In 1964, Dr. David Henry is forced to deliver his fraternal twins during a winter storm. The delivery of his son goes well. However, when he delivers his daughter Phoebe, he realizes that she was born with Down syndrome. In a split moment, he decides he does not want to keep her and hands over the baby to the attending nurse Caroline. He tells Caroline to take her to a home. When his wife, Norah, wakes up he tells her their daughter died. This decision haunts him for the rest of his life. The book explores the effects this secret has on everyone involved- from the nurse who decides to keep and raise Phoebe as her daughter to Paul her twin brother who craves his father's attention throughout his life.

The initial story line was good, but the story focuses too much on the characters inner turmoils and behaviors that sometimes seem unwarranted. For example, Paul seems to hate his father, but you do not understand where this hatred stems from since David has not done anything to his son that would deserve this kind of treatment (at least not anything that is explained to the reader). In addition, the distance that grows between Norah and David would be understandable if Norah was reacting to David's deception, but she does not learn about her daughter for many years so her animosity toward her husband is not easily understood. Although I thought some of the story line was weak, it does get the reader thinking about life and the consequences of our decisions.