Early in her powerful, affecting debut, Desautels writes: "I always mention gratitude because/people like that ending." Unflinching in its candor, this is the story of a woman with two swellings in her belly: a nascent baby, and a cancerous tumor. The poet could focus on the particulars of the medical case, using language from a traditional illness narrative. Instead she gives us the basics, then gathers up surprising and expansive material from various landscapes--the Black Hills, the prairies of Texas, the mountains, switchgrass, and, especially, the neighboring buffalo, to which she feels a profound connection. Desautels' metaphors strike home; they are counterpoints, balm to the uncertainty and grief that make us uncomfortable. The book moves elegantly from its dark beginnings to a transcendent thankfulness. With healing lyricism, she writes: "And I imagine the white sheets as heron wings./And the whirring machines are white eggs./And the worried voices are sunlight on water."