My Sister’s Keeper

post updated March 13, 2021

My Sister’s Keeper– a novel

I enjoyed reading My Sister’s Keeper ,a novel by Jodi Picoult, which touched on several medical themes – cancer, genetic engineering, organ donation ethics, and medical autonomy.

Kate, an adolescent who as a toddler developed a rare form of leukemia, has spent the majority of her life either in the hospital getting treatment or recovering from them. After yet another chemotherapy regimen, she lost her hair.

One day her mother, Sara, offers to take Kate and her younger sister Anna to the mall for a day out. Kate refuses.

“Don’t say it. Don’t tell me that nobody’s going to stare at me, because they will. Don’t tell me it doesn’t matter because it does. And don’t tell me I look fine because that’s a lie.” Her eyes, lash-bare, fill with tears. “I’m a freak, Mom. Look at me.”

Sara looks at her and says, “Well, we can fix this.”

“She walks out of the room followed by Kate and Anna. She finds a pair of ancient electric grooming clippers, plugs them in, and cuts a swath right down the middle of her own scalp.

“Mom”, Kate gasps.

With another swipe of the razor, Kate starts to smile. She points out a spot Sara missed. Anna crawls onto Sara’s lap. “Me next,” she begs.”

As Sara later remembers:

“An hour later, we walk through the mall holding hands, a trio of bald girls. We stay for hours. Everywhere we go, heads turn and voices whisper. We are beautiful, times three.”

Also a movie

My Sister’s Keeper by Jodi Picoult was also made into a major motion picture starring Cameron Diaz, Abigail Breslin, and Joan Cusack.

(These, and other links in this post are affiliate links, used to generate revenue to fund this blog. )

Alopecia- hair loss

You’ve known people who lost their hair due to cancer chemotherapy-you may even be that person. The medical term is anagen effluvium, which means hair loss during the anagen, or active phase of hair growth. 65% of people who receive chemotherapy will lose their hair.

Fortunately, anagen effluvium is reversible; the hair usually grows back in 1-6 months. While waiting, sometimes women wear wigs, while others wear colorful scarves and turbans on their heads. And some simply do as Kate, her mother and sister did- show their heads proudly.

Stress and hair loss

The most common form of diffuse hair loss is telogen effluvium which occurs during the telogen or resting phase. Stress can cause hair loss, it is not a myth . Any type of physical, mental, or emotional stress can cause hair to fall out. Probably the most common stress that precipitates this is pregnancy. Others include

major surgery
serious illness
disorders of the thyroid, kidneys, or liver
Vitamin D deficiency
anemia due to iron deficiency
malnutrition or rapid weight loss

This hair loss is also reversible with the hair usually growing back within 2-6 months after the condition resolves or is treated.

a middle aged woman and a young woman together — Hair loss can occur at any age and with any type of hair. (Lightstock)

Genes and gender

The most common type of hair loss in both men and women is considered a “normal physiologic variant”- that being androgenetic alopecia. It tends to run in families, hence the “genetic” connotation. As many as 50% of men and 30%-40% of women may experience hair loss with increasing age.

There are two forms. (click on the links to see an illustration.)

Male pattern hair loss– affects the temples, front, and top of the scalp

Female pattern hair loss– causes diffuse thinning on the top and sides of the scalp

Two treatments are approved by the FDA.

Minoxidil- a topical solution applied daily to the scalp, causing increased hair growth within 6-12 months, and is used indefinitely. This is effective for both men and women.

Finasteride is a pill approved for use in men only, if minoxidil does not work. It can have undesirable side effects which limit its use.

Another option for both men and women are hair transplants.

5 people young men and women with arms overlapping their shoulders — Hair loss can happen to men and women,; men may start losing hair as young as 30 years old. (Lightstock)

Less common causes of hair loss

Alopecia areata is an autoimmune disorder. it may cause

round, bare patches on the scalp
complete scalp hair loss
hair loss on other body areas

Hair may spontaneously regrow in up to 30% of mild cases. When treatment is needed choices include

topical corticosteroids
topical minoxidil
anthralin
oral janus kinase inhibitors

More info is available from the American Academy of Dermatology

Trichotillomania results from repeatedly pulling, twisting, or twirling the hair. Treatment is difficult.

Trichorrhexis nodosa results from trauma to the hair, including excessive brushing, tight hairstyles, and use of heat and chemical products on the hair.

What to do if you are losing hair

If you experience unexplained hair loss, see your doctor for an evaluation. It’s best not to assume that it is just a hair issue.

It is especially important to determine if there is some underlying condition, such as a thyroid disorder, that needs treatment.

Consider your family history. Have your grandparents, parents, or siblings experienced hair loss?

Evaluate your lifestyle to see if there are nutritional, traumatic, or stress factors that may contribute to hair loss. Remember, these may have happened as long as 6 months ago.

a smiling woman working on a laptop computer — Tightly braiding hair can lead to damage if done often enough. (Lightstock)

Consider the way you care for, style, and wear your hair; do these traumatize your hair frequently or excessively?

