cover image Fragile Beginnings: Discoveries and Triumphs in the Newborn ICU

Fragile Beginnings: Discoveries and Triumphs in the Newborn ICU

Adam Wolfberg, M.D. Beacon, $25.95 (176p) ISBN 978-0-8070-1160-7

They are the littlest patients, facing daunting survival odds and, if they beat those, a lifetime of physical and mental hurdles. But the stories of extremely premature infants—the 2% born before 32 weeks of gestation—could have no better narrator than Wolfberg, a Tufts Medical Center obstetrician. Wolfberg’s own daughter, Larissa, was born three months prematurely, and is the focus of this astounding history of the advances in neonatal medical care, and understanding the brain’s ability to adapt to injury. This story is one of hope: the death rate for very premature babies has fallen dramatically thanks to groundbreaking advances in preventing the collapse of immature lungs and better use of oxygen, among others. Yet the challenges still remaining are daunting, particularly complications that cause cerebral palsy. Wolfberg describes research holding great promise and reviews the ethics of caring for infants whose hold on life is so tenuous, showing how the environment of the newborn nursery has shifted from one in which caregivers and parents had autonomy in decision-making to one open to controversy, disagreements, and court intervention. Wolfberg celebrates each milestone in this important field of medicine—and in nine-year-old Larissa’s remarkable life. (Feb.)