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Fragile Beginnings: Discoveries and Triumphs in the Newborn ICU [Hardcover]

by Adam Wolfberg MD
4.8 out of 5 stars  See all reviews (11 customer reviews)

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Book Description

February 7, 2012 0807011606 978-0807011607 1
Half a million babies are born prematurely in the United States every year. In this gripping medical narrative, Dr. Adam Wolfberg brings readers into the complex world of newborn intensive care, where brilliant but imperfect doctors do all they can to coax life into their tiny, injured patients. As a specialist in high-risk obstetrics and the father of a child born prematurely, Wolfberg explores the profound questions raised by such fragile beginnings, both from the front lines of the NICU and from his daughter’s bedside.
 
His daughter Larissa was born weighing under two pounds, and he describes the precipitous birth at six months that left her tenuously hanging on to life in an incubator. Ultrasound had diagnosed a devastating hemorrhage in her brain that doctors reasoned would give her only a 50 percent chance of having a normal IQ. Through Larissa’s early hospital course, Wolfberg examines the limitations of newborn intensive care medicine, the science of “neuroplasticity,” and the dilemmas that surround decision making at the beginning of life.
 
Wolfberg also takes us into the lab where researchers are working to improve the futures of children born too soon. He follows a young scientist, Jason Carmel, who was inspired to study how the brain adapts to injury when his twin brother was paralyzed in an accident. Through lucid medical reporting, Wolfberg details current scientific practices and discoveries, and explores the profound emotional and ethical issues raised by the advancing technology that allows us to save the lives of increasingly undeveloped preemies.
 
As they make decisions about life-saving care in the first hours of a premature infant’s life, doctors and parents must grapple with profound moral and medical questions: How aggressively should doctors try to save the life of a premature baby, who will be severely neurologically and physically impaired? What might that child’s quality of life be like after millions of dollars are spent on her care? Wolfberg traces the fits and starts of the physicians, government policy makers, and lawyers who have struggled over the years to find the best way to make these wrenching decisions. Written from Adam Wolfberg’s unique experience as a reporter, as a medical specialist and researcher, and as the father of a prematurely born daughter, Fragile Beginnings lays bare the struggles, discoveries, and triumphs of the newborn intensive care unit.

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Editorial Reviews

Review

"A page-turner for any parent of a premature infant."—Boston Globe

“Midway through Dr. Adam Wolfberg's internship, his daughter is born severely premature. Suddenly he finds himself on the other side of the medical curtain, navigating the terrifying maze of life-threatening illness. From his unique vantage point as physician and parent, Wolfberg brings us inside neonatology and intensive care units, on a journey that is both heart-wrenching and eye-opening. Honest, perceptive, engaging.”—Danielle Ofri, MD, PhD, author of Medicine in Translation and Singular Intimacies

“ [An] honest, heart-wrenching yet hopeful account.”—Isis Parenting

“Writing with a physician’s acuity and a father’s compassion, Adam Wolfberg presents a clear-eyed view of the challenges facing premature infants and their families, as well as the harrowing world of newborn intensive care. His honesty will be welcomed by anyone who has navigated this treacherous course.”—Elizabeth Mehren, Professor of Journalism, Boston University, and author of Born Too Soon

 "Adam Wolfberg is uniquely qualified to write this powerful, illuminating, and much-needed book. By blending the fears and hopes of his personal story with the knowledge and insight of his professional experience, he takes readers through every aspect of the newborn intensive care unit. Truth, unsweetened by sentimentality, informs every page. I learned far more than I imagined there was to learn while being so caught up in his daughter's journey that I couldn't put the book down."—Rachel Simon, author of The Story of a Beautiful Girl
 

About the Author

Adam Wolfberg, MD, MPH, is a specialist in high-risk obstetrics at Tufts Medical Center and an assistant professor at Tufts University School of Medicine. He was formerly a research fellow and faculty member in the Department of Neurology at Harvard Medical School. His research into fetal brain injury is supported by grants from the National Institutes of Health and private foundations. Wolfberg has been a contributor to Newsweek, the Chicago Tribune, Slate, WSJOnline, and the Boston Globe Sunday Magazine. He is a physician spokesperson for the March of Dimes.

