9780143037149

Kim Edwards’s stunning family drama evokes the spirit of Sue Miller and Alice Sebold, articulating every mother’s silent fear: what would happen if you lost your child and she grew up without you? In 1964, when a blizzard forces Dr. David Henry to deliver his own twins, he immediately recognizes that one of them has Down Syndrome and makes a split-second decision that will haunt all their lives forever. He asks his nurse to take the baby away to an institution and to keep her birth a secret. Instead, she disappears into another city to raise the child as her own. Compulsively readable and deeply moving, The Memory Keeper’s Daughteris an astonishing tale of redemptive love. BACKCOVER: Edwards is a born novelist. . . . Rich with psychological detail and the nuances of human connection.” —Chicago Tribune Unfolds from an absolutely gripping premise, drawing you deeply and irrevocably into the entangled lives of two families and the devastating secret that shaped them both. I loved this riveting story.” —Sue Monk Kidd Anyone would be struck by the extraordinary power and sympathy of The Memory Keeper’s Daughter.” —The Washington Post Kim Edwards has written a novel so mesmerizing that I devoured it. . . . The Memory Keeper’s Daughterhas it all.” —Sena Jeter Naslund Kim Edwards has created a tale of regret and redemption, of honest emotion, of characters haunted by their past. This is simply a beautiful book.” —Jodi Picoult

Kim Edwards is the author of the short-story collection The Secrets of a Fire King, which was shortlisted for the PEN/Hemingway Award. She has won both the Whiting Award and the Nelson Algren Award and teaches writing at the University of Kentucky.

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1964
March 1964
I

THE SNOW STARTED TO FALL SEVERAL HOURS BEFORE HER labor began. A few flakes first, in the dull gray late-afternoon sky, and then wind-driven swirls and eddies around the edges of their wide front porch. He stood by her side at the window, watching sharp gusts of snow billow, then swirl and drift to the ground. All around the neighborhood, lights came on, and the naked branches of the trees turned white.

After dinner he built a fire, venturing out into the weather for wood he had piled against the garage the previous autumn. The air was bright and cold against his face, and the snow in the driveway was already halfway to his knees. He gathered logs, shaking off their soft white caps and carrying them inside. The kindling in the iron grate caught fire immediately, and he sat for a time on the hearth, cross-legged, adding logs and watching the flames leap, blue-edged and hypnotic. Outside, snow continued to fall quietly through the darkness, as bright and thick as static in the cones of light cast by the streetlights. By the time he rose and looked out the window, their car had become a soft white hill on the edge of the street. Already his footprints in the driveway had filled and disappeared.

He brushed ashes from his hands and sat on the sofa beside his wife, her feet propped on pillows, her swollen ankles crossed, a copy of Dr. Spock balanced on her belly. Absorbed, she licked her index finger absently each time she turned a page. Her hands were slender, her fingers short and sturdy, and she bit her bottom lip lightly, intently, as she read. Watching her, he felt a surge of love and wonder: that she was his wife, that their baby, due in just three weeks, would soon be born. Their first child, this would be. They had been married just a year.

She looked up, smiling, when he tucked the blanket around her legs.

"You know, I've been wondering what it's like," she said. "Before we're born, I mean. It's too bad we can't remember." She opened her robe and pulled up the sweater she wore underneath, revealing a belly as round and hard as a melon. She ran her hand across its smooth surface, firelight playing across her skin, casting reddish gold onto her hair. "Do you suppose it's like being inside a great lantern? The book says light permeates my skin, that the baby can already see."

"I don't know," he said.

She laughed. "Why not?" she asked. "You're the doctor."

"I'm just an orthopedic surgeon," he reminded her. "I could tell you the ossification pattern for fetal bones, but that's about it." He lifted her foot, both delicate and swollen inside the light blue sock, and began to massage it gently: the powerful tarsal bone of her heel, the metatarsals and the phalanges, hidden beneath skin and densely layered muscles like a fan about to open. Her breathing filled the quiet room, her foot warmed his hands, and he imagined the perfect, secret, symmetry of bones. In pregnancy she seemed to him beautiful but fragile, fine blue veins faintly visible through her pale white skin.

