Handle with Care

Handle with Care is Jodi Picoult’s 2009 novel and one of her most morally difficult, which is saying something for a writer whose catalogue is built almost entirely on morally difficult premises. The book centers on the O’Keefe family. Charlotte and Sean O’Keefe have a daughter, Willow, who was born with osteogenesis imperfecta, the brittle bone disease that means even small impacts can cause fractures. Willow’s life is full of doctor visits, casts, and the constant calculation of risk.

The central moral question of the novel is wrenching. Charlotte considers suing her obstetrician, who is also her best friend Piper, on the grounds of wrongful birth. The legal claim is that if Piper had detected Willow’s condition earlier in the pregnancy, Charlotte would have had the option to terminate, and Willow would not be living the painful life she has now. The lawsuit, if successful, would provide the family with the money they desperately need to care for Willow. It would also publicly state that Willow should never have been born, with Willow herself old enough to understand what her mother is saying.

Picoult tells the story in her characteristic multiple first person format, with chapters narrated by Charlotte, Sean, Willow, Willow’s older sister Amelia, and Piper. The strain on every relationship in the book is rendered with the kind of detailed psychological honesty that makes Picoult’s best work hit so hard. The legal procedural elements are accurate and well researched, as her readers expect, and the medical details about osteogenesis imperfecta are handled with care.

Readers who liked My Sister’s Keeper will find familiar territory here. The two books raise related questions about what parents owe their children and what limits exist on the love they can offer. Handle with Care is one of Picoult’s most painful novels and one of her most accomplished.