Handle with Care (novel)

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Handle with Care is a 2009 novel by Jodi Picoult, her 17th book. It tells the story of Willow O’Keefe, a bright young girl with osteogenesis imperfecta (brittle bone disease), and her big, busy family: her mother Charlotte, her father Sean, and Willow’s half-sister Amelia.

After a Disney World trip leads to serious bone breaks, hospital staff suspect child abuse. The O’Keefs hire lawyer Marin Gates, who suggests a different lawsuit: a wrongful birth claim against Charlotte’s obstetrician/gynaecologist, Piper Reece (Charlotte’s best friend). The idea is that if Willow’s condition had been known earlier, the parents could have made different choices about the pregnancy. The trial reveals there was clear sign of OI at an 18-week ultrasound, and the jury awards the O’Keefes $8 million. Piper loses her medical practice.

During the case, Marin learns her own birth mother is on the jury and that Marin was born from rape, adding personal heartbreak to her work. Amelia struggles with bulimia, self-harm, and feeling unseen by her parents, but eventually seeks treatment and finds a new passion for painting. Charlotte, who used to bake pastries, writes a cookbook to raise money for the OI Foundation, and Sean and Charlotte eventually reconcile after earlier worries about the lawsuit.

The story is told from multiple viewpoints: Charlotte, Sean, Marin, Piper, Amelia, and in the final chapter, Willow herself. Willow’s life in first grade includes attending an OI camp, while Amelia grows and heals. The novel builds toward tragedy: Willow wanders onto a frozen pond and drowns, reflecting that this time it was not her breaking but the ice. Charlotte ends by burying the $8 million check with Willow, never cashing it.

Key characters include:
- Charlotte O’Keefe: Willow’s mother who sues to secure resources for her daughter.
- Sean O’Keefe: Willow’s father, a police officer who wrestles with the lawsuit and family tensions.
- Willow O’Keefe: A highly intelligent girl living with OI, who dies after the pond accident.
- Amelia O’Keefe: Willow’s half-sister who battles bulimia and self-harm.
- Marin Gates: The O’Keefe family’s lawyer who seeks her own family history.
- Piper Reece: Charlotte’s best friend and Willow’s godmother, the accused physician.
- Emma and Rob Reece: Piper’s daughter and husband, whose lives intersect with the trial.

Reception was mixed but generally positive: People magazine gave it four stars; The Washington Post praised it as a strong, engaging read with solid medical context; The Boston Globe found it engaging though sometimes arduous. The book was published by Atria and runs about 496 pages.