It had been an excellent pregnancy, without medical restrictions. Even so, he had not been able to make love to her for several months. He found himself wanting to protect her instead, to carry her up flights of stairs, to wrap her in blankets, to bring her cups of custard. "I'm not an invalid," she protested each time, laughing. "I'm not some fledgling you discovered on the lawn." Still, she was pleased by his attentions. Sometimes he woke and watched her as she slept: the flutter of her eyelids, the slow even movement of her chest, her outflung hand, small enough that he could enclose it completely with his own.

She was eleven years younger than he was. He had first seen her not much more than a year ago, as she rode up an escalator in a department store downtown, one gray November Saturday while he was buying ties. He was thirty-three years old and new to Lexington, Kentucky, and she had risen out of the crowd like some kind of vision, her blond hair swept back in an elegant chignon, pearls glimmering at her throat and on her ears. She was wearing a coat of dark green wool, and her skin was clear and pale. He stepped onto the escalator, pushing his way upward through the crowd, struggling to keep her in sight. She went to the fourth floor, lingerie and hosiery. When he tried to follow her through aisles dense with racks of slips and brassieres and panties, all glimmering softly, a sales clerk in a navy blue dress with a white collar stopped him, smiling, to ask if she could help. A robe, he said, scanning the aisles until he caught sight of her hair, a dark green shoulder, her bent head revealing the elegant pale curve of her neck. A robe for my sister who lives in New Orleans. He had no sister, of course, or any living family that he acknowledged.

The clerk disappeared and came back a moment later with three robes in sturdy terry cloth. He chose blindly, hardly glancing down, taking the one on top. Three sizes, the clerk was saying, and a better selection of colors next month, but he was already in the aisle, a coral-colored robe draped over his arm, his shoes squeaking on the tiles as he moved impatiently between the other shoppers to where she stood.

She was shuffling through the stacks of expensive stockings, sheer colors shining through slick cellophane windows: taupe, navy, a maroon as dark as pig's blood. The sleeve of her green coat brushed his and he smelled her perfume, something delicate and yet pervasive, something like the dense pale petals of lilacs outside the window of the student rooms he'd once occupied in Pittsburgh. The squat windows of his basement apartment were always grimy, opaque with steel-factory soot and ash, but in the spring there were lilacs blooming, sprays of white and lavender pressing against the glass, their scent drifting in like light.

He cleared his throat—he could hardly breathe—and held up the terry cloth robe, but the clerk behind the counter was laughing, telling a joke, and she did not notice him. When he cleared his throat again she glanced at him, annoyed, then nodded at her customer, now holding three thin packages of stockings like giant playing cards in her hand.

"I'm afraid Miss Asher was here first," the clerk said, cool and haughty.

Their eyes met then, and he was startled to see they were the same dark green as her coat. She was taking him in—the solid tweed overcoat, his face clean-shaven and flushed with cold, his trim fingernails. She smiled, amused and faintly dismissive, gesturing to the robe on his arm.

"For your wife?" she asked. She spoke with what he recognized as a genteel Kentucky accent, in this city of old money where such distinctions mattered. After just six months in town, he already knew this. "It's all right, Jean," she went on, turning back to the clerk. "Go on and take him first. This poor man must feel lost and awkward, in here with all the lace." "It's for my sister," he told her, desperate to reverse the bad impression he was making. It had happened to him often here; he was too forward or direct and gave offense. The robe slipped to the floor and he bent to pick it up, his face flushing as he rose. Her gloves were lying on the glass, her bare hands folded lightly next to them. His discomfort seemed to soften her, for when he met her eyes again, they were kind.

He tried again. "I'm sorry. I don't seem to know what I'm doing. And I'm in a hurry. I'm a doctor. I'm late to the hospital."

Her smiled changed then, grew serious.

"I see," she said, turning back to the clerk. "Really, Jean, do take him first."

