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My Sister's Keeper by Jodi Picoult


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Discussion Questions (from Reading Group Guides.com)

1. One of this novel's strengths is the way it skillfully demonstrates the subjectivity people bring to their interactions with others. The motivations of individual characters, the emotions that pull them one way or another, and the personal feelings that they inject into professional situations becomes achingly clear as we explore many different viewpoints. For example, despite Julia and Campbell's attempts to remain calm, unemotional and businesslike when they deal with one another, the past keeps seeping in, clouding their interaction. The same goes for the interaction between Sara and Anna during the trial. Is there such a thing as an objective decision in the world of this story? Is anyone capable of being totally rational, or do emotions always come into play?

 

2. What do you think of this story's representation of the justice system? What was your opinion of the final outcome of the trial?

 

3. What is your opinion of Sara? With her life focused on saving Kate, she sometimes neglects her other children. Jesse is rapidly becoming a juvenile delinquent, and Anna is invisible -- a fact that the little girl knows only too well. What does this say about Sara's role as a mother? What would you have done in her shoes? Has she unwittingly forgotten Jesse and Anna, or do you think she has consciously chosen to neglect them -- either as an attempt to save a little energy for herself, or as some kind of punishment? Does Sara resent her other children for being healthy? Did you find yourself criticizing Sara, empathizing with her, or both?

 

4. During a conversation about Kate, Zanne tells Sara, "No one has to be a martyr 24/7." When she mistakenly hears the word "mother" not "martyr" and is corrected by Zanne, Sara smiles and asks, "Is there a difference?" In what ways does this moment provide insight into Sara's state of mind? Do you think it strange that she sees no difference between motherhood and martyrhood?

 

5. Campbell is certainly a fascinating character: guarded, intelligent, caring and yet selfish at the same time. Due to these seemingly contradictory traits, it can be difficult to figure him out. As he himself admits, "motivations are not what they seem to be." At one point he states, "Out of necessity -- medical and emotional -- I have gotten rather skilled at being an escape artist." Why do you think Campbell feels that he needs to hide his illness? Is it significant that Anna is the first to break down his barriers and hear the truth? Why, for example, does he flippantly dismiss all questions regarding Judge with sarcastic remarks?

 

6. At one point, Campbell thinks to himself: "There are two reasons not to tell the truth -- because lying will get you what you want, and because lying will keep someone from getting hurt." With this kind of thinking, Campbell gives himself an amazingly wide berth; he effectively frees himself from speaking any semblance of the truth as long as the lie will somehow benefit himself or anyone else. Did it concern you that a lawyer would express an opinion like this? Do you think, by the end of the story, that Campbell still thinks this moral flexibility is okay? In what ways might this kind of thinking actually wind up hurting Campbell?

 

7. It is interesting that Campbell suffers seizures that only his dog can foresee. How might this unique relationship mirror some of the relationships between humans in this novel? In what ways does Judge introduce important ideas about loyalty and instinct?

 

8. On page 149, Brian is talking to Julia about astronomy and says, "Dark matter has a gravitational effect on other objects. You can't see it, you can't feel it, but you can watch something being pulled in its direction." How is this symbolic of Kate's illness? What might be a possible reason for Brian's fascination with astronomy?

 

9. Near the end of the novel, Anna describes "Ifspeak" -- the language that all children know, but abandon as they grow older -- remarking that "Kids think with their brains cracked wide open; becoming an adult, I've decided, is only a slow sewing shut." Do you believe this to be true? What might children teach the adults in this novel? Which adults need lessons most?

 

10. "It's more like we're astronauts, each wearing a separate helmet, each sustained by our own source of air." This quote comes from Anna, as she and her parents sit in silence in the hospital cafeteria. Besides being a powerful image of the family members' isolation, this observation shows Anna to be one of the wisest, most perceptive characters in this novel. Discuss the alienation affecting these characters. While it is obvious that Anna's decision to sue her parents increases that sense of alienation throughout the novel (especially for Anna herself), do you think that she has permanently harmed the family dynamic?

