But he wanted Karen to be happy. While he trained for his new speciality and learned to deal with the pain of his disease, she racked up four semesters of perfect grades and scored in the ninety-sixth percentile on the Medical College Admissions Test. Will was as proud as he was surprised, and Karen was luminous with happiness. It almost seemed as though Will’s disease had been a gift.

Then, during Karen’s freshman year of medical school-the third year of Will’s residency-she got pregnant. She had never been able to take the pill, and the less certain methods of birth control had finally failed. Will was surprised but happy; Karen was devastated. She believed that keeping the baby would mean the death of her dream of being a doctor. Will was forced to concede that she was probably right. For three agonizing weeks, she considered an abortion. The fact that she was thirty-three finally convinced her to keep the baby. She managed to complete her freshman year of med school, but after Abby was born, there was no question of continuing. She withdrew from the university the day Will completed his residency, and while Will joined the private anesthesiology group led by his old roommate, Karen went home to prepare for motherhood.

They made a commitment to go forward without regrets, but it didn’t work out that way. Will was phenomenally successful in his work, and Abby brightened their lives in ways he could never have imagined. But Karen’s premature exit from medical school haunted her. Over the next couple of years, her resentment began to permeate their marriage, from their dinner conversations to their sex life. Or more accurately, their lack of one. Will tried to discuss it with her, but his attempts only seemed to aggravate the situation. He responded by focusing on his work and on Abby, and whatever energy he had left he used to fight his slowly progressing arthritis.