Study Guide

My Sister's Keeper

My Sister's Keeper Summary

Anna Fitzgerald's sister, Kate, is dying of leukemia and needs a kidney. Anna is expected to give her one, but Anna is sick of giving things to her sister. (Not just toys and money, but blood and plasma.) See, Anna was genetically engineered to be a donor for her sister Kate, but she doesn't want to do it anymore; Anna wants to choose what she gets to do with her own body.

Thirteen-year-old Anna hires Campbell Alexander, an attorney, to sue her parents for medical emancipation. Campbell has a crazy family life of his own, so he agrees to help her. Needless to say, this doesn't go well with Sara, Anna's mother, who gets served court papers while waiting beside Kate in her hospital bed. Brian, Anna's father, kind of agrees that Anna should have the right choose, which only makes Sara mad at him, too.

A woman named Julia Romano is designated as Anna's guardian ad litem, a woman who will work with Anna to try to decide what is best for her. (In other words, someone who will make the decision for Anna in a case that is to determine whether or not Anna can make decisions on her own—say that five times fast.) And, what a co-inky-dink, Julia and Campbell were lovers in college, before he dumped her without warning.

Over the course of a week, Anna waffles back and forth between wanting to give Kate a kidney and wanting to keep her own kidney and watch her sister die. Julia and Campbell sleep together again. Sara decides to represent herself in court, and Brian moves into the fire station where he works and takes Anna with him. And, oh yeah, the Fitzgeralds' son, Jesse, turns out to be an arsonist. Sorry, Jesse, we almost forgot about you… just like your parents did.

In the end, the judge awards Anna medical emancipation. It turns out that Kate wants to die because she's sick of living with cancer anyway, and the whole lawsuit was her idea the whole time. (So much for Anna's choice, huh?) Brian stops Jesse from being an arsonist; Campbell reveals to Julia that he broke up with her because he has epileptic seizures (Julie's and our reaction are similar: Seriously, dude?); and Brian and Sara reconcile.

And everyone lives happily ever after.

Well, until Anna suddenly dies in a car accident literally right after the trial. Because Campbell was awarded power of attorney, he says that Anna's kidney should go to Kate. Kate survives the transplant and lives, even though her sister dies. Brian and Sara regret neglecting Kate her whole life, and Kate lives with the memory (and the kidney) of her sister.

  • Prologue

    • We don't know who is talking, but the first line is, "In my first memory, I am three years old and I am trying to kill my sister" (Prologue.1). Yee-haw.
    • The nameless narrator also says "I didn't seem to exist, except in relation to her" (Prologue.2). Elle Fanning, is that you?
    • Finally, she says, "I did not kill my sister. She did it all on her own" (Prologue.3). This plot is as thick as London smog already, so let's get started.
  • Part 1: Monday / Chapter 1

    Anna

    • Thirteen-year-old Anna was born for a specific purpose: She was genetically engineered to be a match for her sister, Kate, who has acute promyelocytic leukemia (1.1.18).
    • Anna is sick of it.
    • She goes to a pawnshop to sell a beloved locket (for twenty buckaroos—Pawn Stars this ain't); back at home, Anna's mom is trying on a dress that she ordered off the Internet.
    • They hear crying from Kate's bedroom, and Mom rushes in, thinking she's in pain.
    • She is… but because of a soap opera. Like, OMG guys, Serena and Preston are breaking up.
    • Later, Anna gets her brother, Jesse, to drive her to the law offices of Campbell Alexander, an attorney who once sued God on behalf of a nine-year-old boy in a Catholic orphanage.
    • Anna doesn't want to sue God—"Just my parents […] I want to sue them for the rights to my own body" (1.1.99). Whoa.
  • Part 1 / Chapter 2

    Campbell

    • Campbell takes over the narration from Anna.
    • He listens to this thirteen-year-old girl tell him that she wants to sue his parents.
    • At first he thinks she's certified nuts-o (there's probably a certificate you can download off the Internet for that), but the more he hears about her, the more he's interested.
    • He agrees to take on the case (in exchange for Anna polishing his doorknobs) and file a petition in court for medical emancipation.
    • Anna makes fun of Campbell's name (an easy target) and leaves.
    • Later, Campbell exits his office with his service dog, Judge. His secretary, Kerri, asks him why he agreed to take the case. "You can't expect a kid to fend for herself" (1.2.65), he says.
    • He also says, "It's not my problem" (1.2.66), and returns to his office and locks the door.
  • Part 1 / Chapter 3


