Bookmarks Issue: 
Jodi Picoult

A-Handle With Care

The Story: New Hampshire residents Charlotte and Sean O’Keefe hope for what all parents want—a healthy baby. Instead, their precocious Willow was born with brittle bone disease (osteogenesis imperfecta, or OI). Her illness affects the financial and emotional stability of the entire family, including her troubled older sister, Amelia. Then Charlotte, against her husband’s wishes, decides to sue for wrongful birth in order to win the settlement that will provide security for them all. The problem is that the defendant, the obstetrician who delivered Willow, is her best friend; worse, Charlotte will have to take the stand to say that had she known of her daughter’s condition before her birth, she would have aborted the fetus. Soon, the family starts to tear at its seams.
Atria. 496 pages. $27.95. ISBN: 0743296419

Charlotte Observer 4 of 5 Stars
"Willow’s own voice is not heard until the end of the book, but this wise little girl is the driving force of the narrative. … Handle With Care is bound to touch hearts and open minds to a little-known affliction." Pat MacEnulty

San Antonio Exp-News 4 of 5 Stars
"Her books are entirely formulaic—family drama writ large, harrowing legal scene, and then a twist at the end—and her fans (and I count myself among them) as well as critics (and I count myself among them, too) just don’t care. The plotting is so smooth and the writing so seamless, you can’t help but devour every page." Jennifer Roolf Laster

Washington Post 4 of 5 Stars
"It’s well written, it’s conscientiously researched and, most important, it presents a character who is a child instead of a disability personified. … Picoult does a terrific job of evoking OI and its peculiarities—from the likelihood that parents might be accused of child abuse (because of fractures that don’t quite ‘make sense’) to the incessant push and pull of wanting a child to experience kindergarten friendships, Disney World and ice skating, while worrying constantly that another fragile bone will break." Perri Klass

Boston Globe 2.5 of 5 Stars
"Part of the problem may be the subject matter, which, for a parent, can make for painful reading. … Some of the most compelling sections are the recipes Picoult slips in between chapters, reflecting Charlotte’s past life as a baker." Karen Campbell

Critical Summary

Sure, Jodi Picoult can be formulaic, but few critics seemed to mind her well-researched, domestic-and-legal-drama-told-through-multiple-viewpoints framework for Handle With Care. Except for the Boston Globe, which noted that "the construct feels a little tired and trepid, creating more distance than illumination," reviewers embraced Picoult’s latest offering. Told primarily through the voices of Willow’s mother, her father, her adolescent sister, the obstetrician, and a lawyer, the novel wrenched readers’ hearts as it examines motherhood, family, and disability. The bonus? Charlotte, a renowned pastry chef, adds a little sweetness to the family tragedy by interspersing her dessert recipes throughout the novel.

Reading Guide


The Reading Guide below is supplied by the book's publisher, and plot points may be revealed. We recommend that read the book before reading the guide.

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?

Unless otherwise stated, this discussion guide is reprinted with the permission of Simon and Schuster. Any page references refer to a USA edition of the book, usually the trade paperback version, and may vary in other editions.