Handle with Care

Starred review from December 15, 2008
Perennial bestseller Picoult (Change of Heart
) delivers another engrossing family drama, spiced with her trademark blend of medicine, law and love. Charlotte and Sean O'Keefe's daughter, Willow, was born with brittle bone disease, a condition that requires Charlotte to act as full-time caregiver and has strained their emotional and financial limits. Willow's teenaged half-sister, Amelia, suffers as well, overshadowed by Willow's needs and lost in her own adolescent turmoil. When Charlotte decides to sue for wrongful birth in order to obtain a settlement to ensure Willow's future, the already strained family begins to implode. Not only is the defendant Charlotte's longtime friend, but the case requires Charlotte and Sean to claim that had they known of Willow's condition, they would have terminated the pregnancy, a statement that strikes at the core of their faith and family. Picoult individualizes the alternating voices of the narrators more believably than she has previously, and weaves in subplots to underscore the themes of hope, regret, identity and family, leading up to her signature closing twists.

January 1, 2009
In another issue-driven novel, Picoult (Change of Heart, 2008, etc.) explores the impact of "wrongful birth " litigation on an ordinary New Hampshire family.

Charlotte O 'Keefe, a prominent pastry chef, was thrilled when she conceived at age 38 without resorting to fertility treatments. Although she has a daughter, Amelia, by a previous relationship, she and her new husband, police officer Sean, wanted a child of their own. Charlotte 's best friend Piper unwisely agrees to be her OB-GYN. Eighteen weeks into the pregnancy, during a routine ultrasound, Piper, looking for signs of possible Down syndrome, discounts the import of the fetus 's unusually transparent cranium. At 27 weeks, another ultrasound reveals that Charlotte 's daughter has sustained several fractures in utero, a sign that she suffers from osteogenesis imperfecta (OI), a rare congenital defect that causes brittle bones and severe complications (including scoliosis, respiratory problems and years of costly orthopedic interventions). Now age six, Willow, still toddler-sized, cannot walk, play or even turn over in bed without risking a compound fracture. Charlotte abandoned her career to care for Willow 24/7. Although Willow is precocious intellectually and for the most part a joy to be around, her illness is, inarguably, a drain on family finances and emotions. After a vacation at Disney World goes horribly awry, the O 'Keefes spiral apart. Charlotte decides to file a wrongful-birth lawsuit against Piper. The proceeds from the lawsuit, she rationalizes, would provide the quality of lifetime care Willow needs, even if suing amounts to betrayal. Sean is appalled by the implications of the lawsuit: that Willow should never have been born, and that Charlotte, if properly cautioned, would have contemplated abortion. Amelia, once a normal teen, becomes a bulimic, self-mutilating shoplifter.

Picoult 's strengths are evident in her exhaustively researched and gut-wrenching demonstration of OI 's devastating effects and the impact of a child 's disability on a sibling. However, too often characterization takes a back seat to polemic. Worse, the central moral quandary is undermined by an overly pat resolution.

(COPYRIGHT (2009) KIRKUS REVIEWS/NIELSEN BUSINESS MEDIA, INC. ALL RIGHTS RESERVED.)

March 15, 2009
Fans of popular author Picoult ("My Sister's Keeper") won't be disappointed with her newest novel, which offers a glimpse into the life of a family whose daughter is born with a severe medical condition that could have been prevented, but at what cost? Sean and Charlotte O'Keefe's magical world is turned upside down when daughter Willow is born with brittle bone disease, a disease so severe that Charlotte is forced into the role of caretaker for Willow and emotionally abandoning older daughter Amelia. It's only when Charlotte decides to sue for wrongful death that the family begins to unraveleven if the reason for the lawsuit is for Willow's future. In order to win the lawsuit, Willow's parents have to claim that they would have aborted her if they had known about her condition, a claim that is so abhorrent that it literally fractures the family. Picoult's novels are like Russian nesting dolls, with each plot unveiling a subplot, leading to an ending that readers never see coming. Highly recommended for all public libraries. [See Prepub Alert, "LJ" 11/1/08.]Marika Zemke, Commerce Twp. Community Lib., MI

Copyright 2009 Library Journal, LLC Used with permission.

February 15, 2009
Picoult has carved an impressive niche in the topicalfamily drama genre, tacklingmedical ethics, faith, and the law in her sixteenth novel. Charlotte and Sean OKeefe are the parents of Willow, six, who has brittle-bone disease, suffering 68 broken bones in her short lifetime, including 7 before she wasborn. Charlotte gave up her job as a successful pastry chef to care for Willow full time, doing whatever she can to prevent the inevitable breaks and trying to lessen Willows discomfort when they occur. After a lawyer broaches the possibility of a wrongful-birth lawsuit, which would find Charlottes ob-gyn(also her best friend) guilty of failing to diagnose Willows illness early enough for a possible abortion, the family unravels. Charlotte becomes increasingly aggressive in her new attack mode; Sean disagrees with the lawsuit and files for divorce; and Amelia, Willows teenage half sister, seeks attention bybecoming bulimic and cutting herself. In her customary fashion, Picoult probes these sensitive issues with empathy and compassion.(Reprinted with permission of Booklist, copyright 2009, American Library Association.)