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.
