Edwards takes on many themes in this novel, including the burden of secrets, the loneliness of a disintegrating marriage, the heartache and triumph of raising children—and, most pointedly, the need for developmentally disabled children to feel accepted by society. The Memory Keeper's Daughter reveals the strength of family bonds under unique and difficult circumstances.
David Henry's secret is so powerful it destroys his marriage and keeps him estranged from his children. David, haunted by childhood memories, makes a hurried decision immediately following the birth of his and his wife's twins. It is a decision made in a panic and only later will David realize the full extent of the consequences. All through the novel, David tries to reveal his secret to his wife. But the longer he hesitates, the more difficult this becomes. The burden of keeping the secret of having given his daughter away turns out to far outweigh the disadvantages the Down Syndrome child might have caused.
The issue of children with Down Syndrome, especially as they were in the past century, is another theme. This part of the theme is first demonstrated through David, a physician who should have known better. His rejection of Phoebe represents the fear that people have when facing a child with Phoebe's condition. David responds with only the negative aspects, and he even exaggerates them. He is, of course, influenced by his own childhood memories of having to take care of a very ill sister, but as someone who was out to heal the world, as David was, his actions were inexcusable. Most of Caroline's story is centered on helping Phoebe to adjust to a world that was often against her. Unlike David, Caroline sees beyond Phoebe's differences and fights for her rights to live a life defined by what was normal for Phoebe.
Norah and her son Paul represent the theme of loneliness. Neither of them seems able to connect with anyone, at least not until...
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