Easy-to-share Link ~ https://tinyurl.com/y5hdkjyq
ARCHIVE Info Only ~ I attended the Grand Rounds, which was well-attended, and according to Judy Luce, who helped organize the event in Berkeley, his presentation was excellent (particularly his PowerPoint slides – seee below) and very well attended and received. faith ^O^
Dissident Doctor:
My Life Catching Babies and Challenging the Medical Status Quo
This is a temporary posting for the express purpose of convincing local midwives (SF Peninsula, Palo Alto, Mountain View, San Jose, etc) to come to Dr. Klein’s Stanford Grand Rounds presentation on Wednesday, September 4th, and/or his personal appearance in Berkeley on Thursday, the 5th.
Here is the info:
Stanford Grand Rounds September 4th
7:35 Arrive LKSC Building, Berg Hall 2nd floor
8:00 Introduction
8:05 Presentation begins
8:35 Presentation ends
(Please note that the presentation will need to end at 8:35 to allow 15 minutes for question/answer period).
8:35-8:50 Question/Answer period
8:50 Breakfast reception in the hallway
NOTE — See Dr. Klein’s PP notes below (after the review of his book). His presentation is going to be ‘knock-your-socks-off revolutionary :
Berkeley
September 5, 2019 2 – 4:30 pm
The Ed Roberts Campus, Berkeley, CA
Tickets are free: RSCVP & get details at
http://bit.ly/KleinEvent
Dr. K’s Tee shirt reads: “Real Men Love Midwives”
Many California midwives will recognize Dr. Klein as the moderator of the Canadian Maternity Care Discussion Group (MCDG).
He was born and raised in the US, graduated from Stanford’s School of Medicine in 1966, but in protest against the war in Viet Nam, he emigrated to Canada.
In case you don’t know him, or don’t know about him, I have included his biography at the end, after the info on his local appearances Sept 4 and 5th. These events are about his new book: The Dissident Doctor.
The book begins with his personal story, including his mother’s unnecessary Cesarean delivery of him in 1938, his politically-active ‘leftist’ parents and early life as a ‘red diaper’ baby, the impact of the McCarthy Hearing in the 1950s. His father, a ship welder and union organizer, was accused of being a Communist and blacked-listed. As a result, he was fired and unable to get another job for many years, forcing his mother to become the family breadwinner.
Dr. Klein describes his very interesting medical school education, including a life-changing year and a half as a med student in a third-world Ethiopian hospital in the 1960s, among other things (such as tracheostomise on infants and small children with diphtheria), attending normal births under the tutelage of local midwives.
During his medical school years, he had several influential mentors who excelled at medical research. As a result, Dr. Klein developed an avocation for comparison studies on questionable medical treatments and surgical procedures that he and others believed might be ineffective or harmful.
Episiotomy-Comparison Study
As a result, Dr. Klein’s was the very first randomized controlled trial comparing the routine use of episiotomy versus spontaneous perineal lacerations. Turned out that rationale for routinely performing episiotomies, which was to prevent perineal tears that might damage to the mother’s perineal floor, to reduce postpartum pain, incontinence, and long-term sexual dysfunction, was actually ineffective AND harmful. The very problems that episiotomy was supposed to prevent were ever so much higher in the episiotomy cohort than women who had spontaneous tears.
Unexpected Life-Threatening Medical Problem
Very personal medical troubles touched Dr. Klein’s life in 1987 when his healthy wife Bonnie suddenly developed a type of brain-stem aneurysm that triggered a devastating series of strokes that required her to be on a respirator. His wife was unable to breathe on her own, unable to speak, and a quadriplegic. Her condition seemed hopeless and her doctors expected her to die. Only a radial type of ‘experimental’ surgery never before performed a human being saved her life.
Unfortunately, she was still paralyzed, unable to speak and her prognosis for recovery was still poor. But after many more weeks in the ICU and 6 months of hospital-based rehabilitation, Bonnie beat the odds. Over the next 15 years, she recovered her ability to speak and much (but not all) of her normal mobility. As a documentary filmmaker, she made a film about living with disabilities that included her own experience called “Slow Dance: A Story of Stroke, Love and Disability”
This also was a profound experience for Dr. Klein as her husband, as he had a ringside seat for how hospitals so often don’t work from the standpoint of patients and families. That personal experience, along with his experience attending normal births in Ethiopia and “abnormal” births in America hospitals (Stanford and Valley Med in Santa Clara), and his skill with research that provided hard facts to judge the many problem areas of medical practice, combined to “radicalize” Dr. Klein in ways corporate medicine would describe with disdain.