    Sara, 1990

    • Back in the past, Sara wonders why her daughter, Kate, is bruising so easily, like a three-day-old banana.
    • She takes Kate to the hospital, where she has to undergo a series of painful blood tests, and after a lot of waiting, they find out that Kate has leukemia.
    • The doctor is at least encouraging, saying, "Kids beat the odds. Every single day" (1.3.78).
    • Driving home, they play a game to take Kate's mind off everything. "What does the tiger say?" (1.3.88) "What does the elephant say?" (1.3.90) "What does the fox say?"
    • That night, Sara wonders if Kate's leukemia is all her fault because she took her happy family for granted.
  • Part 1 / Chapter 4

    Brian

    • Brian is getting ready for the night shift at the fire station. (Will there be some sweet sounds coming down?)
    • At dinner, Kate and Jesse argue like siblings do, while Anna is late to dinner; when she arrives, she's acting like a sullen girl, but no one seems to care.
    • No one even seems to notice when she leaves the table. It's an ancient philosophical dilemma: If an Anna leaves the dinner table and no one sees, did she go to dinner at all?
    • After dinner, Brian asks Sara if something's wrong with Anna, but she writes it off as "she's just being a teenager" (1.3.99).
    • At the fire station, Brian and the guys talk about the arsonist that's been plaguing the down. Will they ever catch this flaming menace?
    • Late that night, Sara drops Anna off at the fire station so she can visit her dad.
    • On the roof of the fire station, they chat about Greek mythology and look at the stars. ("Look! It's Jennifer Lawrence!")
  • Part 2: Tuesday / Chapter 1

    Anna

    • Anna is with Sara and Kate at the hospital when the sheriff, Vern Stackhouse (relation to Sookie?), slaps Sara with the papers saying that Anna has filed a lawsuit.
    • Before Sara can confront Anna about it, Kate yells out in pain, and Anna flees the room.
    • She calls Jesse, who takes her home.
    • When Sara gets home, it's time for Anna to get slapped. Not with court papers, but an actual slap across the face because she cannot believe that Anna doesn't want to help Kate anymore.
    • That night, while Anna is showering, Kate comes into the bathroom.
    • Kate tells Anna, "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).
    • After going to bed, Anna overhears her parents talking. Sara can't believe that Anna would act this way, but Brian thinks Anna might actually have a point, prompting Sara to snap at him, "Whose side are you on?" (2.1.89).
    • They leave, and Anna wakes up.
    • Oops. Mom is still there—Anna tells her mom "You must hate me" (2.1.94).
    • Sara says she loves Anna, and that they can go to the courthouse and talk to the judge and fix this whole silly problem in the morning.
    • We're not even one hundred pages in yet, though, so something tells us it won't be that easy.
  • Part 2 / Chapter 2

    Sara, 1990

    • Sara meets Kate's oncologist, Dr. Harrison Chance, who draws a face on an inflated glove to cheer Kate up.
    • Kate begins the long painful process of chemotherapy while Jesse is tested to see if he's a match to be a bone marrow donor.
    • Nope—he's not.
    • The doctor tries to give Sara hope, but she still worries about Kate's future.
    • A week later, Kate has another medical emergency and they have to rush her to the hospital.
    • They show Sara Kate's chest X-Ray, and Sara notices the giant tumor in the middle of her daughter's chest.
    • The doctor corrects her: "That's Kate's heart" (2.2.89). D'oh. Stick to legal matters, Sara—you went to law school, not med school.
    • Later that night, Sara tells Brian she wants another baby.
    • No, it's not a line out of Foreplay 101; she wants to do something to make sure that Kate doesn't die…
  • Part 3: Wednesday / Chapter 1

    Campbell

    • Campbell chats with his mom then walks to a nearby café, where he sits and watches everyone around him as though he's in the middle of Tom's Diner.
    • A "woman with a running river of black hair" (3.1.22) catches his eye. Who could he possibly think it is?
    • At his office, Anna is already polishing doorknobs when Campbell gets a call from Anna's mom.
    • Sara says that Anna wants to drop the case, but when Campbell asks Anna if this is true, she says no, she hasn't changed her mind.
    • Later that day, they go to meet the judge. Sara has decided to represent herself in court.
    • She tries to convince the judge that this is all a misunderstanding, but the judge wants to hear it straight from the horse's mouth.
  • Part 3 / Chapter 2

