Interview with Jodi Picoult

Jodi Picoult admits that her notoriously controversial books shouldn't sell. After all, she hand-picks incendiary topics such as the death penalty, organ harvest, and date rape, and she routinely drops her characters into gut-wrenching moral dilemmas. Despite the heavy material, Picoult's books, including My Sister's Keeper, which is also an upcoming film starring Cameron Diaz, are perennial favorites on bestseller lists. Her newest book, Handle With Care, wades into the legal quagmire of wrongful birth lawsuits, in which parents declare under oath that they wish their disabled children had never been born. Picoult talked with Goodreads about the challenges of juggling motherhood and a full-time writing career.

Goodreads: What inspired you to write about a wrongful birth lawsuit?

Jodi Picoult: One morning in a New York hotel, I read this article in The New York Times Magazine about a woman who had sued for wrongful birth, and I had this immediate, knee-jerk reaction: "Oh my God, who would ever sue for wrongful birth? That's disgusting." I really didn't know a lot about the topic, but as I started to read this article I realized that this is such an amazing issue. It takes one of the big, knockdown, drag 'em out controversies in this country, which is abortion rights, and it takes it one step further. It is not even talking about abortion rights; it's asking, beyond that, who gets to decide what makes a valuable life? To me, that is a really interesting question, and it just seemed like the biggest, hottest mess.

We know it's contentious, because you're not allowed to sue for wrongful birth in all the states in America. The premise behind these cases is that the OB/GYNs (who have been sued in wrongful birth cases) should have told their patients, "You're going to have a disabled child." What's amazing is that in some cases the disability is a genetic malformation that has never even been diagnosed before—so there's no way they could have possibly diagnosed it—but juries tend to find in favor of the defendant just simply out of sheer heartbreak. Even more interesting is that the parents who do this all stand up in court and say, "I wish my child had never been born." That's what you have to agree to do if you're going to sue for wrongful birth. But not a single one of them really feels that way. They all say, "Yeah, yeah, I'm totally lying." They're fine with that!

Our health care system is a nightmare, our legal system is a nightmare, and we're considered to be very litigious. How did we get here? I don't know the answer to that, but I do think it's worth addressing as a problem. Issue #1 is the fact that you've got parents who desperately love their disabled children, but can't figure out how to give them all the medical attention and the quality of life that they want their children to have—because it costs too much. And issue #2, whose fault is that? Who has to pay? Should it be the OB/GYN? Should it be the health care system? Who's making all the money? Is it the insurance companies? Because the doctors aren't making money anymore. In many cases, the physicians become the fall guys in wrongful birth suits.

Then you have the added conundrum of whether or not the personal opinions of a physician enter into even their unconscious communication with patients. For example, if you assume that the patient is Catholic, would you not even bring up the option of terminating a pregnancy? You assume they wouldn't do it, which should not happen if you really are an ethical physician. At what point do you counsel termination when you know a child will be disabled? That's a really fuzzy line, because what is a valuable life to one person is not a valuable life to somebody else. What buys happiness? What would really make these parents happy? Would happiness be knowing that you won a payout? A jury gave you millions of dollars to take care of your child. Or does it really make a difference? Because at some point you probably will die before your child, and they're going to be left having to take care of themselves—even with that money. Does money really solve all the problems? I would argue that is not always the case. All of these issues and all of the moral muddiness of it really attracted me to it as a topic.

GR: How did you settle on OI?

JP: There are a lot of people who shy away from discussing disability and people with disabilities. That's the hidden side of Handle With Care. We tend, in our culture, to reduce people to their disability. That's a mistake that a lot of us make. One of the coolest things I did was spend a great deal of time with kids who have osteogenesis imperfecta (Brittle Bone Disease) and their families. I saw how they live, what they have to struggle through on a daily basis, what they fear, what they hope for, and most of all, what these kids are like. They're great! They're wonderful little kids. The reason I picked this particular disability is that a kid who has OI is going to have a really hard physical existence. There's a lot of pain, surgery, and accommodations that need to be made as they grow up. But mentally, they are 100% with you. And maybe even smarter than you, because a lot of the kids who can't play on the playground are sitting at home on Wikipedia or reading a book. So they are really bright little children, and that makes it even harder to say that this child shouldn't have a life.

GR: Did you consider other disorders? Perhaps something less rare, such as autism?

