Mercifully, few parents experience the shattering birth moment we did, and it may be that memories of my daughter's birth magnified the emotional impact of [Kim Edwards]'s debut novel. But I think anyone would be struck by the extraordinary power and sympathy of The Memory Keeper's Daughter. The book opens during a snowstorm in Lexington, Ky., in 1964, when Norah Henry realizes that she's going into labor. The weather keeps her doctor from making it to the office in time, but her husband, David, is an orthopedic surgeon with enough experience to handle the situation. Under the partial influence of gas, Norah gives birth to a healthy baby boy, but as David tells her the happy news, another series of contractions begins. He quickly sedates his wife again, and she gives birth to another child, a girl with Down syndrome.

"Later," Edwards writes, "when he considered this night -- and he would think of it often, in the months and years to come: the turning point of his life, the moments around which everything else would always gather -- what he remembered was the silence in the room and the snow falling outside." In that quiet, terrifying moment, the grief and resentment caused by his sister's death at the age of 12 washes back over him, and he acts to preserve their vision of a happy future. He hands the baby to his nurse and asks her to take it to a home outside the city for handicapped children. When Norah awakens a few minutes later, he tells her their second baby was stillborn. "He had wanted to spare her," Edwards writes, "to protect her from loss and pain; he had not understood that loss would follow her regardless, as persistent and life-shaping as a stream of water. Nor had he anticipated his own grief, woven with the dark threads of his past."