David Henry has worked his whole life to get away from the childhood he had, where his family struggled to make ends meet and died rather early in life. He has become a physician and his young wife is pregnant. On a rare snowy night in Lexington, Kentucky, she goes into labor and delivers twins, one boy and one girl. But, David realizes just after birth that his baby girl has Down Syndrome, and he worries about her fate; his own sister died of heart problems when she was still very young. So, he tells his nurse, Caroline Gill, to take her away to an institution, common during those times. Caroline brings the baby to the institution, but cannot leave her there, and instead runs away with the newborn Phoebe. David simply tells his wife that their baby girl died shortly after birth.

In the years that follow, David's carefully created family begins to fall apart, torn by the secrets each of them keep. David turns to photography, a way to capture memories on film, as a way to escape his secret and express the emotions that tear him up inside. It's not until after his death, though, that the family really understands his obsession with photography and his motivations.

The Memory Keeper's Daughter is a tragically realistic story of what it was like to be disabled in the 1960's and beyond. I have a sister with autism and can fully understand the difficulties that Phoebe, and the others in the story, go through. It's heart-wrenching, and you'll be willing the characters to go against their better judgment by the end. While the story was not likely meant to be inspiring, it can give an insight into the world of the disabled, whether it be individuals with Down Syndrome or other disorders that prevent them from being completely 'normal' in today's society.

While I understand the structure of the novel, I do wish we were given more insight into Caroline and Phoebe's world. There is so much left unsaid on that end of things because so much focus is on David and his wife, Norah, as well as their son, Paul. Perhaps because of this desire to know more about Phoebe, I found some of the sections about David and Norah to be dry and more difficult to get through. Even at the end, though, it's hard to really understand some of the characters, because they weren't fleshed out well. The setting is lacking, though perhaps purposefully. Though the story takes place in two distinct cities, it is told in a way that could really take place anywhere and at almost any time.

This is an excellent book to read, if only because of the insight it offers into a world many people aren't terribly familiar with.