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My Sister’s Keeper My Sister’s Keeper

My Sister’s Keeper - PowerPoint Presentation

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My Sister’s Keeper - PPT Presentation

Jodi Picoult Context In 2004 Picoult published My Sisters Keeper Like most of her works the novel takes on a range of morally complex issues from the ethics of genetic engineering to the right of terminallyill patients to elect to die to a minors right to control her own bo ID: 142850

sara anna campbell kate anna sara kate campbell brian julia jesse tells summary asks hospital kate

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Slide1

My Sister’s Keeper

Jodi

PicoultSlide2

Context

In 2004,

Picoult

published

My Sister’s Keeper

. Like most of her works, the novel takes on a range of morally complex issues, from the ethics of genetic engineering, to the right of terminally-ill patients to elect to die, to a minor’s right to control her own body.

Genetic engineering alone has been the subject of controversy since its very first uses to help infertile couples conceive via in vitro fertilization. As the potential uses of the method have grown, so have the moral questions that such genetic manipulation raises.

Notably, the ethics of using science to create a so-called “designer baby,” meaning one whose physical traits are selected by the parents, has become the object of frequent and heated debates.

These quandaries, and those regarding the rights of terminally ill patients and minors to determine what happens to their bodies, all intertwine in

My Sister’s Keeper

, which tells the story of one family devastated by their eldest

daugther

Kate’s battle with acute

promyelocytic

leukemia

, an extremely aggressive form of cancerSlide3

Background Info

With

My Sister’s Keeper

,

Picoult

drew on her experiences with her middle son, who at the age of five needed ten surgeries over three years to treat a tumour in his ear.

Picoult

says the desperation she felt sitting in the hospital beside her anesthetized son and knowing she could do nothing to help him informed her depiction of Sara, the mother in the Fitzgerald family of

My Sister’s Keeper

. That emotion, combined with the knowledge

Picoult

gathered in her research, imbues the book with a sense of realism.Slide4

In a nutshell...

narrator

 · Multiple narrators alternate throughout the book. These narrators are Anna, Jesse, Kate, Brian, and Sara Fitzgerald, Campbell Alexander, and Julia Romano. The chapters narrated by Sara largely take place in the past, while the rest of the narration occurs in present day. The prologue and epilogue take place several years after the main action has occurred.

point of view

 · Each narrator speaks in first person, allowing the reader to see the world from each narrator’s point of view.

tone

 · Each narrator speaks in a different tone. Anna is observant, thoughtful, and inquisitive. Jesse is sarcastic and angry. Brian is often discursive, wandering into musings on astronomy. Sara is practical and concise. Campbell is sarcastic and sometimes regretful. Julia is open and watchful of the characters around her.

setting (time)

 · The setting alternates between present action and events from the past fourteen years.

setting (place)

 · Rhode Island

CENTRAL protagonist

 · Anna FitzgeraldSlide5
Slide6

Prologue Summary

The prologue begins with an epigraph from Carl von Clausewitz’s

Von

Kriege

. The epigraph states that no one in his right mind starts a war unless they are absolutely clear on two things: what he wants to achieve, and how he plans to achieve it. An unidentified person narrates the second part of the prologue from a first-person point of view. This narrator recalls the time she was three years old and attempted to kill her sister. Her father stopped her and implied she pretend the incident never happened. The narrator confesses that as she grew older she didn’t seem to exist except in relation to her sister. She thought of many different ways she could kill her, but ultimately the narrator says she didn’t do anything after all, because her sister did it on her own.Slide7

Monday Anna Summary

Thirteen-year-old Anna Fitzgerald begins narrating the story. She talks about the different reasons babies come into being and admits that she was born for a very specific purpose. Scientists used her mother’s eggs and father’s sperm to create a specific combination of genes. They created her in this way so she would be able to save her sister, Kate. Anna talks about visiting a pawnshop to sell a locket. She has a difficult time parting from the locket because her father gave it to her as a gift after she donated bone marrow to Kate. Anna goes on to describe herself as skinny and a freak. She talks about her family, how her sister Kate has

leukemia

, and how she has had to undergo medical procedures to help Kate whenever Kate has gotten sick. Her mother, meanwhile, obsessively shops online, and her older brother, Jesse, behaves like a delinquent because their parents don’t have time to care about him.Slide8

cntd.

Anna shows Jesse a newspaper clipping about a lawyer named Campbell Alexander. Jesse warns her not to mess with the system and the roles everyone in the family has, but he still agrees to drive her to Campbell’s office. Anna meets Campbell and notices he has a service dog, which Campbell sarcastically tells Anna prevents him from getting too close to magnets, because he has an iron lung. Campbell tries to send Anna away, and she explains that she wants Campbell to help her sue her parents for the right to her own body.Slide9

Campbell Summary

Campbell gives his account of his meeting with Anna. He talks with her about her case and notices how angry she seems. He agrees to represent her because he thinks the case will be easy to win and great publicity. He doesn’t think they will even need to go to trial, because Anna’s parents will give in before that. Anna leaves after Campbell tells her he will file a petition in family court for her medical emancipation. Campbell’s assistant, Kerri, expresses her shock that Campbell is representing Anna. She wonders where Anna will live during the trial, but Campbell hasn’t thought about it. Campbell’s dog, Judge, pushes against him, apparently alerting Campbell to something. Campbell goes back into his office and locks the door.Slide10

Sara Summary

Sara’s narration jumps back in time to 1990. While bathing Kate and Jesse, Sara talks to Brian, her husband and a career

firefighter

, and she recalls her decision to give up her career as an attorney to become a stay-at-home mother. Sara notices a bruise on two-year-old Kate’s shoulder blade.

The next morning, bruises have spread up and down Kate’s spine. Sara takes Kate to the hospital where Kate undergoes a series of tests. The hospital refers Sara to an oncologist who, after further tests, diagnoses Kate with acute

promyelocytic

leukemia

(APL), a rare and aggressive form of blood cancer.