JP: I narrowed in on OI for a lot of reasons, and it happened pretty quickly. In most cases, the parents who sue for wrongful birth do it because their children are severely disabled with mental retardation. Kids who tend to be at the center of wrongful birth suits are not just physically disabled, but also don't have mental development beyond that of a six-month-old or a one-year-old, no matter how old they get. I really wanted that conundrum of a mother saying, "I wish you'd never been born," and having her child be fully able to understand what she was saying. That, to me, was a much more interesting scenario. So I was looking specifically for a disability that was a physical disability that really was hard enough to make it the subject of a wrongful birth suit, but also allowed for mental normality or excellence.

It's fun for me too to highlight some kind of disability that a lot of people might have heard about, but don't really know much about. I like raising awareness, so if it does anything to make people more aware of what it's like to have osteogenesis imperfecta, that's great. Maybe the next time you do run across a kid in a wheelchair, you won't look away, maybe you'll engage them in conversation. That's hopefully a byproduct of the book.

GR: How did you go about your research with the families and medical experts?

JP: Family research involved going onsite to their homes and following these kids around during the day. A lot of what you see Willow endure during physical therapy came from their lives. Also, a lot of the reflections and fears that Charlotte has about being a capable mother came from the mouths of the moms.

In addition, I spent a lot of time with OB/GYNs—not just for Piper's character, but also to understand what it's like to be sued, how debilitating it can be to wind up with a malpractice suit on your desk. Most of the people I spoke to had, at some point in their careers, faced a malpractice suit, which is why their medical insurance is so high. To know how it affects you on a personal level. That was a really interesting lesson for me. We think of doctors as being incredibly competent all the time, but something like that can really rattle you to your core and make it hard to get back up on the horse again.

I also spent a lot of time with a pediatric radiologist to talk about what you actually could conclusively determine from X-rays and sonograms in utero for OI. The reason this was a perfect disease for this book is that there really is no hard and fast test that says, "This baby is going to be born, stillborn, or dead five minutes after birth. Or this baby will be a Type III instead of a Type II." You don't always know for sure until the baby gets here. The criteria are pretty murky, so a lot of it is open to judgment.

GR: The book touches on the question of what makes a good mother. As the mother of three children, how did your own views on motherhood influence the story?

JP: It definitely informs my books. The things I write about are often chosen because I am a mom, and I'm thinking about these issues. In the book that I'm editing right now, this woman is second guessing herself as a mom, and one of the things that comes across is that if you are second guessing yourself, you're probably a better mother than you think because you're worried about it. That's the paradox of being a mother: You never feel like you're doing a good enough job, but the fact that you're feeling that probably means you're doing a better job than you believe you are.

I am really lucky; I have three incredible kids who are all unbelievably different from each other. We have always been really open in our family; we talk about everything. They know they can come to me if they have a problem, and they do. It also trickles down from my books. We talk about the hard things because I write about the hard things. When my daughter was eight years old, we would discuss rape at the dinner table. I'm not going to shy away from that stuff; I'd rather she know about it than not know about it.

The problem I have sometimes is that I write moms who are not necessarily the same kind of parent I am. I think of Charlotte as too single-minded. I get the mama bear thing—she is willing to do anything for Willow—but I would like to believe that if I were in her shoes, I would not have so grossly abandoned Amelia. And yet, I can say that because I am not in her shoes. Until you experience that kind of situation, you really don't know how you're going to react. There's a lot of My Sister's Keeper in Handle With Care. I know there will be comparisons made, because there is a family with a sick child and the family unit unravels. Although Sara and Charlotte are really different people, they both make the mistake of focusing only on that sick child and excluding the other people around them. In some scenarios, you can look at that and say, "Wow, what a good mom. She's willing to give up her whole life for this child who is sick." But on the other hand, you can look at the same situation from a different angle and say, "This is a horrible mother." This assessment is certainly in the eye of the beholder.

GR: You yourself have dealt with having a sick child. Your middle child was diagnosed at age five with cholesteatoma, a very rare incidence of tumors in both ears.

JP: Yes, a lot more of that came out in My Sister's Keeper than in Handle With Care. It was a lot more recent when I was writing My Sister's Keeper, and to some extent, the concept of a child with cancer who has to go in and out of hospitals—a child who is sometimes perfectly normal and sometimes needs to have an operation or some kind of treatment—that was more what my life was like with my son, Jake. There were times that were absolutely great; we'd go for six months, and then all of a sudden the whole world would come crashing down. That felt a lot like what was going on in My Sister's Keeper, although nothing I experienced with my son (thanks goodness) was anywhere near as life threatening as what the Fitzgerald family experienced. Handle With Care has a slightly different scenario. You're not worried every day about Willow dying; you're worrying about how she lives. It is a slightly different spin, but it does change the way you parent and the dynamic for the family. There is no one in that family who won't say they love Willow for who she is, because she's an amazing little kid. But there's also nobody in that family who wouldn't say, "But I wish she'd been born healthy."