She agreed to see him again, writing her name and phone number in the perfect script she'd been taught in third grade, her teacher an ex-nun who had engraved the rules of penmanship in her small charges. Each letter has a shape, she told them, one shape in the world and no other, and it is your responsibility to make it perfect. Eight years old, pale and skinny, the woman in the green coat who would become his wife had clenched her small fingers around the pen and practiced cursive writing alone in her room, hour after hour, until she wrote with the exquisite fluidity of running water. Later, listening to that story, he would imagine her head bent beneath the lamplight, her fingers in a painful cluster around the pen, and he would wonder at her tenacity, her belief in beauty and in the authoritative voice of the ex-nun. But on that day he did not know any of this. On that day he carried the slip of paper in the pocket of his white coat through one sickroom after another, remembering her letters flowing one into another to form the perfect shape of her name. He phoned her that same evening and took her to dinner the next night, and three months later they were married.

Now, in these last months of her pregnancy, the soft coral robe fit her perfectly. She had found it packed away and had held it up to show him. But your sister died so long ago, she exclaimed, suddenly puzzled, and for an instant he had frozen, smiling, the lie from a year before darting like a dark bird through the room. Then he shrugged, sheepish. I had to say something, he told her. I had to find a way to get your name. She smiled then, and crossed the room and embraced him.

The snow fell. For the next few hours, they read and talked. Sometimes she caught his hand and put it on her belly to feel the baby move. From time to time he got up to feed the fire, glancing out the window to see three inches on the ground, then five or six. The streets were softened and quiet, and there were few cars.

At eleven she rose and went to bed. He stayed downstairs, reading the latest issue of The Journal of Bone and Joint Surgery. He was known to be a very good doctor, with a talent for diagnosis and a reputation for skillful work. He had graduated first in his class.

Still, he was young enough and—though he hid it very carefully— unsure enough about his skills that he studied in every spare moment, collecting each success he accomplished as one more piece of evidence in his own favor. He felt himself to be an aberration, born with a love for learning in a family absorbed in simply scrambling to get by, day to day. They had seen education as an unnecessary luxury, a means to no certain end. Poor, when they went to the doctor at all it was to the clinic in Morgantown, fifty miles away. His memories of those rare trips were vivid, bouncing in the back of the borrowed pickup truck, dust flying in their wake. The dancing road, his sister had called it, from her place in the cab with their parents. In Morgantown the rooms were dim, the murky green or turquoise of pond water, and the doctors had been hurried, brisk with them, distracted.

All these years later, he still had moments when he sensed the gaze of those doctors and felt himself to be an imposter, about to be unmasked by a single mistake. He knew his choice of specialties reflected this. Not for him the random excitement of general medicine or the delicate risky plumbing of the heart. He dealt mostly with broken limbs, sculpting casts and viewing X-rays, watching breaks slowly yet miraculously knit themselves back together. He liked that bones were solid things, surviving even the white heat of cremation. Bones would last; it was easy for him to put his faith in something so solid and predictable.

He read well past midnight, until the words shimmered senselessly on the bright white pages, and then he tossed the journal on the coffee table and got up to tend to the fire. He tamped the charred fire-laced logs into embers, opened the damper fully, and closed the brass fireplace screen. When he turned off the lights, shards of fire glowed softly through layers of ash as delicate and white as the snow piled so high now on the porch railings and the rhododendron bushes.

The stairs creaked with his weight. He paused by the nursery door, studying the shadowy shapes of the crib and the changing table, the stuffed animals arranged on shelves. The walls were painted a pale sea green. His wife had made the Mother Goose quilt that hung on the far wall, sewing with tiny stitches, tearing out entire panels if she noted the slightest imperfection. A border of bears was stenciled just below the ceiling; she had done that too. On an impulse he went into the room and stood before the window, pushing aside the sheer curtain to watch the snow, now nearly eight inches high on the lampposts and the fences and the roofs. It was the sort of storm that rarely happened in Lexington, and the steady white flakes, the silence, filled him with a sense of excitement and peace. It was a moment when all the disparate shards of his life seemed to knit themselves together, every past sadness and disappointment, every anxious secret and uncertainty hidden now beneath the soft white layers. Tomorrow would be quiet, the world subdued and fragile, until the neighborhood children came out to break the stillness with their tracks and shouts and joy. He remembered such days from his own childhood in the mountains, rare moments of escape when he went into the woods, his breathing amplified and his voice somehow muffled by the heavy snow that bent branches low, drifted over paths. The world, for a few short hours, transformed.