The doctor tells Sara and Brian that APL has a twenty to thirty percent survival rate and they should begin treating Kate immediately. At home Sara and Brian deal with the fallout of the diagnosis and the realization that their daughter may not survive. Sara refuses to let Kate die.Slide11

Brian Summary

In the present day again, Brian Fitzgerald describes a fire at a medical school. The fire started because a body got stuck in the cremation incinerator. He turns the story to earlier that night, while he ate dinner with his family. Kate upsets Sara because she wears a t-shirt with a picture of a crab and the word “Cancer” across it. Jesse walks in reeking of pot. Finally Anna arrives, and Brian immediately notices something is wrong. Anna remains quiet and withdrawn through the meal, and she does not have her locket on. She leaves the table without saying a word. After dinner, Brian and Sara discuss their daughters. Sara talks about Kate, but Brian worries about Anna. Sara mentions that she has to take Kate to dialysis the next day. Later that night, Anna visits Brian at the station. She doesn’t want to talk, but together they watch the stars from the station’s roof.Slide12

Tuesday Anna summary

Anna and Sara sit with Kate at the hospital during her dialysis session. Sara talks about kidney donation while Anna thinks about all of the risks associated with the procedure. Vern Stackhouse, a sheriff, comes to Kate’s room. He awkwardly serves Sara papers for the lawsuit Anna has filed for medical emancipation. Sara responds angrily, but before she can talk to Anna about the lawsuit, Kate cries out in pain. Sara goes to Kate’s bedside while Anna runs out of the hospital room. Jesse drives to the hospital to pick Anna up, and they go home.Slide13

cntd.

When Sara and Kate arrive home, Kate runs to her room, and Sara demands to know what Anna is doing. Anna refuses to drop the lawsuit, and despite Brian’s protests, Sara grows even angrier until she slaps Anna. Later, Kate talks to Anna. Kate says that even if she has to lose Anna as a sister she can’t bear the thought of losing her as a friend. Anna doesn’t respond, but in her thoughts admits she couldn’t stand to lose Kate either. Sara and Brian walk into Anna’s and Kate’s room at night. Anna overhears her father saying that maybe Anna’s actions aren’t crazy. He leaves, and Sara sits on Anna’s bed. Anna thinks Sara hates her, but Sara insists she could never hate her. Sara holds Anna and assures her they can fix everything by talking to the judge. Anna only nods.Slide14

Sara Summary

In 1990, Sara and Brian see an oncologist named Dr. Chance, who will be in charge of Kate’s treatments. Sara calls her older sister,

Zanne

, whom she has fallen out of touch with, and later

Zanne

arrives to help the family out. Sara and Brian feel overwhelmed with the list of details and questions facing them about Kate’s cancer and treatment. Since Kate’s form of cancer often resists treatment, the doctors admit they can only do so much. Sara asks what it will be like if Kate dies and wonders how she would survive it. Kate starts chemotherapy and gets extremely sick. The doctors test Jesse to see if he is a genetic match for Kate, since she might need bone marrow if she relapses, but he is not.

Dr. Chance tells Sara that if she and Brian have more children, one sibling could be a match. After chemo, Kate develops an infection and has to be rushed to the hospital. While at the hospital, Sara tells Brian she is thinking of having another child. Brian thinks Sara wants to be able to replace Kate if she dies, but Sara assures him she wants to have another child to see if the child would be a genetic match for Kate.Slide15

Wednesday Campbell Summary

Campbell, while on the phone with his mother, wonders how much people are beholden to their parents. Campbell stops for coffee and gives his waiter a new sarcastic explanation of his service dog, Judge. He returns to his office and finds Anna there. Sara calls while Anna is in the room with Campbell. Sara tells Campbell that Anna has changed her mind, but Anna tells Campbell she has not. Campbell recalls a memory of his father. They competed in a sailing competition, and Campbell ended up embarrassing and disappointing his father. Campbell goes to the courthouse where he meets Sara, who decides to act as counsel for herself and Brian. Sara and Campbell speak with Judge

DeSalvo

, the judge for the case. They argue about what Anna really wants until Judge

DeSalvo

decides he needs to speak with Anna.Slide16

Anna Summary

Anna wonders what her funeral would be like. She doesn’t think many people would come, unlike Kate’s funeral, which would be crowded. At the courthouse, Anna speaks with Judge

DeSalvo

alone. They discuss the trial, and Anna tries to remain composed. But she recalls a time when she and Kate pulled a prank on a nurse at the hospital and starts to cry. She tells Judge

DeSalvo

she can’t give a kidney to her sister. He assures her no hospital would take a kidney from an unwilling donor, but she says being a donor has never been her choice. She says she never wanted to stop the lawsuit and only told her mother she would because she loves her. Judge

DeSalvo

decides to appoint Anna a guardian ad

litem

who can decide what is best for her. The hearing, he says, will take place the following week.Slide17

cntd.

Anna goes home with her parents, even though Campbell wants to speak with her. Brian pleads with Sara to calm down, but Sara shouts that Anna practically signed Kate’s death sentence. Kate runs upstairs. Anna leaves the house to go to a

laundromat

, a place she feels safe. She tries to picture a future without Kate but can’t. They are as connected, she thinks, as Siamese twins.Slide18

Jesse Summary

Jesse thinks about when he was a child and would light bath soap on fire to show Anna. He reflects that Anna is the only proof he has that he belongs in the family. While driving down the highway, he imagines crashing his car because he would be worth more dead and used as parts. He meets a homeless man named Dan. Jesse has a deal with Dan where he brings Dan food if Dan will watch Jesse’s things, including stolen acid and sawdust. Jesse goes to an abandoned warehouse and sets a fire. He admits he has done it before. He watches the fire from far away until he sees his father arrive. Jesse goes home to find Sara frantic. Kate is vomiting blood. Jesse drives Kate to the ER.Slide19

cntd.

