Willow has Type III osteogenesis imperfecta (OI), a disease also known as brittle bone syndrome.

After a disastrous vacation to Walt Disney World that results in Willow severely breaking both of her femora, Sean and Charlotte visit a lawyer to inquire about a lawsuit against the park and hospital after staff thought that Willow's broken bones indicated child abuse.

The lawyer, Marin Gates, mentions a different possibility: a wrongful birth lawsuit against the OB/GYN that treated Charlotte during her pregnancy.

Essentially, if the O'Keefe's had known earlier that their fetus had OI, they would have been equipped with all the information needed to choose whether or not to have the pregnancy aborted.

Amelia, Charlotte's eldest daughter from a previous relationship with a drug addict, develops bulimia and begins to self-harm, partially due to the stress of her home life.

Charlotte, who used to be a pastry chef, wrote a recipe book and is donating all of the profits to the OI Foundation.

She files a lawsuit against Piper Reece, her obstetrician/gynaecologist and best friend, in order to be able to secure the medical resources needed for Willow.

Although he initially attempts to set aside his personal feelings about the lawsuit in order to support Charlotte, his disgust for the wrongful birth suit eventually leads him to testify for the defense.

Eventually, the differences in their health lead to the boy breaking up with her, which further pushes her into isolation, as her parents are occupied by the lawsuit.

Sean eventually discovers Amelia's eating disorder, after Piper brings them to his attention when the pipes burst in their home due to being eroded by the stomach acid (caused by her frequent vomiting).

She is adopted and searches for her birth mother, who she eventually discovers by chance on the jury for Charlotte's case.

The novel is narrated by Charlotte, Sean, Marin, Piper, Amelia and the final chapter by Willow.

Picoult has used this technique in several novels, including Songs of the Humpback Whale, My Sister's Keeper, Change of Heart and House Rules.

[2] The Washington Post called it "a great read, with strong characters, an exciting lawsuit to pull you along and really good use of the medical context".