''Handle with Care'' (2009) is the 17th novel by the American author
Jodi Picoult
Jodi Lynn Picoult () is an American writer. Picoult has published 28 novels, accompanying short stories, and has also written several issues of Wonder Woman. Approximately 40 million copies of her books are in print worldwide, translated into 34 ...
. It debuted at #1 on
''The New York Times'' Best Seller list.
Plot
The story follows the life of a young girl, Willow O'Keefe, and her family. Willow has Type III
osteogenesis imperfecta
Osteogenesis imperfecta (; OI), colloquially known as brittle bone disease, is a group of genetic disorders that all result in bones that break easily. The range of symptoms—on the skeleton as well as on the body's other organs—may be mi ...
(OI), a disease also known as brittle bone syndrome. To her parents, Sean and Charlotte O'Keefe, the disease has meant many sleepless nights, mounting hospital and insurance bills, and the pitying stares of "luckier" parents.
After a disastrous vacation to
Walt Disney World
The Walt Disney World Resort, also called Walt Disney World or Disney World, is an entertainment resort complex in Bay Lake and Lake Buena Vista, Florida, United States, near the cities of Orlando and Kissimmee. Opened on October 1, 1971, th ...
that results in Willow severely breaking both of her
femora
The femur (; ), or thigh bone, is the proximal bone of the hindlimb in tetrapod vertebrates. The head of the femur articulates with the acetabulum in the pelvic bone forming the hip joint, while the distal part of the femur articulates with t ...
, Sean and Charlotte visit a lawyer to inquire about a lawsuit against the park and hospital after park and hospital staff thought that Willow's broken bones indicated
child abuse
Child abuse (also called child endangerment or child maltreatment) is physical, sexual, and/or psychological maltreatment or neglect of a child or children, especially by a parent or a caregiver. Child abuse may include any act or failure to a ...
. The lawyer, Marin Gates, mentions a different possibility: a
wrongful birth lawsuit against the
OB/GYN
Obstetrics and Gynaecology (also spelled as Obstetrics and Gynecology; abbreviated as Obs and Gynae, O&G, OB-GYN and OB/GYN) is the medical specialty that encompasses the two subspecialties of obstetrics (covering pregnancy, childbirth, and t ...
that treated Charlotte during her pregnancy. Essentially, if the O'Keefe's had known earlier that their fetus had OI, they would have been equipped with all the information, and able to make the choice as to whether or not to have the pregnancy aborted. However, the OB/GYN the O'Keefes are suing is Piper Reece, Charlotte's best friend.
Amelia, the eldest daughter of Charlotte, from a previous relationship with a drug addict, develops
bulimia
Bulimia nervosa, also known as simply bulimia, is an eating disorder characterized by binge eating followed by purging or fasting, and excessive concern with body shape and weight. The aim of this activity is to expel the body of calories eate ...
and begins to
self-harm
Self-harm is intentional behavior that is considered harmful to oneself. This is most commonly regarded as direct injury of one's own skin tissues usually without a suicidal intention. Other terms such as cutting, self-injury and self-mutilatio ...
, partially due to the stress of her home life. Sean considers a
divorce
Divorce (also known as dissolution of marriage) is the process of terminating a marriage or marital union. Divorce usually entails the canceling or reorganizing of the legal duties and responsibilities of marriage, thus dissolving the ...
after countless disagreements with Charlotte about the lawsuit, but they eventually go back together.
During the trial, it is revealed that at an 18-week ultrasound, there was evidence of OI, which Piper should have informed Charlotte about. The jury awards the O'Keefes $8 million. This forces Piper to leave her practice and take up a part-time job at a free health clinic. Marin, the O'Keefe's lawyer, has her own issues during the lawsuit as well. She was adopted and is trying to track down her birth parents. She discovers that her birth-mother is on the jury and it is later revealed to Marin that she was a product of rape.
The final chapter is narrated by Willow. She begins first grade, and is going to a camp for kids with OI. Amelia received treatment for her
eating disorder
An eating disorder is a mental disorder defined by abnormal eating behaviors that negatively affect a person's physical or mental health. Only one eating disorder can be diagnosed at a given time. Types of eating disorders include binge eating d ...
and returned home healthy and with a passion for painting. Charlotte, who used to be a pastry chef, wrote a recipe book and is donating all of the profits to the OI Foundation. Sean and Charlotte are able to reconcile and put the
check
Check or cheque, may refer to:
Places
* Check, Virginia
Arts, entertainment, and media
* ''Check'' (film), a 2021 Indian Telugu-language film
* ''The Checks'' (episode), a 1996 TV episode of ''Seinfeld''
Games and sports
* Check (chess), a thr ...
aside for when they might really need it. Willow has always been jealous of her sister as she is a brilliant ice skater.
One day, Willow wanders, alone, to the frozen pond in the backyard and tries to crawl over it carefully. However, the thin ice breaks under her weight and she drowns in the pond. Willow mentions how, this time, it was not her that broke. The story concludes with Charlotte burying the $8 million check with Willow.
Characters
Charlotte O'Keefe - The mother of Willow and Amelia O'Keefe. She files a lawsuit against Piper Reece, her
obstetrician/gynaecologist and best friend, in order to be able to secure the medical resources needed for her daughter, Willow. The lawsuit is successful and shte is awarded $8 million in damages. After Willow's death, she tucks the check into the lining of Willow's coffin, never cashing it.
