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Catching Babies Kindle Edition

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Length: 338 pages Word Wise: Enabled

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Product Details

  • File Size: 557 KB
  • Print Length: 338 pages
  • Publisher: Fourth Chapter Books; Reprint edition (March 1, 2011)
  • Publication Date: March 1, 2011
  • Sold by: Amazon Digital Services, Inc.
  • Language: English
  • ASIN: B004S6UWVE
  • Text-to-Speech: Enabled
  • X-Ray:
  • Word Wise: Enabled
  • Lending: Not Enabled
  • Enhanced Typesetting: Not Enabled
  • Amazon Best Sellers Rank: #585,022 Paid in Kindle Store (See Top 100 Paid in Kindle Store)
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More About the Author

Though it's my third book about health care, Catching Babies is my first published novel. I started researching and writing Catching Babies in 2003 as a non-fiction expose of the messy and often fierce technical, moral, and cultural conflicts at the heart of high-risk obstetric medicine and womens' health. Earlier study of the clinical practice patterns of childbirth and gynecologic surgery, combined with fortuitous friendships with physicians and midwives at critical moments in their training, coalesced in a stark idea I had yet to encounter in the health services literature: obsterics and gynecology stand at ground zero of a broader health care system pulled apart by polarizing forces that often have little to do with medicine, ethics, or patients' real needs.

Our nation's permanent civil war over abortion rights--electrified with religious passion, political hypocrisy, and gruesome rhetoric scarcely related to the clinical and behavioral realities of abortion--is the most glaring example of how America's philosophical and psychological conundra play themselves out in our health care system. Our neurotic obsession with breast cancer, highly out of proportion with the disease's actual prevalence and lethality, is one of the more subtle examples of the same phenomenon. The political, financial, and legal fights over the way we care for women and deliver their babies are the supercharged versions of this spillover effect, of America's most intractable conflicts perennially finding their angriest voices in arguments about health care. For clearest proof, one look no further than the often bizarre rhetoric spewed during the 2009-2010 health care reform debate - and the jarring fact that passage of the entire legislation hinged, in the 11th hour, on the funding of abortion.

Catching Babies was originally intended as a clinically detailed study of how these wildly problematic and deeply misunderstood medical subjects play out in the real world. It was conceived as the general public's first hard look behind the medical curtain into the practice, politics, and often bizarre culture of obstetrics and gynecology, as smashed together into a single specialty and "organized" in the most disorganized health care system in the world. It would also map out the complex turf war between most (but not all) OB/GYNs and the growing and diverse ranks of midwives.

As I dug more deeply into these cases and their often unlikely outcomes, I noticed the recurrence of an odd phenomenon that has confounded health researchers for decades: medical decisions and outcomes often have less to do with what the patient needs or even what society demands, and more to do with what's eating at the doctor, what's making the patient act out, or what's wrong back at either one's home. Fast-forward through a few rough drafts and a few rough years, and suddenly the medical cases I had assembled to illustrate some of health care's thornier problems struck me as far more interesting than the problems themselves. Many of the cases began and ended not with medical facts, economic prerogatives, or philosophical positioning, but with the full spectrum of human impulses: fear, control, compassion, repression, projection, self-hatred, self-aggrandizement, the search for meaning, the leap of faith. The human compulsions at work in these cases begged questions not only about a unique patient's irrational response to her medical situation, but also about the pathological drives of her caregiver.

Who exactly are these physicians, midwives and nurses all thrown--as forcefully as their pregnant patients--into a maddening system not of their own design and often in conflict with their most deeply held values? The systematic brutalization of these caregivers, in particular OB/GYNs during their long and difficult training, has turned many into heroes, some into detached technicians, and a few into monsters--each, of course, in his or her own exquisite way. The closer I looked for patterns, the more elusive such patterning became, until I had crossed, perhaps inevitably, into the realm of narrative fiction. Fast-forward through a few more years and my own terrifying encounter with the realities of the health care system, and the "medical cases" had metamorphosed into human stories.

Catching Babies still seeks to tell the larger story of how and why we deliver most babies and care for most women in the odd and often maddening ways we do. But somewhere in the long process of research, composition, revision and reflection, I discovered that the real story is best told through the myriad fractures and fissures of the human drama - through the doctors, nurses, midwives, patients, family members and others struggling inside the system as they have found it.

In the meanwhile, I'll still be struggling there too! In my "day job," I'm a medical economist, author, and patient advocate. I've helped create four health care information organizations, served as a health care business columnist for the Wall Street Journal, and advised both sides of the political aisle on health policy and legislation. In 2004, I established the Omnimedix Institute, the Portland-based non-profit that helped define, lead and safeguard the way for patients' access to their own medical information on the Web. I also helped establish Health Grades, a health care information company based in Denver, and HCIA (now Solucient), the nation's pioneering health care database research company.