At the hospital, Dr. Chance tells Sara and Jesse that Kate is in the end stages of kidney failure. Sara asks if a transplant is possible, and Dr. Chance tells her that the odds are not good. Sara asks if they would do the transplant if a donor were available. Jesse offers his kidney, but Dr. Chance tells him it must be an exact match. Jesse wonders why he thought he might suddenly be worth something and why he thought he could save his sister when he can’t save himself. Kate tries to tell Jesse something, but all he can understand is “tell Anna.”Slide20

Sara Summary

The time is 1990–1991 and Sara is pregnant with Anna. Sara knows everything about the baby, from the sex to the specific combination of genes that will allow Anna to be a donor for Kate. She admits that she has thought of Anna only in terms of what she will be able to do for Kate. Sara reveals that three months after chemo, Kate went into molecular relapse. Sara recalls the television interview she and Brian did. They explain why they went to a geneticist and deny wanting a “designer baby.” They only wanted a child who would save Kate’s life. Sara goes into

labor

on New Year’s Eve. Anna is born, and the doctors take her umbilical cord to harvest the cord blood. Kate begins a pre-transplant regimen of radiation and chemotherapy, which makes her violently ill. The doctors put her in isolation, then give her Anna’s cord blood.Slide21

Wednesday Julia Summary

Julia argues with her twin sister,

Izzy

, until Judge

DeSalvo

calls. The judge asks Julia if she will be the guardian ad

litem

in Anna’s case. Julia agrees and goes to the Fitzgerald house where she meets Anna. Julia takes Anna to the zoo to talk, hoping it might loosen her up. Julia can’t determine why exactly Anna filed the lawsuit, but she realizes that Anna will either lose her sister or herself. At the house Julia meets Sara. Julia tries to speak with Sara, but Sara brushes her off. Julia realizes that it will be difficult for Anna to live there during the course of the legal proceedings without being swayed by her mother. Afterward Julia goes to Campbell’s office. It emerges that they have had a romance in the past and that they haven’t spoken in years.Slide22

Campbell Summary

Campbell works in his office when Julia walks in. He feels shocked to see her for the first time in fifteen years. After some awkward conversation, the two discuss Anna. Campbell suggests removing Sara from the house, but Julia thinks it is the wrong course of action. The two argue and the dog, Judge, becomes increasingly agitated. Finally, Campbell leaves Julia alone in his office. In a flashback to their high-school years, Campbell remembers when Julia arrived at their prep school. She looked different than the other girls and kept to herself. One day Campbell followed her to a cemetery and asked for help with his homework. In the present, Campbell straightens himself up in a bathroom. When he goes back to his office, Julia has gone. In another flashback, we see Campbell and Julia as teenagers sharing their first kiss.Slide23

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Back in the present, Campbell goes to see Anna at her house. Initially, he feels awkward around Anna and admits that he usually doesn’t spend time with his clients. Later that night, Campbell visits Julia. At first he confuses her with her twin sister,

Izzy

, who acts angrily toward Campbell. Campbell and Julia talk and catch up. Julia admits to Campbell that it is hard to be around him after everything that happened between them.Slide24

Anna Summary

Anna asks Jesse to drive her to the hospital. Jesse tells Anna that she is not doing the wrong thing, but she tells him that she’s not doing the right thing either. Jesse agrees to help Anna see Kate by distracting their mother. In a flashback, Kate wants to talk to Anna about death and the best way to die, but Anna refuses. In the present, Jesse pretends to be drunk in order to get Sara away from Kate’s hospital room.

Anna goes into Kate’s room, and we see another flashback in which the entire family plays football on Thanksgiving. Jesse accidentally knocks Kate down, and Brian gets angry at him. Jesse says he forgot, and Kate smiles. She’s thrilled that, for a moment, Jesse forgot she had cancer. In the present, Anna climbs into Kate’s bed with her. In her thoughts she acknowledges that she didn’t come to see Kate to feel better, but because without Kate, she can’t remember who she is.Slide25

Thursday Brian Summary

Julia meets Brian at the fire station and helps him cook breakfast. They discuss Anna, and Brian hesitates to state his opinion. He thinks about an incident where he saved a child from a burning building. Brian admits he became a

firefighter

to save people but wishes he could have been more specific about who to save. He asks Julia if he can take her to meet someone but doesn’t say who the person is.Slide26

Julia Summary

Julia rides with Brian in his car. In flashbacks, we see Julia at her apartment sobbing the previous night after Campbell left, then going to a bar where she drinks heavily. She remembers how Campbell felt attracted to her because she was different from everyone else at their school. They would meet after school in the cemetery and talk. Their relationship blossomed from there.

In Brian’s car, he tells Julia they named Anna after the galaxy, Andromeda. They find Anna at the house and decide to all go to the hospital together. Anna confesses to Julia that she fears Kate will hate her. Outside the hospital room, Sara begs Julia not to tell Kate that Anna has not dropped the lawsuit. She also insists to Julia that she loves both of her daughters. Julia and Kate talk alone. Julia asks about Jesse, and Kate says that he gets into a lot of trouble because it’s his only way of being noticed. Kate talks about a year where she got sick on almost every single holiday and how hard that was for Anna.Slide27

Sara Summary

In 1996, Sara throws Kate a party for her eighth birthday. Kate has been in remission for five years, but soon after the party Kate relapses. She starts on a new medication in an attempt to put her in remission. In the midst of this, Jesse reminds Sara she promised to take him to get new cleats after his orthodontist appointment. Sara tells him they can’t do either, so Jesse attempts to pry his braces off his teeth with a fork. The new medication works at first, but Kate develops a resistance. Dr. Chance recommends a donor lymphocyte infusion from Anna. Brian suggests it might not be a good idea to make Anna donate blood, since he and Sara only agreed she would act as a donor for Kate once. Concerned about Kate, Sara dismisses the concern.

