01:00 AM EDT on Sunday, April 18, 2004

BY KATHERINE IMBRIE
Journal Staff Writer

At the heart of a new novel by Jodi Picoult is a kind of Sophie's Choice for this brave new millennium: If you use one of your children to save the life of another, are you being a good mother or a bad one?

That's the thorny question the New Hampshire author puts to her readers in My Sister's Keeper, just out from Atria Books. Picoult will be in Providence next weekend to promote the novel, her 11th, which happens to be set in Rhode Island. The family facing the book's central dilemma, the Fitzgeralds, live in the imagined Providence suburb of Upper Darby, and the medical action occurs in fictional "Providence Hospital."

But the "where" is beside the point of this novel: It might as easily have been set in New York, Los Angeles or Kalamazoo. As real-life modern genetic medicine ever more insistently pushes up against the present outer limits of medical ethics, Picoult's book poses questions that have no easy answers: Is it right for a couple to conceive a child expressly for the purpose of becoming a body-part donor for another? And what if the "donor" child, upon reaching the age of reason, decides that she doesn't want to compromise her own life in favor of her sister's?

It isn't the first time that Picoult, 37, has tangled with the emotion-laden intricacies of medical and legal ethics. Previous novels have dealt with such fraught subjects as euthanasia (Mercy), teen suicide (The Pact), stigmata and the existence of God (Keeping Faith), the Amish system of justice (Plain Truth), and sterilization laws (her most recent novel, Second Glance.)

Speaking by phone recently from her home in Hanover, Picoult said she was enjoying a break from a national book-promotion tour schedule that would seem to leave her little time for writing more books. (She gave full credit to her stay-at-home husband, Tim Van Leer, for making it possible for her to pursue her writing career full-time. The couple have three children, ages 12, 10 and 8.)

"I do a lot of traveling, not just promoting my books, but also researching them," she said. An upcoming novel, Vanishing Acts, recently took her to Arizona, where part of the book is set. (This one is about recovered memories in a parent-kidnaps-child case that -- like many Picoult scenarios -- has a basis in real-life news events.)

"My books tend to require a lot of research. I spend as much time researching as writing them, and -- make what you want of this! -- both processes seem to always add up to nine months."

Three areas of research

Before she could begin to write My Sister's Keeper, Picoult had to familiarize herself with at least three different aspects of the fictional case at the heart of the book: the medical intricacies of a rare form of childhood leukemia, the legal ramifications of a child suing her own parents, and the logistics of firefighting and arson. (The father of Anna -- the child who is at the center of the book -- is a firefighter.)

"It was a lot to learn!" she laughed, emphasizing that she considers it vitally important to get the facts that underlie her fiction exactly right. A primary legal source for the book was her friend, former Rhode Island assistant attorney general Jennifer Sternick, who is now in private practice.

"That's part of the reason I decided to set the story in Providence," said Picoult. "I had heard a lot about the city, and I liked the name, because there's so much hope in it. So I went down and spent some time there to see where things were that I would put into the book."

Among them: XO Cafe and the intersection of Fountain and Eddy streets.

But you don't read a book like this one to spot Rhode Island references. You read it to get into the minds and hearts of a group of well-meaning, intelligent, and wryly humorous people who, in the course of the book's events, find themselves confronted with a multi-layered dilemma that allows for no easy answers.

Her ability to lead her readers to see and appreciate each character's point of view is what makes Picoult such an engaging writer. There are plenty of gray hues in My Sister's Keeper: Almost nothing in the book is black and white.

That's how she selects her book subjects, said Picoult: "If I come across a question that I can't let go of -- either from reading something in the news or overhearing a bit of a conversation -- then that's what leads me to want to write about it."

In the case of My Sister's Keeper, Picoult was researching the legalities of sterilization for Second Glance when she read of a Colorado case in which a baby was born, and stem cells from his body were given to his sister, who had leukemia.

As far as she knows, says Picoult, "This case worked out fine, and everybody's happy. But I kept wondering, What if the sister dies? What if, when this boy grows up, he finds out what he was used for, without being asked?

"I don't know all the answers to these questions. I want to leave it up to my readers to think about these issues and come to their own conclusions."

Unexpected twists

As is often the case in Picoult's novels, the ending of My Sister's Keeper contains at least two unexpected twists. Did she know, setting out to write the book, that it would end the way it did?

"Oh, you know, I've done all my research before I start to write, and I know my characters to the point that it feels as if they're real people who are speaking through me, telling me their stories.

"But at the same time, there's always something that comes along that surprises me. But when I get there, I know what the ending has to be. I might not want it to happen -- and in this case I even called one of my medical sources to see if there was any other way to go -- but there wasn't. And fictionally, it is the right ending."

Readers will have to decide for themselves if they agree: It's a Picoult signature, after all, to confront her readers with hard questions.

She'll be available to answer some of them in several area appearances next weekend:

Friday evening at 7, she'll be reading from the book at Borders in Providence Place.

Saturday morning, she'll be a guest on Reading With Robin on talk-radio WHJJ 920 beginning at 7 o'clock.

At 11 a.m. Saturday, she'll be at the Avon Cinema, 260 Thayer St., for a reading and book-signing, with a portion of the proceeds from book sales going to Big Sisters of Rhode Island.

Saturday night at 7:30, she'll be at the Kingston Free Library, 2605 Kingston Rd., Kingston, for a reading, with books for sale by Waldenbooks of Wakefield.

That may seem like a lot of appearances for a small state, but as My Sister's Keeper is set here, said Picoult, "This one's your book, Rhode Island, so enjoy it!"