Handle With Care

“You were, in general, full of information no one else knew or cared about, because you read all the time, or surfed the Net, or listened to shows on the History Channel that put me to sleep. It freaked people out, to come across a five-year-old who knew that toilets flush in the key of E-flat or that the oldest word in the English language is town, but Mom said that lots of kids with OI were early readers with advanced verbal skills. I figured it was like a muscle; your brain got used more than the rest of your body, which was always breaking down; no wonder you sounded like a little Einstein.”

This quote introduces one of the central symbols in the novel, Willow’s trivia. Additionally, it highlights the theme of Visible and Invisible Illnesses and Disabilities. People assume Willow will behave less maturely than she does because of her OI and rarely can look past the physical manifestation of her disability. Amelia uses hyperbole to highlight how frequently Willow breaks bones by comparing her to Einstein, a very intelligent scientist.

“Everything that had ever been good and kind in me, everything people imagined me to be, had been poisoned by the part of me that had wished, in the darkest crack of the night, that I could have a different family. The real me was a disgusting person who imagined a life where you had never been born.”

Amelia thinks this before she purges for the first time, implying that her family dynamics are the root of her mental health conditions and that she feels guilty for wanting a different family. However, like her bulimia, she will keep these thoughts a secret, because she feels shame about her true feelings. By suggesting the “good and kind” parts of her have been poisoned, Amelia implies that she knows, deep down, she is a good person who has been affected by external factors.

“In fact, sometimes I was sure that the reason people stared at you with your crutches and wheelchair had nothing to do with your disabilities, and everything to do with the fact that you had abilities they only dreamed of.”

While many cannot see past Willow’s physical disability, Charlotte frequently sees the strength and talent her daughter possesses. Additionally, while Charlotte often describes herself as a pessimist, this quote highlights her optimism when it comes to Willow’s abilities.

“Being adopted felt like reading a book that had the first chapter ripped out. You might be enjoying the plot and the characters, but you’d probably also like to read that first line, too.”

Marin’s main conflict is her desire to connect to her biological mother. Even though Marin is happy with the parents who raised her, she feels a deep desire to know her full origin story and feels incomplete without it.

“She told me that when she baked, she could feel herself coming back to center, that everything else fell away, and she remembered who she was supposed to be. I’d been jealous. I had a vocation—and I was a damn good doctor—but Charlotte had a calling.”

Piper expresses her envy of Charlotte’s passion for baking and its effect on her, illustrating the differences between how the two friends approach their work. The juxtaposition of “calling” and “vocation” suggests that Charlotte’s love for baking is inherent in her selfhood, while Piper’s job is simply what she does for money. This quote also highlights the theme of The Power and Shortcomings of Motherhood and Maternal Love. Baking is a domestic act, something stereotypically associated with women, but especially stay-at-home mothers. After Piper leaves her practice, she also throws herself into the domestic sphere, but focuses on renovating her house.

“The lawyer glanced at Marin Gates, who cleared her throat. […] ‘The implication is that if your provider had told you earlier on that your baby was going to be impaired, you would have had choices and options as to whether or not to continue with the pregnancy.’

I remembered snapping at Piper weeks ago: Do you always have to be so damn perfect?

What if the one time she hadn’t been perfect was when it came to you?”

This quote shows the fractures beginning to form in Charlotte and Piper’s sisterhood. Charlotte paradoxically criticizes Piper for being too perfect but files a lawsuit centered around a presumed error on Piper’s part. As someone close to Piper, Charlotte knows that even if Piper had missed something on the ultrasound, it would be an uncharacteristic mistake. However, despite their closeness, Charlotte is most devoted to Willow.This quote shows the fractures beginning to form in Charlotte and Piper’s sisterhood. Charlotte paradoxically criticizes Piper for being too perfect but files a lawsuit centered around a presumed error on Piper’s part. As someone close to Piper, Charlotte knows that even if Piper had missed something on the ultrasound, it would be an uncharacteristic mistake. However, despite their closeness, Charlotte is most devoted to Willow.

“Charlotte said that an offer to help was not a comment on else’s weakness, and that a police officer ought to know that. But hell, if you wanted to know what I was really thinking when I asked a lost-out-of-towner if he needed directions or gave a battered wife my card and told her to call me if she needed assistance, it was this: pull yourself up by your bootstraps and figure a way out of the mess you’ve gotten yourself into. There was a big difference, the way I saw it, between a nightmare you woke up in unexpectedly and a nightmare of your own making.”

Sean sees the world concretely and resists ethical dilemmas. This quote highlights how he is frustrated by nuance or grey areas and often looks at situations more simply. He struggles to sign on to the lawsuit for similar reasons, as he has a difficult time accepting that multiple things can be true at the same time: He and Charlotte can love Willow and still wish that their circumstances had been different, and Charlotte can say one thing in court but feel another. Additionally, this quote is ironic because many of the situations Sean finds himself in the novel are of his own doing, but he believes he doesn’t have control over them.

