WARNING! This post could include spoilers for those of you who haven't read this book!! I really recommend for you to read it though, it's awesome!
LOVE AND NEGLECT
By: Frida
Imagine a hypothetical situation where a person has two children and one of them is diagnosed with acute promyelocytic leukaemia, APL, at age two. The only way to cure her is for a donor whom is a HLA (human leukocyte antigen) match to donate blood. No one is a match. The child’s parents decide to create a baby who is. The saviour baby girl is born and has to live her life providing parts of herself to her sister for thirteen years, only having her parents notice her when her sister relapses and they need her body. Finally, that child says no. That is the complicated situation in the Fitzgerald family in My Sister’s Keeper where Anna was born to be a donor for her leukemic sister Kate. The purpose of this essay is to explore how the siblings of a fatally sick child are neglected as their parent is doing everything to save that child. Additionally it will uncover what happens to a child that is overlooked.
The reader is introduced to the Fitzgerald family when one of its members is making an important decision. Anna decides to sue her parents for the rights to her own body. Subsequently, one is thrown into the story of a family where everyone has different views of the same situation, where authority and responsibility is questioned after years of following orders. Anna feels that she alone is the one responsible for her body and that her parents lack the judgement necessary as they have to consider two of their children. She hires a famous lawyer, Campbell Alexander and the case is assigned a guardian ad litem named Julia. Besides the fact that Julia and Campbell have a past together they play important roles in the novel, e.g. in conversations with Anna. She grows to trust these two people, which mean that their conversations gives the reader even further understanding about her situation.
The lawsuit leads to a trial and during the time leading up to it the reader finds out more about the family, its members and their feelings. The only one never really getting her thoughts through is Kate. It is only her perspective that is not presented. Through Anna, however, the reader finds that Kate, just like Anna, is tired of all the medical procedures. Even further on in the novel one finds that Kate actually asked Anna to stop being her donor. “‘Don’t do it,’ she repeated, and it wasn’t until I heard her a second time that I understood what she was really saying.” (pg. 390) There is a part of Anna that wishes that her sister was dead; otherwise she would not do as her sister says. She also admits to dreaming about going to college, maybe travelling abroad or just going to a hockey camp. Nonetheless, this is not possible as long as she needs to be around her sister. Additionally, she realises that if she does not act now it will never stop. This time it is not bone marrow or blood she has to donate, but her kidney, an organ that does not reproduce itself. Furthermore, it is a risky surgery, even though considered safe. The chance of dying on the operating table is 1 in 3000 and it takes approximately a month to recover. Anna understands that her chances of playing hockey, which she loves, will be gone and she fears that if this surgery does save her sister there will be yet another one soon. “‘Yes, you [Anna] are [at Campbell’s office]. I’m just trying to figure out what made you want to put your foot down, after all this time.’ She looks over at the bookshelf. ‘Because,’ she says simply, ‘it never stops.’” (pg. 22) Anna is right of course, the plan was that the first donation – made only a few minutes after her birth – would be sufficient to cure Kate. Still, she has donated something several times after that, each time convinced that it is the last time. When she hires Campbell, Anna has figured out that if she donates a kidney Kate might survive, and then she will need another organ, e.g. the liver. If Anna cannot make the decisions about her own body, her parents might go too far before realizing that both their daughters are dying.
Anna Fitzgerald knows exactly why she was born. In the introduction of the novel she explains that scientists managed to create a genetic match to her sister and that her parents only had her to save Kate. “It made me wonder though, what would have happened if Kate had been healthy. Chances are I’d still be floating up in heaven or wherever, waiting to be attached to a body to spend some time on earth.” (pg. 8) Already in the beginning of the novel Anna questions her existence and sees herself as a container of everything that Kate might need one day. “’Anna,’ I murmur. My mother turns. ‘What?’ ‘A four-letter word for vessel,’ I say, and I walk out of Kate’s room.” (pg. 251) This quote is from when Kate is in the search for a four-letter word for vessel for a crossword puzzle when the doctor comes in to inform her, Anna and Sara that she might only have one week left to live. Sara asks Anna to hinder the lawsuit, to donate her kidney. Everyone assumes that Anna will live up to the expectation they have on her as it is as simple as saving her sister. However, she is sick of living as a container of her sister’s spare parts. Sure, she loves her sister and her family but at the age of thirteen it is not odd that she wants a life of her own. It is an age of being a bit selfish yet being responsible enough to make important decisions and that is all she wants. She wants the simple power of controlling herself and her life.