 

11. During the trial, when Dr. Campbell takes the stand, he describes the rules by which the medical ethics committee, of which he is a part, rules their cases. Out of these six principles (autonomy, veracity, fidelity, beneficence, non-maleficence, and justice), which apply to Anna's lawsuit? Moreover, which of these should be applied to Anna's home situation? In other words, do you think a parent might have anything to learn from the guidelines that the doctors follow? Are there family ethics that ought to be put into place to ensure positive family dynamics? I so, what should they be?

 

12. Early in the legal proceedings, Anna makes a striking observation as she watches her mother slip back into her lawyer role, noting, "It is hard to believe that my mother used to do this for a living. She used to be someone else, once. I suppose we all were." Discuss the concept of change as it is presented in this story. While most of the characters seem to undergo a metamorphosis of sorts -- either emotionally or even physically (in the case of Kate), some seem more adept at it than others. Who do you think is ultimately the most capable of undergoing change and why?

 

13. Discuss the symbolic role that Jesse's pyromania plays in this novel, keeping in mind the following quote from Brian: "How does someone go from thinking that if he cannot rescue, he must destroy?" Why is it significant that Jesse has, in many respects, become the polar opposite of his father? But despite this, why is Jesse often finding himself in the reluctant hero position (saving Rat, delivering the baby at boot camp)? Brian himself comes to realize, in the scene where he confronts Jesse, that he and his son aren't so different. Talk about the traits that they share and the new understanding that they gain for each other by the end of the story.

 

14. My Sister's Keeper explores the moral, practical and emotional complications of putting one human being in pain or in danger for the well being of another. Discuss the different kinds of ethical problems that Anna, as the "designer baby," presents in this story? Did your view change as the story progressed? Why or why not? Has this novel changed any of your opinions about other conflicts in bioethics like stem cell research or genetically manipulated offspring?

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I've just started reading this today - I didn't realise it was another 1st person book till now, but so far I'm already enjoying the fact that I get to see the situation through various eyes as the story switches from one character to another, giving it from their point of view - it's a nice touch for a tricky subject. It also means I woun't get bogged down "being" a character that I don't like (as is sometimes the case with 1st person) which would make a nice change. :D

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It's all making me wonder what I'd do in the same position. I mean, I love my sister very much, but when we were teenagers, we absolutely hated each other. Would I have wanted, at that point, to help her of she'd been ill? Nowadays, my sister is one of my best friends & I know I would want to help, but I can't help thinking that if I weren't a match for something like this, I'd be secretly relieved that I didn't have to go through all those procedures. Of course, I'd feel incredibly guilty over that & would torment myself. To think of a 13-year-old going through that is really painful. The teen years are confusing enough without having that kind of stress on you.

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It's been a while since I read this, but I did enjoy the way it tackles the subject matter. It makes you think about the issues, without getting too 'heavy'. I remember getting quite involved in all the characters. I'm interested to see opinions on the ending, but that had best wait until everyone has finished!

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Here's a question though - what would you do in the same position. Would you have another child specifically to save your sick kid, even knowing that you'll be subjecting a healthy child to repeated hospital procedures? Not being a parent myself Im' interested in hearing people's views on this.

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I don't think anyone can ever say for sure until they're in that position. But, I don't think I would. I can see how it would be tempting if you were already planning on more, and you believed it would be a simple procedure only, such as taking a sample from the cord. However, this story shows how that can be just the beginning.

 

Even now I'm not sure how I would feel if Bethany was seriously ill, and Amy could help, but would have to undergo lots herself. Do you help one child, protect the other... it's all difficult stuff.

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I just cried in the cafe while reading Anna's revelation in court. My nose is all blobby & red, my eyes are watery & pink & I nearly didn't make it back to my desk frmo my coffee break - I almost just kept right on reading.

 

I am loving this book!

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Kell, there were so many times that this book reduced me to tears and believe me the ending knocks the wind out of your sails! I just could not put this book down - it is so beautifully and cleverly written - it is one of those rarely crafted books that you tend to remember forever, it has such impact. Although it is some time since I read it, the raw emotion of it is remembered clearly.

 

It has not changed my mind on 'designer ' babies as the burden on them is so great with the potential for rejection and failure. I don't think that I could do it.....

