A film review by Craig J. Koban

MY SISTER'S KEEPER

2009, PG-13, 108 mins.

Sara: Cameron Diaz / Anna: Abigail Breslin / Campbell: Alec Baldwin / Brian: Jason Patric / Kate: Sofia Vassilieva / Judge: Joan Cusack / Jesse: Evan Ellingson

Directed by Nick Cassavetes / Written by Jeremy Leven and Cassavetes, based on the novel by Jodi Picoult

“Most babies are accidents.  Not me.  I was engineered.  Born to save my sister's life.”

- Anna (Abigail Breslin) in MY SISTER'S KEEPER

When is it acceptable for a parent to risk the health of one child for the sake of saving the life of their other?  

That is the gutsy, disturbing, but unavoidably fascinating arc to Nick Cassavetes’ adaptation of Jodi Picoult’s 2004 novel, MY SISTER’S KEEPER.  At face value, it would be deceptively easy to label this as a “cancer victim” melodrama, but the film dwells on such unthinkable moral conundrums that it sort of defies such lazy descriptors.  To be sure, the film is a masterfully manipulative tearjerker, but at its core it's a work with challenging questions about medical ethics and how they have the power to undermine the family unit as the whole.  Few dramas are as uniquely moving and thought provoking as MY SISTER’S KEEPER:  It aims to tug at our collective heartstrings - and it certainly does so - but the film never condescends by shamelessly wallowing in nauseating, stomach churning sentimentality.  On the contrary, it confronts viewers with difficult themes more than most similar low-rent, TV-movie-of-the-week terminal illness dramas.

Cassavetes – son to actress Gena Rowlands and director John Cassavetes – is no stranger to making effective weepy melodrama.  His THE NOTEBOOK from 2004 was one of the finest Kleenex grabbing romance dramas of its kind and he definitely is attempting to elicit the same sort of intangible emotional anchor in MY SISTER’S KEEPER.  Yet, as efficient as THE NOTEBOOK was his new film goes a bit further than just trying to attain a strong emotional wallop.  The film is gloomy, depressing, and there were certainly few dry eyes in the cinema when the final credits rolled by, but Cassavetes is a sharp enough director to understand how to find a nice dichotomy between making a poignant, tear-inducing family drama and an intriguing courtroom and medical parable.  Both elements never overtly override the other, nor do they struggle to unite together: MY SISTER’S KEEPER is so involving for its penetrating issues, so heart-rending for its portrayal of family strife during the impending death of a loved one, and, as a result, it never feels like its copping out for petty, soap opera payoffs. 

The film also contains thanklessly assured and confident performances, and at the center of it is Abigail Breslin, a sublimely affectionate and natural screen presence that I think has the goods to become the next Jodie Foster.  In the film she arguably plays her most demanding and taxing roles as Anna Fitzgerald, a young girl who was brought into the world under the most unusually and dubious of circumstances.  Her mother, Sara (Cameron Diaz, in her most rancorous and empowered, but vulnerable and sincere, performance) and father, Brian (a quietly strong and charismatic Jason Patrick) have essentially placed their lives on hold in order to nurture her older sister, Kate (an astonishingly genuine Sofia Vassilieva).  Kate was lucky to make it past the age of five: when she was two years old she was diagnosed with acute promyelocytic leukemia, which certainly is a death mark.  Sara was forced to quit her law practice to tend to Kate’s every need 24/7 while Brian became the soul breadwinner of the family as a fireman.  A dreadful day comes when the couple’s family doctor informs them that they are not genetically compatible to be a life-saving donor for Kate.  Just when hopes of saving their dying daughter seem slim to none, the doctor – off the record – informs them that the only way to help secure a donor for Kate would be in the form of genetically creating a new child that could essentially cater to Kate's dire medical needs. 

To ensure a genetic match, Anna was created via invitro fertilization and she became a medical guinea pig the instant she was born into the world.  Her umbilical cord blood was used to assist Kate to recover, but when that served only as a short-term fix, the parents then decided to put the then-infant Anna through a serious of agonizing and emotional debilitating surgeries to ensure that Kate would survive.  Anna would later - mostly against her will and often only as a result of several doctors holding her down - be poked and prodded for more blood and even bone marrow.  A normal childhood existence is a dream world for her, seeing as she essentially exists – and was created for – the soul purpose of ensuring that Kate survives her leukemia for as long as possible.  Despite the hellish ordeal of being in and out of hospitals and labs all of her young life, Anna and Kate have a resoundingly healthy relationship, which is a stirring testament to their inner resolve and strength. 

