It’s been a long time since I last posted my book blog/book review. This time, I will be blogging about the book that made me cry pail of tears. I first saw the movie in the cinema, before I read the book. It was starred by Abigail Breslin (Anna Fitzgerald), Cameron Diaz (Sara Fitzgerald), Sofia Vassilieva (Kate Fitzgerald) and Alec Baldwin (Cambell Alexander).

The story is about 2 sisters Kate and Anna.  The older sister Kate was born with Acute Promyelocytic Leukemia. It is the type of Leukemia where there is an increased accumulation of immature granulocytes called promyelocytes. What’s so nice about this book is, it has a lot of medical terms, which luckily I do understand since I am a nurse. Terms such as white blood cells, granulocytes, lymphocytes, etc. When I was working as a nurse, I encountered these words almost every day. I even know what the normal values of those blood components are. Well, I guess that is the good part of reading this book.

Anna was conceived through in vitro fertilization and genetically engineered to match the DNA of her older sister. In other words, she was created to become a savior sister. There goes the conflict. Anna knows from the starts that it is the role that she is going to play. Her parents never fail to make her feel loved, but the bottom line is, would you believe that you are loved when the first reason why you exist is because you will be the sole donor for all blood components, and tissues that is lacking from your sister for her to survive? At a very young age, she already undergone minor and major operations just so she can provide lymphocytes, granulocytes, peripheral blood stem cells and even bone marrow to her sister. Now this is the twist of the story, after a long battle of Acute Promyelocytic Leukemia, her sisters’ kidney already failed causing the need for a kidney transplant. That is one of the major complication of Leukemia. There is a greater chance for her sister to die of kidney failure, than to die of Leukemia. I love the role of Sara, their mother on this book. She did her best to save her daughter even if it means compromising the life of the other daughter. It is unconditional love. But the love that she showed become biased when she forced Anna to donate her other kidney to Kate. Based on my opinion, it is ethically wrong. Why? Kate already passed the life expectancy of patient with Acute Promyelocytic Leukemia. It is just like a remission and exacerbation case. Yes, medically, her life was prolonged due to the body’s responsiveness to accept blood components being donated to her. In each remission, exacerbation follows. Sara may be in denial, but truth be told, Kate will eventually die. Are you going to sacrifice the life of your healthy daughter for your dying daughter? I can’t answer this question because I am not a mother. I don’t know how it literally feels when this situation happens.

A person can survive with just one kidney, yes, but will that person live longer? Will that person be able to enjoy life’s pleasure with just one kidney? The answer is yes. But will that person be able to do something like all 2 kidney people do? The answer is no. Kidney functions as a regulator for the water and fluid balance and removes waste products from the blood. Say for example you have a very active lifestyle, you drink and eat whatever you like, will you still be able to do that with just one kidney? Answer is no. It is just like being a one-legged amputee. Will the amputee be able to walk or run just like the time when he have both legs? Obviously it’s a no. The disability may not be physical, but it has more risk than being an amputee. I placed myself on the situation of Kate and Anna. If I were Anna and my sister Belle is Kate, will I do that? For the love of the sister you grew up with and loved you dearly, yes I will. It may be a hard decision, but this decision is worth a try. Will I do that if my sister is dying with Leukemia and has 20% chance of living? The answer is I don’t know.

Anna is 13 years old. All surgical waivers are signed by her parents because she is a minor. She doesn’t want to donate her kidney, but she cannot go against her mother’s will. She is not of legal age and incapable of making a decision. Because of that, she went to the office of a lawyer, Campbell Alexander to sue her parents for medical emancipation and the rights to her own body.

Campbell has a service dog named Judge. Every time he is asked why he has a dog with him, he comes up with different reasons. Some reasons are that he is color-blind and judge helps him read stop light, that judge is trained in CPR because he has heart attacks, that he has iron lungs and judge keeps him away from magnets and the most funny is that judge translates for his Spanish speaking clients. It somehow made me laugh as to why he has different reasons for having a service dog.

Case battle went on, family issues resurfaced, mother and daughter relationship was tainted, and husband and wife relationship becomes rocky. They then become a dysfunctional family.

Campbell stood for Anna as a guardian ad litem and Sara stood for herself, since she is also a lawyer, though not a practising lawyer anymore due to the need to take care of her sick daughter. After all hearings and family feud, it was then revealed that it was Kate’s decision for Anna not to accept her mother’s decision for kidney transplant. She is sick all her life and she felt the need to take a rest. She felt like a burden to her family and for her to die means unburdening her family from all stress that she caused them. She also wants to follow her boyfriend who died because of Leukemia, claimed that they will be happy together in heaven. But her number one reason is for Anna to enjoy her life without worrying about her. She wants Anna to join cheer leading, play soccer, become a mother and do all the things that she want to do, that she cannot do because of her. Kate was unselfish, but she also can’t say that to her mother because it will break her heart and will totally disagree with her reasons. It was also during the heated argument when Campbell’s service dog started barking. After a few minutes, Campbell throws epileptic fit. It was revealed that the reason why he have service dog is for him to know if there will be an impending epileptic seizure attack.

Anna won the case, and she became medically emancipated. Now, this is the part of my disappointment. I saw the movie; it showed that Kate died. But in the book, it was Anna who died. Reason? Anna left the court with his lawyer and encountered a vehicular accident. Anna was placed in ICU and in critical condition with full life support. She is not responding with the treatment and is brain dead. Family’s decision? Withdrew life support, did an emergency operation for kidney transplant from Anna to Kate. So yes, it was Anna who died.

I love the book and I love the plot of the story. Jodi Picoult is one of the best authors for me. Her book is well written and very informative. It is unpredictable and the twist is absolutely shocking. I love everything written in the book. I love how the story seemed to be real. She knows how to connect with her reader. Well, if there is something that disappoints me, it is the ending of the story from the movie and from the book that went totally wrong. As a reader, we always wish to have a happy ending, but Picoult is not like everyone else. This story ended tragically, but I guess she is just showing us the irony of life. This made her book utterly unpredictable.

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