Please wait while we process your payment
If you don't see it, please check your spam folder. Sometimes it can end up there.
Don’t have an account?
Create Your Account
Sign up for your FREE 7-day trial
Already have an account? Log in
Choose Your Plan
$4.99/month + tax
$24.99/year + tax
Save over 50% with a SparkNotes PLUS Annual Plan!
for a group?
Get Annual Plans at a discount when you buy 2 or more!
$18.74 /subscription + tax
Subtotal $37.48 + tax
on 2-49 accounts
on 50-99 accounts
Want 100 or more?
for a customized plan.
You'll be billed after your free trial ends.
7-Day Free Trial
Renews December 5, 2023
November 28, 2023
Discounts (applied to next billing)
This is not a valid promo code.
(one code per order)
Annual Plan - Group Discount
SparkNotes Plus subscription is $4.99/month or $24.99/year as selected above. The free trial period is the first 7 days of your subscription. TO CANCEL YOUR SUBSCRIPTION AND AVOID BEING CHARGED, YOU MUST CANCEL BEFORE THE END OF THE FREE TRIAL PERIOD. You may cancel your subscription on your Subscription and Billing page or contact Customer Support at email@example.com. Your subscription will continue automatically once the free trial period is over. Free trial is available to new customers only.
For the next 7 days, you'll have access to awesome PLUS stuff like AP English test prep, No Fear Shakespeare translations and audio, a note-taking tool, personalized dashboard, & much more!
You’ve successfully purchased a group discount. Your group members can use the joining link below to redeem their group membership. You'll also receive an email with the link.
Members will be prompted to log in or create an account to redeem their group membership.
Thanks for creating a SparkNotes account! Continue to start your free trial.
Your PLUS subscription has expired
See discount terms and conditions.
Thirteen-year-old Anna Fitzgerald begins narrating the story, which will
continually alternate among different first-person narrators, in the present. She
talks about the different reasons babies come into being and admits that she was
born for a very specific purpose. Scientists used her mother’s eggs and father’s
sperm to create a specific combination of genes. They created her in this way so she
would be able to save her sister, Kate. Anna talks about visiting a pawnshop to sell
a locket. She has a difficult time parting from the locket because her father gave
it to her as a gift after she donated bone marrow to Kate. Anna goes on to describe
herself as skinny and a freak. She talks about her family, how her sister Kate has
leukemia, and how she has had to undergo medical procedures to help Kate whenever
Kate has gotten sick. Her mother, meanwhile, obsessively shops online, and her older
brother, Jesse, behaves like a delinquent because their parents don’t have time to
care about him.
Anna shows Jesse a newspaper clipping about a lawyer named Campbell Alexander.
Jesse warns her not to mess with the system and the roles everyone in the family
has, but he still agrees to drive her to Campbell’s office. Anna meets Campbell and
notices he has a service dog, which Campbell sarcastically tells Anna prevents him
from getting too close to magnets, because he has an iron lung. Campbell tries to
send Anna away, and she explains that she wants Campbell to help her sue her parents
for the right to her own body.
Campbell gives his account of his meeting with Anna. He talks with her about
her case and notices how angry she seems. He agrees to represent her because he
thinks the case will be easy to win and great publicity. He doesn’t think they will
even need to go to trial, because Anna’s parents will give in before that. Anna
leaves after Campbell tells her he will file a petition in family court for her
medical emancipation. Campbell’s assistant, Kerri, expresses her shock that Campbell
is representing Anna. She wonders where Anna will live during the trial, but
Campbell hasn’t thought about it. Campbell’s dog, Judge, pushes against him,
apparently alerting Campbell to something. Campbell goes back into his office and
locks the door.