However, one fateful day places unwarranted stress on the relationship of the siblings and the family as a whole.  When Kate turns 13 she suddenly goes into renal failure and needs one of Anna’s kidneys if she has any hopes of living on through adolescence.   Anna’s mother and father have forced her all of her life to be a blood and marrow lab rat at the expense of her social life and normal development, so the thought of removing her kidney – which would have obvious ramifications on the rest of her life – is a pill that Anna chooses not to swallow.  Having more than enough of being a cure-all to her parents' needs, Anna decides that she will not, under any circumstance, assist them any further.  She then does what any other bright and determined young girl would do under the circumstances: 

She hires a lawyer and decides to sue her parents for medical emancipation. 

She takes her life savings of $700 and goes to the offices of a slick and razor sharp attorney named Campbell Alexander (Alec Baldwin, in yet another nuanced and terrifically focused supporting performance), who has ads and billboards all over the city that pontificates that he has a 90-plus-percentage success rate.  One of the film’s more fascinating angles is the relationship between this apparent hot-shot lawyer and the young girl:  Campbell may drive an extravagant car, wear finely tailored suits, and has built a somewhat shoddy reputation for being an ambulance chaser, but he is not a stereotypical slimeball lawyer that has placed Anna’s case within a moral vacuum.  He willingly takes her $700, which is a far cry from his usual fee, and he actually listens to and accepts Anna’s request for representation.  One of the hidden pleasures of MY SISTER’S KEEPER is the way Baldwin’s performance offers up a surprising bit of bait and switch: you expect him to embody this man with an obligatory emotional coldness and ruthlessly vile resolve, but he reveals compassion and decency for Anna and her plight (based largely from his own personal circumstances). 

Actually, MY SISTER’S KEEPER is a remarkably democratic film for how in hones in on most of the characters and gives them time to reveal their inner most thoughts.  The film’s plot is structured in the form of multiple flashbacks and multiple voice-overs provided by many of the film’s main cast.  This choice serves to allow them to shed light on Anna’ peculiar lawsuit against her parents, not to mention how Kate’s illness affects the family on a daily basis.  The screenplay, when it does not focus on the more obvious elements of Kate’s ordeal with struggling with leukemia and Anna’s deeply troubling court case against her parents, manages to take segues into subplots that have their own heartfelt resonation.  One of the film’s most touching – and ultimately heartbreaking – stories revolves around Kate’s blossoming relationship with another fellow cancer sufferer (played in a nurturing and caring performance by Thomas Dekker) and how this allows for some semblance of normalcy to enter into her rather abnormal life.  The film has what could have been one of those painfully routine and clichéd moments when Kate comes down the stairs in a prom gown much to the amazement of her parents and new boyfriend (she is to attend a hospital prom for cancer patients).  Well, when she does descend down the stairs her transformation from a terminal ill girl and into a figure of beauty – albeit with some cosmetic augmentations to hide her cancer symptoms – is an unreservedly tender moment.  Her ensuring courtship with the boy emerges as one of 2009’s most genuine, authentic, and melancholic romances. 

The film also strays largely away from clichés in the handling of another small, but key figure in the family’s battle with Anna.  There is the unmistakably brilliant Joan Cusack giving one of her most serenely riveting performances as the judge that presides over Anna’s case.  Her participation in it becomes all the more impossible for the woman seeing as she has just recently gone through a painful family tragedy with her own child, which is revealed in one of the film’s most honest and candid dialogue exchanges between her and Anna.  Considering the judge’s recent past, it would be easy to see how she could have little compassion for helping Anna in refusing to assist her sister in saving her young life, but the judge also has the foresight to perceive that there is also a quality of life dilemma for Anna if she were forced to participate in more medical procedures to help her sister.  Cusack gives an undeniably heartrending Oscar-worthy interpretation of this bereaved and emotionally damaged woman placed in an impractically difficult position.  Watch how effective she becomes in key scenes by revealing her pent up pains and sorrows with her just her eyes:  it’s a marvelous performance of quiet dignity and inner strength.

Then there are the very tricky roles of the parents, and Cameron Diaz – an actress I have been fond of criticizing in the past – who arguably has the toughest part to believably pull off as an ruthlessly uncompromising, tough-as-nails bitch that will stop at nothing – even Anna’s hopes for a normal life – to give Kate a sense of hope.  What’s really interesting is how Cassavetes and Diaz don’t paint this outwardly cruel and vindictive woman in broad, caricature-like strokes.  She clearly is a woman that will selfishly try anything to ensure Kate’s survival, and often her methods and actions are deplorable, but she's not a one-note monster.  Cassavetes balances her verbal tirades and unpardonable treatment of some of her children with moments that reveal her pain and utter emotional exhaustion with dealing with both Anna’s lawsuit and Kate’s worsening condition.  What Diaz is able to effectively modulate is how her mother figure is compelled to do the irrational when her love and commitment overrides rationale impulses.  The frequent voice of reason in all of this madness is Jason Patrick’s soulfully pragmatic and calmly vigilante father, who serves to contravene his wife’s insolence by acting as her conscience when it can’t speak for her.