GR: Even though it may have changed who she was.

JP: Yes. And that's a really interesting point too. One of the women I interviewed for OI is not a child, but an incredible woman in her twenties. She is getting her Ph.D. in psychology, works with body image in disabled girls, is a Paralympian who competed in swimming for the United States, and is planning her wedding. She is the coolest woman. She has Type III OI, just like Willow, although she is totally wheel chair bound. One of the things she said to me was, "Everyone assumes that OI would be the punch line to all of the horrible things that have happened in my life." She explained that maybe that's true, but it is also the reason that all the good things happened. OI doesn't happen just to a person; it happens to the whole family, so the unity that develops around that is one of the really positive silver linings. Sometimes having a child with a disability can bring a family closer together and can lead you toward life experiences that you wouldn't have had otherwise. Is the disability negative or positive? She probably wouldn't have been an Olympic athlete, but she was a Paralympian.

GR: Did you visit the set of My Sister's Keeper? It has an all-star cast with Cameron Diaz, Abigail Breslin, Alec Baldwin and Joan Cusack. What has the process been like?

JP: Filming is totally done. As far as I know, they are currently scoring it. It will come out in theaters on June 26. I really cannot tell you anything else, because I know nothing! I did visit the set twice, and I got to see some of the acting, which was phenomenal. I have not seen the finished product. I was made aware early on that it is not going to be exactly like the book, which is one of the reasons I was tossed off the set. [laughter] They have changed the ending. It is unfortunate, but it is certainly their prerogative. I think they are going to wind up with a great movie with really wonderful acting that follows the book extremely closely for most of the story. It differs at the end. I want those fans who are incredibly devoted to My Sister's Keeper (and I've met many of them) to still see the movie. I can't wait to see the movie! I think they'll enjoy it. If they feel that there's a discrepancy, they should just go home and pick up the book and read the last 20 pages. Hollywood very often makes changes to books, and we readers wonder, "Why on earth would they do that?" But they're not thinking of readers very often.

GR: Your first book was published in 1992. In what ways have you changed as a writer since then? Have certain challenges become easier, others harder? How do you continue to challenge yourself?

JP: The way I challenge myself is by writing something that really engages me, that doesn't have an easy answer, and isn't always an easy book to write. For me, every book is a journey—questioning a really difficult topic that most people don't want to talk about, much less write about. And that's what I need; that works for me as a writer. It makes me excited to get to my computer. I don't write the same book over and over—I think if I did that, I would stop writing. I couldn't write a series with the same character, and I couldn't write a romance novel over and over again that takes place at a different beach every year. That's not who I am. There's plenty of room for all kinds of stories and all kinds of readers. The most wonderful thing is that, if you're a reader, you'll always have something to pick up. For me, I think keeping it fresh and finding the stories that I am interested in, instead of simply writing what I think would sell well. The things I write about are not things that should sell at all, so I am really lucky. They're hard: [sarcastic tone] "Oh yeah, I'm going on vacation and taking a book about a school shooting. Yay!" That's not usually what happens. But I'm so fortunate, because I've been doing this since 1992, and at this point, I have the most devoted and loyal following. I could probably type up my grocery list and they'd all want to read it. I love that they're willing to let me go wherever I need to go as an author, and they're happy to come along for the ride as the reader. There are not a lot of writers who have either that flexibility and freedom, or that fan base. So I am incredibly, eternally grateful to all of the readers who keep coming back.

GR: What are you working on next?

JP: The book that I have currently on my desk is coming out in 2010. It doesn't have a title; I'm going back and forth between a couple right now. It is the story of Jacob, an 18-year-old boy with Asperger's syndrome, who like many kids with Asperger's (which is a high-functioning autism), has a real special passion for one particular subject. His is crime scene analysis and forensics. He knows everything about it, but if you try to hold a conversation with him, he's totally clueless because social skills are where he falls apart. He can't connect socially. He has a social skills tutor who winds up being found dead, and he is accused of murder. What makes it really cool is that it's a legal story about what it means to go through the American legal system if you don't communicate a certain way. Our system of justice works really well for a lot of people, but not if you communicate in a way that the courts do not support. For example, one of the first things you might notice about someone with autism is that they won't look you in the eye, appear to not be listening, they will repeat things you say to them, but they won't always answer your questions, they may flap nervously. To a cop, that looks like guilt. To a mom of a kid with autism, it looks like her son. So that becomes the central focus of the book.