    Anna

    • The judge takes Anna into his chambers, where Anna cries and says she can't give Kate a kidney.
    • The judge decides to appoint a guardian ad litem to spend two weeks with Anna and give a report.
    • Of course, there's the problem that Anna is living with opposing counsel, so Sara is forbidden to talk about the case with her daughter.
    • Sara drags Anna home and tries to force her to tell Kate what she just did.
    • Brian tries to calm Sara down, but she snaps, "I have one child who's just signed her sister's death sentence, and I'm supposed to cool off?" (3.2.66)
    • Kate, hearing the phrase "death sentence" in relation to her, runs to her room.
    • Anna flees the house and hides out at a Laundromat, because it smells good.
  • Part 3 / Chapter 3

    Jesse

    • Surprise: Jesse is the arsonist.
    • He drives around looking for an abandoned place to burn, and finds an abandoned storage facility, which he torches.
    • Back at home, Sara is freaking out because Kate is vomiting; she needs Jesse to drive them to the hospital.
    • Jesse feels kind of useless because he can't give Kate any platelets at the hospital.
    • In the hospital room, Kate mouths to Jesse "Tell Anna" (3.3.43) but he doesn't know what he's supposed to say.
  • Part 3 / Chapter 4

    Sara, 1990-1991

    • Sara and Brian are interviewed on television because of their genetically engineered child.
    • They clarify that they "don't want a superbaby; we just want to save our daughter's life" (3.4.46)—and everyone returns the Superman-logo onesies they bought for the baby shower.
    • As soon as Anna is born, before she's even named, the umbilical cord blood is cryogenically frozen for when Kate is ready to receive it.
    • Sara practices injecting oranges with a syringe because Kate will need injections after the transplant. (Note: Never drink fresh-squeezed OJ at the Fitzgerald family home.)
    • Later, they watch the blood being tubed into Kate, and hope for the best.
  • Part 3 / Chapter 5

    Julia

    • Julia (no, we have no idea who she is yet either) lives with her sister and argues with her a lot.
    • She gets a call from Judge DeSalvo—Julia is Anna's guardian ad litem, so she drives to Anna's house to introduce herself.
    • They go to the zoo to chat and look at cheetahs. As they talk, Julia wonders whether or not Anna is prepared to make this decision (to give Kate a kidney) all by herself.
    • Julie takes Anna home and tries to talk to Sara while she's there.
    • Sara won't talk to her, though, because Kate is in the hospital.
    • After telling Anna she'll call tomorrow, Julia goes to Campbell's office. We get the feeling by the way she talks about how "love doesn't follow the rules" (3.5.93) that she might already know him…
  • Part 3 / Chapter 6

    Campbell

    • Yep, Campbell and Julia already know each other—in the Biblical sense, we're thinking.
    • They put that drama aside to talk about the case, specifically that Julia is afraid Sara is influencing Anna.
    • Campbell suggests removing Sara from her own house, but Julia doesn't think that's in Anna's best interests.
    • The conversation turns back to their nebulous past relationship, and Julia storms out of the office.
    • Flashback time: Campbell remembers when he met Julia at The Wheeler School, and their first kiss. Ooh la la.
    • Back to reality, Campbell drives out to check on Anna, then drives to Julia's apartment, where he accidentally thinks her twin sister, Izzy, is her.
    • He's more concerned about her than the case, saying that he thought that she might be living in the suburbs "with a bunch of kids and some lucky guy" (3.6.175).
    • And he thinks that he might be the guy. Does he really wanna be the guy?
    • Julia says, "You didn't want to be that guy. […] You made that pretty clear" (3.6.178).
    • Campbell's mysterious service dog, Judge, nudges him in the hip. Maybe his service is to keep Campbell from being an insensitive heartbreaker?
  • Part 3 / Chapter 7

    Anna

    • After talking to her dad about Kate, Anna goes to visit Jesse in his apartment over the garage.
    • She wants to visit Kate in the hospital, so Jesse drives her. They chat in the car, and Kate smokes her first cigarette. Delicious. (Not—"It's like licking a barbecue" (3.7.33), she says.)
    • At the hospital, Jesse pretends to be drunk so that his mother will leave Kate's bedside to come get him.
    • When Sara leaves the room, Anna sneaks in to be with Kate, alone.
    • She crawls into bed with Kate and tells us, "I didn't come to see Kate because it would make me feel better. I came because without her, it's hard to remember who I am" (3.7.86).
  • Part 4: Thursday / Chapter 1

    Brian

    • Two things happen in this chapter: Brian has to rush inside a burning building (could it be the arsonist?) to save a three-year-old child, and Julia talks to Brian while he's making an omelet about Anna. He says that you're "supposed to love your kids equal, but that's not always how it works out" (4.2.48), and he tells Julia that he wants her to meet someone… but we're not sure who yet.
  • Part 4 / Chapter 2

