Handle with Care, Jodi Picoult
Anyone familiar with Jodi Picoult knows that she isn’t afraid to lay real-life controversial issues on the table; issues that make her readers think deeply about the lives, crises and decisions of her characters. Prior to reading Handle with Care, I had never heard of wrongful birth lawsuits. Wrongful birth lawsuits are filed against doctors (usually obstetricians or radiologists) who have allegedly failed to diagnose fetal abnormalities in utero, such as birth defects or genetic impairments. After the birth, parents seek compensation for damages caused by the emotional and financial strain of the child’s care. The argument is that the parents lost their opportunity to end the pregnancy due to the doctor’s failure to diagnose these life-altering, debilitating conditions in time. I’m not going to share where I stand on this issue, but I will say that no matter what your beliefs are, Handle with Care will make you think deeply about ethical questions, family dynamics, and what defines quality of life. There are simply no easy answers.
Sean and Charlotte O’Keefe have a healthy daughter, Amelia. They wanted another child, but struggled to become pregnant. When it finally happened, they were thrilled. Charlotte was cared for by her best friend and obstetrician, Piper, during her pregnancy. Charlotte was given every indication that her pregnancy was going smoothly, until a twenty-seven week ultrasound revealed devastating news. Their unborn daughter had multiple bone fractures in utero, an indication of a serious collagen defect known as osteogenesis imperfecta (OI). The disease causes extreme bone fragility, affects growth and bone formation, and can be life threatening. Many people with OI only grow to be about three feet tall, and have bones that break easily upon even very mild impact. A sneeze, for example, can cause multiple fractures. When little Willow later came into the world, she arrived with several broken bones and endured even more during the birth.
As the years pass, Willow and her family are continually held hostage by her disease. Willow is a very bright child, but she cannot enjoy the activities most children take for granted due to risk of serious injury. She can’t run, go to a playground, participate in sports, climb trees or ride a bike. Every family decision must revolve around Willow’s needs. Every emotional, financial, and time resource her parents have go into her care. Hospital bills are mounting, as are household tensions. The marriage and family dynamics suffer. They are all barely hanging on, and then things get even worse with a horrible accusation of child abuse and a subsequent arrest during a much-needed family vacation.
When Charlotte reaches a breaking point and files a wrongful birth lawsuit against Piper, a decision Sean opposes, their lives implode. Their already troubled marriage crumbles. News of the lawsuit goes public, unleashing a barrage of gossip and judgement against them. The press hounds them. Amelia loses her best friend (Piper’s daughter), and is shunned and harassed at school over the impending suit. It tears the family apart.
As all this was going on, Picoult brilliantly interwove another intriguing family sub plot. Marin, Charlotte’s lawyer in the wrongful birth suit, is dealing with some family issues of her own. Adopted at birth, she is on a quest to locate her birth parents. She loves her adoptive parents dearly, but struggles with questions about her roots, her identity, and she longs for answers. Her journey is an emotional one with many twists and turns. Through it all, she is left to consider her place in the world and what exactly defines and constitutes a family.
Goodness, where do I even begin to review this heavy, gripping and extremely complex read, one that raises so many moral, ethical and family issues? Let me start by saying that as a mother, I could so easily relate to the family themes. Parenthood under ideal circumstances is emotionally and physically exhausting, so my heart went out to Charlotte and Sean. I kept imagining myself in their situation – caring for a child with a horrible illness while desperately trying to pay the bills and hold a crumbling family together. Picoult poignantly and realistically presented every side of real, multi-layered family issues under very crushing circumstances. I was so enfolded in the plot and deeply felt every emotion of the broken characters – anger, fear, love, heartache, desperation. I cannot even begin to express how fortunate this book made me feel, and how easy it is to take our lives for granted.
Each chapter was presented in the voice and point of view of a character. Amelia’s character, in my opinion, was the most gripping. Sean and Charlotte had nothing left to give her as Willow’s care was all-consuming. Through no fault of anybody, Amelia was completely on her own – the forgotten child who got no attention, no support, and had so many unmet needs. She internalized it all, and self-soothed with food, purging, and cutting. It was clear that her cutting and eating disorder were desperate attempts for order. These self-destructive habits were a cry for control in a young life spiraling out of control. Watching her plummet was agonizing and reminded me of Theo’s character in Picoult’s House Rules. The difference was that Theo handled his emotional neglect by acting out, while Amelia turned her pain inward – but both are equally damaging.
Clearly, Picoult did considerable legal and medical research to write this novel, all of which was presented intelligently and embedded seamlessly into the fabric of the story line. Handle with Care forces us to consider the multiple dimensions of some very difficult issues. This novel is extremely well-written, well-paced and flowed smoothly. I highly recommend Handle with Care. It is an excellent and engaging read that will stay with you long after you finish the last page.
(On a side note, I am from New Hampshire and love the fact that so many of Picoult’s novels are set in that beautiful and familiar state!)
To purchase this book at Amazon, click here. This is an affiliate link, which only means that when you click the link and purchase the book, I receive a tiny commission at no additional cost to you. My opinions remain my own.
See my review of another Jodi Picoult novel, Leaving Time, here.
“Things break all the time. Day breaks, waves break, voices break. Promises break. Hearts break.” Jodi Picoult
