles?
Answer:
Dr. Chance represents medical authority, prioritizing Kate’s survival and institutional protocols (e.g., consent forms) while dismissing broader ethical concerns. Sara’s urgency to expedite testimony underscores her focus on Kate’s immediate needs, sidelining Anna’s perspective. The attorney, acting as Anna’s advocate, weaponizes medical jargon and consent documents to expose systemic flaws—highlighting how Sara’s decisions and Dr. Chance’s recommendations may overlook Anna’s rights. The judge’s silence hints at judicial scrutiny of these dynamics. Power shifts as the attorney forces Dr. Chance to confront contradictions (e.g., downplaying risks while admitting lack of human studies).4. What literary devices or rhetorical strategies does the attorney use to challenge Dr. Chance’s testimony?
Answer:
The attorney employs:- Sarcasm (“How comforting”) to mock Dr. Chance’s reliance on theoretical safety.
- Hypothetical extremes (e.g., “cutting off Anna’s head”) to reductio ad absurdum the ethics of incremental donations.
- Documentary evidence (consent forms, hospital flyers) to contradict Dr. Chance’s assurances.
- Pacing (deliberate pauses, slow questioning) to mirror the tension and force reflection.
- Historical allusion (thalidomide) to warn of unforeseen consequences. These strategies undermine Dr. Chance’s credibility and reframe Anna’s donations as systemic exploitation.
5. How does the chapter’s opening paragraph set the tone for the courtroom confrontation?
Answer:
The narrator’s disdain for doctors resentful of subpoenas establishes a combative tone, foreshadowing the attorney’s adversarial stance. By describing his deliberate delays (“retie my shoe,” “pregnant pauses”), he mirrors the power struggle in the testimony—where time wasted symbolizes resistance to medical authority. This framing primes readers to view Dr. Chance’s impatience as paternalistic, contrasting with the attorney’s calculated scrutiny of medical ethics. The heat metaphor (“Anna’s body throws heat”) further intensifies the emotional stakes.- Sarcasm (“How comforting”) to mock Dr. Chance’s reliance on theoretical safety.
Quotes
1. “DOCTORS HAVE THIS THING about being subpoenaed: they let you know, with every syllable of every word, that no moment of this testimony will make up for the fact that while they were sitting on the witness stand under duress, patients were waiting, people were dying.”
This opening quote sets the tone for the adversarial dynamic between medical professionals and legal proceedings, highlighting the tension between clinical urgency and judicial process. It introduces the theme of conflicting priorities that runs through the chapter.
2. “Nothing in cancer is a sure thing, Mr. Alexander.”
Dr. Chance’s blunt admission underscores the fundamental uncertainty in medical treatment, particularly in oncology. This quote becomes a pivotal point in the cross-examination, challenging assumptions about guaranteed outcomes in Anna’s donations to Kate.
3. “We were talking about a single cord blood treatment at the time… Subsequent donations came about because Kate didn’t respond to the first one. And because they offered more promising results.”
This revelation exposes the slippery slope of medical interventions, showing how initial limited procedures expanded into ongoing demands on Anna’s body. It raises ethical questions about consent and the boundaries of medical treatment.
4. “Increased chance of hypertension. Possible complications during pregnancy. Donors are advised to refrain from contact sports to eliminate the risk of harming their remaining kidney.”
The highlighted medical flyer contradicts Dr. Chance’s earlier minimization of risks, revealing the significant lifelong impacts kidney donation could have on Anna. This evidentiary moment dramatically shifts the power dynamic in the courtroom.
5. “Physicians don’t tend to prescribe drugs that have the potential to wreak havoc… Have you ever heard of thalidomide, Doctor?”
This exchange encapsulates the chapter’s central conflict about medical ethics and risk assessment. The reference to thalidomide serves as a powerful historical reminder of medical overconfidence and its consequences.