I've been a regular contributor to the policy journal, Health Affairs and The Wall Street Journal. My work has also appeared in JAMA, Barron's, the British Medical Journal, Modern Healthcare, and numerous other publications. My first book, Bleeding Edge: The Business of Health Care in the New Century (Aspen, 1998) was a foundational textbook for many physician-executive MBA programs and health administration graduate programs in the U.S. My follow-up, Oxymorons: The Myth of a US Health Care System (Wiley, 2001), was a scathing and oft-cited criticism of what is wrong with the health insurance industry, and one of the earliest calls for systemic health care reform.

Customer Reviews

Most Helpful Customer Reviews

4 of 4 people found the following review helpful By Suzanna Kruger on April 11, 2011
Format: Paperback
This story takes place over the course of a year, following a number of OB/GYN 4th-year residents as they complete their training at a large metropolitan university hospital and then go on to establish their own practices.

Kleinke delves into medicine, including complicated births, cancer, hysterectomies, psychosis, as well as clinical research and what it takes to run the hospital as a business, although the latter two topics do not receive the same amount of treatment as the first.

The obstetrical cases were very interesting, but the characters are one-sided (an anorexic attending physician, one with a horrible childhood, an African-American lesbian, a pro-choice Catholic, a Jewish OB who wishes she were a midwife, etc.), and their relationships are a little shallow. They all spend a lot of time crying or not being able to sleep without any sort of redemption or even resolution by the end of the book. The setting is completely nonexistent and generic, beyond some large city on the east coast.

For greater complexity of character and plot as well as interesting obstetrics, I would recommend Cutting for Stone by Abraham Verghese. If it's a fictional indictment of midwifery that is interesting to you, Chris Bohjalian's Midwives (Oprah's Book Club) may suffice...although his books are somewhat formulaic.
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4 of 5 people found the following review helpful By Tim Madden on February 24, 2011
Format: Paperback
Catching Babies is a well-written book that draws the reader into the lives of its characters in ways that are challenging as well as compelling. This enjoyable narrative will leave you entertained as well as informed and challenged. Best new fiction of 2011!

While Kleinke's two previous, well-regarded books dealt with the challenges of the organization and structure of our healthcare system, here he uses fiction to draw our focus to the humanity and complexity of the patients and physicians involved in the emotionally charged and life-altering events of childbirth which, Kleinke notes, has historically always been the most high-risk event in a woman's life.

Kleinke's prose is tight and lyrical. His writing shows a finely tuned sense of timing and the ability to turn a phrase. These characters are well drawn and woven into the fast-paced plot. His effective use of both detail and perspective brings a heightened sense of reality to the medical narrative, while his allegorical musings force the reader to confront the heart-wrenching decisions that many women and their caregivers face in the challenging process of bringing new life to life. Kleinke enagages his readers to consider not only medical dimensions of these people and events but also their personal, ethical, moral, and spiritual dimensions.

A great read, you won't be disappointed.
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4 of 5 people found the following review helpful By JoanieL on February 27, 2011
Format: Paperback
This book will take you on a ride as medical residents struggle to find balance between high-risk obstetrics and their own complicated personal lives. Klienke tells one page turning story line after another that all address our flawed medical system through stories about the realities of human nature. I appreciate the way that Kleinke comments on women's health care in a way that I think everybody can relate to. The world of obstetrics has contributed to the creation of a culture of fear around childbirth-- this book definitely brings that out so please aware of this if you plan on having a baby anytime soon. Perhaps follow it up by reading some Ina May! Either way, it's a must read.
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2 of 2 people found the following review helpful By PP4Midwives on April 23, 2012
Format: Paperback Verified Purchase
What a page burner. Klienke provides an incredible insight into the multi-faceted issues surrounding delivery of maternity care in the US. This book really should be a must read for every midwife who wants to develop collaborative relationships with OB providers. This book gave me more perspective on the conflicting issues surrounding OB providers than 10 years of transferring patients in from my home birth practice ever did.
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6 of 8 people found the following review helpful By Reader on February 7, 2011
Format: Paperback
Catching Babies provides insight into physician perspectives and ethical dilemmas regarding something that happens every day in every part of the world: childbirth. The conflicts between physician specialists (who are supposed to be on the same team), midwives, and the public create a fascinating environment for Kleinke's first novel. I especially enjoyed the medical detail as characters quickly processed different treatment pathways in making critical decisions for babies and mothers in crisis. The ethical dilemma in the book is well thought through and reflects a true dilemma in the field of obstetrics. Great book!
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8 of 11 people found the following review helpful By heatherw. on March 19, 2011
Format: Paperback
I wanted to like this book after seeing it on a birth blog. After reading it, I am not sure why any midwife or birth advocate would recommend it. It is so full of birth/ women's health horror stories, it begins to feel gratuitous, titilating, like medical porn. Do we really need yet another book out there that does nothing but contribute to the already prevalent culture of fear about childbirth? Do we really need another portrayal of midwives in a less than powerful light (sweet, naive, bare-breasted, herb gatherers)? But then they fare better than the doctors--truly messed-up characters. I agree with the other reviewer--the book's focus on the character's awful relationships make it read like a bad soap opera. Too depressing to be entertaining and not helpful/hopeful enough to be inspiring.
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