Themes
Key
LitCharts assigns a color and icon to each theme in My Sister’s Keeper, which you can use to track the themes throughout the work.
Bodily Autonomy
Siblinghood
Parenthood
Control
Illness and Isolation
Summary
Analysis
Anna comes into the living room and asks Sara and Brian for $614.96. Sara asks her what she needs it for; Anna is initially evasive but then reluctantly answers that she needs goaltender leg pads for hockey. When Sara says that she doesn’t play hockey, Anna explains that she happened to start playing with a team a few months ago, and that while the coach invited her onto the team, she has to supply her own equipment. Sara tells her that she and Brian have to discuss whether they can buy it for her, and Anna, disappointed, leaves. Sara and Brian realize that neither of them knew Anna was playing hockey.
This scene illustrates how out-of-touch Sara and Brian are with Anna. Despite the fact that Anna has been playing hockey for months, neither of them have noticed at all—and, perhaps more significantly, Anna did not feel comfortable telling them about it. In other words, Sara and Brian have been so wrapped up with Kate that they have paid no attention to where Anna has been in her spare time.
Themes
The Fitzgeralds are about to leave to watch one of Anna’s hockey games, but Kate doesn’t want to go; she’s self-conscious about a rash on her face, which is a side effect of her bone marrow transplant. Sara refuses to let her stay home but wraps her in scarves to hide her face. At the game, Anna plays goalie fantastically, causing all the other Fitzgeralds—even Kate—to get invested in the match. Brian is shocked at her natural talent, but Sara isn’t. After all, “Anna saves, every time.”
In a rare instance of support for Anna, the entire Fitzgerald family goes to see her play hockey. The fact that she plays shockingly well shows the potential that Anna has when she’s not forced into living for Kate. However, as Sara alludes to, Anna’s role as goalie also symbolizes how she is constantly acting as a protector for other people.
Themes
That night, Kate begins to hemorrhage uncontrollably. Sara and Brian rush her to the ER; although they’re used to doing this, they have never seen anything this bad. Dr. Chance sees them and suggests arsenic therapy, a treatment that is so new that there aren’t even any success stories yet. He points out that Kate has already lived 10 years past her prognosis, subtly suggesting that her time has come. Sara, however, insists on the treatment. When Dr. Chance comes out and says that the hemorrhaging will likely outpace the treatment, Sara stares at a children’s growth chart on the wall and tries to remember if she told Kate she loved her before putting her to bed.
The worst development in Kate’s illness serves to emphasize how committed Sara is to Kate’s, no matter what the odds are. Even though Sara’s own doctor suggests that she’s out of time, Sara refuses to let her go and instead insists on a treatment that has almost no data around it. This shows how Sara is incapable of letting go of control and acknowledging that Kate is going to die—but, given that this chapter is a flashback and Kate is alive in the present, it's also clear that her instincts are correct.
Themes
Around two in the morning, Brian slips out of Kate’s room. Sara looks for him and finds him writing on a scrap of paper at the end of the hallway. When he sees Sara, he suggests bringing Kate home immediately, since he believes she would want to die in her own bed. When Sara protests, Brian tells her that Kate is dying, and they’ll be lucky to have her for another year. Sara says that she loves Kate, and Brian says he does too—too much to see her suffer. Sara looks at Brian’s paper and realizes he’s writing a eulogy. Brian, beginning to cry, says he wants to do it now while he’s still able. An hour later, Sara calls Suzanne sobbing and asks her to come down.
In contrast to Sara, who insists that Kate will survive her hemorrhaging, Brian forces himself to accept her imminent death, to the point that he wants to take her home to die in her own bed and is even writing a eulogy for her. This contrast once again illustrates the couple’s differing approaches to Kate: Sara insists on battling to the very end, while Brian sees the value of ending Kate’s suffering and letting her go peacefully.
Themes
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Kate slips into a coma on her 11th day of transfusions and arsenic therapy. Sara attempts to hold a vigil but is pulled away because Jesse has been suspended for exploding the school’s septic tank. She goes to pick him up, and he complains about the principal. When Sara responds that he will always be up against something, Jesse accuses her of making everything about Kate and says that she doesn’t know what it’s like being the brother of a girl with cancer, and Sara points out that she’s the mother of a girl with cancer. She then notices injection marks on his arm and confronts him about it. He tells her that he’s the one who’s been donating blood to Kate, then runs out of the car.
Jesse exploding the septic tank at his school is another clear example of him acting out in an attempt to be seen and cope with his grief over Kate; he himself confirms this when he alludes to the difficulty of being Kate’s brother. However, the revelation that Jesse has been donating platelets shows that he is also acting on his helplessness in a more productive way: although he is not a donor match like Anna, there are still parts of his body he can give to Kate in order to keep her alive.
Themes
Two weeks into Kate’s hospital stay, Sara goes home. She’s hanging out in the kitchen with Suzanne when Anna comes in and happily shows her an acceptance letter from a hockey camp, which she was able to get a full scholarship for. Sara tells her that she can’t go, but Anna points out that it isn’t until next summer—implying that Kate will be dead by then, freeing her of her obligation as a donor. Even so, Sara worries that, if Kate survives, they will need Anna as a donor when she is away. Anna insists on knowing why she can’t go, and Sara asks that Anna not make her do this. Anna retorts that she doesn’t make Sara do anything, then runs out to shoot against the wall of the garage.
Sara’s refusal to let Anna go to hockey camp is a vivid and painful example of how being Kate’s donor affects Anna’s quality of life. Although Kate will likely be gone by the time of the camp, Sara is unable to accept this and therefore refuses to grant Anna any semblance of freedom from her life as a donor. Anna’s angry comment about how she doesn’t force Sara into things is a clear allusion to her resentment at being forced into so many donations.
Themes
Seventeen days into the hospital stay, Kate develops an infection. One day, Dr. Chance comes in to check on her and tells Sara that she needs to say goodbye. The Fitzgeralds prepare to do so, with Jesse and Anna spending time at Kate’s side. Later, Sara and Brian sit with her. Sara says that Brian was right and that they should’ve taken her home, but Brian says they would’ve always wondered if they didn’t try the arsenic. He says that Kate is waiting for Sara’s permission to leave and starts to cry. After he falls asleep, Sara talks to Kate and says goodbye to her, telling her that she’ll be able to see Sara waiting for her in Heaven. Sara squeezes Kate’s hand, then feels her fingers move.
As the Fitzgeralds prepare to say goodbye, it appears as if Brian was right in accepting that Kate would not survive her hemorrhaging—but, importantly, he concedes that he's glad they attempted every last treatment before letting her go. This is by far the closest the Fitzgeralds come to losing Kate, but the faint movement of her hand at the end of the chapter confirms what the reader already knows: despite the near-impossible odds, Kate is going to live.
Themes
