If your parents have you for a reason, then that reason better exist. Because once it's gone, so are you. (1.1.4)
Is Anna being a little overdramatic here? Would her parents stop loving her if Kate were healthy? Or if Kate had died? Actually, the more we get to know the parents, the more we wonder about this ourselves.
I am used to struggling with Jesse, to lightening Kate's load; but Anna is our family's constant. (1.4.31)
That's a nice role to have, but is it fair for a family to put that kind of pressure on any one member, especially one who is only thirteen years old?
I used to pretend that I was just passing through this family on my way to my real one. (2.1.1)
Maybe all kids have this feeling that they're adopted when they don't fit into their family. Anna, though, for better or for worse, knows that this is her family—she was created specifically for them.
"If you don't want to be my sister anymore, that's one thing. But I don't think I could stand to lose you as a friend." (2.1.81)
Kate seems to suggest that friendship is more important than family. This might be true, and many times throughout the book, this family feels like a family in name only. If they didn't have the same last name, we'd think they were all enemies.
We are all, I supposed, beholden to our parents—the question is, how much? (3.1.1)
You'd think this is Anna talking, but it's actually Campbell. It's probably a question everyone has at some point: Do you have to do everything your parents want just because they're your parents? Or does there always come a time when you have to separate from them? (Whether or not this involves a lawsuit is up to you.)
Daughter trumps everything, no matter what the game. (3.2.46)
Well, Anna gets proven wrong here in the end. Her mother ends up not having the final say; the court does.
"No offense, but you don't exactly look like a parent." […]
"What do parents look like?" (3.6.108-3.6.109)
Good question. We think the answer in this case, at least with Campbell, is that parents are supposed to look responsible—and this guy barely looks like he's capable of carrying groceries (based on the fact that his fridge only has ketchup in it).
One Thanksgiving when Kate was not in the hospital, we actually pretended to be a regular family. (3.7.71)
Is there such a thing as a regular family? We think most families have to deal with things like illness, badly behaving teenagers, and other mistakes and maladies. So maybe by ignoring all these problems, they're pretending to be an abnormal family.
If you have a sister and she dies, do you stop saying you have one? Or are you always a sister, even when the other half of the equation is gone? (3.7.85)
Can you answer this one, math majors? Are you the variable formerly known as sister, or do you change to a different type of integer altogether?
"Parents need to be parents. […] But sometimes that isn't good enough." (9.2.46)
And that quote pretty much sums up the whole book. As Hillary Clinton said, it takes a village.
It made me wonder, thought, what would have happened if Kate had been healthy. […] Certainly, I would not be part of this family. (1.1.4)
Anna's whole existence happened because Kate was ill. It's a weird situation to be in, kind of having to be grateful that your older sister has cancer.
[The nurse] removes the needle, and sticks Kate again, who howls even louder. (1.3.34)
"Howls even louder" are just three words that cannot describe the pain Kate must be going through… or the pain Sara feels at having to watch her daughter suffer.
My sister's in pain, and I'm relieved. What does that say about me? (2.1.21)
Anna is too young to know the term schadenfreude, but that's not what's happening here—Anna is just glad that her mother is distracted, and that this takes her attention away from Anna after Anna files the lawsuit. (Which is weird, because isn't attention what Anna really wants?)
I find myself staring at the goldfish. Bright as a penny, he swims in circles, happy to be going nowhere. (4.3.18)
This is a good metaphor for Kate's illness. They cannot cure her, not matter what they try, they just circle around and around the inevitable.
"It's only a little stick," the doctor promises, exactly the wrong words, and Anna starts thrashing. (4.3.80)
Kate isn't the only one suffering because of her illness—Anna has to suffer through pain and fear of pain when she donates blood.
This is the moment I would have had with [Kate] when she got her period; will she live long enough for that? (5.2.8)
Unless it's Carrie, the whole first period thing is a critical moment in a lot of coming of age stories. Unfortunately, in this book, it's not a period Kate's having—it's severe hemorrhaging. There's both pain and sorrow happening here, because the hemorrhaging could lead to death.
Of course Anna should be honored for donating her bone marrow. Of course she deserves recognition. But the thought of rewarding someone for their suffering, frankly, never entered my mind. (5.3.116)
Sara doesn't think she should reward Anna for her suffering because saving her sister's life should be its own reward, we guess. Kate's reward is getting to live. Anna's is… a little more nebulous.
