There's so much going on in this book with gender and bloodlines and legacy. The inversion of the usual weight held by the women married into the family to continue the line, instead resting heavy on the shoulders of the oldest son, who is unable and unwilling to carry things on. I like the disability representation in this book, it's trying neither for pity nor inspiration porn, merely for a piece of the human experience, which is all being disabled is. 

This book is, at its heart, about the seemingly inescapable gravity well of family; the connective tissue that binds family by blood so closely together sometimes a family feels like one organism instead of a collection of individuals. I adore it for that. And I adore it for being a book about siblings. My own relationships with my siblings are deeply important to me, and I love any book that reflects the way those relationships are shaped in a screwed up family system. 

I'm not sure how I feel about the ending, but it's not bad or dissatisfying. I'm just unsure about it. So this falls just short of 5 stars for me.