Product Details

  • Hardcover: 176 pages
  • Publisher: Beacon Press; 1 edition (February 7, 2012)
  • Language: English
  • ISBN-10: 0807011606
  • ISBN-13: 978-0807011607
  • Product Dimensions: 9.2 x 6.3 x 0.6 inches
  • Shipping Weight: 14.4 ounces (View shipping rates and policies)
  • Average Customer Review: 4.8 out of 5 stars  See all reviews (11 customer reviews)
  • Amazon Best Sellers Rank: #830,175 in Books (See Top 100 in Books)

More About the Author

Dr. Adam Wolfberg, the author of "Fragile Beginnings: Discoveries and Triumphs in the Newborn ICU" (Beacon Press, 2012) is an obstetrician specializing in maternal-fetal medicine at Tufts Medical Center in Boston, and is an assistant professor of obstetrics and gynecology at Tufts University School of Medicine. His clinical interests include prenatal diagnosis, fetal ultrasound, and preterm labor. Dr. Wolfberg's clinical research on fetal EKG analysis is funded by the National Institutes of Health.Wolfberg has written on health-related topics for Slate.com, WSJ.com, Newsweek, the Boston Globe Magazine, and other publications. He blogs for the Huffington Post.

Wolfberg went to medical school at Johns Hopkins and completed a residency in obstetrics and gynecology at Brigham and Women's Hospital and Massachusetts General Hospital. He did his fellowship in maternal-fetal medicine at Tufts. He lives in Boston with his wife, Kelly, and three daughters.

Photographer Photo Credit Name: © Martha Stewart/Tufts, 2012.

Customer Reviews

Most Helpful Customer Reviews
8 of 8 people found the following review helpful
By Nancy
Format:Hardcover
Though not a book most expectant mothers should add to their reading list, Fragile Beginnings provides insight into the difficult decisions that clinicians and families must make when working with these tiny, fragile babies.
What does quality of life mean to a parent desperate to hold their only baby? Should extraordinary means be used for babies on the very edge of viability? What is the NICU experience like for parents? What supports and care considerations can help parents and babies?
With one out of ten babies born prematurely in the US, these are important (and expensive) topics to consider. Dr. Wolfberg offers a unique perspective by sharing both personal and professional experiences, making this book especially valuable and compelling.
Nancy Holtzman RN BSN IBCLC RLC
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8 of 8 people found the following review helpful
5.0 out of 5 stars Fascinating! February 9, 2012
Format:Hardcover
Wolfberg gives an account of the NICU and the broader issue of medical ethics from the perspective of both a doctor and a parent. His writing is clear and the topic is fascinating. I highly recommend this book, even if you don't think you're very interested in medical ethics or neonatal care. This book will MAKE you interested!
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5 of 5 people found the following review helpful
Format:Hardcover
Fragile Beginnings, by Adam Wolfberg, starts off with a bang. The author's wife, Kelly, goes into preterm labor in the very hospital where the he works as a first year Ob/Gyn resident. Despite their education and training (Kelly is working toward her PhD) they are as devastated and scared as any parents could be.

Knowledge is not control and things are moving fast. It only makes it worse that Adam knows the medical lingo and knows the possible disabilities that a baby born at 26 weeks could have. The usual IV medications can't stop the contractions; Kelly's water bag breaks; plans move ahead for an emergency C-section and then....well you'll just have to read the book.

Interspersed with the author and his family's experience in the NICU, is the history of the techniques for the care of premature infants and those who pioneered them, including the fascinating theory of neuro-plasticity. If you know what that means, you will want to know more. If you don't....well, you'll just have to read the book.

This is a family drama, an education in medical progress and an inspiring story about a courageous little girl named Larissa. If you are medically-minded, what else could you want in a weekend read?