“On January 22, 1973, nineteen days after I was born and living with the Gates family, the U.S. Supreme Court ruled on Roe v. Wade.”

While the novel stresses that the O’Keefes’ case is not about abortion rights, the concept of abortion comes up frequently in the context of the wrongful birth suit. This is part of the reason Marin struggles so much with the case; she worries that the only reason she can try the case in the first place is because her biological mother didn’t have the opportunity to terminate her pregnancy with Marin.

“Was it the act of giving birth that made you a mother? Did you lose that label when you relinquished your child? If people were measured by their deeds, on the one hand, I had a woman who had chosen to give me up; on the other, I’d had a woman who’d sat up with me at night when I was sick as a child, who’d cried with me over boyfriends, who’d clapped fiercely at my law school graduation. Which acts made you more of a mother?”

This quote explores the theme of motherhood and foreshadows the completion of Marin’s search for her biological mother. When Juliet Cooper rejects Marin and asks Marin to leave her alone, Marin realizes that the person who raised her, but did not give birth to her, is much more of a mother to her than her own biological mother.

“I wished she’d listen. I wished she could hear the things you asked me when we were laying in bed at night, before we fell asleep: Amelia, will you help me brush my teeth, so I don’t have to ask Mom to do it? Amelia, can your parents ever send you back to the place you came from?

Was it any wonder that I found myself staring in the mirror at my disgusting body? My mother was going to a lawyer to sue over a kid who had turned out less than perfect.”

Charlotte’s preoccupation with the lawsuit impacts her communication and connection with her children, leading them to draw their own conclusions about Charlotte’s feelings toward them. While Charlotte is seen as a martyr by many characters for her selfless dedication to Willow, she in fact misses cues from both her children: Willow tries to be as independent as she can, in the hopes her parents won’t get rid of her, while Amelia develops harmful coping mechanisms to deal with her mother’s neglect. Here, Amelia draws an explicit connection between her body image and disordered eating and her interpretation of Charlotte’s motivations.

“You’re going to hear things, and maybe read things, and you’ll think to yourself, My mom would never say that. And you’d be right. Because when I’m in court, talking to that lawyer, I’m pretending to be someone else, even though I look the same and my voice sounds the same. I might fool everyone else in the world, but I don’t want to fool you.”

When people tell Charlotte how harmful the lawsuit will be to Willow, she struggles to believe them because she assumes Willow will trust her true intentions. However, she eventually must address the subject with Willow, admitting to her that she will be lying on the stand. The implication that Willow can and might access details about the case also highlights her precocious nature.

“You can’t win. Either you have the baby and wear your pain on the outside, or you don’t have the baby, and you keep that ache in you forever. I know I didn’t do the wrong thing. But I don’t feel like I did the right thing, either.”

Following Willow’s in-utero OI diagnosis, Charlotte visits a neighbor who had a late-term abortion after finding out that the fetus had a severe condition. The neighbor’s description of her grief following her abortion parallels Charlotte’s feelings about the lawsuit: She knows it’s not necessarily wrong, but it doesn’t feel right either.

“But I was also proud of myself, a little bit. Crazy girls did this—the ones who wrote poetry about their organs being filled with tar and who wore so much black eyeliner they looked Egyptian—not good girls from good families. That meant either I was not a good girl or I did not come from a good family.”

Amelia thinks this after she cuts herself for the first time. While she is relieved to have a physical manifestation of the pain she feels inside, she is more relieved to have an identity to cling to. As with her binging and purging, she directly connects her pain to her family situation. Amelia also suggests that one can’t be both “good” and “crazy”; in this way, she exhibits black-and-white thinking that mirrors her father’s inability to accept nuance.

“‘Okay then,’ you said. ‘I wish you’d never been born, too.’”

As Willow continues to struggle with understanding how Charlotte can say she wishes she’d never been born and still love her, Charlotte struggles to explain to Willow why she believes it’s okay to lie in this context. They play a game of “opposites,” where they both say the opposite of what they mean. Willow ends the game with this line, showing Charlotte that despite her own best efforts, Willow has not been shielded from the lawsuit. Several times in the novel, characters point Charlotte’s words back to her, and she must wrestle with how it feels to hear them.

“Families were never what you wanted them to be. We all wanted what we couldn’t have: the perfect child, the doting husband, the mother who’d let us go. We lived in our grown-up dollhouses completely unaware that, at any moment, a hand might come in and change around everything we’d become accustomed to.”

While playing with Willow, Marin realizes the extent to which the lawsuit has destroyed the O’Keefes’ lives. This quote highlights the fact that many of the characters in the novel long for things they cannot have but are often disappointed when they receive what they think they want. It also highlights the unexpected and fragile nature of life, despite one’s attempts to curate and control it; few people expect to lose a child or sibling or to face a lawsuit filed by their best friend.

