Handle with Care

About Handle with Care

Willow O'Keefe was born with Type III osteogenesis imperfecta—severe brittle bone disease. By the time she is five years old, she has broken more than sixty bones. Her parents Charlotte and Sean have built their lives around her medical needs: the hospital visits, the surgeries, the equipment, the debt. When a lawsuit attorney suggests that the family could fund Willow's lifelong care by suing their OB for wrongful birth—arguing that had they known the diagnosis in time, they would have terminated the pregnancy—Charlotte agrees to file. Sean does not want to. And Piper, the OB who is named in the suit, is Charlotte's best friend.

Published by Washington Square Press in 2009, Handle with Care is one of Picoult's most structurally ambitious novels. It is addressed throughout as a second-person narrative—Charlotte narrating to Willow, "you"—which creates a sustained dramatic irony as the reader comes to understand what the narrator's choices have cost before Willow herself can know. The device is not decorative; it is how the novel inhabits the gap between what parents do for children and what they cannot explain to them.

The wrongful birth lawsuit is real law, not fictional invention. Picoult researched the case type carefully, including the testimony conventions and the particular cruelty of requiring parents to argue publicly that they would have chosen not to have their child. The novel does not pretend this is not cruel. It asks whether the cruelty is justified by the child's need.

What Love Is and What It Costs

Willow is not a symbol of suffering or a lesson about disability. She is a specific child—funny, perceptive, loving, and fully aware of what her parents are doing to obtain money for her future. The novel gives her real interiority, including a voice that is not reduced to her condition. Her perspective on the lawsuit, when it finally comes, is not the perspective her parents expected.

The friendship between Charlotte and Piper is the novel's sharpest emotional line. That Charlotte would sacrifice it for Willow's future makes a kind of sense. That the lawsuit requires Charlotte to say, on the record, that she wishes Willow had not been born is what the book refuses to let be either simply wrong or simply right.

Why Handle with Care Has Been Challenged

Handle with Care has been challenged in 1 state and 5 districts tracked in this catalog. Challenges most frequently cite the wrongful birth legal premise—which some readers interpret as an argument for aborting disabled children—as well as language and mature content. The novel does not argue for that position. It examines the legal mechanism with rigor and the human cost with honesty, and refuses to resolve either cleanly. That refusal is the book's integrity.