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Discussion Questions (from Reading Group Guides.com)

1. One of this novel's strengths is the way it skillfully demonstrates the subjectivity people bring to their interactions with others. The motivations of individual characters, the emotions that pull them one way or another, and the personal feelings that they inject into professional situations becomes achingly clear as we explore many different viewpoints. For example, despite Julia and Campbell's attempts to remain calm, unemotional and businesslike when they deal with one another, the past keeps seeping in, clouding their interaction. The same goes for the interaction between Sara and Anna during the trial. Is there such a thing as an objective decision in the world of this story? Is anyone capable of being totally rational, or do emotions always come into play?

I think that despte best intentions, no one could be truly rational or objective when making a decision like this. Although you would want to make the right one, because of the effects, someone will always technically lose.

 

2. What do you think of this story's representation of the justice system? What was your opinion of the final outcome of the trial?
I was very pleased with the outcome, because although she was only 13, I feel she was old enough to make this kind of decision for herself, afterall it was major surgery that would effect the way she lived after.

obviously not everyone at that age would be able to make those decisions sensibly, but I felt that Anna was.

 

3. What is your opinion of Sara? With her life focused on saving Kate, she sometimes neglects her other children. Jesse is rapidly becoming a juvenile delinquent, and Anna is invisible -- a fact that the little girl knows only too well. What does this say about Sara's role as a mother? What would you have done in her shoes? Has she unwittingly forgotten Jesse and Anna, or do you think she has consciously chosen to neglect them -- either as an attempt to save a little energy for herself, or as some kind of punishment? Does Sara resent her other children for being healthy? Did you find yourself criticizing Sara, empathizing with her, or both?

I think I critcized her throughout the whole book, as a mother of 3 children myself, spookliy they have the same age gap that Sara's kids had between them, I felt that she lived too much for Kate than was right. Not only was she neglecting her other 2 children but she, by her own actions, started up a small resentment bewteen the siblings.

I guess its easy enough to moan about her whilst my 3 are fine and healthy but I honestly do not think I could play around witht he health of one of my children to save the life of another. At least not in the way she did.

 

4. During a conversation about Kate, Zanne tells Sara, "No one has to be a martyr 24/7." When she mistakenly hears the word "mother" not "martyr" and is corrected by Zanne, Sara smiles and asks, "Is there a difference?" In what ways does this moment provide insight into Sara's state of mind? Do you think it strange that she sees no difference between motherhood and martyrhood?

In my opinion it shows that she believes she has almost sacrificed her life in having her children, but I think thats a wrong way to think. You don't have children without knowing that some things in your life will change dramatically, I go without so much too, so that I can be a good mother but I don't see it as a sacrifice afterall I wanted children and I knew what being a mother meant.

It actually made me angry at her for believing she is a martyr, how egotistical is that?

 

5. Campbell is certainly a fascinating character: guarded, intelligent, caring and yet selfish at the same time. Due to these seemingly contradictory traits, it can be difficult to figure him out. As he himself admits, "motivations are not what they seem to be." At one point he states, "Out of necessity -- medical and emotional -- I have gotten rather skilled at being an escape artist." Why do you think Campbell feels that he needs to hide his illness? Is it significant that Anna is the first to break down his barriers and hear the truth? Why, for example, does he flippantly dismiss all questions regarding Judge with sarcastic remarks?

When you have an illness or disability, I think that making jokes about it is a way of coping and letting people know that you don't need, or want pity.

Campbell was a brilliant character, and I think that his way of hiding it was due to the fact that he didn't want to be treated differently. In his mind if someone leaves him its because he's arrogant not because they can't handle his fits.

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14. My Sister's Keeper explores the moral, practical and emotional complications of putting one human being in pain or in danger for the well being of another.

 

I think for most parents, having one child going through a minor procedure, to save the life of his/her sibling would not be a major deal. The question is where should one stop. It is not easy. When you are in the hospital waiting room, watching the clock painfully and slowly moving, and thinking the most horrible thoughts, and then having the doctor come out with a sickening grave look on his face, telling you that your child is "definately not out of the woods yet", or "is facing a major ordeal", (let alone an incurable disease.) At that single moment, you would grab at whatever straw was offered to make it go away. I am sure that Sara would have preferred it, if she herself could be Kate's donor. In her opinion, she was sending one child in a burning house to get the other out, cause like that she had a chance of saving them both. I don't blame her totally. Either decision must be hard to carry around. On the other hand, in my opinion, the rescuer gets a prize,(not get to feel invisible) and only takes on the job if there is a relatively low risk to his own life. Whatever decision, it must be tough to get a good night's sleep in such situations.

