Jodi Picoult’s My Sister’s Keeper explores the medical, legal, ethical, and moral issues related to long-term illness—a complicated subject in the contemporary world. In the book, thirteen-year-old Anna sues her parents for the right to control her body. Conceived as a sibling donor match for her sister Kate, who suffers from leukemia, Anna has undergone numerous procedures to provide Kate with whatever she needs to fight her disease, but when Anna learns she is to give up a kidney for her sister, Anna hires a lawyer and takes her parents to court.
Picoult’s idea for My Sister’s Keeper came while doing research for her novel Second Glance, when she was intrigued by information about eugenics in the United States in the 1930s. Supporters of eugenics wanted to improve the human race by allowing only those with desirable genetic characteristics to reproduce. Picoult also learned about stem cell research and linked the ideas, wondering if stem cell research could become human genome research. The related issues are complex and emotional.
A news story about a mother in Colorado who conceived a child so that the baby could donate cord blood to save the life of his elder sister also captured Picoult’s imagination. The author took the idea to the next level and added more invasive procedures to increase the story’s drama and ethical dilemma.
Picoult’s personal experience also shaped the plot. Her middle child, Jake, had ten surgeries in three years beginning when he was six years old. Picoult’s son suffered from Cholesteatoma—a benign but potentially fatal tumor that can grow into the brain—in both ears. Because of this experience, Picoult understands the lengths to which a mother will go to protect her child and also how needs of a sick child are demanding for the entire family.
My Sister’s Keeper won a 2005 Alex Award from the Margaret Alexander Edwards Trust, and Booklist named it as one of the top ten adult books for teenagers. Reviewing the novel in Booklist, Kristine Huntley concluded, “This is a beautiful, heartbreaking, controversial, and honest book.”
In this report, we are going to attempt to analyze the novel through the psychoanalytic approach. We will dig deeper into the psychological environment of both the author and setting to further understand as to why the novel came to be one of the most provocative literary works that challenges the morality and ethics of the contemporary readers.
The narrative of My Sister’s Keeper alternates between first-person accounts by the novel’s different characters. The bulk of the story takes place in the present, in a one-and-a-half week stretch of time. Sara Fitzgerald, a former attorney and current stay-at-home mom, narrates the remainder of the story from different points in the past but moving gradually toward the present. One final chapter, the epilogue, occurs in the future. In 1990, doctors diagnose Sara’s two-year-old daughter, Kate, with a rare and aggressive form of leukemia. The news that their child might die shocks Sara and her firefighter husband, Brian, but Sara immediately resolves to begin Kate on treatment. Kate starts chemotherapy, and her oncologist, Dr. Chance, suggests she might eventually need a bone marrow transplant, preferably from a related donor. The Fitzgeralds test their four-year-old son, Jesse, but he is not a match. Dr. Chance mentions that another unborn sibling could be a match, and Sara suggests to Brian that they have another child.
Sara’s passages, told at different points over the next fourteen years, focus largely on Kate’s struggles. She describes how scientists help them conceive another daughter, Anna, who is a perfect genetic match for Kate. Over the course of the next few years, Anna undergoes several procedures, including frequent blood withdrawals and a painful bone marrow extraction, to help keep Kate alive. Sara describes in great detail the pain and suffering Kate endures. Chemotherapy and radiation make her violently ill, and an emergency trip to the hospital heralds each new relapse. Sara and Brian’s marriage suffers as a result, to the point where they begin to feel like strangers. In different ways, both Jesse and Anna act out at Sara because of her single-minded focus on Kate.
The present action of the story begins on a Monday. Thirteen-year-old Anna goes to see a lawyer named Campbell Alexander and asks him to represent her. Anna tells Campbell that she wants to sue her parents for medical emancipation. Kate, her sister, is in the end stages of kidney failure, and Anna wants to file the lawsuit so she will not have to donate a kidney to Kate. Campbell, who has a service dog but gives a sarcastic explanation whenever someone asks why, agrees to represent Anna for free. When she is served with the papers for the lawsuit, Sara becomes furious with Anna as she cannot understand Anna’s decision. Brian, however, understands Anna’s point of view to a degree and recognizes that she would not have brought a lawsuit unless she were genuinely unhappy. Judge Desalvo, the judge for Anna’s case, decides to appoint a woman named Julia Romano as Anna’s guardian ad litem, a person whose job is to objectively decide what is in Anna’s best interests. When Julia goes to see Campbell, it becomes clear they have a romantic past and have not seen each other in many years. Throughout all of these events, Jesse has been setting different abandoned buildings on fire. Jesse acts like a delinquent in other ways as well, such as drinking alcohol excessively, but much of this behavior stems from anger over his inability to save Kate and his feelings of being ignored by his parents.
