If some genre authors don’t have much to say but craft lively stories employing genre tropes, then some mainstream authors employ their literary prowess to hold forth on significant themes and characterizations that in the end amount to shallow stories. (Full disclosure: I’m bored by family sagas, quirky dark secrets and all.)

This author brings her considerable literary prowess to a story that could have been ripped from the headlines: Anna, a young teen, who was purposefully conceived as a DNA match to provide blood and bone marrow to her beloved sister mortally ill with leukemia, files a law suit for her medical emancipation from her obsessive controlling parents.

Why? Because after years of emotionally draining and painful blood draws and bone marrow harvests, now her sister’s kidneys are failing and the parents want to harvest Anna’s kidney. Anna just can’t take it anymore.

The incendiary family drama unfolds in shifting POVs and time inversions with the compelling authenticity of technical names for medicines and medical procedures, causes of action and legal procedures, and a parent’s anguish over the pain of a sick child.

In an earlier day, the cancerous child would have died at age three, the grieving parents could have conceived another, and life would have gone on. I don’t know if the author intended this, but the modern medical technology that enables such manipulation of life strikes me as both miraculous and ghoulish.

I really wanted to love this book. *SPOILER ALERT* But I can’t. I don’t object to a dark, ironic end. Or a tragic end. Or an end with a twist. (Like Romeo and Juliet, for instance.) Or an end where the villain (or a villain) gets away with it. (Like Silence of the Lambs.)

But a story’s end should fulfill the inevitable logic of the story. We as readers, however surprised, should be able to say, “This is how the story had to end.” After four hundred pages plus, the end of this book struck me as perfunctory, arbitrary, and nothing less than horrifying, unfairly brutal, even punitive toward the one character we care most about. Four stars for the literary prowess (after the tight beginning, the round-robin of POVs tends to drift) and minus four stars for the end. That leaves me with zero. Sorry, Ms. Picoult, I love your writing. Unrated.

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