"Where's the one-liner? Or is it too hard to joke about something that hits so close to the bone? You back away every time someone gets close to you?" (9.1.72)
Picoult will not rest until every character is miserable, and Campbell and Julia's relationship is a source of suffering for them both. His defense mechanism is to run away, and while this saves him some pain, it causes Julia more.
Life isn't nearly as stable as we want it to be. (9.6.12)
Okay, maybe everyone in this book does have an illness. It turns out that Campbell is epileptic, which happened after he was in a sudden car accident. Disease comes out of left field and affects everyone, not just the sufferer.
There should be a statute of limitation on grief. (Epilogue.1)
There's no end to suffering for the Fitzgerald family. Kate's cancer is cured (as far as we know), but they will mourn Anna's death forever.
A major decision about me is being made, and no one's bothered to ask the one person who most deserves it to speak her opinion. (1.1.98)
On first reading, it seems like Anna is talking about herself. But could she also be talking about Kate? As we find out in the end, Kate doesn't want the kidney either. Is either daughter given a choice in this novel?
"[A guardian ad litem is] a person trained to work with kids in the family court, who determines what's in the child's best interests," Anna recites. "Or in other words, just another grown-up deciding what happens to me." (1.2.36)
This is a touchy subject for Anna. Even though she's ultimately going through this whole case because Kate wants her to, Anna is sick of having all her choices made for her. No wonder she worries this will never end.
"Brian," I whisper. "I've been thinking."
He shifts in his seat. "What about?"
I lean forward, so that I catch his eye. "Having a baby." (2.2.107-2.2.109)
And here we see Sara make the biggest decision: to have Anna. If she hadn't made this choice, we'd never have had a book to read. (And Anna probably wouldn't have died in the 90s, along with grunge music and slap bracelets.)
What would I do, if I found out that Izzy needed a kidney, or part of my liver, or marrow? (3.5.49)
Julia tries to put herself in Anna's shoes, but she seems to forget that Anna's shoes are much, much smaller, and Anna has someone forcing those shoes on her, instead of choosing which pair she wants to wear.
"Why don't you grow up? Why don't you figure out that the world doesn't revolve around her?" (4.3.42)
What Jesse is talking about here is Sara's tendency to choose Kate above anyone and everything else. "Growing up" means making some difficult decisions instead of relying on what feels safe.
"I know what's right for Anna," Julia tells me, "but I'm not sure she's mature enough to make her own decisions." (5.1.73)
Julia is sure of her choice here (whatever it is) but she admits later in the novel that she has no clue what's right for Anna. Is anyone mature enough to make this choice for her?
"If you want to make major decisions, Anna, then you need to start making them now. Not relying on the rest of the world to clean up the messes." (5.1.184)
Anna wants to have her cake and eat it, too. She doesn't want her parents to make decisions for her… but she still doesn't want to take responsibility. No wonder the epigraph for this section is from Hamlet. Everyone is so indecisive.
I put my hands on [Anna's] shoulders. "You don't have to do this if you don't want to, but I know that Kate is counting on you. And Daddy and me." (5.3.89)
Okay, Sara probably thinks that she's giving Anna a choice, but what she's actually giving her is a guilt trip that only the mother of a daughter with kidney failure can give.
"You admitted that you've always considered Kate's health, not Anna's, in making these choices. […] So how can you claim to love them both equally? How can you say that you haven't been favoring one child in your decisions?" (7.1.136)
Is Campbell basically acting Sara to choose who she loves more? It seems like he's asking her to love Anna more, for once, if even for just a little bit.
"It's a Solomon's choice, Your Honor. But you're not asking me to split a baby in half. You're asking me to split a family." (9.4.6)
Julia hasn't seen Sophie's Choice, so she goes a little Biblical with this reference. But the result is the same: This is a choice with huge consequences for everyone involved. Even a super long book can't thoroughly explore all the implications.
To reach my brother's room, you actually have to leave the house, which is exactly the way he likes it. (1.1.54)
Jesse's a chicken-or-egg situation: Did he isolate himself because his parents left him alone too much, or did they pull away because he isolated himself?
"[My parents] don't really pay attention to me, except when they need my blood or something." (1.2.17)
Dang, some kids' parents don't pay attention to them unless they need the trash taken out or the lawn mowed. This is pretty extreme, and makes Anna feel even more objectified, like a mass of organs instead of a daughter, or even a person.
This is when I realize that Anna has already left the table, and more importantly, that nobody noticed. (1.4.52)
This is from Brian's point of view. At least he noticed, right? Even if he was a little late… that's more than we can say for Sara, who is focused completely on Kate right now.
