Paradoxically, this was both an easy and difficult read. Easy, because it's a page-turner. The 400 odd pages read quickly, were well-paced, completely engrossing, featured good dialogue and has a strong narrative flow as it switched through different first person points of view with each chapter. Told in present tense, there's often a lyricism to the prose. Picoult knows how to tell a story and set up an excruciating ethical dilemma. The difficult part? Well, this deals with a girl, Kate, with life-threatening leukemia--and with her younger sister, Anna, who was a "designer baby" deliberately conceived to save her sister's life when her older brother Jesse wasn't a bone marrow match. It was hard reading about what these children go through.
I remember a real life case where a child was conceived that way for such a purpose. I remember mentally brushing aside the ethical concerns raised. As the mother of that baby said, it wasn't as if her new son wouldn't be loved, and what's one donation from an umbilical cord you won't miss set in the balance with a life? But in this case, the thirteen-year-old Anna doesn't seem to have a life or purpose other than being Kate's savior, has undergone several major medical procedures from early childhood on her sister's behalf without her consultation, and her family takes it for granted she'll stay in her destined role and cheerfully give up a kidney. Then Anna gets a lawyer and sues for medical emancipation. And thus the entire family begins to unravel.
It says a lot for Picoult that everyone in the family gains my sympathy when with most there's a reason for reader dislike. I saw at least one reviewer who was outraged a child would defy her family, and I can imagine many who'd consider Anna selfish for demanding her life belongs to her rather than continue sacrificing it for her sister. Jesse is a "lost cause" juvenile delinquent acting in dangerous ways for attenion. Given reviews, I know many hated the mother Sara with a passion, but I felt for her. She's not a monster--she does love Anna. It's not so much she chooses Kate over the others as that she's always putting out fires when it comes to her leukemia so to Sara the problems of her other children are something to take care of--later. I also have to give Picoult points for restraint--this is the kind of story it would be too easy to make cloyingly sentimental or shrilly melodramatic.
I do have problems though that keep me from giving this high marks. The prose style is strong, but the voices aren't. Everyone sounds too much alike, and Anna isn't convincing to me as a thirteen year old, even granting her experiences made her mature beyond her years. She acts adolescent enough, but her voice in her chapters, her inner life, doesn't to me. I also really hated the subplot with the romantic angst and history between Anna's lawyer Campbell Alexander and her guardian ad litem Julia Romano--both of whom seem like walking cliches and I'd have preferred the focus stayed on the family. (At the same time, I admit part of why I kept turning the pages is I did want to learn why they broke up years ago and the mystery surrounding Campbell's dog.) Several reviewers said they hated the ending--I felt conflicted about it. Too deus ex machina, too much of a cop out. On the other hand, given the arc of Sara's mother, it does make some emotional sense.