In the book Anna faces an extremely difficult decision. The only way for her to be in control of herself is to stop being Kate’s donor. Another dimension to the problem is added due to the fact that Kate not only is Anna’s older sister, she is her best friend. Anna’s existence is based on her sister’s disease and the chances of Kate’s survival are based on Anna’s life. Based on this reciprocity it is actually no wonder they grew up to be best friends. A contributing factor to their friendship is the lack of other friends. “’Friends?’ She [Anna] shakes her head. ‘You can’t really have anyone over to your house when your sister needs to be resting. You don’t get invited back for sleepovers when your mom comes to pick you up at two in the morning to go to the hospital.” (pg. 111) Later it continues; “‘So who do you talk to?’ She looks at me. ‘Kate.’” (pg. 111) This quote is from when Anna talks to Julia, the guardian ad litem. Her role is to work with cases concerning underage clients. Julia’s main assignment is to assess if Anna really is responsible enough to be in charge of her own body and if she is mature enough to make life altering decisions. From this quote one derives that Anna is aware that she has no one but Kate. Still, the part of her that wants her own life – a normal life – wants Kate to die. The desire to be something else than a vessel is so prominent that she can overcome her sister’s death.
Already at her birth parts of her were more important than Anna herself. The following quote is from when Sara describes her second daughter’s birth. “‘The umbilical cord,’ I remind him. “Be careful.” He cuts it, beautiful blood, and hurries it out of the room to a place where it will be cryogenically preserved until Kate is ready for it.” (pg. 104) Sara’s obsession with Anna’s blood is almost sickening; she barely cares for the little newborn child, she only cares about how she is an asset in the plan of saving Kate. Sara somehow lost the capability to take all her children into consideration when Kate got sick. She is determined not to let her daughter die, and it clouds her judgement. It is very unlikely that the kidney transplant will save Kate, yet Sara is willing to go through with it, just for the very small chance that it might.
Sara is extremely determined to keep her oldest daughter alive. After they found out about Kate’s condition she said “I’m not going to let Kate die.” (pg. 36) That determination is what leads to the decision to make Anna. One of the clearest mistakes Sara makes in Anna’s upbringing is enhancing how important Anna is for her sister. “We loved you even more,’ my mother made sure to say, ‘because we knew exactly what we were getting.” (pg. 8) What they were getting was someone who could save Kate. Since Anna knows what her mother means, it is implied that Sara only loves Anna for that very reason. One comes to the conclusion that Sara’s constant reminders make Anna feel that they would not love her if she could not save Kate. So, to be loved, she donates parts of herself to her sister, continues to be the one to save her sister. Jesse says: “And you [Anna], you’re the Peacekeeper.” (pg. 15) He is under the impression that she does anything to keep her family happy but the fact is that she does anything to be loved.
Brian’s actual realization of how Anna is treated moves the reader, yet creates a feeling of irritation as he does not do enough to prevent it. He does offer Anna to move in with him at the fire station during the week leading up to the trial, but in the whole picture he too focuses more on Kate. One instance where it is notable to the reader that Brian, unlike Sara, actually pays attention to all his children is during the dinner the same day Anna hired Campbell. “This is when I realize that Anna has already left the table, and more importantly, that nobody noticed.” (pg. 40) Sara is overly focused on Kate to even notice that Anna acts differently whereas Brian notices right away that Anna is acting oddly even before they find out about the lawsuit. After dinner Sara wants to discuss how Kate looked: “Better than Anna did, I [Brian] thought, but this was not what she was asking.” (pg. 44)
Anna has a necklace that she has worn for seven years. It is a gift from her father; he gave it to her after a bone marrow harvest, “because he said anyone who was giving her sister such a major present deserved one of her own.” (pg. 9) The thought to give Anna something does not even occur to Sara. The six year old Anna is of course very pleased with her gift but the reader cannot help to think that she might be better off without it. Anna might start associating medical procedures with gifts and expect to get something every time she helps Kate. Sara’s and Brian’s way of treating Anna are therefore similar; they both say that they give her something in exchange for her body parts. Anna might only donate parts of herself because she is under the impression that it is the only way to get something valuable and materialistic from her father or the only way to get her mother’s love.
