See, unlike the rest of the free world, I didn’t get here by accident. And if your parents have you for a reason then that reason better exist. Because once it’s gone, so are you.

Anna’s statement, which appears in her narration on the first Monday, refers to the way Anna’s parents conceived her. When Anna says she “didn’t get here by accident,” she means that her parents deliberately selected her, or rather the embryo that would become her, for a specific reason. They needed a genetic match to act as Kate’s donor in order to keep Kate alive, and the doctors told them that the best way to find such a match was essentially to create one. As a result, Anna was born. Anna, however, feels that her only purpose, in the eyes of her parents’ anyway, is to serve as Kate’s donor. She says that if your reason for existing disappears, so will you. In other words, if something were to happen and Kate were to die, Anna suggests her parents would no longer need or want her.

These feelings motivate a great deal of Anna’s actions throughout the novel. Although Anna may have filed the lawsuit at Kate’s behest, Anna still admits that having Kate die would be one of the best things that could happen to her. If that were to occur, Anna’s life would no longer depend on Kate’s, allowing Anna to live independently for the first time. Situations such as Sara forcing Anna to leave her friend’s birthday party early so she could take Anna to the hospital would no longer occur. Kate even says if she were to die Anna would be able to do all the things she ever wanted, such as going to hockey camp.