Anna arrives at the hospital to give blood and screams and cries during the procedure. Later, when the doctors need to take more blood, Sara forces Anna to leave a birthday party early. A month later, Anna has to donate blood a third time. Sara also talks about finding Kate’s goldfish nearly dead. Desperate to save

it, she calls a marine biologist who helps her revive the fish.Slide28

Thursday Anna Summary

Anna recalls imagining what life would be like if Kate died. It would be painful, but she also thinks of the exciting things she could do if Kate weren’t alive. In the present, Anna sits with her parents in the hospital cafeteria. Vern Stackhouse serves Sara with a temporary restraining order requiring her not to have contact with Anna. Anna says she never asked for that but Sara is furious. Sara and Brian fight in the car about hiring a “real” lawyer. Reporters have gathered at the courthouse, and Anna and Brian wait outside while Sara and Campbell talk to the judge. Julia arrives and asks if Anna wants Sara to leave the house. Anna says that’s not what she wants. She also says she’s changed her mind and doesn’t want to go through with the lawsuit anymore. After Julia leaves, Brian asks Anna if she wants to stay with him at the fire station to give her distance from Sara. They leave together.Slide29

Campbell Summary

Outside the courthouse, Campbell speaks to the reporters. He recognizes that he wants to draw attention to the case to capitalize on it. Sara and Campbell speak to Judge

DeSalvo

. Julia arrives, tells the judge that Anna is confused, and it would be a mistake to remove Sara from the house. Judge

DeSalvo

refuses to grant the restraining order, but he orders Sara not to say one more word to Anna about the case. Julia, Campbell, and Sara go outside to see Anna only to discover she has left with Brian. Julia tries to talk to Campbell but he avoids her. Once again, his dog, Judge, clearly tries to alert Campbell to something. Julia yells at Campbell while he tries to get away from her. She informs Campbell that Anna said she changed her mind about the petition. Finally, Campbell escapes into an empty room and locks the door.Slide30

Jesse Summary

Jesse arrives home to find Julia on his doorstep. He tries to flirt with her. She asks for Anna, but Jesse says no one is home. Julia brushes off Jesse’s continued flirtations and asks him about his family. He tells her a story about a Christmas Eve when he was 12 and Kate was in the hospital. Anna had to be taken in to give white blood cells, and Jesse was sent to a

neighbor’s

house. He left and chopped down a tree from his family’s front yard, then set it up in the living room and decorated it. The next day when he opened his gifts he realized they were all from the hospital gift shop. Brian and Sara never even noticed the tree. Jesse says that the story explains what it has been like to grow up in his family. He says at least Anna is on their parents’ radar.Slide31

Brian Summary

Brian takes Anna to the fire station. He recalls his visit to the hospital earlier that afternoon. Kate slept, and Brian talked to Sara. He told her Anna was going to stay with him at the station. They argued when Brian told Sara he was worried about Anna. Sara said that, unlike him, she worries about both of their daughters. Later that night, the fire station receives a call to a nursing home where a woman has hit her head. Anna goes along and helps. They take the woman to the hospital, and Brian loses track of Anna. He finds her in Kate’s room, curled up on Sara’s lap. He takes her back to the station. Later, Anna and Brian watch a meteor shower from the station’s roof. Anna wonders aloud if it would be possible to find a fallen star.Slide32

Campbell Summary

In flashbacks, Campbell recalls more scenes from his high-school relationship with Julia. Campbell’s friends teased him about Julia, but he would not defend her. Campbell also avoided telling his parents about Julia, which Julia suspected. When he finally took her to meet them, his parents behaved rudely and refused to invite her to a party the rest of the family was attending. Afterward, Campbell began ignoring Julia. One day they met at the cemetery, and Campbell told Julia their relationship was over.Slide33

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In the present, Campbell goes to the hospital to speak to Dr. Bergen, the head of the ethics committee. Dr. Bergen says the committee never met to discuss Anna, despite the fact that Anna had been a patient at the hospital eight times. After his meeting, Campbell runs into Julia. He convinces her to talk with him about the case, and they go to an Italian restaurant. Campbell avoids answering questions about his service dog and why he took the case. He receives a phone call from Anna asking him to meet her at the police station. When he and Julia arrive, Anna tells them Jesse has been arrested for stealing a judge’s car. She asks for Campbell’s help. Reluctantly, he manages to get Jesse released on probation. In the car on the way home, Campbell tries to get Anna to tell him what she really wants. She explodes in anger and says she’s sick but never sick enough for her family. Campbell is pleased at her anger but also worried that she will sound unsympathetic on the witness stand.Slide34

Brian Summary

Campbell arrives at the firehouse with Anna. When he and Brian talk alone, Brian admits he agrees with Anna and says he is willing to say so to the judge. Brian remembers an incident from the night before in which he shouted at a kid whose girlfriend overdosed on drugs. Another

firefighter

told Brian he could take time off, but Brian says that means he would have to be at home instead. Back in the present, as Campbell leaves he mentions Jesse’s arrestSlide35

Sara Summary

In 1997, Sara finds Kate with blood streaming down her legs. Kate has relapsed and needs a bone marrow transplant. The family’s insurance company refuses to cover the transplant. To prepare Anna for the bone marrow donation, Sara gives her growth-factor shots. Six-year-old Anna tells Sara she hates her. Sara’s sister,

Zanne

, offers to pay for the transplant, but Brian tells Sara the men at the fire-station raised enough money. Sara takes Kate to the hospital to begin her pre-transplant regimen of chemotherapy.

