Simply put, this is an amazing book. Ms. McKay is an excellent novelist (The Birth House, The Virgin Cure, Witches of New York). Her new book is a memoir with a unique context. Her great-great-aunt, Pauline Gross, confided to a pathology professor in 1895 that she expected to die young because she had observed a very strong family history of cancer. This statement led to a cancer genealogy study that ultimately resulted in the discovery of a gene mutation that creates a devastating cancer susceptibility, now known as Lynch Syndrome. Part of the book imagines the lives of Pauline and sister Tillie, the direct ancestor of Ms. McKay. Along this history, there are some dedicated physician-scientists but the ugly reality of eugenics is part of this quest. Much of the book is deeply personal since Ms. McKay also has the Lynch Syndrome mutation. What thought process informs the decision to undergo genetic screening? How does one live with this knowledge, with implications for your children (there is a 50% risk of transmitting the mutation)? And finally, there is Ami’s deeply moving and loving relationship with her mother so this is also a memoir of love and fate, tremendous family resilience, the link between the genes we inherit and the life we choose. This is a fantastic read.