My Sister's Keeper is a 2004 novel written by Jodi Picoult. It tells the story of 13-year-old Anna, who sues her parents for medical emancipation when she is expected to donate a kidney to her sister Kate, who is dying from leukemia.
The story takes place in the fictional town of Upper Darby, Rhode Island in 2004. Anna Fitzgerald's older sister, Kate, suffers from acute promyelocytic leukemia, a blood and bone marrow cancer. Anna was born as a savior sister specifically so she could save Kate's life. At first it is successful, but the cancer continues to relapse throughout Kate's life.
Anna is usually willing to donate whatever Kate needs, but when she turns 13, she is told that she will have to donate one of her kidneys. The surgery required for both Kate and Anna would be major; it is not guaranteed to work, as the stress of the operation may well kill Kate anyway; and the loss of a kidney could have a serious impact on Anna's life. Anna petitions for medical emancipation with the help of lawyer Campbell Alexander, so that she will be able to make her own decisions regarding her medical treatment and the donation of her kidney. This is done on the advice of Julia Romano, the court-appointed guardian ad litem whose job it is to decide what would be best for Anna. Julia was once romantically involved with Campbell when they went to school together, but Campbell broke her heart when he left her. Unbeknown to Julia, Campbell left her because he discovered he had epilepsy and thought she deserved better.
Meanwhile, Anna's brother Jesse, who has spent most of his life being ignored in favor of ill Kate or donor Anna, spends most of his time setting fire to abandoned buildings with home-made explosives and using illegal drugs. He is a self-confessed juvenile delinquent. The one moment when his parents pay him any attention is when his father, Brian, discovers that it is Jesse who has been setting the fires. Brian forgives him, and by the end of the book, Jesse has reformed and graduated from the police academy, despite his criminal record.
During the trial, it is revealed that Kate asked Anna to sue for emancipation because she did not want Anna to have to donate her kidney, and because she believes that she will die anyway. The judge rules in Anna's favor, and grants Campbell a medical power of attorney. However, as Campbell drives her home after the trial, their car is hit by an oncoming truck. Brian, the on-call firefighter who arrives at the scene, retrieves an unconscious and injured Anna from the wreckage of the crushed car and rushes her and Campbell to the hospital. At the hospital, the doctor informs Sara and Brian that Anna is brain-dead, that the machines keeping her alive may as well be switched off, and asks them if they have considered organ donation. Campbell steps in, and declares that he has the power of attorney, and that "there is a girl upstairs who needs that kidney." Kate is prepared for surgery, and Anna's kidney is successfully transplanted. Kate survives the surgery and remains in remission for at least six years (the book ends in 2010).
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