This sequel, undoubtedly greeted with joy by all of us who loved "Karen," in one sense surpasses the first work. Karen, delightful and positive though she is, is depicted far more realistically than in the initial book, which tended to make her a bit of a picture book saint. Her struggles, decisions, and (in all honesty) unquestionable confusion with the expectations of her wonderful family are quite vividly portrayed. (As an example of the last - one wonders why Marie does not realise that much of Karen's dilemma over "walking vs wheelchair" undoubtedly stems from Marie's constant insistence on Karen's walking - she fought the idea of Karen's having a wheelchair at all earlier in the book.) The Killilea family clearly had an unusual and blessed balance - tough-minded, persistent, deeply religious, but hospitable and joyous to the point where their home seemed a favourite stopping place for all whom they knew. Yet many new questions remained unanswered. "Karen," though it did not include many extended family members at length, mentioned a large family - in "With Love from Karen," even the most special occasions include many "honorary" family members but no blood relatives.