Michael C. Klein - Dissident Doctor: My Life Catching Babies and Challenging the Medical Status Quo

Dissident
Doctor

Catching Babies And Challenging the Medical Status Quo

Michael C. Klein, MD

Copyright 2018 Michael C. Klein

All rights reserved. No part of this publication may be reproduced, stored in a retrieval system or transmitted, in any form or by any means, without prior permission of the publisher or, in the case of photocopying or other reprographic copying, a licence from Access Copyright, /

Douglas and McIntyre (2013) Ltd.

P.O. Box 219, Madeira Park, BC, V0N 2H0

www.douglas-mcintyre.com

All photographs are from the authors collection except where otherwise noted.

The excerpt on pages 180181 is reprinted from Michael C. Klein, Too Close for Comfort? A Family Physician Questions Whether Medical Professionals Should Be Excluded from Their Loved Ones Care, Canadian Medical Association Journal, January 1997, Volume 156, Issue 1, 5355. Canadian Medical Association 1997. This work is protected by copyright and the making of this copy was with the permission of the Canadian Medical Association Journal (www.cmaj.ca) and Access Copyright. Any alteration of its content or further copying in any form whatsoever is strictly prohibited unless otherwise permitted by law.

Edited by Amanda Lewis

Indexed by Emma Skagen

Dust jacket design by Anna Comfort OKeeffe

Text design by Sari Naworynski

Printed and bound in Canada

Douglas and McIntyre (2013) Ltd. acknowledges the support of the Canada Council for the Arts, which last year invested $153 million to bring the arts to Canadians throughout the country. We also gratefully acknowledge financial support from the Government of Canada and from the Province of British Columbia through the BC Arts Council and the Book Publishing Tax Credit.

Library and Archives Canada Cataloguing in Publication

Klein, Michael C., 1938-, author

Dissident doctor : catching babies and challenging the medical status quo / Michael C. Klein.

Includes bibliographical references and index.

Issued in print and electronic formats.

ISBN 978-1-77162-192-2 (hardcover).--ISBN 978-1-77162-193-9 (HTML)

1. Klein, Michael C., 1938-. 2. Physicians--Canada--Biography. 3. Midwifery--Canada. 4. Maternal health services--Canada. 5. Pediatrics--Canada. I. Title.

R464.K54A3 2018610.92 C2018-902129-2

C2018-902130-6

To Dr. Howard Levy, who was jailed by the US Army for refusing to train Green Beret corpsmen, who would use their skills for political purposes. The other charge against him was promoting disloyalty and disobedience by discussing his anti-war views with GIs. Dr. Levys treatment by the Army was central to my decision to try to avoid such an experience and, in the end, leave for Canada.

To my lawyer, John Somers, whose advice and advocacy (without his realizing it) prepared me to try to convince the US Army that I was more trouble than I was worth.

To our kids, Seth and Naomi, who put up with my rants at the dinner table, and with whom I partnered in helping with Bonnies recovery. I am so proud of their values and contributions to making a better world. To Zoe, Toma and Aaron, our grandchildren, who light up our lives and who will carry the family story.

To my life partner, Bonnie, who despite her profound illness and disability, remains the force that holds our family together.

Michael Klein is my age, and because I have known him about half our lives, through tumultuous times in our world and in maternity care, my fascination with this book is deep. As I read it, I learned about this rugged individualist who thinks outside the box and can be very persuasive with his clear thinking and ability to support his beliefs with rational explanations and scientific evidence. The book enriched my knowledge of him and the interest we have shared for these many yearsa passionate concern for the well-being of families from conception to successful, healthy integration of the family. For me, the book provided much background to explain how Michael came by his sense of justice, sharp wit and independent thinking skills that have led him to question widely accepted care practices that most clinicians follow without curiosity. Combine those traits with a feisty personality, a trace of stubbornness and a good deal of empathy for childbearing people, and you have a change-maker. I should add that Michaels analyses of published research are most helpful to those of us who lack the time or skills to objectively analyze and evaluate methods and conclusions of research studies. He is a good teacher.

Because I am what some call a birth junkie, known for my work with doulas and childbirth education, I emphasize this area of our shared interest. This is not to minimize the importance of Michaels work in family practice, pediatrics, neonatology and the social determinants of health and the place of birth in the larger context of societys values. Michaels exposure to the Red Scare and McCarthyism, his cross-cultural experiences in Mexico and Ethiopia, his struggles with the US Army and support for single-payer health care dating from his early years as a medical student at Stanford, and his own illnesses and the dramatic life-saving surgery for his wife, Bonnie (and his role in it)all set the stage for his iconoclastic research on birth and critical analysis of old and new technologies. Michael thinks of himself not as a dispassionate physician-scientist but as a fully engaged human, free to use his own personal experiences within the therapeutic relationship.

Within family practice, his research emanates directly from questions posed by his patients or directly from his personal experience with family illness. As he puts it: Apart from treating the condition, I could not afford not to look deeper into why the patient was vulnerable to the disease. Although a substantial portion of the book is about the challenges of providing high-quality caring birth environments for women and families, it is not a birth book. Michael uses birth as a window through which to understand the values of a society.

Because of my particular background and focus, Ive decided to highlight several areas of maternity care where Michael has made unique and original contributions, thereby changing maternity care practices or raising questions that challenge current entrenched maternity care customs or sacred cows. The bibliography at the end of the book includes references to his publications on these topics. I encourage readers to check out these sources. You will admire his critical-thinking skills and learn a lot! Although his studies are scientific, they are devoid of jargon and easy to read and understand by a general reader.

Michael has authored numerous studies, commentaries and editorials analyzing and questioning the broad application of the findings of some meta-analyses (studies that group a number of research efforts together), demonstrating inconsistencies in which studies were or were not included and other flaws. Any of these flaws might skew the results. He has expressed these faults as Garbage in; garbage out! By carefully deconstructing the methodology and findings of many meta-analyses and systematic reviews, Michael has revealed fallacies in their design and conduct that led to reasonable doubts about their conclusions.