Simon Bear is a respected and well-loved internist, albeit with some questionable medical treatments, operating his Baltimore practice from a wing in his stately home. His wife, Emily, is a partner in a PR firm, and while she's successful at work, she feels like a failure as a mother to their sullen and rebellious teenage daughter.
The tragic loss of the couple's firstborn, as an infant, created a fissure in the foundation of their marriage, and years of refusing to talk about it or grieve properly have served to steadily widen the crack.
When Simon discovers and tests a surprising new treatment for chronic pain and Emily begins an affair with an old boyfriend, the rift grows larger. And, just as Simon realizes he needs Emily more than ever, if only more professionally than personally, she realizes that she doesn't need him at all anymore.
Although neither Simon nor Emily were particularly likeable characters, I nonetheless cared about their respective fates, wondering how, and when, their poor decisions would catch up with them. Ledger's writing is powerful, as she has a talent for "just right" descriptions. She deftly tackles big issues and thoughtfully examines the unraveling of a marriage, exploring how much pain can be endured before a breaking point.