2005 399 pages
In a blizzard in 1964, Dr. David Henry delivers his own twins - a boy, Paul, and a girl, Phoebe. Phoebe has down syndrome. David's own sister died when she was young and to protect his wife, Norah, from the pain, he tells his nurse, Caroline, to take the baby to a home in another city. Caroline takes the baby to Pittsburgh instead and raises her. She eventually marries a truck driver, Al. Over the years she sends David anonymous updates and he sends money. His own family is destroyed by the secret. After his death at 51, the secret comes out.
Good writing, but dark.