He stood there for a long time, until he heard her moving quietly. He found her sitting on the edge of their bed, her head bent, her hands gripping the mattress.

"I think this is labor," she said, looking up. Her hair was loose, a strand caught on her lip. He brushed it back behind her ear. She shook her head as he sat beside her. "I don't know. I feel strange. This crampy feeling, it comes and goes."

He helped her lie down on her side and then he lay down too, massaging her back. "It's probably just false labor," he assured her. "It's three weeks early, after all, and first babies are usually late." This was true, he knew, he believed it as he spoke, and he was, in fact, so sure of it that after a time he drifted into sleep. He woke to find her standing over the bed, shaking his shoulder. Her robe, her hair, looked nearly white in the strange snowy light that filled their room.

"I've been timing them. Five minutes apart. They're strong, and I'm scared."

He felt an inner surge then; excitement and fear tumbled through him like foam pushed by a wave. But he had been trained to be calm in emergencies, to keep his emotions in check, so he was able to stand without any urgency, take the watch, and walk with her, slowly and calmly, up and down the hall. When the contractions came she squeezed his hand so hard he felt as if the bones in his fingers might fuse. The contractions were as she had said, five minutes apart, then four. He took the suitcase from the closet, feeling numb suddenly with the momentousness of these events, long expected but a surprise all the same. He moved, as she did, but the world slowed to stillness around them. He was acutely aware of every action, the way breath rushed against his tongue, the way her feet slid uncomfortably into the only shoes she could still wear, her swollen flesh making a ridge against the dark gray leather. When he took her arm he felt strangely as if he himself were suspended in the room, somewhere near the light fixture, watching them both from above, noting every nuance and detail: how she trembled with a contraction, how his fingers closed so firmly and protectively around her elbow. How outside, still, the snow was drifting down. He helped her into her green wool coat, which hung unbuttoned, gaping around her belly. He found the leather gloves she'd been wearing when he first saw her, too. It seemed important that these details be right. They stood together on the porch for a moment, stunned by the soft white world.

"Wait here," he said, and went down the steps, breaking a path through the drifts. The doors of the old car were frozen, and it took him several minutes to get one open. A white cloud flew up, glittering, when the door at last swung back, and he scrambled on the floor of the backseat for the ice scraper and brush. When he emerged his wife was leaning against a porch pillar, her forehead on her arms. He understood in that moment both how much pain she was in and that the baby was really coming, coming that very night. He resisted a powerful urge to go to her and, instead, put all his energy into freeing the car, warming first one bare hand and then the other beneath his armpits when the pain of the cold became too great, warming them but never pausing, brushing snow from the windshield and the windows and the hood, watching it scatter and disappear into the soft sea of white around his calves.

"You didn't mention it would hurt this much," she said, when he reached the porch. He put his arm around her shoulders and helped her down the steps. "I can walk," she insisted. "It's just when the pain comes."

"I know," he said, but he did not let her go.

When they reached the car she touched his arm and gestured to the house, veiled with snow and glowing like a lantern in the darkness of the street.

"When we come back we'll have our baby with us," she said. "Our world will never be the same."

The windshield wipers were frozen, and snow spilled down the back window when he pulled into the street. He drove slowly, thinking how beautiful Lexington was, the trees and bushes so heavy with snow. When he turned onto the main street the wheels hit ice and the car slid, briefly, fluidly, across the intersection, coming to rest by a snowbank. "We're fine," he announced, his head rushing. Fortunately, there wasn't another car in sight. The steering wheel was as hard and cold as stone beneath his bare hands. Now and then he wiped at the windshield with the back of his hand, leaning to peer through the hole he'd made. "I called Bentley before we left," he said, naming his colleague, an obstetrician. "I said to meet us at the office. We'll go there. It's closer."