Only being alive to keep her sister alive creates feelings of invisibility in Anna. She realises that she is forgotten at times “There are pictures of me, too, but not many. I go from infant to ten years old in one fell swoop.” (pg. 130) When the parents do not have the time for their children it shows and one could argue that the number of photos of the child is evidence of that. Her mother is so focused on Kate and her disease that she barely considers Anna. Brian does not really know what to do or say and finds it extremely difficult to find the right thing to do. They both try to do their best, but parents are often only asked to looking out for one child’s best interest. “But if they are blinded, instead, by the best interests of another one of their children, the system breaks down.” (pg. 112) Sara and Brian are blinded, and so Anna becomes invisible. She tries to become visible again by suing her parents. That is her way of fighting against years of neglect.
Anna is not the only one who is forgotten in the Fitzgerald family, Jesse also suffers from feeling invisible. Jesse is Kate’s and Anna’s older brother. He is two years Kate’s senior, which means that he had a perfectly normal life for four years – until his sister got diagnosed with APL. After Kate’s diagnose there has been no room for Jesse. Before Anna was born Sara and Brian only had two children to look after, but they still managed to forget their son. “’Who else is going to watch Jesse?’ Brian and I [Sara] look at each other; we haven’t thought that far.” (pg. 71) His parents are the ones who should remember him, who should always think of him. Yet, the only one who actually does think of him is Suzanne, Sara’s older sister.
It is understandable that they forgot him once, in the beginning when everything was new and scary. Yet, in the following fourteen years Jesse had to live with the fact that one of his siblings – most often Kate – was more important. Nonetheless, what the reader finds more upsetting is how he realises and handles it. One is told about a few instances where he is neglected from Sara’s flashbacks and others from Jesse himself. At age ten, Jesse needs to go to the orthodontist, after which he is promised to buy a pair of cleats. Because of Kate, Sara decides that they cannot go and tells her very disappointed son to grow up. “Jesse looks out the window, where Kate straddles the arm of an oak tree, coaching Anna in how to climb up. ‘Yeah, right, she’s sick,’ he says. ‘Why don’t you grow up? Why don’t you figure out that the world doesn’t revolve around her?’” (pgs. 166) One could argue that this quote shows that Jesse knows that his mother’s life only revolves around his sister, that she barely has the time for anyone else. This realization leads to Jesse lashing out and acting drastically, anything to get some of his mother’s attention. “Blood covers Jesse’s mouth, a vampire’s lipstick; bits of wire stick out like a seamstress’s pins. I notice the fork he is holding, and realize this is what he has used to pull off his braces.” (pg. 167) Pulling out his own braces with a fork could be seen as an act towards becoming the person he is when the reader is introduced to him – a very problematic young man. One could argue that he acted the way he did to get his mother’s attention. Also, it could only be that he, like Anna, is sick of being a child, controlled by his parents and it is an act of blind desire to independence.
Jesse was always an afterthought, and never the first one to be taken into consideration. Kate’s procedures meant that Anna ended up in the hospital as well and if you are in the hospital your parents will notice you, sooner or later. Jesse did not end up in there with his sisters so he was forgotten until a few weeks later. When he was eleven he got a skateboard for what – on the surface – seemed like no reason at all. “I never asked for one; it was a guilt gift.” (pg. 244) It is difficult to determine if it is positive or negative that Jesse got these “gifts of guilt” from his parents. He knows that he was forgotten and therefore it adds to his feelings of being neglected. Admittedly, it is probably better that he got the gifts in the end as he would have realised at an older age that his parents ignored that he was overlooked. That might have led to something worse than what Jesse turned out to be.
