This is how I imagined my son’s childhood when he was just a twinkle in my eye: we live in a big house with a huge yard, maybe a pool. There’s family around us, lots of family. He has two younger siblings. He rides his bike with the neighborhood kids and likes school well enough. He is easygoing and adventurous. In the evenings he hides under his blanket with a flashlight to read history books until it’s way past his bedtime. Everyone’s healthy.

Here is the reality: Sam is an only child. His father is in frail health. He had a heart attack when he was 39 and we worry that he has passed on to our son a serious form of rheumatoid arthritis that makes his shoulders slope, his joints stiff and sensitive to weather changes. We have a small family and we live far away from most of them. We are about to move into a condo, with no yard, no pool, so that we don’t have to worry about maintenance. The neighborhood kids leave him out of football games and call him a baby when he gets upset. He is afraid to ride his bike. He struggles with anxiety at school and bad dreams keep him up at night.

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