Hair care by Arbonne

Arbonne carries hair care products that help keep our hair healthy and attractive-True Hair, TrueStyle, TrueSmooth- for all hair types:

color treated
dry or damaged
fine or limp
curly
short

Lightstock photos at this affiliate link

exploring the HEART of health

This website is owned and operated by Aletha Oglesby, an Arbonne Independent Consultant, and is not endorsed by Arbonne. Any opinions expressed on this website are made by and the responsibility of the Independent Consultant and should not be construed as a representation of the opinions of Arbonne.
Arbonne makes no promises or guarantees that any Independent Consultant will be financially successful, as each Independent Consultant’s results are dependent on their own skill and effort.
You should not rely on the results of other Arbonne Independent Consultants as an indication of what you should expect to earn. The annual typical earning statement is contained in the Arbonne Independent Consultant Compensation Summary (ICCS) available iccs.arbonne.com.

Dr Aletha

I hadn’t planned on writing book reviews when I started this blog. I love to read so I recommended health and medical books that sounded interesting.

After reading one myself, I wanted my readers to know abut it, so I wrote my first book review Working Stiff: Two Years, 262 Bodies, and The Making of a Medical Examiner-

After that, I continued reviewing non-fiction medical books, including memoirs and biographies, medical history, health advice, books on dying, vaccination, nutrition, and medical care. I didn’t expect to review fiction, but I have.

“based on a true story”

That shouldn’t have seemed strange, since most fiction is based on real life, which is full of twists and turns related to our health and well being. Our state of health, good or bad, directs much of what we do, and can change suddenly and unexpectedly, and turn our lives upside down. Consider how many TV dramas are based in hospitals, involving health care workers, and sick or injured people.

A true story written by a physician, Twelve Patients: Life and Death at Bellevue Hospital was the inspiration for the NBC drama New Amsterdam.

EXPLORING HEALTH IN FICTION -www.watercresswords.com

by Jodi Picoult

I didn’t review this book but I used an excerpt in a post about hair loss.

The book tackles several cutting edge health technologies that can create touchy ethical issues that I haven’t dealt with here, but if I do, I’ll revisit this book.

My Sister’s Keeper is a novel that touches on several medical themes including cancer, genetic engineering, organ donation, and medical autonomy. The book was also a movie which I haven’t seen yet.

The story is about Kate, an adolescent who as a toddler developed a rare form of leukemia, and has spent the majority of her life either in the hospital getting treatment or recovering from them. After yet another chemotherapy regimen, she has lost her hair.

spoiler alert- skip this section if you don’t want to know something that happens in the book

One day her mother, Sara, offers to take Kate and her younger sister Anna to the mall for a day out. Kate refuses.

Sara looks at her and says, “Well, we can fix this.”

“She walks out of the room followed by Kate and Anna. She finds a pair of ancient electric grooming clippers, plugs them in, and cuts a swath right down the middle of her own scalp.

“Mom”, Kate gasps.

With another swipe of the razor, Kate starts to smile. She points out a spot Sara missed. Anna crawls onto Sara’s lap. “Me next,” she begs.”

As Sara later remembers:

“An hour later, we walk through the mall holding hands, a trio of bald girls. We stay for hours. Everywhere we go, heads turn and voices whisper. We are beautiful, times three.”

Say Goodbye for Now

by Catherine Ryan Hyde

I was drawn to this book because the main character is a woman physician. I started it just for pleasure, but once drawn into the story, I knew I wanted to review it for the blog.

In 1959, Dr. Lucille Armstrong, or Dr. Lucy as she is called, practices medicine of sorts in a small Texas town. Although she is a “doctor of human beings”, she spends most of her time taking care of stray and injured animals.

To support them and herself, she occasionally treats people; “ it’s not a hobby, I do it for the money.” But because “people there didn’t take well to a woman doctor”, her patients are not always the town’s model citizens.

Dr. Lucy lives alone except for the menagerie of injured animals she has doctored back to life. She likes her life the way it is, until she opens her home to three unexpected and unlikely guests.

Say Goodbye for Now- a book review

Labor Day

by Joyce Maynard

Leaving for a trip, I bought a book to read on the airplane. After reading a few pages, I realized it was also a movie I had seen. So my subsequent review was a book/movie review. The medical themes in this book/movie were subtle, but no less real.

Henry, who narrates the story, lives with his divorced mom in a small town. At 13, Henry seems more mature than he should need to be, while his mother Adele seems childish and naive for a grown woman. As the story unfolds, you begin to wonder if Adele’s eccentric behavior is due to something more than immaturity.

Adele and Henry are in their small town store buying clothes for school when a man they don’t know approaches them asking for help. Frank seems nice enough and asking for help might not be a problem except for the fact that is is bleeding, and evasive about why.

He asks Adele to take him to her house and either due to fear or poor judgement, she says yes. Both she and Henry seem to realize that something dramatic is about to change in their lives, but what it is, they can only guess at this point.

Labor Day, a book more interesting than the holiday

You can probably borrow these books from your local library- I do. But if you do decide to buy books, please consider the affiliate links here. Purchases through them help support this blog and help share the HEART of health.

Support independent bookstores

Bookshop.org is an online bookstore with a mission to financially support local, independent bookstores. They believe bookstores are essential to a healthy culture and they are dedicated to the common good. Bookshop.org donates a portion of every sale to independent bookstores.