Quality of Care

by Elizabeth Letts

A dedicated obstetrician, Clara Raymond comes face to face with her childhood friend, Lydia Benson, who had once saved Clara's life following a horseback-riding accident, a brief reunion that ends in tragedy and sends Clara on an odyssey back to her California past and to a rediscovery of the meaning of life. A first novel. Original.

Genres: Fiction

288 pages, Paperback

First published March 1, 2005

About the author

ELIZABETH LETTS is an award winning and bestselling author of both fiction and non-fiction. The Perfect Horse was the winner of the 2017 PEN USA Award for Research Non-fiction and a #1 Wall Street Journal bestseller. The Eighty-Dollar Champion was a #1 New York Times bestseller and winner of the 2012 Daniel P Lenehan Award for Media Excellence from the United States Equestrian Foundation. She is also the author of two novels, Quality of Care and Family Planning, and an award-winning children's book, The Butter Man. She lives in Southern California and Northern Michigan.

Reviews

[Elizabeth Havey · Rating 5 out of 5]

As a labor and delivery RN who is writing a book whose main character is--you guessed it--a labor and delivery RN, I loved this book--especially the first few chapters. Dr. Clara Raymond is called to help a pregnant patient who seems to be in early labor. Then all hell breaks loose. The patient is her childhood friend, Lydia Benson, the father of the child is Clara's first and possibly only true love, Gordon Robinson, and as I was pulled into the developing trauma and complication of the birth--well, things...but you have to read the book. Still not convinced? Then what if you loved horses or were familiar with the Northern California coastline and the horse farms in "them there parts." That part of the novel takes over after the birth of the child, and in a series of chapter flashbacks, Letts reveals the turbulence of her relationships with both Lydia and Gordon. It's a good read, if you like the elements I've mentioned, and in the end you will route for Clara to return to the world that is truly hers, delivering babies.

[Maudeen Wachsmith · Rating 5 out of 5]

I like these NAL Accent books. They're trade paperback size and on the bottom it says "Fiction for the Way We Live" - Other authors in this line include a favorite of mine, Lisa Wingate; and several books I have in my TBR pile. I even like the feel of this book. The smooth pages, the size. I also like the conversation guide in the back which includes an interview with the author as well as a discussion guide. I do admit to sometimes reading the conversation guide before the book, allowing for spoilers sometimes, but it has never ruined my enjoyment of the book itself.

I am a sucker for a good medical story and this is a doozy. Letts, a midwife herself, writes about Dr. Clara Raymond an obstetrician who is on-call but busy with another patient when a childhood friend (Lydia) who is 34 weeks pregnant arrives in labor and delivery. Lydia happened to marry Clara's former live-in boyfriend, Gordon but Clara has lost touch with the two until they show up rather unexpectedly at the hospital. Lydia has vague symptoms but since Clara is busy with the other patient, goes unattended by other than the nursing staff for a brief period of time. Soon things go tragically wrong and eventually Clara ends up taking a trip to her childhood home in California to find answers regarding her own past. This book is really well done and is a great debut by an author to watch. The California portion of the book takes place on a horse ranch and it says in the bio that the author is not only a midwife but a former competitive equestrian. I enjoyed nearly everything about this book and my only big complaint is that the book wasn't longer. For those of you who are tired of the run-of-the-mill women's fiction or coming-of-age stories, I would highly recommend QUALITY OF CARE for a great chance of pace. This is an exceptional read and I can't wait to see what the author comes up with next. It can't be too soon for me.

[Karen · Rating 3 out of 5]

Held my interest, but I didn't like the horse stuff. I also was upset that the author, a midwife, chose to write about an obstetrician. Why not use her talents to write about a midwife and get midwifery more "out there" into the mainstream? I also have some issues with her management of the shoulder dystocia she describes - will surely come back to haunt her if she ever finds herself in court for a similar situation. I kept waiting for her to make the point that the obstetrician had done the wrong thing and that's why there was a bad outcome, but it never happened. And by the way, what's with the Franny Baker red herring? No significance to that at all?

[Jan · Rating 4 out of 5]

Clara, a highly skilled and caring obstetrician is caught off guard when a pregnant woman comes into the ER with minor complaints. That woman turns out to be a childhood friend who just so happened to marry Clara's ex-boyfriend. Everything that could go wrong does and Clara finds herself in California with her surgeon's privileges suspended and in the house of someone who has answers to questions in Clara's past.

[Bonnie · Rating 4 out of 5]

I've read Letts's non-fiction books, The Eighty Dollar Champion and The Perfect Horse, as well as her novel based on fact, Finding Dorothy. This is her debut novel, straight up fiction, and it's really just as good as her other works. Letts has a really nice range of talents. Some of the plot had a bit too much coincidence for me to buy and the final reveal when Elizabeth tells Clara what really happened the day of her accident was a bit hasty and over and done with but, overall, I really enjoyed the book. The characters were well drawn, and the tension was palpable throughout. A very good read.

