When Aaron Maciver's beautiful young wife, Madeline, suffers brain damage in a bike accident, she is left with the intellectual powers of a six-year-old. In the years that follow, Aaron and his second wife care for Madeline with deep tenderness and devotion as they raise two children of their own.

Narrated by Aaron's son, Mac, When Madeline Was Young chronicles the Maciver family through the decades, from Mac's childhood growing up with Madeline and his cousin Buddy in Wisconsin through the Vietnam War, through Mac's years as a husband with children of his own, and through Buddy's involvement with the subsequent Gulf Wars.

Jane Hamilton, with her usual humor and keen observations of human relationships, deftly explores the Maciver's unusual situation and examines notions of childhood (through Mac and Buddy's actual youth as well as Madeline's infantilization) and a rivalry between Buddy's and Mac's families that spans decades and various wars. She captures the pleasures and frustrations of marriage and family, and she exposes the role that past relationships, rivalries, and regrets inevitably play in the lives of adults.

Inspired in part by Elizabeth Spencer's Light in the Piazza, Hamilton offers an honest and exquisite portrait of how a family tragedy forever shapes and alters the boundaries of love.