GR: So are you writing from his perspective, in the voice of a person with Asperger's?

JP: I am writing from everyone's perspective. Jacob, his mother, his brother Theo, who does not have Asperger's, their lawyer, and the detective on the case. I will say I have an absolute blast writing in the voice of this kid with Asperger's—what a great character. I spent a lot of time with kids who have Asperger's at schools for autism. They are incredible kids, absolutely fascinating. And yet, what makes it such a slippery disorder is that these are kids who look totally normal, who can in certain situations act totally normal, and then who might, because there is a fluorescent light in the store, have an utter breakdown and go completely to pieces. It is fascinating to see what sets them off, why it sets them off, and how do you combat that. Also, how you can make your client sympathetic for a jury, although all he's going to want to talk about is the death scene and what it looked like. And it looks a little macabre, unless you understand why he is functioning the way he is. I'm really enjoying it!

GR: Describe a typical day spent writing. Do you have any unusual writing habits?

JP: I usually get up at about 5 AM. I go for a walk with a friend of mine; we do a three-mile loop and gossip the whole way. And then I come back, take a shower, get the kids off to school and come up to my computer. By about 7:30 in the morning, I'm answering fan mail. I answer every letter by myself; I don't have assistants. I've got nothing. It's just me. When I finish that, which usually takes about a half an hour to 45 minutes, I pull up whatever it is that I was working on and read through it, editing as I go, and then I'll just keep writing when I get to the end. Or if I'm doing what I'm doing today, which is editing, I'm going through it literally line by line and making changes. Then at about 3:30 PM, my kids come home from school, and I turn back into a mom, and I drive places and go to school meetings and make dinner and do all that other good stuff.

GR: So you've managed to write a book a year within the hours that your kids are at school. Do you consider yourself extremely disciplined?

JP: It has gotten a lot easier—now my kids are in school 8 hours a day. When they were little, they weren't. I have to be disciplined, because there's nobody here cracking a whip. So I have to be the one to say, "It's a work day. I may not be feeling particularly inspired, but I have to be here, and I have to find it within me to work." That's probably the biggest difference between the people who make it in this industry and the people who don't: the ones who are able to recognize that even if you love it, it's a job versus the ones who sit and wait for inspiration to strike. There is a big difference between those two mindsets. If it's a writing day, I am going to sit down and write.

GR: Who are some of your influences?

JP: The first book that I really remember inspiring me was Gone with the Wind, which I read when I was about twelve years old. I used to act out the parts of both Rhett and Scarlett, which is probably why I did not have a boyfriend until I was fifteen. I loved it because she had created an entire world made out of words. I completely bought into the fiction. I thought I could do that—never really expecting that I would do that—but that's the first book I remember really leaving an impression on me.

Another person who really changed my life is my mentor, Mary Morris, a teacher at Princeton. She's a fantastic writer, but I had not read her until I met her. She truly taught me everything I know. I wouldn't be doing this today if it weren't for her, because she really forced me to figure out what my voice was and how I could present it. I'm still friendly with her, and she's still just a fantastic person.

The writer who has probably inspired me the most as a reader has been Alice Hoffman. I love her writing. She was the first book I picked up when I left college—it was not just something I was reading for a course. Now I read all of her stuff. She makes writing seem very fluid and easy, and no matter how good you are, it is never fluid or easy. I am captivated by her magical realism, by her sense of character, and by her descriptions of love. I used to mention her whenever I was asked, "Who is your favorite author?" She must have thought I was stalking her. Finally, I got to meet her, and she's exactly what you want when you fall in love with a book. She is a really great person. You want the writer to be as great as the book, and she is. We're friends now, we exchange emails, we have breakfast together, it is almost too much! Definitely one of the perks of my writing career.

GR: What are you reading now? What are some of your favorite books and authors?

JP: My favorite book of Alice Hoffman's is Turtle Moon, but I loved The Probable Future, Second Nature. She's just a beautiful writer.

Then there are books here and there that I read and I think, "Oh, I wish I'd done that." The Life of Pi is a great example of that. That book blew me away. And The Time Traveler's Wife.

I am reading a galley right now—I read a lot of stuff before it's on the shelves, which is really frustrating to other readers. There was a book that came out a few years ago by Michelle Wildgen called You're Not You. She has a new book coming out: I think it's called A Little Light.