If you haven't read the book it's about a girl (Kate) with leukemia whose parents had a second genetically matched child (Anna) to help with blood and bone marrow to save their first daughter. As the girls grow up, more and more is required of Anna until she's had enough of being nothing but an organ donor.
There are a lot of interesting points in the book, like what do you do when you have to pick one child over another, how do you balance your time and love between children especially when one requires more from you, and at what age can you be responsible enough to make choices about your own body instead of letting your parents word go as law. Even at a young age, a child's sense of self and decision making should always be respected. Even a three-year-old should be asked, not even such catastrophic questions as do you want to donate blood, but would you like to give your teddy bear away. If a child even considers emancipation, then you have crossed the line. Use your persuasion skills with children, not force or games.
When you read a second book by an author it's easier to pay attention to the writing style and not get so carried away with the story. Her techniques were a distraction from the story. Picoult is very good at doing research to get statistics on paper, but that's all her characters feel like it. None of these characters had a real breathing personality. They were just stereotypes of what she wanted to portray and therefore not very deep. Even the little memories of the girl's childhood felt like stock photographs set to these vague lives. Throw in a politically correct tendency to add variety to your characters with random stereotypes and I enjoyed the story more for the case study it could be then the story it was.
The character I enjoyed the most in the book was Jesse, the older brother who had fallen off the deep end in an attempt to get his parent's attention and still went unnoticed. I liked the quiet things he set about doing to help his sisters. Although I did not find him very well developed, I liked the father, Brian, too. I think he truly did love both his daughters and wanted to set out to do good by both of them. Even though Sara kept saying she loved both her daughters, I failed to find the evidence. All I got was a brazen woman who bullied everyone, especially Anna, into saving the only daughter she did care about. I found her completely unsympathetic, even the chapters written in her perspective, especially then. When she told Anna she couldn't go to hockey camp because she had to be around in case Kate when into relapse, I was disgusted. Yes a sick child would take up more time and emotion, but not to the exclusion of other children. How hard is it to yank Anna out of camp if necessary? Picoult wanted to show a woman who loved both her daughters but had to make tough decisions in order to keep both of them alive, but it fell flat. She tried to credit her with too many contradictory emotions and never fully justified her behavior.
I wasn't satisfied with the family dynamics. I found the emotional neglect completely at odds with the scenes of a loving huggy family Picoult threw in to convince us that it was a good family with good intentions. Sara and Anna constantly saying they loved each other just didn't jive with the way Sara treated Anna. I could not picture this child on the verge of growing up wrapped up in her mother's arms when she's being scolded and manipulated by that very woman. But if I found Sara a hard character to pin down, I found Anna even more elusive. Again, too many contradictory motives that just didn't make sense. I got why Anna and Kate loved each other, but I didn't get why the rest of the family did. I think the idea of the story was a good concept, but I think it was under developed.
I found the twist at the end unnecessary. I keep asking myself it is the most tragically beautiful ending and I'm not sure it is. Even though I get the point of it, I think I would have rather had a resolution that required a decision, a choice. I liked what Kate said at the end that Anna took her place and how it showed how much of a shadow she was, but it felt a little like a cop out. I want to know what Anna would have done and how her parents would have reacted if she said no or how belittled she would have felt had she said yes.