You remember the Kleenex boxes. If you saw My Sister's Keeper in a theater back in 2009, you probably remember the collective sniffing of a hundred strangers as the credits rolled. It was heavy. It was also, behind the scenes, a total casting whirlwind that almost looked completely different.
Honestly, when people talk about the cast My Sister's Keeper brought together, they usually focus on Cameron Diaz playing a "serious" role. But the real story is in the swaps, the shaved heads, and the tragic reality of what happened to some of these actors years after the cameras stopped rolling.
The Fanning Switch That Changed Everything
Here is the piece of trivia that usually shocks people: Abigail Breslin and Sofia Vassilieva weren't the first choices. Not even close. Originally, real-life sisters Dakota and Elle Fanning were signed on to play Anna and Kate. It made sense, right? Built-in chemistry.
But there was a massive sticking point. Dakota Fanning refused to shave her head.
She felt she could play a leukemia patient with a bald cap, but director Nick Cassavetes—who isn't exactly known for being "light" with his actors—wasn't having it. He wanted authenticity. Dakota walked, and because they were a package deal, Elle walked too.
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That’s how we ended up with Sofia Vassilieva. She was 15 at the time and actually did the deed. She shaved her head and her eyebrows. Cameron Diaz later called it one of the bravest things she’d seen a teenager do on a set. You can see it in the performance; there’s a vulnerability there that a bald cap just can't mimic.
Breaking Down the Fitzgerald Family
The ensemble was a weird, eclectic mix of A-listers and character actors who somehow made a "designer baby" plot feel grounded.
- Abigail Breslin (Anna Fitzgerald): Fresh off her Little Miss Sunshine fame, Breslin had to play the "savior" sibling suing for medical emancipation. She was only 13 but had to carry the legal weight of the film.
- Cameron Diaz (Sara Fitzgerald): This was a huge pivot for her. No Charlie’s Angels hair-flipping here. She played a mother so blinded by the need to save one child that she basically forgot how to parent the others. Critics were split—some loved the "shrill" desperation she brought; others thought she lacked the maternal warmth found in Jodi Picoult’s book.
- Jason Patric (Brian Fitzgerald): He’s the quiet anchor. While Sara is screaming at lawyers, Brian is the firefighter father just trying to keep the house from burning down emotionally.
- Sofia Vassilieva (Kate Fitzgerald): The heart of the movie. Most people knew her as the eldest daughter from the TV show Medium, but this role won her a Young Artist Award.
The Support Staff: Baldwin and Cusack
Alec Baldwin played Campbell Alexander, the slick lawyer with a secret. He provided the only "breather" moments in the movie. It’s funny—he has this dog in the film that he claims is for "iron lung" issues, which ends up being a classic Baldwin-esque delivery of a tragic-comic reveal.
Then you’ve got Joan Cusack. She plays Judge De Salvo. If you look closely at her performance, she’s playing someone who is grieving her own child while trying to decide the fate of another. It’s subtle, but it’s one of the best parts of the movie.
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What Happened to Evan Ellingson?
This is the part that hits hard now. Evan Ellingson played Jesse, the "forgotten" brother. In the movie, his character is a bit sidelined, mostly wandering the streets or dealing with his own rebellion while his sisters are in the spotlight.
Tragically, in late 2023, Evan Ellingson passed away at the age of 35. He had struggled with addiction for years and died in a sober-living home in California. He hadn't acted in a decade, but for fans of the movie, his death was a grim reminder of how much time had passed since that 2009 premiere.
The Ending Controversy
You can't talk about the cast without talking about what they were forced to act out. If you read the book, you know Anna (Breslin) dies in a car accident right after winning her court case. It’s a gut-punch.
The movie? They flipped it. Kate dies instead.
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Jodi Picoult was famously unhappy about this. She basically said she regretted letting Cassavetes direct because he fundamentally changed the message. The cast had to navigate this change mid-stream, and you can sort of feel that tension in the final scenes. The movie chose "peaceful" over "shocking," and fans are still arguing about it on Reddit today.
Where is the cast now?
Most of them moved on to very different lives. Cameron Diaz famously retired for years to start a wine brand (Avaline) and be a mom before recently teasing a comeback. Abigail Breslin is married now and still works constantly, though she's moved into more indie thriller territory.
Sofia Vassilieva graduated from Columbia University and still pops up in shows like Black Lightning and Looking for Alaska. She’s stayed relatively low-key compared to the child-star trajectory we usually see.
Quick Cast Reference
- Sara Fitzgerald: Cameron Diaz
- Anna Fitzgerald: Abigail Breslin
- Kate Fitzgerald: Sofia Vassilieva
- Brian Fitzgerald: Jason Patric
- Campbell Alexander: Alec Baldwin
- Judge De Salvo: Joan Cusack
- Jesse Fitzgerald: Evan Ellingson
- Taylor Ambrose: Thomas Dekker
If you’re planning a rewatch, keep an eye on the background. You’ll see Emily Deschanel (of Bones fame) playing Dr. Farquad. It’s one of those "before they were even more famous" moments.
Basically, the movie works because the kids carried the adults. Without Vassilieva’s willingness to go bald and Breslin’s ability to look Alec Baldwin in the eye and demand her rights, the whole thing would have collapsed into a Hallmark-style puddle.
If you want to see how these actors have evolved, check out Abigail Breslin's recent work in Stillwater or look for Cameron Diaz's upcoming project Back in Action. It's wild to see the "designer baby" all grown up.