In a conversation with Julia Jesse brings up another memory of being neglected. When he was twelve Kate got an infection and had to spend Christmas Eve at the hospital, together with Anna who had to donate granulocytes, more commonly known white blood cells. Jesse was left with the neighbours. When he got bored he snuck out, chopped down a tree and made Christmas in the living room before returning back to them. The next morning his parents collected him from neighbours and he came home to find presents to him under the tree. “… I [Jesse] happened to know that it [the present] was on sale in the hospital gift shop. As was every single other present I got that year. Go freaking figure.” (pg. 192) Furthermore, his parents did not even mention the tree. Following this recollection Jesse states that it feels as if you are constantly forgotten and overlooked growing up in the Fitzgerald family, at least for him. “Do you think it’s the same for Anna?’ ‘No. Anna’s on the radar, because she plays into their grand plan for Kate.” (pg. 192) As Jesse puts it; Anna’s on the radar. She is, at least, noted by their parents. Maybe not for the best of reasons but she is still there, something Jesse envies. All the children in this family envies each other in one way or another “No matter who you are, there is some part of you that always wishes you were someone else” (pg. 138) Kate does not want to be sick, Anna does not want to be a vessel for Kate’s body parts and Jesse just wants to be noted, accepted. All the neglect that Jesse suffers, and all the times that he is forgotten due to his sisters adds up to him becoming self-destructive.
Another time that Jesse makes a big lash out is when he blows up a school toilet using sodium from the school’s lab and gets suspended for three weeks. Despite all this, Sara, who is the one to pick him up, somehow gets on the subject of Kate - again. “He [Jesse] glares at me [Sara]. ‘You could take a conversation about the frigging Red Sox and somehow turn it back to Kate.” (pg. 266) This shows that no matter what Jesse does, his sister and her disease still get the attention. Blowing up the school toilet should be looked at as an act of desperation; he is in desperate need of his mother’s attention but she is incapable of seeing the signs. Even when he screams it out loud she does not understand. “You don’t know what it’s like being the kid whose sister is dying of cancer.’ ‘I have a fairly good idea. Since I’m the mother of the kid who is dying of cancer.“ (pg. 267) She does not comprehend the point that he is trying to make. There is a huge difference between being the mother of a dying child and being the child’s brother. Anna gets some satisfaction from saving the sister she loves so much but Jesse cannot do anything else than look from the sideline. Not only is Jesse neglected but he has to live with the feelings of being completely useless.
All these instances made him into the young man the reader is introduced to in the beginning of the book. He is a very angry eighteen-year-old living above the family garage, only showing up for dinner. One would call Jesse extremely troubled; he smokes, drinks, uses drugs and he is an arsonist. He spends most of his time starting fires in abandoned buildings. Even though he feels useless and does so many bad things, one would say that his heart is in the right place. He might forget it at times but he is a good guy. Jesse has the desire to help people – especially his family. At the age of fourteen Sara finds marks of needles on his arms and assumes that he is using drugs. “Yeah, Ma. I shoot up every three days. Except I’m not doing smack, I’m getting blood taken out of me on the third floor here.’ He stares at me. ‘Didn’t you wonder who else was keeping Kate in platelets?” (pg. 267) This quote shows that he really wants to help his sister and does whatever he can to do so. When Kate needs a kidney he offers to donate one, but is told that the donor has to be a better match. “But inside I’m [Jesse] burning just as hot as I was when that fire caught at the warehouse. What made me believe I might be worth something, even now?” (pg. 98) He feels very ashamed and angry at himself for being worthless. The reader comes to the conclusion that the repressed rage is the reason behind the arsonist in Jesse.
Another instance where Jesse shows his unconditional love for his sisters is when he acts drunk to get Anna into Kate’s room in the hospital. Anna really wants to talk to her sister so she turns to Jesse for help and, knowing he will be punished, he enters the oncology wing, pretending to be severely intoxicated. This really shows his desire to help people, especially his sisters. He is always there for them though no one is ever there for him.
