Reviewed By: Carolyn Vachani, MSN, RN, AOCN
The Abramson Cancer Center of the University of Pennsylvania
Last Modified: August 7, 2005
When Sara and Brian's three year old daughter Kate is diagnosed with leukemia, they are determined to save her. They decide to have a baby, Anna, who is predetermined to be an HLA-matched bone marrow donor for Kate. Anna's life becomes one of constant donations, from bone marrow to leukocytes; she is continually called upon to save her sister. But Anna feels the line is crossed when she is told she needs to donate a kidney to her. It seems she doesn't exist unless it is in relation to helping her sister, and so, with the help of a lawyer, the 13 year-old files for medical emancipation from her parents.
Sadly, Sara (the children's mother) has little time, patience, or understanding for her two other children (Anna & Jesse) during Kate's bouts with illness, and much of the story focuses on their feelings and problems because of this. I saw this as a strong lesson for any parent with a sick child – be cautious not to see the needs of their other children as frivolous. Interestingly, a friend whose child was sick for many years said the nursing staff caring for her daughter had made a point to tell her this. The author also gets into the issues surrounding being a donor, and the responsibility the donor feels during a relapse and when the recipient is faced with the possibility of death. As a transplant nurse, I have given these issues much thought and it was interesting to see other viewpoints.
This book grabbed my attention from page one, but, like many readers, I was disappointed with the ending – which I won't give away. Despite this, I would recommend this book to anyone. The author, Jodi Picoult, spoke with children with leukemia, their families, physicians and nurses in order to develop a realistic rendition of this journey. The book is written in first-person format chapters, so the reader gets a glimpse into each character's mind. You can't help but explore and question your own thoughts and beliefs of the situation. I found my beliefs changing depending on which character's viewpoint I was reading – just showing me how complex this topic can be.