Even as he perpetrates his unconscionable crime, Dr. David Henry believes his intentions are good. When he sees that his newborn daughter has Down syndrome, his medical training moves him to make a pessimistic calculation of her potential. Acknowledging the complications that come with this syndrome, he views Phoebe as an impediment to the perfect life he wants with his wife and family. David coldheartedly sees in the circumstances surrounding her birth the opportunity to keep her out of their lives. By lying to his wife Norah that their daughter was born dead, he incorrectly believes that he tidies up any possibility that Phoebe could affect their lives going forward, .

David’s motivation has its roots in firsthand experience of living with a sibling born with a congenital disorder. Growing up, he felt neglected by his parents’ preoccupation with his sister June’s care. June died at the age of twelve. In her grief, David’s mother demanded that he do something meaningful with his life, and he said he would be a doctor. He watched with resentment as his parents lost interest in life after June’s loss. Financial security drives David’s decision-making as well. Raised by impoverished parents in the mountains of West Virginia, he feels like an imposter among his affluent doctor colleagues. This same drive informs his opposition to his son’s choice of musical performance as a career.

David courted and married Norah for her elegance and beauty. He hadn’t planned on her grieving the loss of her daughter nor anticipated how deeply he would be affected by guilt. He shuts down any mention of Phoebe and channels his feelings into his photography hobby. David is the titular Memory Keeper, documenting Phoebe’s imagined life through images of strangers frozen as babies, girls, and young women. His search for meaning moves him to make memories, a kind of magical thinking that seeks to dominate the world, conform everything to his expectations, and control the narrative. When he finally makes his confession that he gave away his daughter, he does so to a stranger, Rosemary, who does not judge him. David dies of a heart attack while running, having never revealed Phoebe’s existence to his wife Norah. He is mourned by hundreds of his patients.