She was silent for a moment, her hand gripping the dashboard as she breathed through a contraction. "As long as I don't have my baby in this old car," she managed at last, trying to joke. "You know how much I've always hated it."

He smiled, but he knew her fear was real, and he shared it. Methodical, purposeful: even in an emergency he could not change his nature. He came to a full stop at every light, signaled turns to the empty streets. Every few minutes she braced one hand against the dashboard again and focused her breathing, which made him swallow and glance sideways at her, more nervous on that night than he could ever remember being. More nervous than his in first anatomy class, the body of a young boy peeled open to reveal its secrets. More nervous than on his wedding day, her family filling one side of the church, and on the other just a handful of his colleagues. His parents were dead, his sister too.

There was a single car in the clinic parking lot, the nurse's powder-blue Fairlane, conservative and pragmatic and newer than his own. He'd called her, too. He pulled up in front of the entrance and helped his wife out. Now that they had reached the office safely they were both exhilarated, laughing as they pushed into the bright lights of the waiting room.

The nurse met them. The moment he saw her, he knew something was wrong. She had large blue eyes in a pale face that might have been forty or twenty-five, and whenever something was not to her liking a thin vertical line formed across her forehead, just between her eyes. It was there now as she gave them her news: Bentley's car had fishtailed on the unplowed country road where he lived, spun around twice on the ice beneath the snow, and floated into a ditch.

"You're saying Dr. Bentley won't be coming?" his wife asked. The nurse nodded. She was tall, so thin and angular it seemed the bones might poke from beneath her skin at any moment. Her large blue eyes were solemn and intelligent. For months, there had been rumors, jokes, that she was a little bit in love with him. He had dismissed them as idle office gossip, annoying but natural when a man and single woman worked in such close proximity, day after day. And then one evening he had fallen asleep at his desk. He'd been dreaming, back in his childhood home, his mother putting up jars of fruit that gleamed jewel-like on the oilcloth-covered table beneath the window. His sister, age five, sat holding a doll in one listless hand. A passing image, perhaps a memory, but one that filled him simultaneously with sadness and with yearning. The house was his but empty now, deserted when his sister died and his parents moved away, the rooms his mother had scrubbed to a dull gleam abandoned, filled only with the rustlings of squirrels and mice.

He'd had tears in his eyes when he opened them, raising his head from the desk. The nurse was standing in the doorway, her face gentled by emotion. She was beautiful in that moment, half smiling, not at all the efficient woman who worked beside him so quietly and competently each day. Their eyes met, and it seemed to the doctor that he knew her—that they knew each other—in some profound and certain way. For an instant nothing whatsoever stood between them; it was an intimacy of such magnitude that he was motionless, transfixed. Then she blushed severely and looked aside.

She cleared her throat and straightened, saying that she had worked two hours overtime and would be going. For many days, her eyes would not meet his.

After that, when people teased him about her, he made them stop. She's a very fine nurse, he would say, holding up one hand against the jokes, honoring that moment of communion they had shared. She's the best I've ever worked with. This was true, and now he was very glad to have her with him.

"How about the emergency room?" she asked. "Could you make it?"

The doctor shook his head. The contractions were just a minute or so apart.

"This baby won't wait," he said, looking at his wife. Snow had melted in her hair and glittered like a diamond tiara. "This baby's on its way."

"It's all right," his wife said, stoic. Her voice was harder now, determined. "This will be a better story to tell him, growing up: him or her."

The nurse smiled, the line still visible though fainter, between her eyes. "Let's get you inside then," she said. "Let's get you some help with the pain."

