Rachel Belmore is married to Doctor Wes Belmore, a man she loves deeply when she weds him. Together they have a child, a baby girl they name Ellie. With that birth, Wes's true nature is revealed and Rachel's perfect marriage descends into a hellish nightmare, a terrible battle to save the body and soul of her baby.

In quite an eye-opening first chapter, with Ellie just a year old, we see what Wes, the "Surgeon to the Stars," is capable of. We understand immediately the overriding need for Rachel to protect her daughter from her own father's evil actions against her. It is the ultimate betrayal, that of parent sexually abusing a child.

A few years pass by. The courts and legal system have been only partially helpful. Rachel is looking to stop Wes from being allowed to see Ellie unsupervised. And, since we know the truth about the "charming" doctor, we agree with Rachel's demand and cheer her for her continued battle to assure the court makes the correct ruling. However, the judge in this case is hesitant to keep the father from having private visitation rights to see his daughter, feeling that the possibility exists that the child has been turned against the father by a vindictive ex-wife. Arrogant social workers who take the father's side, refusing to recognize the truth when it is there before their eyes, do not aid Rachel in her fight but hinder her.

There is an indictment of the Child Protection Services system here, but to be fair to the judge and the social workers, false charges of abuse are at times made, and it is often difficult to ferret out the truth. The judges and social workers in the Family Court system and the Child Protection Services are the people in the middle, and the middle is often muddied by the accusations that fly from all sides, some true and some not. But in the case of The Puppet Child, we know absolutely the terrible facts as stated by Rachel to be true, having been granted witness to them by the author from the beginning, and so we are frustrated by "the system's" inability to act appropriately, as the author intends.

Rachel's desire to protect Ellie increases when she learns of the "Zoo game" Wes plays when given the chance. It's clear that any time he is alone with Ellie, for whatever period of time, he will use the opportunity to sexually abuse his daughter. The court judge insists that the father be given a chance to bond with his daughter, and Rachel, knowing with absolute certainty what he will use that time for, is left with no choice. In order to protect her baby, she allows her own parents to take their granddaughter Ellie and run and hide while Rachel goes to prison, found in contempt of court for not handing Ellie over to Wes. The nightmare worsens behind bars, where Rachel is herself threatened with sexual abuse.

There is no real effort by the author to state a solution to what she obviously sees as a failing system. Unless, of course, hiding the child is the solution for every parent, as it is in this novel. More in-depth explanations about the Child Protection Services mechanisms, how they fail and, more importantly, how they can be improved to assure no child is abused as Ellie is, would have been welcomed by this reader.

But that is not the choice Carner has made here. She has chosen to write a novel of almost pure suspense that happens to have as its impetus the abuse of a beloved child. The court system as given to us fulfills the part of a co-villain, acting to aid the true villain, Ellie's father. This is a well-written, gut-wrenching, heart-breaking novel that is almost impossible to put down until the last page is read.