    Julia

    • As Julia rides in Brian's car, she thinks about what happened last night after Campbell left.
    • She went to a bar to drown her sorrows, not realizing that it was a gay bar.
    • Conveniently, she finds the one hetero bartender that works at a gay bar and spills the beans on her problem with Campbell: "I had the heart of the relationship, and no body to grow it in" (4.2.101). Wait… are we talking about a relationship, or Frankenstein's monster?
    • Brian takes Julia to the hospital to meet Kate. The whole family is there. Well, except Jesse, who's probably off burning a school down or kicking a cat or something.
    • Sara drags Julia into the hall to have a chat with her—and by chat, we mean be vaguely threatening. "My job is to take care of my daughters. […] I love both of them" (4.2.149-4.2.150), she says.
    • After that little talk, Brian and Sara take Anna to the cafeteria, leaving Julia alone with Kate.
    • Kate talks about how Jesse causes trouble to get attention, and how she once wanted to be a ballerina when she grew up. If she grows up… (Man, this is the most depressing ballerina story since Black Swan.)
    • She also talks about the one time Anna ran away, because Kate was sick every holiday that year and Anna just wanted to find a normal family.
    • Kate says, "I used to wonder what it would be like to be normal. So I totally understood why she'd wonder about it, too" (4.1.181).
  • Part 4 / Chapter 3

    Sara, 1996

    • At this point, Kate has been in remission for five years.
    • Remission is officially over, though, and Kate's starting to bruise again on her birthday.
    • She gets a fish for her birthday, and names him Hercules.
    • Later, now that Kate is in molecular relapse (ouch, that sounds serious) Sara is back to her old ways: ignoring her other kids and focusing all of her attention on Kate.
    • In a fit of rage, Jesse pulls his own braces off with a fork. Yow.
    • Sara decides to bring Anna in to donate blood to Kate.
    • Kids and needles don't mix, and Anna thrashes and cries when they draw blood.
    • One afternoon, Sara knocks over the fishbowl, and Hercules flops out onto the floor; Sara manages to fish him out from under the desk (har har) and drop him back into his bowl.
    • He's not moving, and Anna wonders why, but before Kate can answer, a fishy miracle happens: Hercules starts to swim again.
    • On another day, Suzanne comes to visit to pour some wine down Sara's throat and get her to take a freaking break from Kate for once. They watch Jerry Springer, laughing and enjoying themselves for the first time in a long time.
    • Finally, there's one last dead-fish scare, but again Sara manages to bring Hercules back to life—she wonders if she's used up her life saving miracles on a fish instead of her own daughter.
  • Part 4 / Chapter 4

    Anna

    • Sara and Anna argue and argue and argue about Kate, kidneys, lawsuits, and more.
    • The sheriff shows up again and slaps Sara (not literally) with a temporary restraining order from her own daughter.
    • They drive to the courthouse, where dozens of media folks are waiting with microphones and cameras; Anna realizes that she's the huge news story.
    • Inside the courtroom, Anna almost changes her mind and drops the lawsuit again, but her dad says that she can stay with him at the fire station so her mother won't have to leave the house.
    • They leave the courthouse and ignore all the reporters along the way.
  • Part 4 / Chapter 5

    Campbell

    • More disorder in the courtroom as Sara and Campbell argue over what's right for Anna.
    • Campbell tries to find his client, but she's already left with her dad.
    • When Julia tries to talk to him, Campbell runs away—he considers jumping out a window to get away from her (or busting through a wall, Bugs Bunny style), but Julia catches up with him.
    • She tries to convince Campbell to stop talking to Anna as though she's an adult; she's only thirteen, and it's confusing her more.
    • Campbell retreats into a room and locks the door behind him. Very mature.
  • Part 4 / Chapter 6

    Jesse

    • Julia goes to visit Jesse, who spends a lot of time gawking at her chest and hitting on her in the subtle way teenage boys do. (Read: not subtle at all.)
    • The reason for Julia's visit: to get another opinion on the life of a Fitzgerald family member.
    • Jesse relays a heartwarming Christmas tale: the time he chopped down a tree and decorated it all by himself… and no one noticed.
    • To top it all off, he got a cheap gift from the hospital gift shop as a present. ("A stethoscope! You shouldn't have!")
  • Part 4 / Chapter 7