He went into his own office to find a coat, and when he entered Bentley's examination room his wife was lying on the bed, her feet in the stirrups. The room was pale blue, filled with chrome and white enamel and fine instruments of gleaming steel. The doctor went to the sink and washed his hands. He felt extremely alert, aware of the tiniest details, and as he performed this ordinary ritual he felt his panic at Bentley's absence begin to ease. He closed his eyes, forcing himself to focus on his task.

"Everything's progressing," the nurse said, when he turned. "Everything looks fine. I'd put her at ten centimeters; see what you think."

He sat on the low stool and reached up into the soft warm cave of his wife's body. The amniotic sac was still intact, and through it he could feel the baby's head, smooth and hard like a baseball. His child. He should be pacing a waiting room somewhere. Across the room, the blinds were closed on the only window, and as he pulled his hand from the warmth of his wife's body he found himself wondering about the snow, if it was falling still, silencing the city and the land beyond.

"Yes," he said, "ten centimeters."

"Phoebe," his wife said. He could not see her face, but her voice was clear. They had been discussing names for months and had reached no decisions. "For a girl, Phoebe. And for a boy, Paul, after my great-uncle. Did I tell you this?" she asked. "I meant to tell you I'd decided."

"Those are good names," the nurse said, soothing.

"Phoebe and Paul," the doctor repeated, but he was concentrating on the contraction now rising in his wife's flesh. He gestured to the nurse, who readied the gas. During his residency years, the practice had been to put the woman in labor out completely until the birth was over, but times had changed—it was 1964—and Bentley, he knew, used gas more selectively. Better that she should be awake to push; he would put her out for the worst of the contractions, for the crowning and the birth. His wife tensed and cried out, and the baby moved in the birth canal, bursting the amniotic sac. "Now," the doctor said, and the nurse put the mask in place. His wife's hands relaxed, her fists unclenching as the gas took effect, and she lay still, tranquil and unknowing, as another contraction and another moved through her.

"It's coming fast for a first baby," the nurse observed.

"Yes," the doctor said. "So far so good."

Half an hour passed in this way. His wife roused and moaned and pushed, and when he felt she had had enough—or when she cried out that the pain was overwhelming—he nodded to the nurse, who gave her the gas. Except for the quiet exchange of instructions, they did not speak. Outside the snow kept falling, drifting along the sides of houses, filling the roads. The doctor sat on a stainless steel chair, narrowing his concentration to the essential facts. He had delivered five babies during medical school, all live births and all successful, and he focused now on those, seeking in his memory the details of care. As he did so, his wife, lying with her feet in the stirrups and her belly rising so high that he could not see her face, slowly became one with those other women. Her round knees, her smooth narrow calves, her ankles, all these were before him, familiar and beloved. Yet he did not think to stroke her skin or put a reassuring hand on her knee. It was the nurse who held her hand while she pushed. To the doctor, focused on what was immediately before him, she became not just herself but more than herself; a body like other bodies, a patient whose needs he must meet with every technical skill he had. It was necessary, more necessary than usual, to keep his emotions in check. As time passed, the strange moment he had experienced in their bedroom came to him again. He began to feel as if he were somehow removed from the scene of this birth, both there and also floating elsewhere, observing from some safe distance. He watched himself make the careful, precise incision for the episiotomy. A good one, he thought, as the blood welled in a clean line, not letting himself remember the times he'd touched that same flesh in passion.

The head crowned. In three more pushes it emerged, and then the body slid into his waiting hands and the baby cried out, its blue skin pinking up.

It was a boy, red-faced and dark-haired, his eyes alert, suspicious of the lights and the cold bright slap of air. The doctor tied the umbilical cord and cut it. My son, he allowed himself to think. My son. "He's beautiful," the nurse said. She waited while he examined the child, noting his steady heart, rapid and sure, the long-fingered hands and shock of dark hair. Then she took the infant to the other room to bathe him and to drop the silver nitrate into his eyes. The small cries drifted back to them, and his wife stirred. The doctor stayed where he was with his hand on her knee, taking several deep breaths, awaiting the afterbirth. My son, he thought again.

"Where is the baby?" his wife asked, opening her eyes and pushing hair away from her flushed face. "Is everything all right?"