I look for places like me: big, hollow, forgotten by most everyone. (3.3.17)
Jesse says a lot about himself here. He's the one in the family voted Most Likely to be Forgotten—he's so forgotten, he barely knows himself, and he chooses to fill those empty places with fire.
They called [Julia] Freak, because she wasn't one of us. (3.6.52)
Let's add Julia to the list of people who have felt isolated in their youth. She didn't fit in while she was in college, so that helps her sympathize with Anna (and fall in love with Campbell… or she would if he would be honest about himself for once).
There are pictures of me, too, but not many. I go from infant to about ten years old in one fell swoop. (3.7.3)
Anna seems to suffer doubly from being both a genetic experiment and the youngest child. Her parents just don't care to document her childhood as much as they did with their other kids. No wonder Anna feels she doesn't exists—there's barely any physical evidence of her life.
I tell myself that I've invited [Duracell Dan] along to add to the thrill—one more person who knows only makes it more exciting. But it's really because there are some nights when you just want to know there's someone else besides you in this wide world. (5.4.9)
Poor Jesse is so lonely that he has to pay a homeless man (in Happy Meals) to accompany him on a truck-jacking. If only he lived in a world with meetup.com, he might not have as hard a time finding friendship. Alas, this is the 1990s.
"How the hell did Anna Fitzgerald slip through the cracks?" (7.2.78)
It's not just Anna's family who ignores her; the medical ethics committee, whose freaking job it is to analyze cases like these, didn't even notice Anna.
The summer I was fourteen my parents sent me to a boot camp on a farm. (7.4.1)
Jesse's parents' hearts are in the right place (or are they?) but this is bad parenting. He's acting out because he feels isolated from his family… so they isolate him more. Spoiler alert: It doesn't work.
I do what I know will destroy [Jesse]: I pull Jesse into my arms as he sobs. (7.5.42)
And here we go. Brian finally figures out the cure to fix his lonely children: Show them love. Hugs not drugs, y'all.
In my first memory, I am three years old and I am trying to kill my sister. (Prologue.1)
Okay, from the very first line of the novel, you know that there is going to be death hanging over everything, like a mobile over a crib… a mobile consisting solely of rotating grim reapers.
"What happens if you don't give your sister a kidney?"
"She'll die." (1.2.20-1.2.21)
Yep, things are serious—we're talking real life-or-death consequences here. Picoult doesn't pull any punches.
Kate is going to die. It took me a long time to be able to say that. We all are going to die, when you get down to it, but it's not supposed to be like this. Kate ought to be the one who has to say good-bye to me. (1.4.87)
Death is hard for anyone to accept, but the hardest might be a parent trying to accept the inevitable death of a child.
Gamma rays, leukemia, parenthood. It is the things you cannot see coming that are strong enough to kill you. (3.4.27)
Add car accidents to this list, because this is what claims Anna in the end. Sara is talking about the unpredictability of illness and death… and that's pretty much how the book ends, too.
"You know, normal people don't sit around thinking about dying."
"Liar. Everyone thinks about dying."(3.7.61-3.7.62)
How many books have you read that have to deal with death? You wouldn't be able to read them all in your lifetime. Yes, we're talking about death right now. Death death death. Yeah, everyone thinks about it, some people just try to deny it.
"Is this… a eulogy?"
By now, Brian is crying, too. "If I don't do it now, I won't be able to when it's really time." (6.4.52-6.4.53)
Brian is preparing for his daughter's death like some dads would prepare for college or a new car. Unfortunately, death will likely come for Kate before either of those other milestones.
"That's why [Kate's] hanging on, you know. She wants your permission to leave." (6.4.113)
Of course Kate's parents don't want her to die, but it's almost like Kate is afraid that she'll get in trouble if she dies, despite her parents' best efforts.
"It's not suicide," [Kate] said, "if you're already dying." (9.5.34)
Well, the M*A*S*H theme taught us that suicide is painless, but dying by kidney failure… not so much. So we're not sure if Kate's analogy holds up—at least not to the logic of 1970s television show theme songs.
Kate's death would be the worst thing that's ever happened to me… and also the best. (9.8.62)
Kate's death would close some doors for her (the final door), but it would open some windows for Anna. A death is really just the end for one person: the person dying. For others, it can be a new beginning.
"It was a good one, Mom, wasn't it?" I bite my lip, feel the heaviness of tears. "It was the best," I answer." (9.8.31)
Here's the big tear-jerker moment of the book (well, one out of about a dozen): Sara finally accepts that Kate is going to die. Kate, being the dying one, has accepted it for a while. It just takes a little longer for mom to get with the program, understandably.