Kate becomes seriously ill and must be hospitalized. Dr. Chance says she will die within a week. Anna refuses to change her mind about the lawsuit, however. At the hearing, Sara decides she will represent herself and Brian. Consequently, Brian takes Anna to stay with him at the fire station to give Anna some distance from her mother. He believes if they remain in the same house together, Anna may unwillingly cave to her mother’s wish that she donate her kidney. Meanwhile, through flashbacks Campbell and Julia alternately recall scenes from their high-school relationship. They both attend a prep school populated by children from wealthy families. Julia feels and acts like the outsider, and Campbell falls in love with her despite the reservations of his friends and parents. Their relationship ends abruptly, however, when Campbell breaks it off without explanation. In the present, Campbell and Julia initially bicker with each other, but they end up sleeping together the night before the trial begins.
At the trial, both Sara and Campbell question witnesses, including one of the doctors familiar with Kate’s medical history, and both are effective at different times. Reluctantly, Anna takes the stand and admits that she filed the lawsuit because Kate told her to. At the very moment she makes this announcement, Campbell has an epileptic seizure and collapses. When his seizure ends, he admits he has been having seizures ever since a car accident in high school. He broke up with Julia because he didn’t want his seizures, which limit him greatly, to limit Julia as well. He also explains that the seizures are the reason he has a service dog, which can tell when another seizure is coming on. Julia and Campbell reconcile. Back on the stand, Anna explains that Kate asked Anna not to donate her kidney because she was tired of being sick and waiting to die. Anna also admits that while she loves her sister, part of her wanted Kate to die, too, so that she could have more freedom with her life. Judge DeSalvo decides to grant Anna medical emancipation and gives Campbell medical power of attorney over her.
On the way to the hospital, Campbell and Anna get into a serious car accident. At the hospital, the doctors tell the family that Anna has irreversible brain damage. Campbell tells the doctors to give Anna’s kidney to Kate. Kate narrates the epilogue, set in 2010. She discusses the grief her family went through after Anna’s death, and the fact that she blames herself. She knows, however, that she will always carry Anna with her.
Critical Approach on the novel, in the Psychoanalytic Perspective.
The Psychoanalytic Approach refers to literary criticism which, in method, concept, theory, or form, is influenced by the tradition of psychoanalysis begun by Sigmund Freud. Psychoanalytic reading has been practiced since the early development of psychoanalysis itself, and has developed into a rich and heterogeneous interpretive tradition. The basis of this approach is the idea of the existence of a human consciousness – those impulses, desires, and feelings about which a person is unaware but which influence emotions or behavior.
It is a literary approach where critics see the text as if it were a kind of dream. This means that the text represses its real (or latent) content behind obvious (manifest) content. The process of changing from latent to manifest content is known as the dream work, and involves operations of concentration and displacement. The critic analyzes the language and symbolism of a text to reverse the process of the dream work and arrive at the underlying latent thoughts.
1. What connections can you make between your knowledge of the author’s life and the behavior and motivations of characters in his or her work?
As mentioned earlier, Jodi Picoult’s fascination towards medical drama has manifested towards a lot of her literary works. It has been known that her son has suffered a very traumatic illness. Her son, Jake was diagnosed with Cholesteatoma in his ear. Cholesteatoma is a kind of benign tumor that can grow in one’s brain and can be fatal. Picoult’s son had ten surgeries in three years and was partially deaf until recently. It can be said that she underwent a lot of difficulties in making hard decision concerning her son’s condition. That is probably why she mostly explored on the emotional and mental aspects not only concerning the protagonists on her works, but on the people surrounding them.
2. How does your understanding of the characters, their relationships, their actions, and their motivations in a literary work help you better understand the mental world?
