Lois Lowry's many awards testify to her gifts at storytelling and her compassionate imagination. Each chapter of this book is accompanied by a black and white reproduction of a period photograph which helps to situate the characters in the very specific historical moment evoked. Katy's point of view is realistic and intelligent; interspersed with the main story line are episodes that develop her relationship with a pregnant mother, her love of books and story, and her curiosities about her father's medical practice, and her friendship with the local boy who eventually becomes her husband.

Simply told and engaging, the story handles the final tragedy with gentle clarity. Jacob's condition is never named; we come to understand its nature entirely by means of Katy's observations. A poignant bit of medical history imbedded in a personal story. A book that may help young people reflect on the humanity of those suffering from mental illness that prevents them from giving and receiving love and understanding in ordinary ways.