Sean O'Keefe - Charlotte's husband, Willow's father and Amelia's stepfather. He is a police officer who works hard to support his family. Although he initially attempts to set aside his personal feelings about the lawsuit in order to support Charlotte, his disgust for the wrongful birth suit eventually leads him to testify for the defense. He files for divorce from Charlotte, although they eventually reunite.
Willow O'Keefe - A young girl, born with brittle bone disease. The hospital and insurance bills for her condition are immensely expensive and her family needs money to pay for her treatment. She is extremely intelligent and is especially interested in trivia, and often reads while recovering at home or in hospital from a bone break. During the lawsuit, she worries that her parents do not want her anymore because she is not perfect. At the end of the novel, she attempts to go skating on a frozen pond, but the ice breaks and, trapped underneath, she drowns. As she drowns, she reflects on her short life: how she was loved, and profoundly, that this time, it was not her that broke.
Amelia O'Keefe - Willow's older half-sister, who is overshadowed by her sister's illness. Amelia falls in love with a boy who has the same disease as her sister, whom she meets at an OI convention. She lies and tells the boy that she is the one with OI, but he finds out. Eventually, the differences in their health lead to the boy breaking up with her, which further pushes her into isolation, as her parents are occupied by the lawsuit. Amelia develops
bulimia
Bulimia nervosa, also known as simply bulimia, is an eating disorder characterized by binge eating followed by purging or fasting, and excessive concern with body shape and weight. The aim of this activity is to expel the body of calories eate ...
and begins to
self-harm
Self-harm is intentional behavior that is considered harmful to oneself. This is most commonly regarded as direct injury of one's own skin tissues usually without a suicidal intention. Other terms such as cutting, self-injury and self-mutilatio ...
. She begins shoplifting and dyes her hair blue. Sean eventually discovers Amelia's eating disorder, after Piper brings them to his attention when the pipes burst in their home due to being eroded by the stomach acid (caused by her frequent vomiting). Charlotte suggests that Amelia should check into a treatment center. Amelia, furious with her mother, testifies in court that Charlotte told Willow that she would never wish that Willow had never been born. Charlotte admits later that they should have discussed the treatment center as a family before she and Sean made that kind of decision.
Marin Gates - The lawyer handling the O'Keefes' case, although she is privately opposed to it. She is adopted and searches for her birth mother, who she eventually discovers by chance on the jury for Charlotte's case. However, her mother confides to her that she was the product of rape, and makes it clear that she does not want a relationship with her. Marin accepts this and becomes more appreciative and closer to her adoptive parents.
Piper Reece - Charlotte's best friend and obstetrician/gynaecologist, as well as the
godmother to Willow. She is a competent doctor, although this is called into question during the trial. She is forced to take an extended leave from work during the lawsuit. She brings to Sean's attention Amelia's bulimia and self-harming.
Rob Reece - Piper's husband. He is an orthodontist whose patients include many people from the town of Bankton, including Amelia. His older brother, Stephen, died by suicide at the age of 17; then-12-year-old Rob discovered his brother's body. Although the lawsuit initially causes strain in their marriage, Rob ultimately supports his wife.
Emma Reece - Piper and Rob's daughter. She met Amelia through skating and became her best friend. However, she quickly casts Amelia aside after Charlotte sues Piper and the two never reconcile. When she finds out about the lawsuit, she is able to persuade the other students to alienate Amelia. She was the first person to notice Amelia's self-harming.
Narrative style
''Handle with Care'' employs an alternating narrative style, in which various characters take turns narrating chapters and providing their perspective on the events that are unfolding. The novel is narrated by Charlotte, Sean, Marin, Piper, Amelia and the final chapter by Willow. Picoult has used this technique in several novels, including ''
Songs of the Humpback Whale'', ''
My Sister's Keeper'', ''
Change of Heart'' and ''
House Rules
House rules are unofficial modifications to official game rules adopted by individual groups of players. House rules may include the removal or alteration of existing rules, or the addition of new rules. Such modifications are common in board g ...
''.
Reception
''
People
A person (plural, : people) is a being that has certain capacities or attributes such as reason, morality, consciousness or self-consciousness, and being a part of a culturally established form of social relations such as kinship, ownership of pr ...
'' magazine gave the book four stars. ''
The Washington Post
''The Washington Post'' (also known as the ''Post'' and, informally, ''WaPo'') is an American daily newspaper published in Washington, D.C. It is the most widely circulated newspaper within the Washington metropolitan area and has a large nati ...
'' called it "a great read, with strong characters, an exciting lawsuit to pull you along and really good use of the medical context". However, ''
The Boston Globe
''The Boston Globe'' is an American daily newspaper founded and based in Boston, Massachusetts. The newspaper has won a total of 27 Pulitzer Prizes, and has a total circulation of close to 300,000 print and digital subscribers. ''The Boston Glob ...
'' called the novel "fairly engaging if sometimes
narduous read".
References
External links
''Handle With Care'' at Jodi Picoult.com
{{Jodi Picoult
2009 American novels
Medical ethics in fiction
Novels by Jodi Picoult
Atria Publishing Group books