Looking at ‘My Sister’s Keeper’ and dead serious issues

Nov 10th, 2009 | By | Category: Book Reviews, Commentary, Opinions, Reviews

by Mike Courson

Every so often, I find a book that absolutely moves me. Unfortunately, Jodi Picoult’s “My Sister’s Keeper” failed to do that. Still, I read the 430 or so pages in four days, so surely that means something.

Of course, this book was made into a major motion picture. Another book of this sort comes to mind: I have read/listened to most of the Nicholas Sparks books. While the puffy non-reality of said books is bothersome, it is fun to drive deserted roads and act out the scenes with more realistic dialogue. Anyway, I did finish “The Notebook” in one sitting, the only book that make that claim, but the movie was terribly disappointing.Sisterskeeper

I am no book critic, but Picoult’s book starts with a great premise: a young girl wants to take control of her body at the cost of denying her sick sister a chance at a healthy kidney.

As I am not a book critic, I will stay mostly away from critic-type thoughts. Briefly, though, I hated all the little quips. Just coming off Maugham’s “Of Human Bondage,” I like long, thoughtful paragraphs. So many contemporary authors put in little quips of this and that to draw out the characters or make something relevant. It seems like weak writing to me, and it’s made all the worse when a 13-year old is the one having these profound thoughts.

Most of the characters seem pretty cliché: the attractive, self-centered attorney; his overly attractive love interest; a brother who lashes out criminally to garner attention. The book changes viewpoints frequently, yet the writing styles do not change much from a 13-year girl to a high-level attorney.

Then there is the ending. Honestly, I did not see it coming. I will not be a spoiler, but I thought the last few pieces of story really brought down the entire book. There are about three things that all seem better fit for filling pages with twist ending than for the rest of the story.

Regardless, I do like the book for one reason: it makes us think about death. I cannot give too many details regarding the book without being a spoiler, so I will use generalities.

A few weeks ago, Newsweek’s cover story was about killing granny. It was a poor choice of words, but got your attention. The article was a response to the idea of death panels and health care rationing.

In college, I learned of the Nancy Cruzan case and subsequently read the book “Long Goodbye: The Deaths of Nancy Cruzan.” Already a believer in right-to-die, this book cemented my ideals. Years after she finally died, Terri Schiavo’s case was put into the spotlight in a similar set of circumstances. She died in 2005, after being declared brain-dead in 1990.

Picoult’s book reraises these issues though not in the same manner. A young girl has had many bouts of life-threatening illnesses by the age of 16, and a battle ensues to determine how far her family can go to attempt to save her life. All the while, I am thinking maybe death is the best answer.

I consider myself a thoughtful humanitarian, but it seems like this is a late-20th century problem. Prior to that, a child plagued with these illnesses would have died early on. Obviously there are cons with that, but I think there are pros as well. For one, that child’s suffering would be limited. The child would not have to battle years of terrible illness just so the parents could avoid death. She could die in relative peace, and the family could move on as well.

This is precisely what the Newsweek article was about. We don’t want anyone to die, especially when we have the means to keep them alive. But think about that: with today’s technology, we could virtually keep someone “alive” infinitely. Schiavo had no brain waves for 15 years. Her body was kept “alive” by a breathing machine and nurses who probably could have helped someone else. This could have continued for decades longer. Who among us really wants to exist and cause so much difficulty for others? A paraplegic can still communicate and such. In other words, he can still offer a reward for his existence. A brain dead body offers nothing. To be kept alive by machine merely means those who make that decision do not have to deal with death.

All this life may be killing the world. This planet was not made to sustain so many billions of people and their wants, needs, and byproducts. That a fundamentally destructive gene mutation or illness can live long enough to reproduce goes against millions of years of evolution. It is not a pleasant thought, but the greater reality is this: people die. Perhaps it is not in our best interest to live beyond life expectancies, suffering through illness but remaining alive because of technology. Likewise, it is sad, but maybe some babies should not be strung along by science for years. Who benefits from this other than the families who cannot handle death?

This is not to say I am entirely pro-death. What about the 30-year old in a car accident. Sure, save him (assuming he’s not brain dead). At all costs if necessary. An accident is not the same as an illness. An accident victim can recuperate and get better. A terminally ill patient merely struggles.

Obviously, this is a tough topic. I’ve had family and friends with serious illnesses (cancer, leukemia, etc). One person had leukemia as a child and fully recovered. A friend from college had cancer and battled for a couple years before dying recently. In both these cases, I cannot argue against treatment. The leukemia was beat. A rational adult made the decision to fight his cancer, and he was able to live a great life while doing so. But what if the leukemia came back, in a rare form (I am no doctor, but in Picoult’s book, this is the case, and the medical problems are never ending…use that example)? The child in this book never did lead a normal life. And what if my friend had been reduced to endless pain and immobility from the beginning? What if he’d wanted to give up? What if it were a child who did not have control over his own care in that same situation?

I’ve long believed there should be a certain dignity in death. If a person wants to fight it, so be it. But that same right should exist to those who don’t want to fight. The problem arises when the young or old are the sick ones, and decisions are being made for them. Like society, it seems Picoult, despite hundreds of pages of medical jargon and emotional scenes, wasn’t quite ready to face the realities of this heavy topic.

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  1. Just a correction: Schiavo had a PEG “feeding tube”.

    12 hours/day liquid nutrient solution was transferred via an IVAC infusion pump directly to her stomach.

    She breathed on her own normally, but did required repeated hospitalizations for pneumonia.

    It is likely she needed respiratory support at those times, however health care privacy laws are now so strict that we only know a small fraction of the medical treatment she received (only what was publicly revealed in litigation)