"It's a boy," the doctor said, smiling down at her. "We have a son. You'll see him as soon as he's clean. He's absolutely perfect."

His wife's face, soft with relief and exhaustion, suddenly tightened with another contraction, and the doctor, expecting the afterbirth, returned to the stool between her legs and pressed lightly against her abdomen. She cried out, and at the same moment he understood what was happening, as startled as if a window had appeared suddenly in a concrete wall.

"It's all right," he said. "Everything's fine. Nurse," he called, as the next contraction tightened.

She came at once, carrying the baby, now swaddled in white blankets.

"He's a nine on the Apgar," she announced. "That's very good."

His wife lifted her arms for the baby and began to speak, but then the pain caught her and she lay back down. "Nurse?" the doctor said, "I need you here. Right now."

After a moment's confusion the nurse put two pillows on the floor, placed the baby on them, and joined the doctor by the table. "More gas," he said. He saw her surprise and then her quick nod of comprehension as she complied. His hand was on his wife's knee; he felt the tension ease from her muscles as the gas worked. "Twins?" the nurse asked.

The doctor, who had allowed himself to relax after the boy was born, felt shaky now, and he did not trust himself to do more than nod. Steady, he told himself, as the next head crowned. You are anywhere, he thought, watching from some fine point on the ceiling as his hands worked with method and precision. This is any birth. This baby was smaller and came easily, sliding so quickly into his gloved hands that he leaned forward, using his chest to make sure it did not fall. "It's a girl," he said, and cradled her like a football, face down, tapping her back until she cried out. Then he turned her over to see her face.

Creamy white vernix whorled in her delicate skin, and she was slippery with amniotic fluid and traces of blood. The blue eyes were cloudy, the hair jet black, but he barely noticed all of this. What he was looking at were the unmistakable features, the eyes turned up as if with laughter, the epicanthal fold across their lids, the flattened nose. A classic case, he remembered his professor saying as they examined a similar child, years ago. A mongoloid. Do you know what that means? And the doctor, dutiful, had recited the symptoms he'd memorized from the text: flaccid muscle tone, delayed growth and mental development, possible heart complications, early death. The professor had nodded, placing his stethoscope on the baby's smooth bare chest. Poor kid. There's nothing they can do except try to keep him clean. They ought to spare themselves and send him to a home. The doctor had felt transported back in time. His sister had been born with a heart defect and had grown very slowly, her breath catching and coming in little gasps whenever she tried to run. For many years, until the first trip to the clinic in Morgantown, they had not known what was the matter. Then they knew, and there was nothing they could do. All his mother's attention had gone to her, and yet she had died when she was twelve years old. The doctor had been sixteen, already living in town to attend high school, already on his way to Pittsburgh and medical school and the life he was living now. Still, he remembered the depth and endurance of his mother's grief, the way she walked up hill to the grave every morning, her arms folded against whatever weather she encountered.

The nurse stood beside him and studied the baby.

"I'm sorry, doctor," she said.

He held the infant, forgetting what he ought to do next. Her tiny hands were perfect. But the gap between her big toes and the others, that was there, like a missing tooth, and when he looked deeply at her eyes he saw the Brushfield spots, as tiny and distinct as flecks of snow in the irises. He imagined her heart, the size of a plum and very possibly defective, and he thought of the nursery, so carefully painted, with its soft animals and single crib. He thought of his wife standing on the sidewalk before their brightly veiled home, saying, Our world will never be the same.

The baby's hand brushed his, and he started. Without volition he began to move through the familiar patterns. He cut the cord and checked her heart, her lungs. All the time he was thinking of the snow, the silver car floating into a ditch, the deep quiet of this empty clinic. Later, 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 steadily outside. The silence was so deep and encompassing that he felt himself floating to a new height, some point above this room and then beyond, where he was one with the snow and where this scene in the room was something unfolding in a different life, a life at which he was a random spectator, like a scene glimpsed through a warmly lit window while walking on a darkened street. That was what he would remember, that feeling of endless space. The doctor in the ditch, and the lights of his own house burning far away.

