MOVIE REVIEW: My Sister’s Keeper (2009)
A Truly Honest Look at Grief
This article has been so popular that I’ve updated it for coherence and clarity. I hope you enjoy the changes!
A couple times a year, I do a deep-dive into my streaming service du jour to see what’s out there and what’s interesting.
Maybe it was the biblical echo of “my brother’s keeper,” or maybe it was suggested because I had been on a Cameron Diaz nostalgia kick, or perhaps it was just the ethical tug in the Netflix trailer… but something about My Sister’s Keeper (2009) piqued my interest when I noticed it was about to disappear from streaming.
I ended up watching it twice in two days.
Disclaimer: General plot spoilers throughout, but the biggest twist is saved for The Big Reveal section at the end.
Why Teen Trauma Films Usually Make Me Cringe
Generally speaking, I have a love-hate relationship with movies that cover youth trauma and illness, but it’s the ones that are distinctly made for teenagers that I particularly hate, because they’re always some sort of weird, trauma-made-beautiful stories that often seem to glorify things that have no business being glorified. Maybe someday I’ll write about how uncomfortable The Perks of Being a Wallflower made me, but that might require me to actually watch it again.
The teen trauma film that My Sister’s Keeper brought to mind was The Fault in Our Stars, which I hated for its über-deep melodrama, despite the fact that the story still made me cry a whole bunch (the concept of different types of infinities was actually great). The connection here is ‘teenagers with cancer,’ though I think My Sister’s Keeper does a better job of connecting to people of all ages, not just the teens in question. Perhaps it’s because the story is actually not that much about the teens, but the whole family as a unit.
What It’s All About
This movie is, on the surface, about an 11-year-old girl named Anna Fitzgerald (Abigail Breslin) who is trying to legally stop her parents from forcing her to donate any more of her body to her leukemic sister, Kate (Sofia Vassilieva).
However, beneath all that, this story is actually about love, grief, and death, and what not coming to terms with those things can do to families.
Sara Fitzgerald (the mother, played by Diaz) has dedicated her life to keeping Kate healthy after her cancer diagnosis, even going so far as to genetically engineer Anna to make sure they always had a donor to supply blood, marrow, and eventually even a kidney to Kate.
Anna’s brother, Jesse (Evan Ellingson) takes her to see a television lawyer, Campbell Alexander (Alec Baldwin), for this medical emancipation, which is the catalyst for everything that follows.
Family Flashbacks
The movie regularly flashes back to different moments in Kate’s life: her happy childhood with her baby brother, her diagnosis, endless treatments, finding love with another young cancer patient, hospital prom, a grief-ridden suicide attempt stopped by Anna, and so on.
We also get small glimpses into the rest of her family’s lives, like how her brother Jesse’s dyslexia went unnoticed for years because Kate’s health and needs were priority number one. The film shifts from the present to past seamlessly, adding depth and context to the current-day circumstances. It’s not just Kate’s story, it’s their family’s.
The Characters at the Heart of the Story
Let’s look at the characters for a moment, because I found them all so fantastic and relatable.
Sara is technically the villain—or more accurately, the antagonist—of this story. I love a nuanced antagonist, so no matter how much Sara upset me by ignoring the wishes of her child, I couldn’t help but feel the spirit of a woman trying desperately to protect her child in the only way she knows how: get her treatment. She’s asked, repeatedly, when is enough enough? Where’s the line? But she never answers. She stays defiant. You see someone who feels so justified in her choices, almost heartlessly so, that she can’t admit when she’s gone too far.
The husband could’ve used more screen time, but maybe the most emotional moment relating to him is when Kate looks at her scrapbook and apologizes for taking his first love (her mother) away from him. Brian (Jason Patric) is the likable foil to Sara—he listens, he cares about all of his children equally, and he doesn’t bulldoze over their feelings the way Sara does.
The brother, Jesse, could’ve played a bigger part, or maybe shouldn’t have been included at all. There are scenes of him lurking around the city, but they don’t do a great job showing what his life is like. From what I understand, in the book, it seems he developed a drug habit due to the neglect at home, but the film doesn’t address that; rather, it shows him lonely and alone. He comes across as a tired, compassionate brother, but giving him more attention would have only added depth, whereas leaving him out could have given more space for the father.
Anna and Kate are wonderful. You have two very close sisters: one who fully understands her role in the family, and one who feels guilty for putting everyone through so much—despite it being no one’s fault. When Anna is asked if she understands the consequences of not donating her kidney, she responds with remarkable clarity. At first, it almost seems like she’s repeating someone else’s script—but by the end, the film makes sense of that too.
And Kate… she’s just that sweet, exhausted kid who’s had to carry too much for too long. She’s tired, unhappy, frustrated, and guilty—all things that make perfect sense for a child who’s been through years of chemo and radiation, who truly understands life, death, and the toll in between.
Monsters Made of Grief
The ethical question at the core of the story is this: Is it okay to harvest one of your children for the sake of another? Where is the line drawn?
As I mentioned earlier, there’s nothing in the world better than a sympathetic antagonist, which is why I loved Sara’s character so much. She is 100% on her daughter’s team… it’s just that she got so fixated on “fixing” Kate that she forgets that Anna is a human being too.
I felt part of her in me, when my cub was still alive… the mother who would do anything—be anything—to protect her damaged child. The lengths we can go to, the monsters we become, all with the best intentions of keeping our loved ones safe and with us.