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My apologies in advance for this because it is likely to be long. Through certain personal experiences of my own I've been able to relate to characters in this book and therefore have plenty to say. You have been warned :D (don't worry though, not all questions were answered ;) )

 

2. What do you think of this story's representation of the justice system?

 

I don't think you can fairly answer this question on the basis that for the purpose of this book, although the outcome was vital to the storyline, the 'how it got there' wasn't, in my personal opinion. A case like this would be so indepth, I don't you could judge the representation of the justice system based on this novel. I also don't believe that in a case like that the mother would have been able to have represented herself, I don't think they would have allowed it, however, I could be wrong.

 

What was your opinion of the final outcome of the trial?

 

I felt it was the fairest outcome. No outcome was going to be easy on any of the family, especially on the two family members opposing each other.

 

3. What is your opinion of Sara? With her life focused on saving Kate, she sometimes neglects her other children. Jesse is rapidly becoming a juvenile delinquent, and Anna is invisible -- a fact that the little girl knows only too well. What does this say about Sara's role as a mother? What would you have done in her shoes? Has she unwittingly forgotten Jesse and Anna, or do you think she has consciously chosen to neglect them -- either as an attempt to save a little energy for herself, or as some kind of punishment? Does Sara resent her other children for being healthy? Did you find yourself criticizing Sara, empathizing with her, or both?

 

I find this a very difficult question to answer as it stirred an awful lot of emotion within me. I will be honest and explain my reasons why. I have never had to go through what this family went through, not as a child or parent. I have, however, been through the feelings of neglect, invisibility etc caused by parents. I therefore was very much able to relate to both Jesse who acted out and Anna. My personal case, as I say was entirely different, and nothing to do with a health issue, nonetheless, as a child or a human being, these feelings are soul destroying. I found myself for the first part of the book, reliving some of the anger I felt towards my own parents as a result of the actions Sara was taking.

 

As I have grown older and wiser and with help from various quarters, I now see my own parents in a different way. I now see that they were doing the best they could in the situation they were in. By the end of this book, I felt myself empathising with Sara.

 

Like has been mentioned in this thread before, until you are in the situation yourself, there is no way of knowing how you would react and I'm sure Sara really didn't mean to 'neglect' the other two children. I also felt that it wasn't just two she was neglecting. The only reason Anna did what she did was because she was the one who had actually listened to Kate. On that basis, the mother neglected all three of her children as she never gave Kate the chance to put her own opinion across.

 

 

5. Campbell is certainly a fascinating character: guarded, intelligent, caring and yet selfish at the same time. Due to these seemingly contradictory traits, it can be difficult to figure him out. As he himself admits, "motivations are not what they seem to be." At one point he states, "Out of necessity -- medical and emotional -- I have gotten rather skilled at being an escape artist." Why do you think Campbell feels that he needs to hide his illness? Is it significant that Anna is the first to break down his barriers and hear the truth? Why, for example, does he flippantly dismiss all questions regarding Judge with sarcastic remarks?

 

I didn't view the answers regarding Judge sarcastic. I found them to be not only humerous but also a very common way of dealing with serious/terminal illness issues. It is a sad fact of nature that when you are in the company of someone like Kate or Campbell, once you are aware of their illnesses, you behave differently. You don't mean to but it happens. You can't help feel pity for them, you can't help wonder how YOU would feel in their situation. You often are scared to speak your mind through fear of upsetting the situation or making them worse. Those people have already accepted their situation, it is part of their life and something they have to live with day in, day out. Avoiding discussing it can often be worse than just speaking openly. Watching someone avoiding it is not an easy thing to do. By masking the illness by humour, Campbell, Kate and the young lad she was involved with were sparing not only others, but themselves the discomfort of that situation. This is my personal opinion. They don't want pity and they also don't want to be treated as 'different'.