    Brian

    • Anna moves into the fire station, and Sara is still miffed at Brian for choosing her side; she plays the "I'm worried about both our daughters" (4.6.47) card again, and Brian wonders what happened to the woman he married—the one who used to actually smile and laugh.
    • The fire station gets an emergency call that night, and Anna rides with her dad to pick up an old woman who had a stroke.
    • Anna holds the old woman's hand on the way to the hospital, then she sneaks away to Kate's room.
    • Brian takes Anna back to the station, where they sit on the roof and watch a meteor shower. Anna wonders if Kate can see the meteors from her hospital window.
  • Part 5: Friday / Chapter 1

    Campbell

    • Campbell goes into the hospital to talk to Dr. Bergen, the head of the medical ethics board; he's told that the ethics committee "has never convened on Anna Fitzgerald's behalf" (5.1.15).
    • Coincidentally Julia shows up on the elevator. They debate the ethics of the case, as usual, and end up at a restaurant called Luigi Ravioli. (Mario's Meatballs had too long of a wait.)
    • Campbell says he's sure Anna will stop acting like Hamlet and settle on a decision soon, but he won't say why he's so sure.
    • The phone rings. It's Anna—Jesse's been arrested, and she wants Campbell to help him.
    • He reluctantly agrees, and fills out all the paperwork necessary to get Jesse off from stealing a judge's car. And he gives him an earful about what a "dumb little shit" (5.1.140) he is. His words, not ours.
    • After leaving the courthouse, Campbell confronts Anna, saying that he's her attorney, not her friend, and that if she wants to be treated as an adult, she needs to start acting like one.
    • She tells him, "I'm sick of being a guinea pig. […] I'm sick, but I'm never fucking sick enough for this family" (5.1.196).
    • Well, well. All that salty language makes Campbell realize that Anna could actually stand up for herself on the witness stand… although she might come across as unsympathetic. (Unless he can press the bleep button on all those swears.)
    • Interspersed with all this are a few flashbacks on the dissolution of Campbell and Julia's relationship. He once took her to meet his parents, which went terribly, and then he never called her again. What a jerk, huh?
  • Part 5 / Chapter 2

    Brian

    • Brian meets with Campbell and has something pretty shocking to say: "I think Jennifer Lawrence is a terrible actress… and human being."
    • No, wait, that's not right. He says, "I think Anna's right" (5.2.19).
    • He even agrees to tell that to the judge.
    • Before he leaves, Brian is informed that Campbell got Jesse off on bail, too. Then he leaves.
  • Part 5 / Chapter 3

    Sara, 1997

    • It's time for yet another hospital visit, but this time it's Anna, who went over the handlebars of her bike.
    • Meanwhile, Kate goes through a clinical relapse and is bleeding all over the place. Man, her cancer sure is a drama queen, huh?
    • This is when they decide to prepare Anna for the bone marrow transplant.
    • It seems pretty painful, and to make things worse, Sara doesn't want to leave Kate's bedside, even though Anna's in the hospital, too. Thanks, Mom.
    • She finally does, and then she does what all good mothers do: dose their daughters on extra-strength prescription pain meds.
    • Thankfully, the marrow transplant sticks, and Kate's white cell count rises.
    • During all this, however, they have to fight with the insurance company to get the operation paid for.
    • Sara's sister offers to pay for the operation, but Brian refuses, saying that the firefighters had a fundraiser and raised enough money.
    • He was partially lying, it turns out. They raised a good chunk of it, and he used Kate's college fund to cover the rest. He says, bluntly, "She's not going to live long enough to use that money for college" (5.3.155). Plus, what they had saved would barely cover a semester anyway.
    • As Kate gets stronger, Sara wants to take her to the mall.
    • Kate doesn't want to go, though, because she's bald and it's been a cool minute since Sinead O'Connor was relevant.
    • As a show of solidarity, Sara and Anna shave their heads, then they all go to the mall together.
  • Part 6: The Weekend / Chapter 1

    Jesse

    • Jesse steals a cement mixer and takes it to show off to his favorite vagrant, Duracell Dan.
    • He brings Dan with him—as a special treat—to torch a shed.
    • Dan doesn't find it as beautiful as Jesse does, though, and he's upset because there's another homeless person who lives in there.
    • Jesse rushes in and saves the guy, then runs away before the po-po arrive.
  • Part 6 / Chapter 2

    Anna

    • Anna is visiting Kate in the hospital, and everyone is trying really hard not to mention that Anna is withholding a kidney and Kate will probably die within a week.
    • Later that afternoon, Anna spends some time with Julia. They talk about boys and more boys (if you can call Campbell a boy), but Anna still wonders what she'll do when Kate dies.
    • That night, her mom calls to say she's sorry for arguing with her that morning, and to say goodnight. Aw, how sweet, and not at all passive-aggressive manipulation that a thirteen-year-old wouldn't pick up on.
    • In the middle of the night, Anna sneaks onto the fire station roof. Her dad comes up later, and they talk about the stars. ("Look, it's Jennifer Garner!")
  • Part 6 / Chapter 3