Before she leaves the house, Kate cleans her room in case she doesn’t come back. Again, the chemo makes Kate violently ill. The time arrives for Anna’s bone-marrow extraction, and Sara tells her she doesn’t have to do it but that everyone is counting on her. Sara goes to be with Kate. Brian arrives after Anna’s procedure and says Anna has been asking for Sara. Sara feels torn but goes to see Anna. Anna says she hurts, so Sara finds a nurse to give her medication. When Sara goes back to Anna’s room, she sees Brian putting the locket on Anna’s neck.Slide36

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A few weeks later, Brian takes Sara out to dinner. They have nothing to talk about other than Kate and feel like strangers. When it’s time to take Kate home from the hospital, Sara notices how different Kate looks. Later, Sara learns that Brian lied about the

firefighters

having raised enough money to cover Kate’s bone marrow transplant. When Sara confronts him, he says he used the money from Kate’s college fund to help pay for it, because Kate won’t live long enough for college. Time passes and Sara tries to get Kate to leave the house, but Kate feels self-conscious about her appearance. Sara shaves her own head, and then Anna asks to have her head shaved, too. All bald, they go to the mall.Slide37

Weekend Jesse Summary

Jesse steals a dump truck and picks up Dan. In flashbacks, Jesse recalls when he was eleven and received a skateboard as a “guilt gift,” meaning a gift his parents gave him whenever Kate became seriously ill. Brian promised him he would take him to a parking lot where he could ride it, but Kate’s nose started to bleed. When Jesse reminded Brian of his promise, Brian looked at Jesse like he didn’t see him. That day, Jesse walked into the middle of traffic, hoping to get noticed. In the present, Jesse takes Dan to a shed. Jesse lights it on fire and admires his work, until Dan tells him that a homeless man named Rat lives in there. Jesse runs in to the burning shed, saves Rat, and runs away just as the fire trucks arrive.Slide38

Anna Summary

Anna waits at the hospital with Kate and Sara. Kate feels alert, but Dr. Chance cautions that Kate’s lucid moments will occur less and less frequently because she is in end-stage renal failure. Kate asks Dr. Chance how long it will be before she dies, and he tells her maybe a week. Sara begins crying. When Anna tells her to stop, Sara looks at Anna and tells her to stop. Later at the fire station, Anna talks to Julia about her crush, Kyle, and Julia asks Anna what it will be like when Kate dies. Anna can’t answer. Sara calls to apologize to Anna and say goodnight. On the roof that night, Anna and Brian talks about the stars and celestial navigation.Slide39

Brian Summary

Brian goes to the hospital to see Sara. He talks to her about a trip they took to Nevada years ago. They saw a fortune teller who told Sara her life wouldn’t be good enough and told Brian to save himself. Sara doesn’t remember the trip and only wants to talk about Anna. Brian tells her he plans to speak on Anna’s behalf. Sara can’t understand this. She asks Brian to remember what it used to be like between them. But Brian knows Sara is not the same woman she used to be. He also knows he is not the same man he used to be, a man who believed Sara when she told him she would always love him.Slide40

Sara Summary

In 2001, Anna asks for money for goaltender pads. She has started playing ice hockey. Four years have passed since Kate’s bone marrow transplant. One night, the family goes to watch Anna play hockey. Later, Kate wakes up bleeding badly. She has relapsed and her body is failing. Dr. Chance suggests a new and untested arsenic therapy. That night, Sara finds Brian writing Kate’s eulogy. He wants to bring Kate home to die in her own bed. He tells Sara the arsenic will just postpone what is coming. Sara tells him it’s not time.Slide41

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Kate slips into a coma. Sara receives a call from Jesse’s school. He blew up a septic tank and has been expelled. Sara picks him up from the school and notices needle marks on his arms. She suspects drug use, but Jesse reveals he has been donating platelets for Kate every three days. Anna gets accepted to a prestigious hockey camp, but Sara tells her she won’t be able to go because they might need her for Kate. Anna says the camp is a year away, implying that Kate won’t be alive then anyway. Kate develops an infection and becomes seriously ill. Jesse and Anna say their good-byes to Kate. Brian tells Sara that Kate needs her permission to leave. As Sara tells Kate that it’s okay for her to go, Kate grips her hand and begins to claw her way back to life.Slide42

Anna Summary

Anna ponders what heaven will be like. She wonders what age people are in heaven, and how anyone recognizes each other. Sara calls a meeting at Campbell’s office. She tells Anna that if Anna gives Kate a kidney she will never ask Anna for anything again. Anna hugs her mother but tells her she can’t do it. Without a word, Sara tries to smile and then leaves.Slide43

Julia Summary

Julia admits to

Izzy

that she still has feelings for Campbell. Just then, Campbell arrives and asks Julia out to dinner to discuss Sara’s plea bargain. He takes her out on his boat, and though they’re having a good time, Julia suspects Campbell wants to sway her decision. Julia gets angry and wonders if Campbell ever says anything that isn’t a lie, but Campbell kisses her. She remarks that it feels like the most natural thing in the world.Slide44

Monday Campbell Summary

Campbell wakes up in his boat after spending the night with Julia. He thinks that he loved Julia because she was an independent spirit and he couldn’t bear to take that away from her. He leaves while Julia sleeps and goes to the courthouse. Neither Sara nor Brian knows where Anna is. Campbell finds her in Kate’s hospital room and drives her back to the courthouse. On the way, Campbell pulls over and asks Anna why they’re going to court. Anna counters by asking him about his dog. Campbell says that the dog is for a hearing problem. Anna says she’s sick of things always being about Kate. Campbell points out that Anna is lying, and Anna says Campbell is also lying about the dog.Slide45

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Campbell and Anna arrive at the courthouse, and everyone moves into the courtroom. Anna asks Campbell if she’ll have to speak. He lies and says she probably won’t. Campbell speaks first and says in the justice system what is legal differs from what is moral. Sometimes is hard to tell them apart, but the court is there to help. Campbell calls Sara to the stand. She talks about Anna’s conception, and Campbell asks her about all the times Anna has undergone a medical procedure to help Kate. He also asks if Anna had a choice in any of these cases. Sara says Campbell can see things in black and white because he only represents one of her daughters, but Sara represents both of her daughters.Slide46