It is not mentioned that Jesse is punished for the scene he created at the hospital, which implies that Sara does not really care enough to punish him. No one really cares enough to react to his toxic behaviour. Imagine being able to show up for dinner visibly affected by drugs without making a scene – that is Jesse’s everyday life, and that is how little time his parents have to care about him. “Don’t get me wrong – it isn’t that my parents don’t care about Jesse or whatever trouble he’s gotten himself mixed up in. It’s just that they don’t really have time to care about it, because it’s a problem somewhere lower on the totem pole.” (pg. 14) A child should not be lower than anything on the totem pole. Sara does not even know when or why she stopped caring about his actions. “I wonder when, exactly, I gave up on him. I wonder why, when Jesse’s history is not by any stretch as disappointing as his sister’s.” (pg. 266) In the actual neglecting of Jesse, Sara and Brian are not too different. They both see most of the things that are going on and they both decide not to do anything about it. One might argue that there is nothing you can do to help a troubled child. However, if Jesse got the love and attention that every child deserves he would probably behave completely different.
Sara spends all her time fighting for Kate, fighting for a child that might not make it. One cannot say that she should not do that because she should. She should be fighting for her daughter’s life but she should also fight for Anna’s and Jesse’s lives. Her obsession with Kate leads to the neglect of her other two children. They tried to make it work and to have their children lead a normal life “but that’s a relative term. The truth is, I [Anna] was never really a kid. To be honest, neither were Kate and Jesse. I guess maybe my brother had his moment in the sun for the four years he was alive before Kate got diagnosed, but ever since then, we’ve been too busy looking over our shoulders to run headlong into growing up.” (pg. 9) It is, of course, extremely difficult not to forget the other children when one is lying at her deathbed but Kate is not always sick; she actually have years when she is healthy. The thing is, Sara always focuses on Kate and the others wind up in the shadows. In that aspect, Brian is a better parent. It is clearly implied throughout the novel that he tries to be there for all of his children when Kate is healthy. Sara and Brian are not evil in any way; they just do not know how to prioritize and therefore they end up neglecting their children. It is not done on purpose, but forgetting one’s children is unforgivable.
Though Jesse and Anna are neglected in similar ways it takes much longer for Anna to react. This is because she is appreciated and noted by her parents from time to time. Jesse is almost always forgotten and therefore starts to act out much earlier. It could also be caused by the fact that Anna was born into the situation, she never knew any other life than the one where she is her sister’s keeper. Jesse, however, was not. As Anna stated in the quote mentioned earlier “... my brother had his moment in the sun for the four years he was alive before Kate got diagnosed,” (pg. 9) meaning he knows a better life – a life where he got as much attention as his sister and a life where he did not feel useless. With memories of times when he was not neglected the reader understands why Jesse acts the way he does. This is slightly different when it comes to Anna. One is, of course, upset about the neglect she suffers, and wishes that something was done differently. Yet, it is not until Kate’s view on the lawsuit is brought into the open one that one truly understands her actions and sympathizes with Anna.
It could be debated whether Anna’s and Jesse’s ways of reacting are different or similar. They both act drastically, but Anna is very hesitant towards her actions whereas Jesse does not appear to have a bad conscience about what he has done. This could of course be related to how long he has been acting the way he does. Anna has lived thirteen years pleasing others and now that everything changes it is not odd that she hesitates. Jesse has been living on “the dark side” for a long time, and it is possible that he simply stopped caring after a while. It is at least safe to say that nothing good comes from being neglected. Anna might be happy on the surface but her anger and sadness are revealed as the story unravels. Jesse, on the other hand, has been neglected for so long that the happy surface has faded away, and the rage is all that one can see. What Sara and Brian do is basically fantastic, but what one forgets, or may not consider, is the backside of fighting so hard for one child. They do their best and they do an honorary job, but Anna and Jesse are forgotten and that is the biggest mistake any parent can make.
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