    Brian

    • In this short chapter, Brian reveals to Sara that he plans to speak on Anna's behalf.
    • Guess what? This doesn't go over well. They stare at each other in angry silence.
    • Finally, Sara says that she wants Brian to take her back. But "she is not the woman [he] used to know" (5.3.29)—she's just somebody that he used to know.
  • Part 6 / Chapter 4

    Sara, 2001

    • Anna asks for money for hockey equipment she found on eBay, and they end up buying it for her and going to watch her play hockey, which turns out to be a metaphor about as subtle as a hockey puck to the teeth: "Anna saves, every time" (5.4.32).
    • Later, Kate ends up back in the hospital again, bleeding from every orifice.
    • While everyone is watching her in the hospital, Jesse flushes a bomb down the toilet and blow's up the school's septic tank. Talk about being in deep, er, doo-doo.
    • He alludes to this being a whole "cry for attention" thing, but Sara just grounds him.
    • To rub in how unfairly they treat him, he chooses this moment to reveal that he donates blood every three days to keep Kate supplied with platelets.
    • Sara and Brian decide to do a controversial arsenic therapy on Kate, and while it's touch-and-go for a while, she manages to pull through.
  • Part 6 / Chapter 5

    Anna

    • In this super-short chapter, Anna's parents offer her a deal: give up the kidney, and they'll never ask her to help Kate again.
    • We don't get to hear Anna's answer yet. The chapter ends on a kidney-related cliffhanger.
  • Part 6 / Chapter 6

    Julia

    • Campbell takes Julia to dinner to discuss the plea bargain.
    • Dinner turns out to be a romantic snack aboard a sailboat.
    • Campbell reveals that Anna turned down the deal—then he kisses Julia, and she reveals her chest.
  • Part 7: Monday / Chapter 1

    Campbell

    • Campbell leaves Julia alone on the boat and goes to the hearing, only to find that Anna is missing; he finds her in Kate's room at the hospital and drives her to courthouse.
    • On the way, she asks him why he has a service dog, but he makes up a really big lie about it, as usual.
    • Here's another lie: He tells Anna she won't have to testify, even though she probably will.
    • The first witness is Sara, and Campbell grills her a like a turkey and cheese Panini.
    • His big question: "How can you claim to love both of [your daughters] equally? How can you say that you haven't been favoring one child in your decisions?" (7.1.136).
    • Ooh, good point.
    • Sara responds, "Aren't you asking me to do that very thing. […] Only this time, to favor the other child?" (7.1.137).
    • Zing.
  • Part 7 / Chapter 2

    Anna

    • After recess (we don't get to see the judge playing on the swings and slides), the second witness is called: Dr. Bergen, head of the ethics committee.
    • Bergen admits he voted against Anna donating a kidney to Kate, because it's still unlikely Kate will survive.
    • In cross-examination, Sara asks him a hypothetical question: If he had a way to save his own son, would he question the medical ethics committee, or would he just take the opportunity to save him? "He doesn't answer. He doesn't have to" (7.2.99).
    • During the second recess, Anna gives her mother a kiss on the cheek and tells her that she did a good job. Wait, who is the mother here?
  • Part 7 / Chapter 3

    Sara, 2002

    • Kate meets a nice boy at the hospital by the name of Taylor Ambrose. He's got a lot going for him: He's cute, his name's Taylor, and he's chronically ill—it's a trifecta of perfection for a teen girl with leukemia.
    • Taylor holds her hand through chemo and asks her to the hospital dance.
    • She gets to wear a pretty dress and go to the dance, and gets some hot smooching action, too.
    • After the dance, Taylor doesn't call her for three days, though. What a jerk.
    • Oh wait, turns out that he died. Oops, our bad. Sara keeps it from Kate for a whole month, because she thinks the news will make Kate worse.
    • Kate is furious when she finds out Sara has kept this from her. "'Don't talk to me,' [Kate] murmurs. 'You're good at that'" (7.3.161).
  • Part 7 / Chapter 4

    Jesse

    • In this short, introspective chapter, Jesse regales us with a tale of helping a sheep give birth (to a baaaa-by… see what we did there?) and he asks Kate if she's afraid of dying.
    • "I'll let you know" (7.4.24), she says.
    • Jesse, mad that life isn't fair, punches a whole through the wall.
    • The wall, mad that life isn't fair, wonders what it did to Jesse to deserve being punched.
  • Part 7 / Chapter 5