Patricia Harman CNM MS, nurse-midwife and author of Arms Wide Open: A Midwife's Journey Arms Wide Open: A Midwife's Journey and The Blue Cotton Gown The Blue Cotton Gown: A Midwife's Memoir
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2 of 2 people found the following review helpful
5.0 out of 5 stars A superb book about the tiniest of newborns March 11, 2012
Format:Hardcover|Verified Purchase
Adam Wolfberg was an OB-GYN intern at Harvard's Brigham and Women's Hospital when his wife, Kelly, was pregnant with their third child, a girl who would be named Larissa. Her previous two pregnancies were uneventful, and all indicators pointed to another straightforward one. However, Kelly suddenly developed contractions when Larissa reached 26 weeks of gestation, 14 weeks before her due date. Despite the Wolfbergs' proximity to one of the leading obstetric and neonatal centers in the world, Kelly's labor could not be reversed, and Larissa was born after a very traumatic and stressful delivery. She was stabilized in the delivery room, placed on a mechanical ventilator due to her inability to breathe on her own, and whisked away to the NICU (or neonatal ICU; a neonate is a baby 0-28 days of age) at Brigham and Women's. Her birth weight was 1 lb 15 oz, making her tiny enough to fit into the palm of her father's hand.

From his training, Adam knew that a baby as premature as Larissa faced serious complications, including cerebral palsy; epilepsy; severe developmental delay that could prevent her from being able to walk, talk, eat by mouth or function independently; and death. One of his greatest fears was realized within days of Larissa's birth, when she developed a severe intracranial hemorrhage, or brain bleed, within the first week of life, due to the trauma of her labor. This injury is always associated with some degree of impairment; however, the extent of the damage is often not known for a year or more, once the baby begins to sit, crawl, walk and perform routine activities of daily living.
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1 of 1 people found the following review helpful
3.0 out of 5 stars Not relevant to all NICU experiences June 12, 2012
By Jill
Format:Hardcover|Verified Purchase
I had high hopes for this book, being written by an obstetrician who also had a daughter born at 26 weeks. Being a NICU parent, I hoped for something that would balance the NICU experience from a parent's perspective with medical knowledge. Unfortunately, Adam Wolfberg seems to write more from the perspective of a doctor than a parent. That's fine, really, just not the book I was looking for. Here is what you can expect from this book:

1) If you have a micropreemie born before 26 weeks, you may not like this book, especially at the beginning. In stressing the fragility of his 26 week-old's life, he writes off babies born before that. That was not something that I, as the parent of a barely 23 week baby, wanted to hear. You also have to keep in mind, though, that his story started nearly a decade ago possibly? Which is forever in the world of neonatology, and a lot has improved even since then.

2) The book skips around a lot confusingly. One minute you're reading about Wolfberg's experience, then we're reading the life story of the head of the NICU. Oh, now we're reading about some random guys doing research on rats. I'd like to say he pulls it all together, but while it does become a little more apparent why these things are relevant, they never really come together in a meaningful way. It's like watching a disjointed film looking at very loosely connected people living different lives.

3)It's very technical at times - possibly beyond the capability of many NICU parents, especially during the stressful time actually spent in the NICU.

4) As his daughter had a Grade 4 IVH (intraventricular hemmorhage of the brain), Wolfberg focuses on IVH, brain development research, and neuroplasticity.
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Most Recent Customer Reviews
5.0 out of 5 stars Excellent Read
I started reading this book the day I got it, and could not put it down. The science is easy to understand, and the emotional side of having a premature baby comes through... Read more
Published 14 months ago by Elizabeth Smith
5.0 out of 5 stars A poignant, beautifully written book about a family's journey
It's not often that a book so informative about a medical subject is also so gracefully written. The reason is clear: the author, an MD, lived through some of the scariest times... Read more
Published 20 months ago by Brett J. Blackledge
5.0 out of 5 stars Advances in Neuroscience Made Human
Fragile Beginnings has a tense personal storyline layered with bulletins on the latest research in neuroscience. Read more
Published 24 months ago by Bob Parks
5.0 out of 5 stars Compelling read!
This book takes readers through the author's own experience of having a premature daughter - during his medical residency - the challenges he and his wife faced, and ultimately... Read more
Published on March 15, 2012 by KW
5.0 out of 5 stars Fragile Beginnings
Absolutely fantastic and engaging story that took me through an emotional roller coaster and provided a fascinating look into the developement and science of the modern neonatal... Read more
Published on March 14, 2012 by Rick
5.0 out of 5 stars Fragile Beginnings
The story of Dr. and Mrs. Wolfberg's harrowing experience with the birth of their premature daughter is one that will tug at anyone's heartstrings, parent or not. Read more
Published on March 13, 2012 by west_of_eden_books
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