‘She is dying Sara. She will die, either tonight or tomorrow or maybe a year from now if we’re really lucky. You heard what Dr. Chance said. Arsenic’s not a cure. It just postpones what’s coming.’
My eyes fill with tears. ‘But I love her,’ I say, because that is reason enough.

Sara and Brian have this exchange in Sara’s narration during The Weekend chapter, and it takes place in 2001, when Kate relapses and goes into system failure. The quote illustrates the different views Brian and Sara take of Kate’s cancer. Brian recognizes that Kate’s leukemia is fatal and that, even if they provide treatment, that treatment may only prolong Kate’s life without curing her. Sara, on the other hand, cannot accept the possibility that Kate may die. On the contrary, she feels determined to fight endlessly to keep Kate alive. This mindset motivates Sara to try any treatment on Kate, even those that require Anna as a donor, so long as it may aid Kate’s survival.

This quotation additionally brings up the ethical question of quality of life versus sanctity of life. In this moment, Brian and Sara each represent a different side. Brian knows that the treatments Kate has endured for her leukemia, such as radiation and chemotherapy, have harsh side effects. Though these treatments may extend Kate’s life, they cause her a great deal of suffering. In Brian’s view, the quality of Kate’s life may have deteriorated so much that the better option appears to be to allow Kate to die. Sara’s main priority, however, is keeping Kate alive. Sara obviously does not want Kate to suffer, but she feels the positive aspects of Kate’s survival, primarily her continuing to be present in the family, outweigh the negative aspects, such as the side effects of the treatments she must undergo.