This fictional novel begins on the night of an unusual Kentucky blizzard with Dr. David Henry delivering fraternal twins to his wife, Norah, assisted by his devoted nurse, Caroline Gill. David realizes that Paul, the boy baby, is healthy but that the other child, a girl, has Down’s syndrome. In order to spare Norah the heartache of this discovery, David orders Caroline to place the baby in an institution. Caroline, thirty-one and single, ignores David's request and flees with the baby, Phoebe, to a new life in Pittsburgh. The plot thickens and a dark shadow appears over the marriage of David and Norah. Paul, the male twin, is impacted by the problems of his parents. The new life of Caroline and Phoebe is also detailed. The novel chronicles the characters lives over three decades from 1964-1988. This is one of the best fiction books I have read in years. A page turner that I read over two nights. Every person I have recommended it to has the same reaction. Mesmerizing and excellent, the novel spent most of 2006 on the New York Times Best Seller List mostly through word of mouth. Deep themes of the treatment of the disabled and women are evident. In the end, life continues and we must live with the choices we make.