As we got older, I didn't seem to exist, except in relation to her. (Prologue.2)
Right at the starting line, we see that identity is going to be an issue for Anna over the course of the novel. She wants to be her own person, not just known as "Cancer girl's sister" or "That girl played by Abigail Breslin in the movie."
"Don't mess with the system, Anna," [Jesse] says bitterly. "We've all got our scripts down pat. Kate plays the Martyr. I'm the Lost Cause. And you, you're the Peacekeeper." (1.1.68)
Do you agree with Jesse here? Do all the characters easily fall into these assigned roles? And if so, does that make Anna Nicole Kidman? Oh wait—that's the Peacemaker.We just wanted to say Anna Nicole Kidman. Talk about an identity crisis.
When you only have a hammer, everything looks like a nail. (1.2.1)
This little phrase says a lot about Campbell, and how he conducts his business… and his life. At first he sees Anna as a nail (no, not in that way), as a case that he can take on. It takes him a while to see her as a person.
I think half the battle is figuring out what works for you, and I am much better at being a mother than I ever would have been as a lawyer. (1.3.15)
Sara has chosen to identify herself as "mother" and she takes the title seriously. Do you think she's a good mother? And if not, does that make her a lousy attorney?
Either this girl loses her sister, I think, or she's going to lose herself. (3.5.61)
Anna's identity is so inextricably linked to Kate's that she runs the risk of becoming Kate. But no, as we've said before, Anna needs to find a way to separate herself from Kate to become herself, and the only way to do that might be for Kate to die.
I have a feeling that if I really try to figure out who I am without Kate in the equation, I'm not going to like who I see. (4.4.4)
Maybe this explains why Anna waffles back and forth so much on her decision. How much will her sister's death affect her? Okay, she's not as selfish as we're making her out to be.
"You don't know what it's like to being the kid whose sister is dying of cancer." (6.4.73)
Again, we only see Anna in relation to her sister. We can't imagine how many times she's called "the one with the dying sister" instead of "Anna."
It's getting harder and harder to be a bastard. (9.2.1)
It seems that "bastard" is Campbell's self-assigned label (at least until he gets so good at the part that everyone else starts calling him one, too). But he puts up this front to protect himself and his soft gooey center.
"There are several studies that indicate children who serve as donors have higher self-esteem, and feel more important within the family structure. They consider themselves superheroes, because they can do the one thing no one else can." (9.2.21)
Campbell agrees that this doesn't sound like Anna at all—a "study" can't accurately describe the identity of a group any more than a stereotype can.
"You deserved better than some freak who might fall down frothing at the mouth any old minute." (9.7.13)
Anna defines herself by her sister's illness; Campbell defines himself by his own. And he adds the moniker "freak" to it, which doesn't do his self-esteem any favors.
I am a monster. (9.8.62)
Campbell calls himself a freak; Anna calls herself a monster. Yep, these guys are two of a kind. Anna feels like a monster because she's basically killing her sister… even though that's what Kate wants her to do. Maybe making such a difficult choice makes her a saint instead of a monster.
"Ten years from now, in my opinion, I think [Anna's] going to be pretty amazing." (10.6.1)
This is the first time anyone has acknowledged that Anna will still be alive in ten years. It's almost as though people think that since Kate isn't expected to last that long, Anna won't be around then either.
"I want to sue [my parents] for the rights to my own body." (1.1.95)
And boom, we're off on a legal drama that would make John Grisham jealous. This book wouldn't be possible if the U.S. weren't such a litigious society.
"Does there have to be a trial?" (3.2.12)
Oh, Anna, if you file a lawsuit, yes there has to be a trial—that's the way these things work. And the more public spectacle (or ripped-from-the-headlines material that can be used on Law and Order), the better.
"You cannot talk about this case with your daughter unless her attorney is present." (3.2.41)
This is such a bonkers legal order that we have to wonder if it would fly in real life. Sara, as opposing counsel, lives with her daughter. Does the judge actually think she won't talk about the case?
"I certainly don't think my client ought to be the one to move out. She hasn't violated the judge's orders. I'll get a temporary restraining order keeping Sara Fitzgerald from having any contact with her." (3.6.38)
The legal drama intensifies when Campbell adds a restraining order to the mix.
"If it comes to my attention at some future date that you have ignored this directive once again, I will report you to the bar myself and personally escort you from your home." (4.5.14)
Judge DeSalvo totally lays down the law (with a "salvo" of legal terms like "directive" and, um, "bar"). We're surprised he doesn't smack Sara in the face with his gavel.
