Left to her own devices in the early years, Barbara struggles with grief from the loss of the expected "normal child" and battles self-defeating thoughts. Demoralizing encounters with medical professionals and insensitive remarks about Jim's face leave mother and child feeling vulnerable. They struggle with self-blame and fight against dark thoughts.

Over time they encounter and endure new doctors, multiple surgeries with disappointing results, and peers who taunt and bully. Gradually, Jim and Barbara empower themselves in their own ways, protest dismissive treatment, and become strong advocates for themselves. Jim proves to himself he can handle the world on his own after a successful 400-mile solo bike trip. As he ages into a young adult, Barbara frees herself from her own worries and drawing on her experiences, shapes a career as a counseling psychologist so that she can address the needs of parents of children with birth defects and disabilities. Jim also develops a successful career, a loving partnership, and a settled relationship with his cleft palate.

Then, prompted by an invitation from her 45-year-old son to "share our story," mother and son embark on an unflinching account of their personal and shared experiences, their often-differing memories, and how they dealt with and learned from his cleft lip and palate birth defect.

Entwined with Barbara's narrative of her mothering experience, Jim's poems shine a light on a teenager's struggle, and both discover that this candid sharing of private challenges has taken them to a deeper parent-child relationship.

For children with birth defects, the message of this powerful, tender, and truthful book is "You are not alone; hardship is not ruinous; a full life is yours even if your hopes are not completely realized."