    Brian

    • While looking for Anna, Brian finds evidence that Jesse is the arsonist in the form of all sorts of explosives in his apartment.
    • He confronts Jesse about it, and Jesse breaks down crying.
    • Instead of punishing him, though, or telling the cops, Brian just hugs him. Hugs not jugs of explosive chemicals, yo.
  • Part 7 / Chapter 6

    Campbell

    • Campbell has Kate's oncologist, Dr. Chance, in the hot seat, and he makes him read a document aloud to the court: "Donors are advised to refrain from contact sports to eliminate the risk of harming their remaining kidney" (7.6.52).
    • What is Anna gaining if she gives the kidney? Dr. Chance answers, "she's saving her sister" (7.6.58)—but what about hockey?
    • During recess, Julia tries to confront Campbell about how he one-night-stand-ed her the other night, but he avoids her.
  • Part 8: Tuesday / Chapter 1

    Campbell

    • Campbell is as happy as a pig in Charlotte's Web because he knows that as long as Brian agrees with Anna, in court, this case is a lock.
    • Everything is going fine on the stand until Brian says, "I still wish Anna would donate a kidney" (8.1.42). Dude…
    • And Campbell's case crashes and burns like the Hindenburg. Oh, the humanity.
    • The only way to save this from being a total disaster is for Anna to testify, but she doesn't want to.
    • Campbell suggests she sleep on it, but she insists that she won't change her mind.
    • "Don't expect me to be able to change your life" (8.1.75), Campbell says. Ooh, burn.
  • Part 8 / Chapter 2

    Sara, Present Day

    • Now Sara gets to cross-examine Brian. And by cross-examine we mean… well, that's exactly what we mean. No euphemism here; she just asks him questions.
    • In the middle of asking him questions, all of a sudden, something clicks within Sara—she realizes "if we lose Kate today, we will have had her for sixteen years, and no one can take that away" (8.2.24).
    • She's ready to live and let live (or die, in this case) and she just wants her husband back.
    • Brian moves back into the house that night, and they tuck Anna into bed.
    • Sara admits that Anna reminds her of herself.
    • And back in the bedroom, well… now it's time for Sara to cross-examine Brian, if you catch our drift.
  • Part 9: Wednesday / Chapter 1

    Julia

    • Julia comes back from a 4:30AM run; she's frustrated about Campbell, of course, and their, um, cross-examination on the boat from the other day.
    • At court, Julia confronts Campbell about how he "back[s] away every time someone gets close" (9.1.32).
    • He refuses to address the issue, of course, instead telling Julia that she's the next witness.
  • Part 9 / Chapter 2

    Campbell

    • Before Campbell can call Julia to the stand, Sara butts in and calls someone else: a child psychiatrist named Dr. Beata Neaux.
    • Dr. Neaux testifies that donating a kidney would be good for Anna; she would consider herself a "superhero" (9.2.21).
    • Campbell cross-examines (no nudge-nudge italics) Dr. Neaux, saying that if Anna gives a kidney and Kate still dies, wouldn't that cause "significant psychological trauma?" (9.2.31).
    • Dr. Neaux continues, saying that Sara also benefits psychologically from keeping Kate alive.
    • So Campbell wonders, since Sara is just as emotionally invested as Anna is "why is [Sara] any more capable of making this choice than Anna?" (9.2.45).
    • The judge bangs his gavel (he must have been feeling left out) and Campbell concludes, "Parents need to be parents […] but something that isn't good enough" (9.2.46).
  • Part 9 / Chapter 3

    Julia

    • It's finally time for Julia to take the stand, and she's full of good quotes she must have been saving up for the whole book.
    • "When you love someone, you'll do anything you can to keep them with you" (9.3.12), and "Unfortunately […] there is also a point when you have to step back and say that it's time to let go" (9.3.15).
    • The chapter ends before Julia can give her recommendation to the court, though. Grr…
  • Part 9 / Chapter 4

    Campbell

    • Campbell is afraid that Julia is going to veto the petition.
    • But she doesn't.
    • In fact, she has no recommendation—she's completely stymied by this case.
    • Everything grinds to a halt, like it's the final episode of American Horror Story or something, until Anna speaks up: "I have something to say" (9.4.11).
  • Part 9 / Chapter 5