"The kid doesn't have a record."
"That's because he just turned eighteen. He's got a juvy record a mile long." (5.1.132-5.1.132)
Campbell ends up getting Jesse off because of a legal loophole—all Jesse's crimes when he was seventeen and younger can basically be swept under the rug. Good thing kids become totally different people the second they turn eighteen.
I'm actually educated to think that morals and ethics do not necessarily go hand in hand. (5.1.160)
We wondered what happened in law school. This explains why the law sometimes let killers go free, while also putting people in jail for years over comparatively minor infractions like tax fraud.
"We actually have reviewed your daughter's case," the woman says. "Unfortunately, at this time, we don't think that procedure is in her best interests." (5.3.26)
Even more frustrating than the legal system is the medical insurance system. In this chapter, Sara fights big time just to get Kate's procedure to happen.
"Are you indicating that if my client willingly donates a kidney, then she will be absolved of all other medical procedures that may be necessary in the future to prolong Kate's life?"(6.5.20)
We've seen plea bargains on legal shows before, but rarely are people bargaining for a human organ. Once again, Sara uses the legal system to reduce her daughter to merely an organ. That can't be good for Anna's self-esteem.
"In America—even if the consequences are tragic—you are not responsible for someone else's safety. You aren't obligated to help anyone in distress. Not if you're the one who started the fire, not if you're a passerby to car wreck, not if you're a perfectly matched donor." (7.1.71)
This isn't what we learned from the final episode of Seinfeld… but if Campbell says it, we'll believe it.
"Oh, Anna," my mother sighs, "how can you not know how much I love you?" (2.1.95)
Well, not showing it is one reason Anna doesn't know. Does a parent just love a child by default, and not have to show it every once in a while?
He smiles at me, and I suddenly am seventeen again—the year I realized love doesn't follow the rules, the year I understood that nothing is worth having so much as something unattainable. (3.5.93)
No, Julia doesn't turn in Zac Efron, but when Campbell smiles at her, she remembers her first love. It's like muscle memory, or riding a horse (no snickering please): That first love is something she'll never forget.
I wonder if Julia feels like it has been moments, not years, since we've been together. (3.6.172)
Yep, Campbell feels the same way Julia does, as though love is like riding a bike. When you get back on, it's like you never stopped.
"We all know you're supposed to love your kids equal, but that's not always how it works out." (4.1.48)
Forgiving Brian's grammar here (adverbs, people—use them), do you agree? Do you think parents play favorites? Does Brian love one of his kids more than the others? What about Sara? Do the kids realize it?
"The bottom line […] is that we never fall for the people we're supposed to." (4.2.84)
Love happens out of the blue, it seems. Although by the time we finish this book, it seems that Campbell is supposed to fall in love with Julia, so we guess it depends on who is doing the supposing.
"I had the heart of the relationship, and no body to grow it in."
"What happened then?"
"What else," I said. "It broke." (4.2.101-4.2.103)
This sounds like plot of a Picoult-meets-Frankenstein story. But what Julia seems to be saying is that she really loved Campbell, but he wasn't there to support her. She put her heart on the line, and he left it behind.
I wondered what happened when you offered yourself to someone, and they opened you, only to discover you were not the gift they expected and they had to smile and nod and say thank you all the same. (4.2.123)
Wow—this is disappointing. Julia is putting a lot of the blame for her relationship with Campbell on herself. We think this quote could totally apply to him, too.
True love is felonious. […] "You take someone's breath away. […] You rob them of the ability to utter a single word. […] "You steal a heart." (4.2.151, 4.2.153)
Hearts get broken, too, which is totally destruction of property.
"You did really great up there," I tell [mom], because I don't know how to say what I really want to: that the people you love can surprise you every day. (7.2.103)
This is a little role reversal, with Anna telling Sara that she did a great job. Love does surprise us in this case: It turns the daughter into the mother.
When you love someone, you'll do anything you can to keep them with you. (9.3.12)
This late in the game, this is kind of stating the obvious, but it's still true. Not just for the Fitzgeralds either; we'll soon see that Campbell and Julia will also do what it takes to keep the other with them.
"You don't love someone because they're perfect," [Julia] says. "You love them in spite of the fact that they're not." (9.7.18)
Ain't that some fortune cookie wisdom? Sure, it would have to be a big cookie, but this is one of those universal truths: Imperfections make someone loveable. Or maybe people just say this because they know they'll never find the perfect person.