Having evolved as a “free thinker” in many different aspects of contemporary allopathic medicine, his book identifies both the successes and failure of the contemporary medical services delivery system, particularly, the institutionalized (i.e. baked into the cake) failure of out high-tech obstetrical system to provide appropriately science-based physiologic care for healthy women with normal term pregnancies.
Over several decades, the surgical specialty of obstetrics that trains its practitioners to be surgeons has slowly, and from the standpoint of scientific evidence, irrationally replaced non-interventionist management of normal vaginal childbirth in healthy women with long list of unnecessary medical treatments, and surgical procedures, most especially scheduled pre-labor Cesareans and elective Cesarean surgeries during labor based on “physician preference” rather than medical necessity.
As we already know, this iatrogenic policy is associated with an increase in preventable maternal deaths and serious, long-term morbidities. These include secondary infertility and complications for both mothers and babies in subsequent pregnancies.
The historical, economic and cultural reasons for this are the topic of Dr. Klein’s excellent book.
Below are the show-stopping notes for Dr. Klein’s oral presentation at Stanford Grand Rounds:
In a moment of despair
over the loss of maternity skills,
I created “Michael’s Birth Dystopia”.
Notes for “Michael’s Dystocia or the future is now, or Margaret Atwood was right in “A Handmaid’s Tale”
1.
- If she is too small, cxion her
- if she is too big, cxion her
- if she is too late, cxion her
- if she is too early, cxion her
2.
- If she is breech, cxion her
- If she has twins, cxion her
- If you think her baby is too big, csion her
- If the induction you did for no good reason fails, cxion her
3.
- If you do not have a nurse to look after her, cxion her
- If you are too busy, cxion her
- If the unnecessary or too early epidural stops her labor or gives her a malposition (OP/OT) due to the deflexed head that you caused, cxion her
4.
- If she is not in labor, but you think she is, cxion her
- {{ Doula contribution to be made her}}
- If she has a uterine scar, cxion her
- If her risk-score is too high, cxion her
- if she is afraid, cxion her {{doula role here}}
5.
- If she has or is worried about urinary incontinence, cxion her
- If she is worried about sexual dysfunction, cxion her
- If her husband is worried about HIS sexual functioning, cxion her
6.
- For those remaining irresponsible women who insist on a vaginal birth, they are really guilty of child and pelvic floor abuse, but if they insist, they will need a consult before “attempting” a “trial” of vaginal birth . . . .
7.
- Or if they really insist on a vaginal birth, who will look after them?
- Midwives and a few screwy family docs — both working closely with a few dedicated but very strange doulas.
8.
- Since vaginal birth will become obsolete, then the specialty of OB/GYN will become Gynecology only, and cesarean will be part of that skill set.
9.
- But who would want to be an obstetrician if there were no decision to be made and he/she would simply be a Cesarean technician?
10.
- But wait, the US Army has successfully trained medical technicians to do Cesareans (Faith’s addition “midwives working Ethiopia or other 3rd world countries”). If all that is required is to know how to do a cxion, then why not technicians?
11.
- In the future, everyone can have a cesarean and large surgi-centers can be established where all women will come for their Cesarean.
12.
- Rural maternity care will of course disappear, as well it should. And shortly after that, so will family doctors providing maternity care, then midwives, then doulas.
13.
- The few remaining pregnant women who insist on doing it their way will join the back-to-the-landers, the end-of-the-worlders, and some throwbacks to the 60s and all will retreat deep into the wilderness to continue to practice their arcane belief {in normal childbirth for healthy women with low- and moderate-risk pregnancies}.
END
- Sound like science fiction? The raving of a Don Quixote nearing the end of his career? Read Margaret Atwood and look around you.
-
As a family practitioner, pediatrician, advocate, professor and researcher Dr. Klein played a vital role in placing maternity care at the heart of family medicine in , addressing the harmful effects of widespread medical interventions, pushed for the adoption of family-friendly birth practices, the re-introduction of midwifery, the promotion of doulas in birth and the elimination of routine intrusive interventions such as episiotomy. An influential mentor to many, his approaches are now widely adopted in maternity care.
He was appointed as a Member of the Order of Canada in recognition of his extraordinary contributions in these fields.
Hope to see all you CALM members at the Stanford Grand Rounds, if for no other reason than to watch Dr. Maurice Druzin’s face after Dr. Klein’s revolutionary presentation.