I think that in general, the human mind is a very complex organ, one driven by countless catalysts, that shapes and moves decisions, emotions, and beliefs, every second of everyday. My Sister’s Keeper gives us an in-depth experience on how a particular disease fuels a mother into making crucial yet provocative decisions. And although it is not a general problem occurring nowadays, it is one problem that makes us think differently. “What if it happened to us?” Like Anna’s family, we are all connected by a single word – love. And sometimes love drives us to go beyond normal limits of our human capacity, consequently reaching barriers of morality and ethics. I believe that the human mind, in its infinite possibilities, is still partially, or in some cases fully controlled by the affective aspect of a person. Although the book shows a very exaggerated and bold move in the part of the young Anna, we can see the shadows that haunt her and the rest of her family, proof that their ties as a family could still overcome even the greatest of challenges.
3. How does a particular literary work — its images, metaphors, and other linguistic elements—reveal the psychological motivations of its characters or psychological mindset of its author?
I think most literary works are directly or indirectly reflecting their elements and themes through the conscious or unconscious psychological backgrounds of its characters and mostly through the author’s psychological mindset as a whole. In the novel, several symbols became prominent in the whole course of the story. One of them, “Fire” is a major symbol, represented in the conflicts and decisions of the character’s problems and challenges, as well as the relationships and behavior of the characters in the story. Another of the epigraphs Picoult chooses, (and of which symbolizes her personal involvement on the story,) is the poem “First Fig” by Edna St. Vincent Millay, which talks about a candle burning at both ends. The family, like that candle, is metaphorically burning itself out.
4. To what extent can you employ the concepts of Freudian psychoanalysis to understand the motivations of literary characters?
If we focus on two characters, Anna and Sara Fitzgerald, it is already enough to make a study about Freudian application on the complexity of their relationship. Freudian three main concepts, the id, the ego, and the superego reflect on both sisters on every decision that they have made in the course of the story. Sara’s drive as a mother, gives testimony of the id principle, the need for a mother to do whatever it takes for the survival of her young. However, there is also a conflict when the ego principle sets it, for it symbolizes the reality of their situation as a whole. It reminds them that Sara is not mostly Anna’s mother; she represents someone who controls her body and using it to save her other daughter. Then the moral compass of both their superego is challenged when Anna finally gets legal help, to sue her parents and obtain freedom of her body through medical emancipation. Their moral decisions become more evident as the story progresses and a deeper problem within their family has surfaced.
5. What kind of literary works and what types of literary characters seem best suited to a critical approach that employs a psychological or psychoanalytical perspective? Why?
Jodi Picoult’s other literary works, such as “Mercy,” and “Perfect Match,” which deals about the issues of mercy killing and sexual molestation respectively could also provide a good platform for studying the psychoanalytic approach. However, I would also personally recommend Thomas Harris’s third novel, “Hannibal.” The book sets off shortly after the novel “The Silence of the Lambs,” which garnered positive response from readers since its inception. However, “Hannibal” digs a lot deeper into the mind of the antagonist, Hannibal Lecter and it explores his beginnings and the events that led to him becoming who he is. I think the book and the character himself would serve as a good medium for studying and analyzing though the psychoanalytical approach. The complexity of the Hannibal Lecter’s character could provide a challenging study considering the fact that the author has been said to be a very different nature compared to the atmosphere of his series.
6. How can a psychological or psychoanalytic approach to a particular work be combined with an approach from another critical perspective—for example, that of biographical or formalist criticism or that of feminist or deconstructive criticism?
The psychological approach can be proved very beneficial as a supplementary to other approaches because it is a well-suited and very rounded approach. Like all forms of literary criticism, psychoanalytic criticism can yield useful clues to the sometime baffling symbols, actions, and settings in a literary work; however, like all forms of literary criticism, it has its limits. For one thing, some critics rely on the psychoanalytic approach as a “one size fits all” approach, when in fact no one approach can adequately illuminate a complex work of art. So this approach complements other approaches; it simply provides added information, especially on the relationship between the literary work and the psychological background of the author, to the pre-existing approaches where it was said earlier, also lack certain elements that can fully analyze a literary work to its fullest capacity.