When my cub died, I had to reshape my entire worldview on death, because I couldn’t exist in a world where my son simply ceased to be. That worldview echoes throughout the movie. The kids talk vaguely about reincarnation—Kate hopes to see Taylor again (her boyfriend, who died just days after prom), and Anna asks if Kate will wait for her in the great beyond.
Sometimes, life is just too hard to go on. Sometimes, life is too much and we have to let go.
My cub didn’t suffer from cancer like Kate, but he suffered from the trauma of physical and emotional abuse from his birth family. His health was fragile and any stress (which he was extremely prone to) could make him dangerously ill. He never attempted suicide himself, though there were drug scares, and he often spoke about wanting to die.
I tried to give him the best life I could. But even that isn’t always enough. Death comes for us all. And sometimes, us mamas have to let go… for everyone’s sake.
That’s why I think the movie isn’t ultimately about Anna, or even Kate. It’s about Sara—and the moment she has to accept that her daughter is going to die.
That scene, where she finally realizes it, is one of the most powerful things I’ve ever seen from Diaz (whom I’ve often considered kind of an over-actor). I recognized that collapse. That moment of realization. The inhale and outburst that follows.
Anyone who called this movie a “melodramatic tear-jerker” clearly hasn’t lived through grief—not like this. There’s nothing melodramatic here.
Grelief is a real thing.
The Film Versus The Book
One of the things that really surprised me about this film was how different it is from Jodi Picoult’s novel, on which it’s based. I’ll be honest—I haven’t read the book, just a few summaries, but if we’re going to call anything a melodramatic tear-jerker, I’m inclined to preemptively slap that label on the book, not the movie.
The biggest difference is the ending: in the novel, Anna dies in a freak car accident, and all of her organs are harvested for Kate. Kate goes on to live a happy life thanks to her sister’s death.
And… I don’t know. Maybe I’m wrong about where cancer medicine was at in the ‘00s, but it feels wildly unrealistic that Kate's illness is suddenly all better because she happens to get Anna’s organs after a freak accident.
And honestly? There’s something a bit sick about that ending to me.
Take me again with a grain of salt because I haven’t actually read the book, but it gives off the vibe that Anna—a literal child—is treated like a last-minute blowout sale on body parts. It strips her of all agency and humanity and turns her into a plot device for someone else’s survival.
That’s not a story about grief or ethics. That’s not even a story about love. That’s just… a convenient deus ex machina that makes sure no one actually has to make any hard decisions.
More than that, it robs the story of its emotional weight.
Meanwhile, the film offers a more grounded, resonant ending—a story that actually sits with the discomfort of love, ethics, and grief.
I’m kind of astounded by how much better the movie handled it.
The Big Reveal
The subtle nuances in this movie were really well done, because around halfway through the movie, I clocked what was happening.
Why does Anna seem so mature in her choice?
Why does she push it so hard, while refusing to justify the decision?
Why does it almost feel like she’s reading from a script every time she insists on a medical emancipation?
Maybe because it wasn’t her idea in the first place.
Indeed, as the trial proceeds, we find out that it was actually Kate who put Anna up to this. She saw that her chances of survival were mediocre at best and didn’t want to cripple her sister’s future for a “maybe,” while locking her family into who knows how many more years of medical care.
Kate really feels like an exhausted 15-year-old who has been suffering for most of her life. She doesn’t want to put her sister through more painful procedures. She doesn’t want to watch her mother burn every bridge over a lost cause. She doesn’t want her brother and father permanently placed on the emotional back-burner.
She’s tired.
She’s done.
She knows she doesn’t have the strength left to go on.
She’s ready to let go.
The Emotional Bomb Drops
The thing that hurts most about this movie is that you can see how ready Kate is to die, but Sara refuses to let her. It shows how truly afraid we Westerners are of death.
Throughout the film, everyone else seems to understand that Kate isn’t going to have a long life, so they put in every effort to make memories and share joy with her, so that they’ll have as much of her with them as possible once she’s gone.
But Sara’s not there yet. Sara’s still fighting long after everyone else has silently accepted the truth.
It’s devastating because everything Sara does, she clearly does for love. For the unending, undying love between a mother and her child.
From someone who regularly aches from the opportunities lost when my son passed away, it hurts in a good way to see it reflected in fiction. Gawd, do I know where she’s coming from—that desperation to hold onto her daughter and not need to say goodbye. Not yet.
The most gutting scene for me was when Kate tells Sara to accept reality.
There’s no dramatic monologue. No cinematic swell.
Just the soft, gentle truth of asking someone you love: please let me go.
Sara’s deep inhale before a full-body breakdown felt like exactly what I would’ve done, had my situation been the same.
In the End
This isn’t a flawless movie by any means, but it’s one of the most emotionally honest films I’ve seen about death, family, and the quiet horror of loving someone you know you’re going to lose. You try so hard, you get so far, but in the end…
This film doesn’t glorify trauma. It doesn’t hand you a tidy redemption arc wrapped in tragedy. Instead, it gives you the harsh reality of love and grief: the harder you love someone, the harder it’s going to be to let them go.
For me, My Sister’s Keeper was more than a film. It was a mirror. It validated my own loss, even though my experience was completely different. It showed me that, yes—mothers do love this hard. And they grieve even harder.
But in the end? I feel lucky. Lucky to grieve this much, because it means I got to love that much.
And I hope people who watch this film walk away, not feeling the bleak tragedy of what Kate’s family lost, but with the unique beauty of what she gave them.
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