"My Sister's Keeper" is a tearjerker. It knows that, accepts that, and doesn't ever try to be anything more. That's one of the reasons that it works so well. Another reason is the high count of fabulous performances, most notably by Cameron Diaz and Sofia Vasillieva. Diaz's is so impressive primarily because of her stepping outside of her comfort zone. Appearing so often in comedies, she gives a raw and ruthless performance as a woman whose sole purpose is to keep her daughter alive, whatever the cost. Vasillieva's performance works in multiple ways. She's believable, charismatic, and gloriously understated. She knows that she is on the verge of death and embraces the fact, strenuously trying to enjoy the short amount of life that she has left. The story is incredibly thought-provoking and grabs hold of you from the get-go as the wonderful Abigail Breslin announces that rather than an accident, she was manufactured (so to speak) to be a donor for her sister Kate, diagnosed early on with a rare type of Leukemia. The film then proceeds to show us Anna (Abigail Breslin) speaking to a big-shot lawyer (an oddly cast Alec Baldwin) and asking to sue her parents for "Medical Emancipation." Basically, she wants to have the freedom to decide whether or not to donate to her sister, especially when it becomes evident that she is in need of a kidney. The film shows us various flashbacks from various characters' points of view, building Kate's (Vasilleava's) story. In her ruthless search to save her daughter, Sara (Diaz) casts aside her husband (Jason Patric) and son and casts aside Anna's well-being. The best sequence of the film chronicles Kate's first love interest, a boy who also has leukemia. It captures with great feeling love and loss. With all of these ingredients, the film is bound to be good, and when you add in a wonderfully non-stereotypical judge (a very powerful Joan Cusack), you know you can't go wrong. It is stepped up even further when, toward the end of the film, a twist comes and punches you full-on in the gut. But the film isn't perfect. The direction is overly sappy and very heavy-handed at times, hammering across music-video style montages with music that contrives emotion. But contrived or not, it's still emotion. Expect a few instances of salty language, mild sexual content and some heavy themes.