Caroline Denecke's nightmare is only beginning when, awakened by strange noises at 2 a.m., she creeps into the nursery to find her ten-day-old adopted son Zach missing and then, when her husband Joe returns with her, dead in his crib. Zach is so cold, and it's been so long that he's eaten, and his sleeper looks so new, that Caroline is convinced that the dead baby isn't Zach at all, but someone else who's been exchanged for him. Not surprisingly, though, John and the cops tell her she's in denial; it's impossible that anybody could've gotten into the nursery to carry Zach off. (Later, a particularly aggressive cop tells her she must have suffocated Zach herself.) The only person who'll listen to Caroline is Diana Larsen, the Women magazine reporter whose story on the Crane's Island Adoption Unit turns up ever more disturbing irregularities--hotshot director Dr. Sidney Hazelton's impatience with oversight procedures, his worshipful wife Dolly's lackadaisical attitude toward the nuts and bolts of adoption, the unhealthy closeness between the Adoption Unit and the Heart's Retreat maternity home, and, inevitably, the diminishing life expectancy of the Heart's Retreat clients. The stage seems set for a Robin-Cook-among-the-midwives scenario, and debut novelist Culbertson does provide her share of shivers and screams, but without ever losing sight of the everyday tragedy of Caroline's grieving or the logic even a nightmare like hers ought to have.