“Once, I’d held you in my arms while you slept, and I’d watched dreams screening across your face; now, I loved you in theory if not in practice. I was too busy protecting and serving the rest of Bankton to focus on protecting and serving you; that had fallen to Charlotte instead.”

To keep up with Willow’s growing medical bills, Sean takes on extra shifts, which leads to him spending less and less time with Willow. As a result, he is seen by the outside world as a hero for his career as a police officer, but at home, he is a stranger to the family. Here, he acknowledges Charlotte’s role as the primary caregiver and parent despite criticizing her as a martyr.

“Just as the doors were closing, a crutch jammed between them. The man who had signed us in yesterday was standing on the threshold, but instead of smiling at me in welcome, like he had twelve hours earlier, his eyes were dark as pitch. ‘Just so you know—it’s not my disability that makes my life a constant struggle,’ he said. ‘It’s people like you.’ Then, with a rasping of metal, he stepped back and let the elevator doors close.”

Charlotte is quickly recognized at the OI convention for being involved in the wrongful birth lawsuit and faces criticism from other attendees. While Marin and Sean have warned her that people will think negatively of her because of the lawsuit, this is the first time she has had to publicly face the consequences of her actions.

“This was worse than being judged by a jury of my peers. This was being judged by a jury of your peers.”

Ultimately, the worst part of the OI convention for Charlotte is the fact that people like Willow—people who understand intimately what the O’Keefes experience daily—disapprove of the lawsuit. This makes Charlotte second-guess her decision. The use of “jury” connects this experience to the lawsuit: Even though Piper is technically the one under legal scrutiny, Charlotte is aware that she, too, is being judged in the courtroom.

“If I had not been able to read Charlotte correctly, how could I trust myself to understand the needs of patients who were virtual strangers? I had wondered for the first time about the terminology of running your own office as a doctor. It was called a practice. But shouldn’t we have gotten it right by the time we opened one?”

Piper takes a sabbatical following the lawsuit, now unsure of her medical abilities, but also her judgment. She believed that she knew Charlotte inside-out, which is why the lawsuit comes as such a surprise. The lawsuit, and her rift with Charlotte, humbles Piper, leading her to question the sound judgment she previously took for granted as a trained clinician.

“I’ve always sort of wondered about the term bearing witness. Is it that testifying is such a hardship? Or is it childbirth lingo, the idea that a witness brings forth something new to the trial?”

Marin reflects on the dual meanings of “bearing”—one can “bear,” or carry, a heavy load or a burden, but “bear” can also mean to bring something into being. Notably, Charlotte’s position reflects both meanings—she carries the load of Willow’s care, but she also brought Willow into the world. Marin’s reflection also highlights how the trial has emphasized the power and shortcomings of motherhood and maternal love. It has brought Marin’s search for her biological mother to an end and transformed the kinds of mothers Piper and Charlotte will be in the future.

“What would I do?

I would go back to the moment Charlotte had asked me to help her have a baby, and I’d refer her to someone else.

I’d go back to when we were more likely to laugh together than to cry.

I’d go back to the time before you had come between us.

I’d do whatever I had to, to keep you from feeling like everything was breaking apart.

If you chose to stop a loved one’s suffering—either before it began or during the process—was that murder, or mercy?”

While reflecting back on the time Charlotte asked Piper if she would sign the DNR for Willow in Charlotte’s position, Piper cannot help but think of all the things she would do differently. Notably, she begins by not being Charlotte’s doctor, indicating that to Piper, agreeing to do so despite her hesitation was her biggest mistake. She highlights both her love for Charlotte, but also her love and empathy for Willow.

“And here’s the weirdest thing of all: now that the worst had happened—now that I’d been found out—it wasn’t disastrous. It felt, well, inevitable. My father was furious, but me, I couldn’t stop smiling. You see me, I thought, my eyes closing. You see me.”

Throughout the novel, Amelia is desperate for the support and attention of her parents. When her bulimia and self-harm come to light, she feels relief that her pain is no longer invisible to her father. Her feeling that her parents finding out was “inevitable” suggests both her awareness that her coping mechanisms are not sustainable, as well as her hope that her parents would notice.

“Prenatal testing reduces a fetus to one trait: its disability. It’s unfortunate that prenatal testing automatically makes the assumption that a parent might not want a child who’s disabled, and that it implies it’s unacceptable to live life with some sort of physical impairment. I know plenty of parents in the deaf community who would love a child just like them, for example. One person’s disability is another person’s culture.”

During the trial, Guy Booker and Lou St. Pierre often bring up the ethical dilemma that the lawsuit presents: that it could open the door to people terminating pregnancies for reasons that appear more like eugenics. This quote from St. Pierre highlights the fact that there are strong communities formed around disabilities, much like what Willow found at the OI convention. Notably, St. Pierre’s argument assumes that parents who find out that a fetus will later have a disability will want to terminate, but it does not address parents who would want to proceed with a pregnancy, but from a fully informed perspective.