    Anna

    • Campbell's dog, Judge, is going nuts as Anna gives her testimony.
    • She has a brief flashback to the night when Sara asked Anna for a kidney. Kate, the one who, you know, actually needs the kidney, says, "I'm not doing it again, all right? I'm sick of it" (9.5.32).
    • Back in the present, Anna confesses that someone convinced her to file the petition and not donate the kidney…
    • … It was Kate.
    • We'll let that sink in for a moment.
    • Campbell collapses (Picoult's plot twists do that to people).
  • Part 10: Thursday / Chapter 1

    Campbell

    • "It's raining" (10.1.1).
    • Looks like Julia and Campbell are shacking up, even though Julia hates Campbell's apartment.
    • The only thing that really happens in this chapter is Campbell fears hearing the judge's decision—"Nobody's going to win" (10.1.9).
  • Part 10 / Chapter 2

    Jesse

    • "It's raining" (10.2.1).
    • Jesse runs outside and hopes to get struck by lightning.
    • He doesn't.
  • Part 10 / Chapter 3

    Anna

    • "It's raining" (10.3.1).
    • Honestly, that's all that happens here. Anna draws a metaphor out of rain: "water never stops moving" (10.3.3).
    • Well, unless it's in a glass. Or ice.
  • Part 10 / Chapter 4

    Brian

    • In case you forgot, "It's raining" (10.4.1).
    • Brian flashes back to the day Anna was born, and they named her Andromeda, so that she would be made fun of throughout high school.
    • He chooses it because it's like the princess and the constellation—"She's between her mother and her father" (10.4.5).
    • Deep, man. Deep as space.
  • Part 10 / Chapter 5

    Sara

    • "It's cloudy with a 72% chance of snow showers, winds coming from the northwest at 12 mph, and a wind chill of 29 degrees."
    • Just kidding: "It's raining" (10.5.1).
    • In court, Sara chucks out her index cards and wings her closing statement.
    • She says that "this lawsuit was never really about donating a kidney… but about having choices" (10.5.10).
    • She also says that she doesn't know if it was moral, or foolish, or cruel to ask Anna to give a kidney, but she knows "it was right" (10.5.12). The italics mean you know she's serious.
  • Part 10 / Chapter 6

    Campbell

    • Campbell chucks out his index cards and wings his closing statement. (Sara: "Copycat.")
    • He says, "What Sara and Brian and Kate Fitzgerald think doesn't matter. What Anna thinks does" (10.6.4). Again, italics mean business.
    • Judge DeSalvo calls a fifteen-minute recess, then he returns with his decision.
    • Are you sitting down for this? Well, it's a courtroom, so you'd best stand up to hear the decision.
    • He says to Anna, "I'm going to declare you medically emancipated from your parents" (6.10.19).
    • Whoa… Did you see that coming?
    • Even more shocking, he gives Campbell power of attorney for Anna until she's eighteen.
    • Julia tells Anna and Campbell they were both very brave, and then Anna slips away into a group hug with her parents.
  • Part 10 / Chapter 7

    Anna

    • Now that's all done, Anna asks Campbell what he thinks she should do.
    • He basically says you decide.
    • Then he says that he thinks Anna will be an amazing girl in ten years—all she wants to be in ten years, though, is "Kate's sister" (10.7.20).
    • Oh how sweet. What a happy ending. Let's turn the page and see how this sweet story wraps up…
  • Part 10 / Chapter 8

    Brian

    • Brian is called to the scene of a horrific car accident.
    • Hmm, that car looks a lot like Campbell's, and… the guy in the driver's seat looks a lot like Campbell…
    • Oh no, it is Campbell…
    • And in the passenger seat…
    • At the hospital, we find out that Anna suffered a fatal head injury. Brian has to make a decision: "Is organ donation something [he'd] like to consider?" (10.8.20).
    • Campbell, who is still alive and conscious and has power of attorney, answers: "There's a girl upstairs who needs that kidney" (10.8.22).
  • Part 10 / Chapter 9

    Sara

    • Sara stands by Anna's bed; she's in a coma with a respirator keeping her breathing.
    • Brian tries to tell Sara that Anna's already gone, but she starts crying: "She wasn't supposed to [die]" (9.9.5)..
    • They flip off the respirator, and Anna goes away for good.
  • Epilogue

    Kate, 2010

    • In our first and only Kate chapter, she tells us that her dad claims to see Anna in the night sky (that's just the constellation, dude) and her mom believes that Anna would return to them (like a thirteen-year-old female Jesus, we guess). 
    • Campbell and Julia got married, and Jesse graduated from the police academy.
    • The transplant stuck.
    • Kate talks about when they found a picture of Anna. Kate saves it in a drawer, in case one day she forgets her.
    • But she won't. She has a scar from the surgery, so "I take [Anna] with me, wherever I go" (Epilogue.15).