Anna Summary

During a recess in the trial, Campbell and Anna speak alone. Anna says even if they win they still lose. When the trial resumes, Campbell calls Dr. Bergen as his second witness. Dr. Bergen says the ethics committee has discussed whether Kate should have a kidney transplant and that they arrived at a split decision. Campbell asks if the committee discussed the risks to the donor, and Dr. Bergen said it wasn’t an issue since Anna wasn’t a patient. Campbell shows Dr. Bergen Anna’s hospital records, and the doctor admits that Anna has had several invasive procedures. He also admits he voted against the kidney donation since he did not believe Kate would live through the procedure.Slide47

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Anna recalls how Kate saved her when she was a baby. She was in a walker and almost rolled onto the street before Kate caught her. In the present, Sara questions Dr. Bergen and asks if he has children. She then asks if he ever puts himself into a patient’s shoes. She asks if, offered a course of action that could save his child’s life, would he question it or try it. He doesn’t answer. Another break follows. As Anna leaves the courtroom, she tells her mother she did great.Slide48

Sara Summary

In 2002, Kate meets a boy named Taylor while she receives platelets and he receives chemo. Sara watches them flirt and feels happy that her daughter likes a boy. Kate goes on a date with Taylor. That night, Sara overhears Kate gushing about it to Anna. Kate goes into relapse, and Sara has difficulty convincing Kate, who does not want to be hospitalized again, to undergo a stem cell transplant. The oncology team lets Kate begin chemo as an outpatient. Taylor visits Kate during her chemo, helps her when she throws up, and asks her to a dance for patients hosted by the hospital.Slide49

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Sara, Kate, and Anna shop for a dress for Kate. Kate fells self conscious about her baldness, her chest catheter, and all of the scars on her body from chemo. Sara tries to comfort her, but Kate says she can’t fix it every time. Anna drags Kate into a hair salon and asks the hairstylist if she can give Kate, who has no hair, an up-do or a perm. Anna and Kate laugh at the stunned reaction they get. Kate attends the dance with Taylor, and Sara see them kiss. Soon after the dance, Kate goes into the hospital for her transplant. She worries because she hasn’t heard from Taylor. Sara finds out that Taylor died suddenly, but she waits to tell Kate until a month after her transplant. When Kate finds out, she says she loved him and doesn’t speak to Sara for a week. Sara finds Kate looking at old pictures, including one of Kate when she was a baby, before cancer. Kate remarks that she was beautiful.Slide50

Monday Jesse Summary

Jesse recalls the time he went to boot camp on a farm as a fourteen-year-old. While there, he helped a sheep give birth. The baby sheep almost died, and he thought that, afterward, the sheep always looked like it had seen the other side. In the present, Jesse sits with Kate at the hospital and sees a similar look on her face. They talk about dying, and Jesse asks if she feels afraid. She smiles and says she will let him know. In his head, he tries bargaining to keep Kate alive. Kate tells Jesse how much she will miss him. After she falls asleep, Jesse walks into the hall and punches a wall.Slide51

Brian Summary

In flashbacks to the morning of the hearing, Brian goes home to look for Anna. He searches Jesse’s room and finds materials that could be used to start a large fire. In the present, Brian gets called to work and leaves the courthouse during the hearing. He goes to the site of a recent arson fire at an abandoned elementary school and finds a cigarette left by the arsonist.

At home, Brian accuses Jesse of starting the arson fires. Jesse tries to deny it until Brian shows him the cigarette butt. Jesse breaks down, saying he couldn’t save her (he doesn’t specify who), and asks if Brian has told anyone. Brian hugs Jesse. He thinks he can’t blame Jesse and understands that Jesse chose to use fire for the same reason Brian did: both wanted to control something uncontrollable. Brian resolves not to tell anyone about what Jesse has done.Slide52

Campbell Summary

At the courthouse, Campbell questions Dr. Chance. He asks about Anna’s conception and about any risks to Anna from the procedures she’s undergone or will undergo. Dr. Chance concedes there are some risks and complications, but most of them are minor. Dr. Chance admits that having one kidney might affect Anna later in life and could make it risky for her to play contact sports, such as hockey. He states that up to that point she has not experienced significant harm from any procedures, but she has experienced the benefit of saving her sister. Slide53

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During a recess, Julia asks Campbell if the previous night was a joke to him, and Campbell tells her she doesn’t want to know the real answer. When the hearing adjourns for the day, Campbell drives Anna to the fire station. Once there, Anna confesses that sometimes she hates herself. Campbell says he sometimes feels the same way. Anna asks about Campbell’s relationship with his parents, and he tells her that somewhere along the way he stopped wanting to be like them. Anna tells him that she gets it, that Campbell was invisible, too.Slide54

Tuesday Campbell Summary

Campbell questions Brian on the stand, confident that Brian will help him win the case by disagreeing with Sara’s position. Brian admits there have been times he’s disagreed with Sara, such as the time they needed Anna to donate lymphocytes. However, he says that while he doesn’t want to hurt Anna, he can’t lose Kate, and that when your child is dying you do not always have a choice. He notes that he disagreed with Sara’s decision to start Kate on arsenic therapy, but that Kate ended up surviving. Although he hates to see Kate suffer, he says he doesn’t want to make the same mistake twice and agrees with Sara’s wish to have Anna continue as a donor. Campbell feels stunned by Brian’s reversal. Brian acknowledges he doesn’t know—and has never known—the right answer, and begins to cry.Slide55

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During a recess, Anna wonders whether she made Brian fall apart. She says she had never seen him cry before. Campbell tells her she will need to testify if they want to win. Anna declines, despite Campbell’s insistence that they will lose. She yells at Campbell that he needs to find another way to win the case. Campbell assures Anna that, this time, when she speaks people will listen. Anna refuses, but when Campbell asks why, she won’t say.Slide56

