My Sister's Keeper

Control is at the core of the novel because Anna is seeking control over her own body through medical emancipation. However, Anna’s motive for seeking this petition isn’t as much about control as it is about fulfilling her purpose in life—giving Kate what she needs. While she does desire some bodily autonomy, she is mostly acting out of love for her sister (which, in itself, speaks to her parents’ hold over her, as her level of selflessness has been ingrained in her over 13 years). Yet, there are several characters whose desire for control is more apparent.

As a mother and a determined person, Sara needs to control Kate’s illness. Sara promised herself and Brian that she would not allow Kate to die when she was first diagnosed with APL. To fulfil this promise, Sara needs to control the disease and control the treatments used to put it in remission. For this reason, she visits a geneticist and arranges to become pregnant with an allogeneic donor for Kate. Sara then uses the possibility of Kate’s death to guilt Anna into making medical donations. Not once does Sara step back and ask Anna or Kate if they truly desire treatment. However, control over her daughters allows her to feel in control of an otherwise uncontrollable situation.

The Fitzgeralds’ eldest, Jesse, also desires control. He feels he has no control within his family, no control over whether or not Kate survives, and no control over the fleeting attention he gets from his parents. For this reason, Jesse begins lighting fires. The fires are something Jesse can control. He can choose when, where, and how these fires begin, and can watch them burn. This is Jesse’s way of getting his father’s attention—and working through his inability to help Kate as a non-genetic match, yet another uncontrollable situation.

Kate herself also desires control. When Sara tells Kate and Anna that Kate’s kidney failure has progressed to the point where she will likely need a transplant, Kate is overwhelmed with the possibility of going through another procedure. Kate has already been through a great deal of pain, especially for someone her age. She doesn’t want the transplant, but knows her mother will not listen to her plea. For this reason, Kate takes control by convincing Anna to find a way to stop being her donor. Kate needs to control something in her life, even if it’s her own death.

Anna’s lawyer Campbell, too, desires control. Campbell has a seizure disorder with no known cause and no known cure. When he has a seizure, he loses complete control of his own body. The only control he is able to achieve is through the help of his service dog, Judge, and fabricated stories about his disorder. It is this need for control over his own body that compels Campbell to take Anna’s case, as he sympathizes with her plight.

While most of the characters desire control, it can be argued that none of them achieve it through their original means. Sara can never truly control Kate’s illness, despite it being in remission at the end of the novel. Jesse’s fires only give him a fleeting sense of control, but eventually garner his father’s attention. Kate doesn’t get to choose whether or not she receives Anna’s kidney, but the result of the transplant gives her renewed health that allows her more freedom. Campbell continues to have seizures, but the revelation of his disorder wins him the heart of Julia, the woman he loves. In the end, no one truly gets what they want, but they get an outcome that allows them a path forward.