I don't know what I was expecting from this book, other than I knew it was popular and the premise sounded interesting. It is not really the kind of thing I normally read, but I liked it more or less.
My Sister's Keeper is about a 13 year old girl, Anna, who was conceived using Preimplantation Genetic Diagnosis to be a donor match for her sister, who has had leukemia since age two. The book is mostly about Anna's legal attempt to get medical emancipation from her parents, because she claims they are failing to make decisions based on her best interest. She is frustrated because her entire life has been defined by donating marrow and other bits of her body to her sister.
The book is written from several perspectives including that of Anna, her delinquent brother, each of her parents, and others involved in her case. The tone and voice for each is all pretty much the same, and the stories of the point of view characters are too intertwined for this to be a really effective narration style, in my opinion. Plus, they change the font for different characters. Distracting much?
The book does not add much-needed depth to Anna or her family. They all seem pretty much one-dimensional, with the possible exception of her mother who vacillates between incredibly callous and mean to a perfectly normal sounding mother. Other characters' personalities are not very well fleshed out. I think writing from the perspective of a 13 year old must be remarkably challenging. Picoult fails by making her sound alternately like an incredibly thoughtful adult and really, really juvenile.
All of the characters go back and forth between the present-day trial to random reflections on their past. There are countless recollections from Anna and her brother that boil down to something like "when I was 10 my parents forgot about me because all they care about is my sister's leukemia." Or something. It was annoying when things were actually happening in the book to be switching between the present and past and between characters. It made it seem like Picoult was being paid by the word. Or maybe by the analogy. The characters all provided enough cheesy analogies and shallow metaphors that the only reasonable explanation is Picoult got paid a bonus for each one!
Considering the premise of the book, one gaping hole was the lack of any explanation of the relationship between Anna and her sister. It was almost never mentioned, except "Kate wouldn't let me choose the music we listened to" type complaints from Anna. After finishing the book, I feel like their relationship was left out in an attempt to mislead the reader about the nature of the relationship, leading up to a pair of remarkably contrived twists towards the end of the book.
One of those twists is pretty much the biggest trope of a way to end a story ever. I don't want to completely give it away, but it sucks. The ending of this book sucks balls.
This book was frustrating in several ways but what ultimately redeems it is its study of modern medicine's morality and the contradictions and conundrums it can cause. I am sure there are better fiction and nonfiction takes on this issue, but this books has its own perspective that adds some value. It definitely has me thinking about depressing things like leukemia and organ donation!