Sara Summary

For the first time, Sara narrates in the present. She prepares to question Brian and notices all of the qualities that made her fall in love with him. She also notices how much he has changed but doesn’t necessarily for the worse. She begins questioning him but finds herself talking about a family trip they took. Suddenly Sara realizes they are no longer pushing each other away but are fighting on the same side. She feels like none of the past arguments matter. She thinks that they will have each other to remember what their family used to be like, to share the fact that they had Kate for sixteen years. Sara decides she doesn’t need to cross-examine Brian. She simply asks when he is coming home.Slide57

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Brian and Anna move back home that night. After Brian and Sara tuck Anna in, Sara tells Anna she is not a bad person because she wants to be herself. She also says Anna reminds her of herself. Later that night, Brian and Sara make love. Afterward, Sara tells Brian that they are going to lose her, and she doesn’t know which daughter she is talking about.Slide58

Wednesday Julia Summary

At their apartment, Julia and

Izzy

talk, and Julia cries over Campbell. He did the exact same thing to her that he did in high school. The next morning at the courthouse, Julia hears Campbell and Anna fighting over Anna’s refusal to take the stand. Julia confronts Campbell and tells him that both he and Anna are cowards afraid of facing consequences. Julia also tells Campbell he runs away every time someone gets close to him. Campbell starts to tell Julia something about his dog, but Vern Stackhouse interrupts to tell them the hearing needs to begin.Slide59

Campbell Summary

In the courtroom, Sara questions a psychiatrist named Dr.

Neaux

. She asks him about the potential harm Anna will suffer if Kate dies. Dr.

Neaux

says that if Anna donates her kidney and keeps Kate alive she will experience an immense benefit. He also does not believe Anna capable of making her own medical decisions. While Sara questions the doctor, Campbell jokes with Anna about the names of Dr.

Neaux

and Dr. Chance. Campbell then questions Dr.

Neaux

. He suggests Sara defines whether or not she is a good mother by her ability to keep Kate healthy. Campbell also suggests that Sara, who also stands to benefit by Kate staying alive, can’t make independent decisions any better than Anna.Slide60

Julia Summary

Campbell questions Julia on the stand. Julia says she can see how the

Fitzgeralds

want to do everything possible to save Kate, but how medically it does not serve Anna’s best interests to donate a kidney. Julia says that no one in Anna’s family has the ability to make unbiased decisions regarding Anna’s health care, but Anna also lacks the ability to make her own decisions.Slide61

Campbell Summary

Campbell realizes Julia will not veto Anna’s petition. He also recognizes how much the case has affected Julia, the same way it has affected him. Julia, however, expresses those feelings. Judge

DeSalvo

asks for Julia’s recommendation to the court, but she says she hasn’t been able to reach a decision. Anna stands up and tells Judge

DeSalvo

she has something to say.Slide62

Anna Summary

On the witness stand, Anna notices that Campbell looks awful and sweats. Campbell walks up to Anna and cracks a joke, giving Anna the courage to continue. She notices Campbell’s dog behaving excitedly, and Judge

DeSalvo

asks Campbell to control him. Campbell begins to question Anna and asks her why she wanted to file the petition.

In a flashback to two months before, Sara and Brian sit Kate and Anna down to talk. They say Kate needs a kidney transplant, and the kidney will have to come from Anna. Before Anna can reply, Kate says she doesn’t want the transplant. Sara snaps that if Kate won’t accept the kidney it will be just like suicide. Kate says if she’s already dying it’s not suicide.Slide63

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In the present, Campbell’s dog barks and jumps, but Campbell ignores him and continues with his questions. He asks Anna if she decided to file the lawsuit herself. Anna tries to lie but responds that someone else convinced her. Campbell asks Anna who, and Anna tells him it was Kate. Just then, Campbell collapses to the floor.Slide64

Wednesday Brian Summary

Brian rushes to Campbell, who has had a seizure. Julia asks if Campbell will be okay, and Brian assures her that Campbell will be fine. In the Judge’s chambers, Campbell regains consciousness. He doesn’t remember what happened, but Brian fills him in. Campbell apologizes to his dog for not listening. Brian helps Campbell change into clean clothes, and Campbell admits that he’s been hiding his seizures since he was eighteen. He says they started after a car crash. Julia enters the room, and Brian leaves. Brian observes that things don’t always look as they seem.Slide65

Campbell Summary

Campbell tells Julia he had a car accident the night he took her home from his parent’s house. The seizures started that night, and he has hidden them from everyone ever since. Judge, he explains, is an epilepsy dog, and he broke up with Julia he didn’t think she should have to live with his seizures. Julia tells Campbell that you don’t love someone because they’re perfect but in spite of their imperfection. She also tells Campbell that she will never leave him.Slide66

Anna Summary

Anna talks to Campbell alone. She asks him if he took her case because he knows what it’s like not to have control over his own body. He says “maybe.” They go back to the courtroom and Anna takes the stand again. Campbell asks Anna to confirm that Kate asked her to file the petition, and Anna says that’s not exactly true. She says Kate asked Anna to kill her.

