Adapted from Jodi Picoult's 2004 novel, My Sister's Keeper is the story of the Fitzpatricks, a family defined and consumed by the leukemia that has plagued teenager Kate since the age of two. Sara, Kate's mom, has devoted her life to saving her child, giving up her career as a lawyer early on in the process.  Brian, Kate's firefighter dad, is a strong and loving presence, despite the fact that he is often rendered speechless by his own emotion and the force of his wife's fierce determination. Evan, Kate's older brother, is lost and aimless, often overlooked in the ongoing crisis management that demands his family's focus. And Anna, Kate's younger sister, is an 11-year-old kid resigned to needles and operations and the knowledge that she was deliberately engineered to be an ideal donor match for her sick sibling.

In the opening scenes of the movie, we learn that Kate's cancer has once again roared back out of remission, and that, worse, her kidneys are failing in the aftermath of thousands of treatments. We also discover that Anna is expected to donate one of her own perfectly compatible kidneys, and that she has secretly retained the services of an attorney to fight for "medical emancipation"—the right make decisions about her own body. The stage is set for drama of the courtroom, medical and familial variety, and My Sister's Keeper delivers it all relentlessly. Will Anna give in? Will Kate die? Will Sara's myopic (and completely understandable) fight to save one child destroy another one (or two) in the process? Will anyone notice Jesse isn't doing very well? Will Sara and Brian's marriage finally crumble under the terrible burden of their circumstances?

Cameron Diaz as Sara, Sofia Vassilieva as Kate

Cameron Diaz as Sara, Sofia Vassilieva as Kate

Some people are afraid of spiders, some of heights, but every person who has a child is afraid of the word "cancer." Director Nick Cassavetes (who showed his willingness to assault tear ducts with The Notebook) exploits this primal, universal fear shamelessly, showing us heartbreaking details of Kate's diagnosis and illness in a series of no-holds-barred flashbacks. It's all crushingly sad, and—thanks to uniformly effective acting—moving. Audiences will care desperately about Kate's physical and Anna's emotional survival. But simultaneously, they may find themselves suspicious of the film itself and annoyed by its blatant manipulations.

The problem lies chiefly in the transition from novel to screenplay. Cassavetes and co-writer Jeremy Leven do their best to retain the multi-character perspective that makes the book so well rounded, but something gets lost in adaptation. The decision to have each of the main characters provide voiceovers burdens the film with a talky, exposition-heavy clunkiness, and frequent dissolves, narration and montages (particularly in the first third of the movie) create an unwanted aura of artificiality. Further contributing to the sense of contrivance are the "happy" scenes scattered throughout, like the extended back-yard bubble-blowing sequence in which everyone laughs in slow motion while a poignant pop song plays. I imagine that in the face of imminent death, the highs would be intensified just as much as the lows, but the Fitzgeralds' spurts of family bliss in the midst of a tense court battle stretch the limits of credibility.

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Abigail Breslin as Anna

Abigail Breslin as Anna

This is not to say that everything in My Sister's Keeper feels contrived. There are many genuine and genuinely beautiful moments, thanks in no small part to the caliber of the actors. Cameron Diaz proves more than capable of handling an uncharacteristically dramatic role, while Jason Patric quietly anchors some of the films' most effective scenes with understated gravitas. Abigail Breslin is reliably strong in the role of Anna, but it is newcomer Sofia Vassilieva who will really turn heads with her devastatingly winsome portrayal of Kate. Alec Baldwin is appropriately slick as Anna's headline grabbing lawyer, but he never becomes a caricature. And Joan Cusack is outstanding in the role of a judge still in the throes of grief over the loss of her own daughter.

With a compelling premise and terrific acting on the one hand, and problematic screenplay adaptation and direction on the other, My Sister's Keeper is a sometimes maddening mix of authentic and inauthentic moments. The subplot of Kate's romance with a fellow cancer patient named Taylor (Thomas Dekker) is a case in point. In the novel, Kate is 16; in the film she is 14. In the novel, Kate and Taylor's relationship culminates in a kiss; in the film they are sexually intimate. Both Dekker and Vassilieva are note-perfect in their portrayal of love blossoming in intensifying conditions. But the casting is problematic: Dekker appears to be so much older than Vassilieva that there is something unintentionally disquieting about their relationship. They wring aching pathos out of their scenes together (and Patric is breathtaking in his portrayal of a conflicted dad watching his fragile daughter embark on her first real date), but the whole plot is marred by slight misfires in screenplay and casting. The frustration of seeing something so close to brilliance just miss the mark is provoked repeatedly by various aspects of the film.

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Jason Patric as Sara's husband Brian

Jason Patric as Sara's husband Brian

Still, contrived or not, sad is sad, and My Sister's Keeper will have all but the most cement-hearted reaching for tissue. And the film aims to be more than a tearjerker, raising hot-button issues like the ethics of genetic engineering and the right to death with dignity. Here again, the movie falls a bit short of its potential, dabbling in Big Ideas mostly as devices to move the plot forward. An ending significantly altered from the novel leaves viewers with some fairly generic conclusions about death being a part of life and some vague notions about the hope of an afterlife. Audiences will be relieved to be thrown a bone of hope after so much sadness, but irritated by the nagging awareness that there could have been—should have been—more.

Talk About It

Discussion starters
  1. Sara and Brian decided to do whatever it took to try to save their daughter, including genetically engineering another baby. Do you agree with their original decision? Would you make the same choice? Why or why not?

  2. Stem cell engineering often involves the creation of several fetuses, with the intention of using only one. Do you feel this practice is morally acceptable? Why or why not?

  3. Anna concludes: "There's no reason for it, I guess—death's just death—nobody understands it." Compare her conclusions with Ecclesiastes 3:1-8, 1 Thessalonians 4:13-18, and Philippians 1:21-23. Which take on death do you most resonate with? Why?

  4. Kate's New Age relatives offer her mind-over-matter advice even on her deathbed. Do you know what to say when you visit someone who is sick? What is the best way to approach someone who is suffering? (See Proverbs 25:20.)

The Family Corner

For parents to consider

My Sister's Keeper is rated PG-13 for mature thematic content, some disturbing images, sensuality, language, and brief teen smoking. There is liberal use of strong language, including several instances of cursing with God's name. The effects and complications of cancer are portrayed graphically (for example, Kate is shown more than once vomiting blood) in a manner inappropriate for child viewing. Teen sex is implied, teen smoking is briefly shown.

My Sister's Keeper
Our Rating
3 Stars - Good
Average Rating
(9 user ratings)ADD YOURSHelp
Mpaa Rating
PG-13 (for mature thematic content, some disturbing images, sensuality, language, and brief teen smoking)
Directed By
Nick Cassavetes
Run Time
1 hour 49 minutes
Cameron Diaz, Abigail Breslin, Alec Baldwin
Theatre Release
June 26, 2009 by New Line Cinema
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