My Sister's Keeper

Campbell visits the firehouse to speak to Brian. Brian tells Campbell that he thinks Anna shouldn’t be forced to donate a kidney and agrees to testify to that fact. That same day, Brian and his crew respond to an ambulance call for a young woman who is unconscious. When they arrive, it is clear that the woman is suffering a drug overdose, even though her boyfriend insists she is only drunk. Brian loses control and yells at the boyfriend, prompting his coworker to suggest he take time off. He refuses because he would rather work than watch Kate grow sicker.

The novel cuts to the past. Sara and Brian rush Anna to the hospital because she fell off her bike and cut her head. Kate expresses pleasure in being the one in the waiting room instead of the patient. Not long after, Kate experiences a clinical relapse that begins with anal hemorrhaging. Dr. Harrison Chance recommends a bone marrow transplant. Sara struggles to get information from the insurance company regarding coverage of the transplant, only to learn that they will only pay 10 percent of the cost because they want Kate to undergo a donor lymphocyte transfusion first. Sara and Brian go forward with the preparation, with Anna undergoing growth factor shots to increase her bone marrow production. On the day Kate is hospitalized to prepare for the bone marrow transplant, Zanne attempts to give Sara and Brian 100,000 dollars to cover the medical costs, but Brian insists that his fellow firefighters have raised the money for the procedure.

Sara stays with Kate as she goes through the painful procedure of induction that is designed to kill her immune system so it will not fight the bone marrow transplant. The former is well known among the nurses, and they often try to ease her burden when they can. When the day of Anna’s procedure arrives, Sara walks Anna into the operating room and stays with her until she is put under anesthesia. When the procedure is over, Anna is in pain and asks for her mother. Sara is torn between being with Anna and being with Kate. She goes to Anna and intimidates a nurse into giving her daughter stronger painkillers, arriving in the room just as Brian puts a locket around Anna’s neck (the one she sells in Part 1, Chapter 1). Later, when the doctors prepare Kate’s transplant, Anna is allowed to watch.

When Kate begins to respond to the transplant three weeks later, Brian takes Sara out to dinner where they struggle to talk about anything other than Kate. A few weeks later, Kate is released from the hospital. At home, everyone wears masks to protect Kate. One afternoon, Sara finds a letter from the bank revealing that Brian has emptied a mutual fund earmarked for Kate’s college fund. When she asks him about it, he admits that his fellow firefighters were only able to raise 10,000 dollars. He had to use this money and the money from the mutual fund to put a down payment on what they owe the hospital. Sara and Brian are forced to take on a payment plan.

As Kate recovers, she refuses to go out in public because her hair hasn’t grown back and she doesn’t like how she looks. To make her feel better, Sara shaves her own head and then shaves Anna’s head. They go to the mall and feel inspired.

Jesse steals a dump truck left on the side of the road by a road crew. He drives to Duracell Dan’s to pick up his arson bag. Duracell Dan is so taken with the dump truck that Jesse invites him along for the ride. They go to a boathouse that Jesse lights on fire. Duracell Dan begins to cry and tells Jesse a homeless man named Rat lives in the shed. Jesse goes inside and pulls the homeless man out before running away as sirens approach.

The novel cuts to the past, as Jesse remembers when he was 11 and given a skateboard by his parents out of guilt, due to them spending so much time with Kate in the hospital; his father promised to take the family to a local school so Jesse could try out skateboard tricks. However, on the day in question, Kate got a nosebleed. Angry, Jesse walked all the way downtown where he was picked up by police and later picked up from the police station by his father.

Anna is in Kate’s hospital room with Kate and Sara when Dr. Harrison Chance comes by and shares that Kate will likely die within the next week. Sara turns to Anna, asking her again to drop her petition; Anna leaves the room. At the firehouse, Anna talks to Julia again. She tells Julia about Kyle McFee, a boy she went to the movies with. After the movie, Kyle had an erection and Anna asks Julia if she is a pervert for staring at it and struggling to forget about it. Julia asks if she has anyone she can speak to about sex, and Anna says “no”. Anna thinks about the family pictures in their home and how there are pictures of Kate and Jesse throughout the years, but only a few of Anna—and how this seems to imply she’s invisible except when Kate needs something. Later that night, Sara calls to wish Anna good night. Anna goes to the roof to study the stars with her father.

Brian goes to the hospital and tells Sara that he is going to testify on Anna’s behalf on Monday. Sara points out what will happen if Brian does, but he admits that he no longer believes that Kate will get better.

The novel cuts to the past. Anna asks for money to buy hockey gear because she wants to play goalie for a local team. Sara and Brian agree. On the day of Anna’s first game, Kate refuses to go because of a leukemia-related rash on her face. Sara convinces her to go by covering her with a hat and scarf. Everyone is proud of Anna’s performance.

Kate begins hemorrhaging in the middle of the night. Dr. Harrison Chance recommends a new treatment that uses arsenic to treat relapse. Brian doesn’t believe it’s a good choice and tries to convince Sara to take Kate home and allow her to die in her own bed. Sara refuses, insisting the arsenic will work. After 11 days, Kate slips into a coma. About this time, Jesse is expelled from school for using a chemical from the science lab to blow up the school’s septic tank. Jesse blames his actions on the stress of Kate’s situation. Sara throws his words back at him, expressing her frustration at Kate’s situation too. When Sara notices a bruise on Jesse’s arm, she questions him about it and learns he donated platelets to Kate.

A few days later, Sara takes a day to rest at home. Anna comes in with a letter inviting her to hockey camp, but Sara insists she cannot leave home in case Kate needs her. A few days later, Kate develops a fever. Dr. Chance tells the family to say their goodbyes to Kate. The children say goodbye, with Anna promising to never go anywhere. Soon, Kate responds to her treatment.

Campbell calls Anna and Brian into his office because Sara wants to talk. Sara promises to put an end to Anna’s future donations if she agrees to the kidney transplant, but Anna refuses.

Julia is in her apartment with her sister when Campbell stops by. Campbell asks Julia to go to dinner with him so they can discuss Sara’s plea bargain, and Julia agrees. They go to a marina where he gets her to take off her shoes and walk barefoot in the grass. They board a sailboat and have dinner on the deck. They discuss Anna, but Julia is careful not to hint at what she plans to tell Judge DeSalvo. Campbell and Julia kiss.