In a flashback, Anna finds Kate drunk with a bottle of pills. Kate tells Anna she’s sick of waiting for something that’s going to happen anyway, and she’s tired of ruining everyone’s lives. But she admits that she can’t kill herself. Anna realizes this means Kate has tried before. Back in the courtroom in the present, Sara says Anna’s story isn’t true. Anna tells her mother that Kate didn’t say anything because she knew telling Sara would kill her, too. Anna also says she doesn’t want Kate to die, but Kate doesn’t want to live the way she’s been living. Anna, as always, is the only one who can give her what she wants.Slide67

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In another flashback, Kate asks Anna not to donate her kidney. She acknowledges that there are so many things Anna could do if she weren’t around. Anna feels ashamed to admit that she has had the same thought. In the present, Campbell asks Anna if she’s willing to take an action that might kill her sister. Anna says Kate wanted it, but admits that she wanted it, too. It would be the worst and best thing to happen to her. Anna told Kate she was going to be stop being a donor. Kate thanked her.Slide68

Sara Summary

Judge

DeSalvo

moves the proceeding to the hospital so he can talk to Kate. When they arrive, Kate is watching TV with Jesse. Judge

DeSalvo

speaks with Kate alone. When he leaves Kate’s room, he tells Sara, Brian, and Campbell that he will announce his decision the following morning. Before Julia and Campbell leave, Campbell tells Sara he is sorry. The entire family gathers in Kate’s room. Anna tells Kate that she tried. Jesse jokes with Kate to lighten the mood. Everyone leaves except for Sara. She climbs into bed with Kate and tells her how sorry she is. Kate tells her not to be, because she isn’t.Slide69

Thursday Campbell Summary

On a rainy morning, Campbell wakes up with Julia at his apartment. Campbell thinks about Judge

DeSalvo’s

decision and echoes what Anna says. No matter if they win or lose, it won’t be over. Julia tells Campbell she hates his apartment.Slide70

Jesse Summary

In the rain, Jesse goes to a soccer field and lies down. He recalls lying down in other storms, hoping to be struck by lightning so he would feel alive.Slide71

Anna Summary

Anna thinks about the rain and how it never really stops moving. She notes that rain goes through a cycle, evaporates like a soul into the clouds, and then like everything else, starts over again.Slide72

Brian Summary

Brian recalls another rainy day, the New Year’s Eve when Anna was born. Brian remembers there were no stars that night. He also remembers his decision to name Anna after Andromeda, a princess in the sky between her mother and father.Slide73

Sara Summary

Sara gives her closing arguments. She has note cards but quickly abandons them. She tells Anna she loves her and says that every day she wonders if she’s doing the right thing. Sara says that even if Anna and Kate don’t agree with her, she wants to be the one who’s right ten years later, when they are all still together. Sara says she knows the lawsuit was never really about donating a kidney but about choice. She also knows that no one ever really makes decisions by themselves. Sara makes an analogy to a burning building. She says that in her life one child has been in a burning building, and her other child has been the only one who knew the way to save her. She acknowledges that she might be risking the one child to save the other, and that it might be unfair, but it’s the only way she can save both children. She doesn’t know if it was legal or moral, but she knows it was right.Slide74

Campbell Summary

In his closing arguments, Campbell says the case isn’t about donating a kidney, but about a thirteen-year-old girl who deserves the chance to figure out who she is going to be. He says ultimately nothing else matters except what Anna thinks. After a short recess, Judge

Desalvo

returns with a picture of his daughter, who was killed by a drunk driver. He acknowledges that they have entered into a debate about the quality of life versus the sanctity of life. He says the sanctity of Kate’s life has become intertwined with the quality of Anna’s. He admits there is no good answer, because morals are more important than ethics, and love is more important than law. But he decides that only Anna can decide how to treat her body. He declares her medically emancipated and gives Campbell medical power of attorney. Anna and her parents hug.Slide75

Anna Summary

Campbell drives Anna to the hospital in the pouring rain. Anna asks Campbell what he thinks she should do, and he says it’s her choice now. Campbell tells Anna he thinks she will be amazing in ten years. Anna thinks about what she wants to be and knows only that in ten years she wants to be Kate’s sister.Slide76

Brian Summary

Responding to a call, Brian arrives at the scene of a car crash. A large truck has crushed a small car. Campbell’s dog comes whimpering out of the car just as Brian realizes that Anna is one of the passengers. His fellow

firefighters

try and hold him back, but he insists on pulling Campbell out of the car and then Anna, who is unconscious. At the hospital, Sara finds Brian. He doesn’t know how to explain what happened. Campbell comes out with his arm in a sling and asks about Anna. A doctor tells them that Anna is brain dead and asks if they want to consider organ donation. Brian thinks about twin stars and how the first one can shine so bright that the other may be gone before you notice it. Back in the present, Campbell tells the doctor that he has medical power of attorney over Anna, and a girl upstairs needs Anna’s kidney.Slide77

Sara Summary

Sara observes that in the English language no word exists for someone who loses a child. After doctors remove Anna’s organs, they bring her back down to the family. Everyone is there, and Sara and Brian sit beside Anna. Sara says she has spent years anticipating the loss of a daughter, but she is still at a loss. Brian reminds Sara that Anna is gone and that her body is just a shell. Finally Brian turns off the respirator. Sara puts her hand on Anna’s chest as her heart stops.Slide78

Epilogue Summary

The year is 2010, and Kate narrates in the first person. She discusses grief and how, after Anna’s death, Brian believed he could see Anna in the night sky and Sara thought Anna would come back to her. Kate says she began to hate herself. She blamed herself for Anna’s death.

Kate stayed sick for a long time after the transplant, but suddenly got better. Dr. Chance had medical explanations, but Kate believed it was because someone had to go and Anna took her place. Kate talks about the immediate stages of grief in her family, how much her mother cried and how much her father kept away. But she said one day she laughed, and the very act of living started to ease the pain.Slide79

Kate wonders if Anna keeps tabs on them, if she knows they stayed close to Julia and Campbell and even went to their wedding, and whether Anna saw Jesse’s graduation from the police academy or witnessed Brian’s drinking problem and how he gradually got better. She also wonders if Anna knows that she teaches dance to little girls now.

One year after Anna’s death, Sara came home with a roll of developed film from Kate’s high school graduation. The last picture on the roll showed Anna. Sara and Kate stared at the picture until they memorized every detail. Kate fears a day will come when it will be harder to remember Anna. But she knows she can lift her shirt and feel the scar from where she received Anna’s kidney. She says she takes Anna with her, wherever she goes.