"All right. Clean her up, please," he said, releasing the slight weight of the infant into the nurse's arms. "But keep her in the other room. I don't want my wife to know. Not right away." The nurse nodded. She disappeared and then came back to lift his son into the baby carrier they'd brought. The doctor was by then intent on delivering the placentas, which came out beautifully, dark and thick, each the size of a small plate. Fraternal twins, male and female, one visibly perfect and the other marked by an extra chromosome in every cell of her body. What were the odds of that? His son lay in the carrier, his hands waving now and then, fluid and random with the quick water motions of the womb. He injected his wife with a sedative, then leaned down to repair the episiotomy. It was nearly dawn, light gathering faintly in the windows. He watched his hands move, thinking how well the stitches were going in, as tiny as her own, as neat and even. She had torn out a whole panel of the quilt because of one mistake, invisible to him.

When the doctor finished, he found the nurse sitting in a rocker in the waiting room, cradling the baby girl in her arms. She met his gaze without speaking, and he remembered the night she had watched him as he slept.

"There's a place," he said, writing the name and address on the back of an envelope. "I'd like you to take her there. When it's light, I mean. I'll issue the birth certificate, and I'll call to say you're coming."

"But your wife," the nurse said, and he heard, from his distant place, the surprise and disapproval in her voice.

He thought of his sister, pale and thin, trying to catch her breath, and his mother turning to the window to hide her tears.

"Don't you see?" he asked, his voice soft. "This poor child will most likely have a serious heart defect. A fatal one. I'm trying to spare us all a terrible grief."

He spoke with conviction. He believed his own words. The nurse sat staring at him, her expression surprised but otherwise unreadable, as he waited for her to say yes. In the state of mind he was in it did not occur to him that she might say anything else. He did not imagine, as he would later that night, and in many nights to come, the ways in which he was jeopardizing everything. Instead, he felt impatient with her slowness and very tired all of a sudden, and the clinic, so familiar, seemed strange around him, as if he were walking in a dream. The nurse studied him with her blue unreadable eyes. He returned her gaze, unflinching, and at last she nodded, a movement so slight as to be almost imperceptible.

"The snow," she murmured, looking down.

But by midmorning the storm had begun to abate, and the distant sounds of plows grated through the still air. He watched from the upstairs window as the nurse knocked snow from her powder-blue car and drove off into the soft white world. The baby was hidden, asleep in a box lined with blankets, on the seat beside her. The doctor watched her turn left onto the street and disappear. Then he went back and sat with his family.

His wife slept, her gold hair splayed across the pillow. Now and then the doctor dozed. Awake, he gazed into the empty parking lot, watching smoke rise from the chimneys across the street, preparing the words he would say. That it was no one's fault, that their daughter would be in good hands, with others like herself, with ceaseless care. That it would be best this way for them all.

In the late morning, when the snow had stopped for good, his son cried out in hunger, and his wife woke up.

"Where's the baby?" she said, rising up on her elbows, pushing her hair from her face. He was holding their son, warm and light, and he sat down beside her, settling the baby in her arms.

"Hello, my sweet," he said. "Look at our beautiful son. You were very brave."

She kissed the baby's forehead, then undid her robe and put him to her breast. His son latched on at once, and his wife looked up and smiled. He took her free hand, remembering how hard she had held onto him, imprinting the bones of her fingers on his flesh. He remembered how much he had wanted to protect her.

"Is everything all right?" she asked. "Darling? What is it?"

"We had twins," he told her slowly, thinking of the shocks of dark hair, the slippery bodies moving in his hands. Tears rose in his eyes. "One of each."

"Oh," she said. "A little girl too? Phoebe and Paul. But where is she?"

Her fingers were so slight, he thought, like the bones of a little bird.

"My darling," he began. His voice broke, and the words he had rehearsed so carefully were gone. He closed his eyes, and when he could speak again more words came, unplanned.

"Oh, my love," he said. "I am so sorry. Our little daughter died as she was born."