 

I've never had such a serious illness, but when I suffered my breakdown, there was only one person out of a vast variety of friends and relatives who would actually sit and talk to me about it without skirting the issue or avoiding it entirely. I always loved speaking with that person because believe it or not, it made me feel normal. The others, god bless them, treated me with kid gloves which made me feel like a freak to be honest.

 

 

9. Near the end of the novel, Anna describes "Ifspeak" -- the language that all children know, but abandon as they grow older -- remarking that "Kids think with their brains cracked wide open; becoming an adult, I've decided, is only a slow sewing shut." Do you believe this to be true? What might children teach the adults in this novel? Which adults need lessons most?

 

I believe that society conditioning strips humans of alot of their best qualities as they grow from children to adults. It was only yesterday I was discussing just this with a group of people. As a child, you didn't really suffer stress. If you had anger, you stomped your foot or screamed. If you hurt, you cried. If you were happy, you laughed even when there was apparently no reason. I agree with Anna's 'slow sewing shut' theory totally. As an adult you lose the ability to speak your mind and be totally honest to yourself and about situations as you see them because you are conditioned that it is the wrong thing to do. Don't get me wrong, I don't expect to see adults stop in the street and stomp their feet having a tantrum but at least do it in your home. Be honest with those you have contact with, don't hide behind a wall of fear because you are scared the person you are speaking with will think badly of you. These are things I have to tell myself daily, I'm a nightmare for them. I'm always honest with people but the guilt I feel after is horrendous if I've hurt them with my honesty. My policy now is, if you haven't reviewed ALL the possible 'what if' answers to that question and aren't prepared for any of them to be given to you, then don't ask the question :roll:

 

I personally feel fantastic reverting back to child tactics. I'm happy to stand in my own home (or my friends or families to be honest) and stomp my foot if I don't get my own way. Yes, they laugh at me as well as with me but it DOES relieve stress and trust me, that stuff weights a frickin tonne!!!. I'd rather be shot of it and if one stomp of a foot is all it takes then I'm there lmao

 

The main thing I feel this novel teaches adults, however, is about not just hearing but 'listening' because there is a world of difference. Had Sara listened to Kate rather than just hearing, Anna may not have felt the need to revert to such drastic measures. Obviously, there is no guarantee of this though. There are no rights or wrongs when dealing with emotions and that's exactly what this case was, a rollercoaster of emotions.

 

12. Early in the legal proceedings, Anna makes a striking observation as she watches her mother slip back into her lawyer role, noting, "It is hard to believe that my mother used to do this for a living. She used to be someone else, once. I suppose we all were." Discuss the concept of change as it is presented in this story. While most of the characters seem to undergo a metamorphosis of sorts -- either emotionally or even physically (in the case of Kate), some seem more adept at it than others. Who do you think is ultimately the most capable of undergoing change and why?

For me, I think this comes down to what I believe was the most powerful part in the book. A crossword question is asked, a 4 letter word for vessel and Anna replies 'Anna'. Incidentally, this was one part I bawled at too, it wrenched me.

 

I think because of age, change in legal circumstances, ability to understand properly, due to growing, what is happening, Anna had the most capability of change. In order to do that though, she needed to do what she did. By taking her parents to court, not only did Kates wishes finally sink in but Anna was able to give herself more self worth. I think the 'vessel' line in the book was the most thought provoking for me. To be so young, to know you were born to provide for another, to have desires of your own unmet, to feel invisible, more importantly to 'feel' like a vessel, something had to change. Only Anna could have done this as the only time it would have stopped would have been when Kate had died.

 

 

14. My Sister's Keeper explores the moral, practical and emotional complications of putting one human being in pain or in danger for the well being of another. Discuss the different kinds of ethical problems that Anna, as the "designer baby," presents in this story? Did your view change as the story progressed? Why or why not? Has this novel changed any of your opinions about other conflicts in bioethics like stem cell research or genetically manipulated offspring?

 

I didn't really have an opinion on this subject before reading this book quite simply as it is something I have never had to deal with before. I'm ashamed to say that, as there have been cases in the news etc about it but that's the pure truth of the matter. I also didn't know what platelets were or how much trauma a leukemia sufferer has to go through. It has been an education that's for sure!!