Sara’s narration jumps back in time to 1990. While bathing Kate and Jesse,
Sara talks to Brian, her husband and a career firefighter, and she recalls her
decision to give up her career as an attorney to become a stay-at-home mother. Sara
notices a bruise on two-year-old Kate’s shoulder blade. The next morning, bruises
have spread up and down Kate’s spine. Sara takes Kate to the hospital where Kate
undergoes a series of tests. The hospital refers Sara to an oncologist who, after
further tests, diagnoses Kate with acute promyelocytic leukemia (APL), a rare and
aggressive form of blood cancer. The doctor tells Sara and Brian that APL has a
twenty to thirty percent survival rate and they should begin treating Kate
immediately. At home Sara and Brian deal with the fallout of the diagnosis and the
realization that their daughter may not survive. Sara refuses to let Kate
In the present day again, Brian Fitzgerald describes a fire at a medical
school. The fire started because a body got stuck in the cremation incinerator. He
turns the story to earlier that night, while he ate dinner with his family. Kate
upsets Sara because she wears a t-shirt with a picture of a crab and the word
“Cancer” across it. Jesse walks in reeking of pot. Finally Anna arrives, and Brian
immediately notices something is wrong. Anna remains quiet and withdrawn through the
meal, and she does not have her locket on. She leaves the table without saying a
word. After dinner, Brian and Sara discuss their daughters. Sara talks about Kate,
but Brian worries about Anna. Sara mentions that she has to take Kate to dialysis
the next day. Later that night, Anna visits Brian at the station. She doesn’t want
to talk, but together they watch the stars from the station’s roof.
The epigraph, Carl Sandburg’s poem “Kin,” sets up the symbol of fire and the
theme of kinship, both of which will continue throughout the novel. In the poem, the
speaker says he will warm his brother, wrap him up, use him, and change him, in the
same way that fire warms the kindling as it envelops and ultimately burns it, using
it up and changing it. The poem talks about kinship’s nurturing, destructive, and
transformative powers, all of which the reader will see in the relationships within
the Fitzgerald family. This complex dynamic describes Anna’s and Kate’s relationship
in particular. Anna’s role as a donor to Kate uses her up, emotionally and
physically to a degree, even as it sustains Kate. Anna instigates the lawsuit
because she no longer wants to play this role.
Much of the section describes the Fitzgerald’s family life, as seen from the
perspectives of different members of the family. In Anna’s view, the family revolves
around Kate. Anna even wonders if she would exist if not for Kate’s leukemia. She
also recognizes that much of Sara’s and Jesse’s behavior, specifically Sara’s
obsessive shopping and Jesse’s self-destructive tendencies, stem from their
inability to deal with the fact that Kate may die and they can do nothing to stop
it. Brian appears to be the only character capable of considering each member of the
family individually instead of in relation to Kate. Only Brian notices when Anna
doesn’t eat dinner and keeps quiet, for instance. When Brian speaks to Sara later
that evening, Sara seems concerned only about Kate, specifically whether she looked
healthy or not, and apparently hasn’t even noticed Anna’s unusual
The fact that Sara begins her narration in the past—aside from providing the
reader with the family’s back story—reveals a great deal about her character. Sara
starts her narration at Kate’s diagnosis with leukemia because Kate’s cancer served
as the major turning point in Sara’s life. From then on, Sara’s life has centered on
keeping Kate alive at any cost. Upon learning Kate’s treatment options, for example,
Sara ignores all the discouraging statistics and latches on to any hope of Kate
surviving. Sara’s desire to save her daughter comes across less as a choice and more
as a primal urge. Discussing the topic with Brian, she sounds determined, even angry
at times, but never despondent. After Kate’s diagnosis, when Brian and Sara lie in
bed together, Brian breaks down into tears, while Sara says aloud that she will not
let Kate die.
From his narration, Campbell initially comes across as the stereotype of the
slick lawyer, with a fancy office and bristling, annoyed demeanor. But two facts
suggest that his narrative doesn’t give the reader a complete picture of him. First,
he evidently doesn’t want to explain why he needs a service dog. Though he doesn’t
give Anna (or the reader) any real information about Judge, Campbell does reveal
that, if nothing else, he has a secret he would like to keep, suggesting some
vulnerability he wants to hide. Second, Campbell chooses to take on Anna’s case even
though he apparently thinks he shouldn’t. He compares the decision to coming to a
fork in the road where one path is clearly wrong and choosing that path anyway.
These actions hint at some deeper motivations of Campbell’s that remain