Summary: A doctor delivers his wife's child and is surprised to find twins: a healthy baby boy and a baby girl with the unmistakable signs of Down Syndrome. Fearful for the girl's prospects and aware of his own mother's grief over his sickly sister (who later died), the doctor instructs his nurse to secretly take the girl to a group home. He tells his wife the baby girl died. The nurse, however, cannot leave the child, and she runs away to Pittsburgh where she raises the girl herself. Spanning several decades, the novel chronicles the lives of David Henry (the doctor), Norah (his wife), Paul (their son), Caroline (the nurse), and Phoebe (the daughter David gave away).
In some ways, I felt irritated by the grief David and Norah carried with them. David understandably carried a large burden by keeping this terrible secret from his family, but would such guilt never dissipate? Norah, on the other hand, mourns for a daughter she thought died. Would she continue to be haunted by the daughter that never was 5, 10, 15, and 20 years later? Having never experienced such grief myself, I suppose I'm not in a position to judge, but I found the constant fixation on unrelenting and unreasonable grief and loss irritating (and boring).
The novel frequently changes viewpoint so you see the events unfolding from the minds of David, Norah, Caroline, and Paul. The novel is less action and more the thoughts of each character as he/she grows and changes with those around him/her. This allows for an intimate glimpse into each character but makes it hard to picture the characters interacting with one another. Many times the characters' perspectives seemed at odds with one another, and I wanted to shout to the characters to just speak to one another! This was probably intentional, as it gives the reader an infuriating look into the way in which people hide emotions and destroy relationships in the process.
The book is on the long side, and the addition of a new character late in the book seems oddly placed. The melodrama and suppression of emotion can be draining; I found myself looking most forward to the chapters about Caroline and Phoebe because, unlike the Henry family, they were freer, more open, and less burdened. Phoebe, with her Down Syndrome, at least saw the world as a place full of possibility and opportunity.