Image copyright © by Marcus Trahan

My Sister’s Keeper


What was this movie doing at the drive-in? I’m not complaining, really I’m not, but I have never seen a real tear-jerker at the drive-in. I’ve seen some serious dramas, like The Departed, but ever since I was a teenager going with friends to dusk-to-dawn 5-movie marathons the flicks playing have tended to feature giant radioactive ants, creatures from outer space, cowboys, teenage werewolves, or girls in bikinis. (They still do, in 21st century versions, except for the cowboys, which have been replaced by comic book superheroes.)
This was based on a book by Jodi Picoult, co-written and directed by Nick Cassavetes. And it is a harrowing story. Sarah (Cameron Diaz) is a lawyer, married to Brian (Jason Patric) a fireman. They have a son, Jesse, and a daughter, Kate. At age 2, Kate is diagnosed with acute promyelocytic leukemia. She will die without donations of bone marrow. None of the family is a match, chances of finding a match are slim. But if they have another child …
Their daughter Anna is the result of in vitro fertilization and selection, carefully chosen to be a match for Kate. And already we are into very tough bioethics questions. Anna’s first contribution is fetal cord blood. Well, sure, why not? It’s just going to be thrown away. But not long after, Kate needs blood, then bone marrow … we are treated to descriptions of how painful that is, of how two nurses had to hold Kate down, how there were complications, how she spent a week in the hospital. We see a lot of this stuff in flashbacks.
And now Kate is 15 and Anna is 11, and Kate needs a kidney. It doesn’t even occur to Mom to ask Anna if she wants to do this. Of course she wants to! It’s her sister! She loves her sister. Only … Anna has had enough of being sucked dry by vampires and turned into an organ farm. She goes to a lawyer (Alec Baldwin) and wants to get “medically emancipated.”
And I can’t talk about what I want to talk about here without issuing the famous
This movie is so good, much of the time, that it made me angry that it was so bad some of the time. There were scenes that were played honestly, and were heartbreaking. I was in tears through about half the running time. But there were entirely too many musical montages of impossibly happy people enjoying life, skipping and jumping, laughing heartily, smiling, smiling, grabbing for the gusto … I might as well have been watching a beer or soft drink commercial. Nick Cassavetes needs to decide if he’s going to make a serious film, or a Hallmark TV movie of the week. This movie is half and half, and frustrating because of that. There is also a serious case of piling on the tragedy. Jesse is dyslexic. The judge lost her beloved daughter to a drunk driver six months ago and “suffered a very public nervous breakdown.” She’s only just back on the bench. The lawyer is epileptic. (This is actually rather neat, as he has a service dog and we are puzzled as to what the dog does. The man doesn’t seem disabled. But the dog senses when the lawyer is about to have a seizure—service dogs can be trained to do that!—and gives him some warning. Still, with everything else, it’s too much.)
But worse, I felt that both the book and the movie didn’t have the courage to explore some of the really tough questions raised by this situation. (I haven’t read the book, but the Wikipedia article summarizes it, and enumerates the differences between book and movie.) In both book and movie it turns out that Kate, recognizing that kidney donation is a possible life-threatening situation for Anna, and a certain life-limitation for her (she won’t be able to do a lot of things, and her life expectancy will be shortened) … and since the new kidney will probably give her only a few more years of life … that she asks Anna to go to the lawyer. She wants to die, her life is too painful anyway, she’s weary of it, and she doesn’t want to ruin Anna’s life. Very brave, very commendable, very believable. In the movie the mother relents, Kate dies, and Anna wins her case when it no longer matters.
Now here’s where it gets sticky. In the book, Kate is in a very convenient auto accident, and is left brain-dead. WRONG!!! Wrong, wrong, wrong! I very seldom approve of changes to novels made into films, but every once in a great while Hollywood is right, and this is one of them. I’m sorry, Ms. Picoult, but this is a massive cop-out. I’m glad I didn’t read the book; I would have thrown it across the room. Here’s from the Wiki summary: “In the epilogue, it is revealed that Kate survived the transplant, although doctors had thought she might be too weak. Kate believes that the reason she survived is that Anna took her place in heaven.” Oh, please. Once more Kate gets the best of it, and little Anna is screwed. Anna’s whole life is about being screwed, by everybody in sight. This auto accident allows the author to skirt the really, really important question she raises, which is this: Does Anna have the right to refuse to donate her body parts?
I say a resounding YES. The law supposes that a minor child is unable to give informed consent. Fine, I agree. Now, a five-year-old may not want a polio vaccination, and the parents may overrule her, even hold her down. All well and good … but the shot is demonstrably for her own benefit. There is no way you can make the involuntary “donation” (actually, theft) of an organ look like it is to the owner’s benefit. Therefore, I believe it is immoral, and should be illegal, to take an organ from a minor child for any reason. In the eyes of the law, she cannot consent. Try to imagine the pressure Anna will feel from her frightening mother (and I’ll get to her in a minute). “Don’t you love your sister? How can you murder her this way?” You can’t tell me an eleven-year-old can be said to consent in that situation.
One of the good things about the movie is that we see how this horrendous situation came to be, and even to understand it, a little. Sarah loves her little daughter to distraction. She has given up her law practice, and when she finds her darling is sick, she basically gives up everything else, to devote herself to keeping Kate alive at all costs. That’s fine, for her, but she never stops to count the costs to Anna. Never once, not for a second. And I see how it happened. When a doctor suggests (unethically, by his own admission) engineering a perfect donor child, Sarah leaps at the chance, and two years later she has her organ bank. Her attention is focused like a laser beam on keeping Kate alive. The family basically forgets about their son, and I understand that, too. (At one point he runs away, and expects them to be angry when he returns. They don’t even notice he’s been gone.) When you have a dying child, that child takes over your entire life, and everybody in the family suffers. And when Anna says she doesn’t want to donate the kidney, mom couldn’t be more stunned if a potted tree told her to stop picking its fruit. Sarah is that type, which lawyers so frequently are, that is totally intent on winning. The problem is, her opponent here is Death, and nobody beats Mister Death in the end. This puts her in an impossible situation, determined to win, fated to lose. She is started down this path by love. She was basically a decent woman, and she never sees what a monster she has become.
All this is so good that it makes me very sad about the bad parts. The amazing Abigail Breslin of Little Miss Sunshine shines again. Cameron Diaz is very good in a tough part. Sofia Vassilieva manages to keep the dying girl from being too sappy; I liked her, I wanted her to live. It broke my heart.
Here’s the story I’d have liked to have seen: It is Anna’s decision to seek emancipation. She does love her sister, and Kate loves her, but enough is enough! She must stand up for herself, or what’s next? Half her liver? They can do that, you know. One of her lungs? What if Kate’s bowels fail? Could she take half of Anna’s intestines? Can they do that? I have a feeling they’d like to try, see what happens, the fucking ghouls, and Mom would be demanding they give it a shot. Anna hopes Kate will understand. Given the horrors of Kate’s life and the certainty that she won’t survive very long even with a new kidney, I think she might.
And I haven’t even addressed what would be a really tough situation. In this story, Kate is going to die. Without a kidney, she will die right now, in hours or days. With one, she might live another two or three years. What if the donated kidney would save her life for a meaningful amount of time? Say, twenty, thirty years? Would Anna still have the right to turn her down?
My answer is yes. What’s yours?