Baby Esther (or Essie, as her parents have taken to calling her) is a prematurely born eight-day-old neonate with severe lissencephaly syndrome who is currently residing in the neonatal intensive care unit. Lissencephaly-a rare genetic brain malformation characterized by the absence of normal folds in the cerebral cortex and an abnormally small head-was a devastating diagnosis for Esther's parents, who had been trying to get pregnant for over seven years. Symptoms of lissencephaly syndrome include profound intellectual disability, unusual facial appearance, difficulty swallowing, inability to grow, muscle spasms, seizures, severe motor impairment, and deformities of the hands, fingers, and toes. Children with severe lissencephaly require total and continuous care in order to survive and rarely live past the age of ten. On the morning of Esther's ninth day of life, her medical team discovers that she needs surgery to remove a section of necrotic intestine if she is to have any chance of survival. Esther's parents-who have a strong Christian faith-and her clinicians are both conflicted about the operation. Each wonders if Esther's constrained future and vast potential for suffering recommend against surgery. A nurse raises the question of what can be known, if anything, about the nature and extent of Esther's suffering, as it exists either now or in the future.