My Sister's Keeper

Plot summary

Anna Fitzgerald's older sister, Kate, suffers from acute promyelocytic leukemia, a cancer of the blood and bone marrow. Anna was conceived in order to harvest blood from her umbilical cord in order to use in treatments to help save Kate's life; although the treatment was initially successful, Kate relapsed; ever since, Anna - the only compatible family member, since both her parents and her older brother Jesse are incompatible donors - has been used as a donor for any other bodily substance needed to treat Kate, who continues to swing between remission and relapse as she grows up.
Anna is usually willing to donate whatever Kate needs, but when she is thirteen, she is told that she will have to donate one of her kidneys. The surgery required for both Kate and Anna would be major; it is not guaranteed to work, as the stress of the operation may well kill Kate anyway; and the loss of a kidney could have a serious impact on Anna's life. Anna petitions for medical emancipation with the help of lawyer Campbell Alexander, so that she will be able to make her own decisions regarding her medical treatment and the donation of her kidney.
Anna's mother, Sara, is an ex-lawyer and decides to represent herself and her husband in the lawsuit. Over the course of the novel, she tries on several occasions to make Anna drop the lawsuit. Anna refuses to do so, but the resulting tension between her and her mother result in her moving out of the house to live with her father Brian in the fire station where he works. This is done on the advice of Julia Romano, the court-appointed guardian ad litem whose job it is to decide what would be best for Anna. Julia was once romantically involved with Campbell when they went to school together, but Campbell broke her heart when he left her.
Meanwhile, Jesse - who has spent most of his life being ignored in favor of ill Kate or organ donor Anna - spends most of his time setting fire to abandoned buildings with home-made explosives, using the knowledge that his fire-fighter father gave him to make the fires bigger and fiercer, and doing drugs. He is a self-confessed juvenile delinquent and pyromaniac, and the only time throughout the book that his parents pay him any attention is when Brian discovers that it has been him who was setting the fires. Brian forgives him, and by the end of the book, he has reformed and graduated from the police academy.
During the trial, it is revealed that Kate asked Anna to sue for emancipation because she did not want Anna to have to transplant, and because she believes that she will die anyway. The judge rules in Anna's favor, and grants Campbell medical power of attorney. However, as Campbell drives her home after the trial their car is hit by an oncoming truck. Brian retrieves Anna, who is unconscious, and suffers an injury to the head, and Campbell, who suffers an injury to the arm, from the wreckage of the crushed car and rushes them to hospital. However, after some time, the doctor informs them that Anna is brain-dead, that the machines keeping her alive may as well be switched off, and asks them if they have considered organ donation. Campbell steps in, and declares that he has the power of attorney, and "there is a girl upstairs who needs that kidney". Kate is prepped for surgery, and Anna's kidney is successfully transplanted. Kate survives the surgery and goes into remission. Most of Anna's usable organs are removed for transplants in the future. Kate stays in remission for at least 6 years, while Anna dies for her sister's life.

Characters

• Anna: Thirteen years old, born to be a perfect donor match for Kate. Anna sues her parents for the rights to her own body, which would result in Kate's death.
• Sara: Mother of Anna, she is protective of Kate, thus letting her other children, Jesse and Anna, fade away from her parental bonds.
• Brian: Being the father of Anna, Jesse, and Kate, Brian is a hobby astronomer who loves to lie on the roof of the firehouse and look at the stars.
• Kate: Sister of Anna and Jesse, Kate has APL, and has a relapse of kidney failure.
• Taylor: Boyfriend of Kate, with "brown eyes that could dance",Taylor is an AML patient who is sixteen to Kate's fourteen. He dies from his cancer right after he and Kate become serious about each other.
• Jesse: Brother of Anna, Jesse is a drug, alcohol, and pyro addict who always wants excitement and attention.
• Campbell: The lawyer Anna hired, Campbell is living with epilepsy and has a service dog, Judge.
• Judge: Campbell's service dog whose use is unknown throughout much of the novel.
• Zanne: Sister of Sara Fitzgerald, aunt of Kate, Anna, and Jesse, Zanne is wealthy and always wants to babysit the children when Kate has a relapse. She is known as a support for Sara throughout the novel. When Brian and Sara were having problems paying for Kate's medical treatment, Zanne offered to help but Brian refused to accept her money.
• Dr. Chance: Kate's oncologist and close friend of the family, Dr. Chance speaks in the trial and doesn't know if the kidney transplant will be beneficial to Kate.
• Julia Romano: In the book to advise Anna while she is going through the trial, and decide what the best for Anna and tell the judge. But she is also romantically involved with Cambell, and heartbroken by him when they were younger.

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