This reading group guide includes an introduction, discussion questions, ideas for enhancing your book club, and a Q&A with author Jodi Picoult. The suggested questions are intended to help your reading group find new and interesting angles and topics for your discussion. We hope that these ideas will enrich your conversation and increase your enjoyment of the book. Introduction Another heart-wrenching, controversial novel by Jodi Picoult, Handle with Care introduces Willow, a smart and charming five-year-old who was born with a brittle bone disease called osteogenesis imperfecta. Over her lifetime, Willow will have hundreds of broken bones. Her mother, Charlotte, will do anything to give Willow the best life possible--even if she has to say under oath that Willow never should have been born. In pursuing a wrongful birth suit against her obstetrician (and best friend for nearly a decade), Charlotte is willing to put everything on the line in hopes of gaining the financial means necessary to take care of her daughter. Picoult constructs an emotionally complex novel, weaving tender and poignant moments into a difficult story of suffering and sacrifice.
Charged with thought-provoking questions about medical ethics, morality, parenting, and honesty, Handle with Care asks just how far we would go to care for the ones we love. Questions for Discussion 1. Charlotte and Sean are faced with a very difficult decision when presented with the option of suing for wrongful birth. How did you feel about the lawsuit? The matter is complicated in many aspects, but especially because of Charlotte''s close friendship with Piper, her ob-gyn. How might the O''Keefes have considered and entered into the lawsuit if they had not had a personal relationship with Piper? Would your own reaction to it have changed? 2. During the filming of a day in Willow''s life, Charlotte purposely asks Willow''s physical therapist to try some exercises that she knows Willow isn''t ready for yet, and Willow begins to cry in pain. Charlotte rushes to her daughter''s side, blaming the physical therapist, and when she asks if they got that on film, Marin--Charlotte''s lawyer--is angry at Charlotte for exploiting her daughter. Do you agree with Marin that Charlotte exploits Willow? Charlotte believes she is doing everything out of love for Willow, to win the case that will get her the care she needs, but does this take it too far? Where can we draw the line? 3.
Breaking is a theme in Handle with Care : bones break, hearts break, friendships break, families break. Consider examples from the book and discuss why you think certain breaks can or cannot be mended. Is there anything in the book that represents the unbreakable? 4. The author inserts recipes throughout the book that highlight certain baking techniques, such as tempering, blind baking, and weeping. How do these recipes provide further insight into the story and into Charlotte''s character in particular? 5. Throughout the story, the question is raised of what it means to be a mother. For Charlotte, it means doing anything in her power to provide the best life for Willow, but at the same time, her other daughter''s suffering goes unnoticed as she develops bulimia and begins cutting herself. For Marin, the question of what it means to be a mother addresses the issues of her adoption.
Is a mother someone who gives birth to you and gives you away, or the woman who raises you? Discuss the different ideas about mothering that the author presents in this book. At what moments do certain characters fail or succeed at being a mother? 6. The term wrongful birth suggests that some people never should have been born. If abortion had been legal when Marin was conceived, she likely would not have been born. Willow''s severe disability, had Charlotte known about it early enough, could have been cause for abortion. How do we determine what kind of life is worth living? Who has the right to say whether a pregnancy should be brought to term? 7. Discuss the roles that honesty and deception play in this novel. How do the characters lie to themselves? To each other? Is it sometimes better not to know the truth? 8.
Charlotte is confident that the potential end of her lawsuit will justify the means, but Sean can''t handle the idea that the means may leave Willow thinking she is unloved or unwanted. Clearly, they both love their daughter, but express it in drastically different ways. What do each of their approaches say about love? Do Charlotte''s actions speak louder than Sean''s words? 9. What message does the trial verdict send? Do you agree with the jury''s decision? 10. How do you think Amelia''s testimony affects the outcome of the case? 11. We follow Marin through the search for her birth mother, and what she eventually finds out about the circumstances surrounding her conception are truly devastating to her. Why do you think she thanks her birth mother for this information? Discuss Marin''s reaction to what she learns. 12.
Why do you think the O''Keefes never cash their $8 million check? How do you feel about what they end up doing with it? 13. How do you feel about the ending? Why do you think the author chose to write it this way? Enhance Your Book Club Try baking some of Charlotte''s recipes for your book club meeting. Discuss the different baking techniques you used; were you able to relate to Charlotte''s experience of making these treats? Learn more about osteogenesis imperfect by visiting www.oif.org. Visit www.jodipicoult.com to view book trailers, see what Jodi''s up to, and find out about upcoming signings and appearances.
A Conversation with Jodi Picoult Q: What led you to OI as the topic for this book? Did the idea of a wrongful birth suit come first or second? Talk about the research required for writing this novel. A: The seed for Handle with Care began with an article I read about wrongful birth--a mother in New York sued her ob-gyn after her son was born with severe chromosomal abnormalities and won a multi-million-dollar settlement. It was clear from the article that she loved this child dearly--but that in order to give him a better lifestyle, she needed to tell the world she would have aborted the fetus if given the chance. That moral conundrum got me thinking: what if her child had not been profoundly mentally disabled, but just physically disabled? What if her child could hear her in court, saying that she wished he''d never been born? That led me to osteogenesis imperfecta. Also known as brittle bone disorder, it is a genetic bone disease characterized by fragile bones that break easily. It''s caused by a mutation on a gene that affects the body''s production of collagen in bones. It affects between twenty-five thousand and fifty thousand Americans--the range is large, because mild cases of OI often go undiagnosed. There are eight types of OI, ranging from lethal at birth to mild with few symptoms.
A person with severe OI might experience hundreds of fractures and have a reduced life span. Other symptoms include short stature (people with severe OI are approximately three feet tall), hearing loss, curvature of the spine, respiratory failure, and loose joints and muscles. Physically, it''s a very difficult condition--but mentally, people who have OI are one hundred percent normal. Many kids with OI are even brighter than their able-bodied friends, because they do so much reading after a break, when they can''t run around. For research, I tried to walk a brief way in the shoes of a parent whose child has OI, by visiting multiple families with kids who were afflicted by the disorder. The first girl I met with OI, Rachel, had Type I--a milder form--but had suffered nearly fifty breaks in her eight years because her parents wanted her to live as normal a life as possible. Rather than having her walk on her knees or restrict her activities, they allowed her to do what she wanted. knowing that it would lead to broken bones.
I remember asking Rachel what it felt like when that happened. "It feels like lightning under my skin," she said, and I realized then that the pain these kids feel is just what you or I would feel if we broke a bone--it just happens much more frequently for them. From Rachel, I moved on to meetings with kids who had Type III OI--the most severe type you can get that isn''t lethal at birth. I remember the flash in five-year-old Hope''s eyes when the waitress at the restaurant mistook her for a toddler, due to her size; the pain in Jonathan''s mom''s voice when she talked about how she used to think about just leaving him and running away, because she was so afraid she''d be the one to cause another break. During my visit with Matthew, his mom asked me to take him out of his car seat--and I panicked. What if I was the one who snapped a bone this time? This, I realized, was what these parents went through on a daily basis. The kids I met who had OI were all sweet, bright, engaging, adorable--and much more than the sum of their disabilities. This was best illustrated in the case of a young woman who became my technical advisor for Handle with Care .
Kara Sheridan is a Paralympian who swam in Athens for Team USA in 2004. She is currently a Ph.D. student in clin.