My Sister's Keeper

"My Sister's Keeper" features an angel-faced teenage girl named Kate Fitzgerald, dying from renal failure after a decadelong struggle with leukemia. Adapted from the novel by Jodi Picoult and directed by Nick Cassavetes, the movie is unabashed in its intention to have audiences reaching for anything, even a napkin smeared with faux popcorn butter, to wipe away their tears. But its tear-jerking is dignified by strong, measured performances, a provocative premise and the fact that it really is just sad as hell.

Kate, played by Sofia Vassilieva (of TV's "Medium"), has a younger sister named Anna (Abigail Breslin), who was genetically conceived as a blood marrow donor to help Kate live about 12 years earlier. Anna has declined to give Kate her kidney, which might or might not save her life. She hires an attorney, Campbell Alexander (Alec Baldwin, at his silkiest), off a billboard to help her gain medical emancipation from her parents, which would give her the legal right to say no to the transplant.

Their good, kind firefighter father, Brian (Jason Patric), sympathizes while their mother, Sara (Cameron Diaz), who has been single-mindedly focused on Kate's health for a dozen years, cannot fathom Anna's refusal. Improbably, Sara, a lawyer turned stay-at-home mother, decides to act as her own attorney. Even more improbably, the trio end up in a courtroom presided over by Judge De Salvo (Joan Cusack), who has just returned to the bench after a six-month leave, recovering from the death of her 12-year-old daughter at the hands of a drunken driver. Everyone bleeds in this movie, and these aren't emotional flesh wounds. What's surprising is that, as overwrought as Judge De Salvo's backstory might be, Cusack does the best supporting work of her career. She's fantastic.

As an audience, we are immediately on Anna's side. At 11, she has already endured eight hospitalizations to extract something of hers that might help her sister. Donating a kidney is a big and possibly life-altering decision. Practically speaking, Kate appears to have run out of the willpower to keep fighting. Sara is so used to playing the fierce lioness protecting her cub that she's poised to snarl at everyone and everything. Pity the poor woman who asks Sara if she's considered contacting the Make-A-Wish people. Pity even more her healthy son, Jesse (Evan Ellingson), who forgotten by his distracted parents, wanders the streets at night. (What's he doing? Turning tricks? The movie is too coy about his activities.)

When one looks at Diaz, one does not automatically think "lawyer," or, for that matter, mother of teenagers. The Diaz we know is the one we see in the family snapshots that Cassavetes keeps lovingly panning over, with her fabulous hair, figure and perfect, constant, I-was-a-model-first grin. But the performance Cassavetes has pulled out of Diaz is restrained, modest and affecting. When Kate meets another cancer victim, a cute, chemo-bald boy named Taylor (Thomas Dekker), at the hospital, Sara says nothing, but her hopes and fears for her daughter are written across Diaz's face. She also keeps something back, something private, and that deepens the performance. This is a seismic career shift, along the lines of Mary Tyler Moore's playing against type in "Ordinary People."

Cassavetes has two major claims to fame: He directed the mushy, gushy, wildly adored film "The Notebook," and he is the son of the late John Cassavetes, one of the great, brutal realists of American cinema, who no matter how much he loved his son, had he been alive and forced to sit through "The Notebook," he likely would have followed the paternal example set by William F. Buckley. According to the late Buckley's son, writer Christopher Buckley, on receipt of Christopher's latest novel, his father sent him an e-mail that read, "This one didn't work for me. Sorry."

But Cassavetes has nothing to be ashamed of. While there are people who prefer to seek their emotional release in real life, not from entertainment -- a legitimate stance -- there are also plenty of us who appreciate a good cry in the dark. He has made an affecting movie, and did it without merely following Picoult's bestselling formula to its conclusion. (The outcome of the Fitzgeralds' saga has been changed from the book.) Had Cassavetes and his co-writer, Jeremy Leven, gone with Picoult's over-the-top cosmic cruelty of a climax, "My Sister's Keeper" would have been, like "Beaches," the kind of movie that makes you feel betrayed and manipulated. This movie may bathe the Fitzgeralds in too gauzy a light, may unnecessarily build nobilities of character, but it is a good weepie, and that is a hard thing to pull off.