Handle with Care (novel)

Handle With Care

First edition
Author Jodi Picoult
Country United States
Language English
Publisher Atria
Publication date
March 3, 2009
Media type Print (hardback & paperback)
Pages 496 pp
ISBN 978-0-7432-9641-0

Handle With Care is a novel by Jodi Picoult published in 2009. It debuted at #1 on The New York Times Best Seller list.[1]

Main Plot

The story follows the life of a girl named Willow O'Keefe and her family. Willow suffers from Type III osteogenesis imperfecta (OI), a disease also known as brittle bone syndrome. To her parents, Sean and Charlotte O'Keefe, it also meant sleepless nights, mounting bills, and the pitying stares of "luckier" parents.

After a disastrous vacation to Disney World that results in Willow suffering severe breaks to both of her femurs, Sean and Charlotte visit a lawyer to inquire about a lawsuit against the park and hospital after they (the park and hospital) thought Willow's breaks were out of child abuse. The lawyer mentions a different possibility: a wrongful birth lawsuit against the OB/GYN that treated Charlotte during her pregnancy, meaning that they are saying that if they had known earlier that their fetus had OI, they could have aborted. But, the OB/GYN they are suing is Piper Reece, Charlotte's best friend.

Amelia, the eldest daughter of Charlotte and Sean develops bulimia and starts cutting herself out of all the stress from her home life. Sean and Charlotte considered getting a divorce after countless disagreements about this lawsuit, however they eventually get back together. During the trial it is revealed that at an 18-week ultrasound, there was evidence of OI which Piper should have acted upon. The jury sides with the O'Keefes and awards them an $8 million check, forcing Piper to leave her practice and take up a part-time job at a free clinic. Marin Gates, the lawyer for the O'Keefes, has issues during the lawsuit as well, as she was adopted and is trying to track down her birth parents. She discovers her birth-mother is on the jury and it's revealed Marin was a product of rape.

The final chapter is narrated by Willow. She is starting first grade and is going to a camp for kids with OI. Amelia received treatment for her eating disorder and came back healthy and with a passion for painting. Charlotte wrote a recipe book (as she used to be a pastry chef) and is donating all the money to the OI Foundation. Sean and Charlotte reconcile and put the check aside for when they really need it. Willow has always been jealous of her sister as she is a brilliant ice skater. One day, she wanders to a frozen pond alone and tries to crawl over it carefully, but the thin ice breaks under her weight, drowning her. Willow mentions how, this time, it wasn't her that broke. The story concludes with Charlotte saying that the check was buried with Willow.


Charlotte O'Keefe is the mother of Willow and Amelia O'Keefe. She files a lawsuit against Piper Reece, her ob/gyn and best friend, in order to be able to secure the resources for her daughter, Willow. The lawsuit succeeds, and Charlotte is awarded $8 million in damages. After Willow's death, however, she tucks the check into the lining of Willow's coffin, never cashing it.

Sean O'Keefe is Charlotte's husband, Willow's father, and Amelia's stepfather. He is a police officer who works hard to support his family. Although he initially attempts to set aside his personal feelings about the lawsuit in order to support Charlotte, his disgust for the wrongful birth suit eventually leads him to testify for the defense. He also files for divorce from Charlotte, although they reunite eventually.

Willow O'Keefe: Born with osteogenesis imperfecta - also known as brittle bone disease - leading to the family greatly needing money to pay for her treatment. Despite her physical disability, she is extremely intelligent and is especially interested in trivia. She often reads while recovering from a bone break. During the lawsuit, she worries that her parents do not want her anymore because she isn't perfect. Near the end of the book, she goes out skating. The ice breaks, and Willow, trapped underneath, drowns. As she drowns, she reflects that she was loved, and that this time, it wasn't her that broke.

Amelia O'Keefe: Willow's older half-sister, who is overshadowed by her sister's illness. Amelia falls in love with a boy who suffers from the same disease as her sister with whom she meets at a convocation for her sister. She lies and tells them that she has OI, but he finds out. Eventually the differences in their health leads to him breaking up with her which further pushes her into isolation since her entire family is swallowed by the lawsuit. She then suffers from bulimia and self-injures. Suiting her character as a rebellious teen, in the novel she begins shoplifting from various stores and she dyes her hair blue. Sean eventually discovers her secrets after Piper brings them to his attention because pipes burst in their home from being eroded by the stomach acid(caused by her bulimia.) Charlotte suggests that Amelia goes to a treatment center. Amelia, furious, states in court as a witness that Charlotte told Willow that she would never wish that Willow had never been born. Charlotte admits later on that they should have discussed the treatment center as a family before she and Sean made that kind of decision.

Marin Gates: The lawyer handling the O'Keefes' case, although she is privately opposed to it. She is adopted and searching for her birth mother, who she eventually discovers by chance on the jury for Charlotte's case. However, her mother tells her that Marin's father was a rapist and makes it clear she doesn't want to know her daughter. Marin accepts this and becomes closer to her adoptive parents.

Piper Reece: Charlotte's best friend and obstetrician, as well as the godmother to Willow. She is a competent doctor, although she takes an extended break from work during the lawsuit. She brings to Sean's attention Amelia's bulimia and self-injury.

Rob Reece: Piper's husband. He is an orthodonist who works on many of the people in Bankton, including Amelia. His older brother, Stephen, committed suicide at the age of seventeen; the then-twelve-year-old Rob was the one to discover his body. Although the lawsuit initially causes strain in Rob and Piper's marriage, Rob ultimately agrees to support his wife.

Emma Reece: the daughter of Rob and Piper. She met Amelia through skating and became her best friend; however, she quickly casts Amelia aside after Charlotte sues Piper, and the two never reconcile. When she finds out about the lawsuit she made sure everyone at school alienated Amelia. She was the first one to notice Amelia's self-injury.


People gave the book four stars,[2] and The Washington Post called it "a great read, with strong characters, an exciting lawsuit to pull you along and really good use of the medical context."[3] However The Boston Globe called the novel "fairly engaging if sometimes [an] arduous read."[4]


  1. "Hardcover Fiction Best Sellers". The New York Times. March 13, 2009. Retrieved 2010-03-14.
  2. Donahue, Deirdre (March 3, 2009). "Jodi Picoult's life is far from her wrenching novels". USA Today. Retrieved 2010-03-14.
  3. Klass, Perri (March 3, 2009). "A 'Wrongful Birth' Lawsuit, a Mother in Anguish". The Washington Post. Retrieved 2010-03-14.
  4. Campbell, Karen (March 20, 2009). "Drawing strength from a brittle child". The Boston Globe. Retrieved 2010-03-14.
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