We meet Louise Bradshaw [of Jacob Have I Loved] in the summer of 1941, smarting under the disproportionate attention lavished on her fragile, musically talented twin sister Caroline since their birth 13 years earlier…. The interesting aspect of all Louise's torment and self-sacrifice is the growing realization that it isn't being forced on her. But not until she has settled down as a nurse-midwife (the only medical help) in a small Appalachian community—marrying a man with three children to boot—does she recognize and freely accept that she was destined to fulfill herself in a life of service. Paterson has to get into these later years to make the point, and to avoid the instant realizations that substitute in too many juvenile novels. However, this tends to flatten the tone and blur the shape of the novel. Louise's earlier, intense feelings evoke recognition and sympathy, but this hasn't the...