In the Middle of All This : Martin Kreutzel and his ill sister, Elizabeth, are as close as grown siblings can be - they have an essential connection. However, she lives with her husband outside of London and he lives with his wife and two children in a small Pennsylvania college town where he and his wife are both professors. Neither one of them likes the atmosphere there but they both have tenure track positions and can raise their two children in a safe neighborhood, in a house they can own. As Elizabeth's cancer worsens, Martin's love for her cripples his abilities at work and at home. When Elizabeth's husband, Richard, disappears for a few days, and one of Martin's students hangs herself, Martin finds himself torn between serving his sister and being a good husband, father, and professor. After Martin makes a trip to London to be with his sister, the situation gets stranger, alarming even, when Richard returns and whisks his wife off for the day, disappearing again, except this time he takes Elizabeth with him. Leebron's compelling third novel brings us into the world of domestic unease as two couples and their joined families wrestle with empathy's limitations in the uncompromising teeth of mortality.