Last week we talked about the brain: Ted Kennedy’s brave battle with cancer, Joe Biden’s two aneurysm surgeries, and Cindy McCain’s stroke.

This week Down syndrome is on many people’s minds. In her speech last night, vice presidential nominee Sarah Palin said that "special needs children inspire a special kind of love," and she pledged to be a "friend and advocate" to those in the same boat if she’s elected.

I called a top expert on Down syndrome, who reminded me that while TV may have presented a pretty picture of Palin and her family in the Xcel Energy Center in St. Paul, including baby Trig (with Palin, above), the wee one may have a tough road ahead. “There is a whole spectrum when it comes to Down syndrome,” says Kwame Anyane-Yeboa, MD, a professor of pediatrics specializing in genetics at Columbia University Medical Center. (Down syndrome is a chromosomal abnormality.) “Some babies don’t have serious complications, but others may need surgery right away or down the road for heart, gastrointestinal, thyroid and other problems.”

“Decades ago,” he says, “many of these babies were institutionalized, but we know kids raised at home do better.” That takes a lot of commitment. For example, Dr. Yeboa says, “Down syndrome babies have low muscle tone and benefit from early intervention, such as physical therapy and occupational therapy, often where the therapist comes to the home every day. Their physical development is delayed; most sit by the time others are walking. Speech is another area with many limitations, and most need special education. Many can’t live on their own as adults, although some thrive in group homes.”

Dr. Yeboa says he is seeing fewer Down syndrome babies than he used to, mainly because of earlier screening methods (a blood test can indicate risk as early as 11-12 weeks into pregnancy). Today, one in five women has a child when she’s over 35. The risk of Down syndrome at 35 is 1 in 400. At 40 (Sarah Palin is 44), it rises to 1 in 100. (At age 25, in comparison, it’s 1 in 1,250.)

There will continue to be much debate about how Palin will juggle it all, although, as Giuliani pointed out in his speech last night, would anyone be asking that question if she were a man?