 

I can totally understand why Sara and Brian opted for another child to help Kate in the way they did. I'm not a mother but I do know that mothers will generally do anything in their powers to protect their children. I think research into this subject is a positive thing personally. There is no such thing as bad learning in my opinion and the more 'we' know about things, the better. There may come a day where during that research they find a way of preventing or curing some of our most horrendous diseases worldwide, so keep at it I say.

 

HOWEVER.......I think that before entering a situation like Sara and Brian did, they should have received counselling of some kind to prepare them for what was to happen. Having a child merely to benefit another (as lets face it, they did) for the mere use of the part they throw away at birth was one thing. To take it as far as they did should have been discussed at the beginning. There HAS to be a cut off point and to me, it was obvious they would use Anna's blood/bone marrow as she was an identical genetic match and it was obvious at some point that Kate would need it.

 

There was a part in the book that mentioned that if cutting off Annas head to save Kate was an option, would it have been considered. This was treated with disdain as a question but I didn't flinch as I read it because as the book had progressed all I kept thinking was 'for gods sake, when will this stop!'.

 

There was no doubt Anna was more than willing to be there for Kate, but she was a human being too and the parents should have been MADE to see that from the start.

 

 

 

So, that's my opinion on the subject in general. Long winded, some of you no doubt have quit half way through, can't say I blame you cos when I ramble I ramble but I had a lot of opinions on this book and I just love to share *giggles*.

 

 

One thing I will add though, the ending sucked :typing: And I don't mean that as in it was a weak or lame ending I just mean jeeeez...after all that :lol: My heart felt like it was breaking as soon as they got that car door open and the dog came out. I just knew from that moment that was it and sobbed the rest of the way through. How tragic. How terrible. How sad. How like life.

 

Thank you Jodi for a wonderful read.

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One other thing I have to mention is, I feel Kate did not put her point across as forecefully as she could have done. She sort of let her mother take all decisions for her.

I think perhaps a large part of what Kte was going through was guilt - guilt that she was ill & making her parents worry, guilt that she was putting her sister through all those medical procedures, guilt that she was getting the attention rather than her siblings, guilt that she wasn't getting better no matter what everyone did for her. Guilt that despite Anna only being brought into the equation to keep Kate alive, she no longer wants to be kept in limbo, negating her own sister's existence.

 

In that kind of situation, I don't think she wanted to add to the baggage guilt for putting her entire family through a courtroom drama. Remember, she didn't telll her parents she wanted to die - only Anna - the only one who would actually benefit from her death. It was an offloading of guilt to her sister.

 

That kind of pressure, I think, would render me almost incapable of doing anything against my parents' wishes when I knew that they think they had my best interests at heart. The only person she could trust with this was Anna herself - & she wanted her sister to be able to become herself, thus releiving some of the burden of guilt on her shoulders.

 

I have no idea if any of that made sense.

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Yes, but that would make Anna to be the "heartless" one in people's eyes.....(Even though I still would not call her that) Anna is the one who does not want to help......and who is not going help her sister live. And Kate is older than Anna, so should be more mature....at that age, even a year makes a difference.

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Not heartless at all - Anna is the very heart of the story in every way - not only is she the focus of the story, she is the one who actually listens to Kate & tries to help her by doing the only thing she can - refuse to have surgery.. Kate, I think, has been kept in an unrealistically coddled way; wrapped in cotton wool by her parents & unused to doing things on her own (shown very well in her "date" with the lad in the hospital - by that age, I'd had countless boyfriends,) but she has been kept away from having a normal life & therefore the normal rules of "older sister" don't really apply here. In this case, it's the younger sister forced into the role of older sister - Anna always having to look out for Kate, instead of the other way round.

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  • 3 weeks later...

There was a point brought up at The Posh Club last night that I wonder if anyone here picked up on (I didn't, but when it was mentioned it was like an "oh yeah!" moment - LOL!). All the way through, there was chapters narrated frmo every character's point of view - except Kate's. She's the only one who doesn't get to tell her side of the story, which kind of mirrors what the story's about in the first place - that nobody's listening to what SHE wants.

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Actually, thinking about it, it seems like nobody in that family is actually talking to or listening to anyone else in the family. nobody knows how anyone's feelnig & it's all just taken as given that they all feel teh same about what's happening. It's interestnig to see how even basic communication falls by the wayside when something like this hapens to a family.

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