[April Luxner · Rating 3 out of 5]

On paper this book sounded great... it's a medical novel with an OB concentration, there are horses in it (which I love) but it was just okay. The writing was definitely not amazing. A review on the back cover said "A good read" and I remember thinking that that isn't what you'd call a rave review, is it?

[Hayseed · Rating 4 out of 5]

A quick read, if you like medical stories and mishaps, it is interesting.

[Mich · Rating 4 out of 5]

ob dr takes over care of pt who she knows, while pt is in labor, woman dies and what happens next.
not BAD from an ob point, but i didnt like the 'horse' stuff included

[Kim Hollstein · Rating 3 out of 5]

My need to like the protagonist, even just a little bit, marred my enjoyment of this book. Obstetrics and horses combined? Should’ve been one of my favorite reads of all times. But I just couldn’t understand or like Clara. But other aspects of the book, I enjoyed.

[Allison · Rating 3 out of 5]

I thought the premise of this was good. Well written too. Just found myself impatient and skipping ahead too much to enjoy.

[Karen Baadsgaard · Rating 1 out of 5]

BAD-DIDN'T READ

[Karen · Rating 5 out of 5]

Loved this story.

[Debbie · Rating 1 out of 5]

Blech. Too many unbelievable storylines and an unlikable lead character.

[Rita · Rating 4 out of 5]

Another book that has been sitting in my TBR stack for a few years! This is the fast-moving story of an OB-GYN doctor who has a very personal and very terrible experience when delivering a baby for a couple from her past. In her attempts to resolve her feelings, she goes to California where shes works incognito as a lowly stable-hand. While doing this, she also works to resolve two things which have always been a mystery to her: her physician father’s death and an accident which occurred to her as a young girl. It also becomes apparent that she needs to resolve her own love life.

I found this book to be one of those books that I read in one sitting. It was this author’s second book and I am interested in reading some of her later works, two of which have achieved the best seller lists and won literary prizes.

[Louise · Rating 4 out of 5]

For a debut novel this was a deeply touching story. Tragedy, uncertainty, pondering, and healing are the most striking issues that come from this exquisitely written novel. I'll definitely be watching for further Elizabeth Letts novels.

From back cover:

"Clara Raymond is the kind of obstetrician any woman would want-caring, skilled, dedicated. But she is caught off guard when a pregnant woman is wheeled onto the labor and delivery floor with what seem to be minor complications. The patient turns out to be Lydia Benson, a childhood friend who saved Clara's life after a terrible horseback riding accident. And at Lydia's side is her husband, Gordon Robinson, a man whom Clara once loved passionately and then left, although she has never forgotten him.

That night, in the labor and delivery room, the brief reunion goes tragically wrong. For Clara, the consequences will include a journey to California and to her own past and a rediscovery of hope in a place she never expected...An involving, nuanced story about the search for healing and the fragility of both our bodies and our souls."

[Bev Sykes · Rating 3 out of 5]

This is Letts' first book, written in 2005 when she was still working as a midwife (now, after 9 published books, she has given up midwifery and is a full time author). Her talent as a writer, writing books that will ultimately become prize winners, is apparent in this first work, though it is kind of a weird book, which combines both her medical experience and her love of horses (who will become her primary subject in later books).

Clara is an obstetrician who is overwhelmed by two women in labor, one of whom is her good friend, who once saved Clara's life and who is now married to Clara's former lover. A tragedy happens that results in Clara taking some time off from the hospital while investigations take place. About 1/3 of the way into the book, things begin to happen which are almost fairy tale....relationships and situations are improbable, but written so well it was 3 a.m. before I finished the book and could put it down.

[Nikki · Rating 4 out of 5]

One night, an obstetrician gets a surprise patient -- a childhood friend who once saved her life. Things go horribly wrong. The complication? The childhood friend is married to the obstetrician's former lover. Did the OB do all she could? Doubts assail her from within and without, and she escapes to her childhood home in California, where (under somewhat false pretenses) she finds work as a stablehand. During this time she learns much about herself and her own past. I was afraid this was going to be more melodramatic than it turned out to be, and I particularly liked the ending. I've read one other of Letts's books (I think it was called Where the Heart Is) and enjoyed that also. Based on these two I will be looking for more of her work.

[Karen Jett · Rating 4 out of 5]

I really enjoyed this book. On the surface, it's the story of an obstetrician who experiences a traumatic birth where the mother dies. On a deeper level, it's the story of a woman who has never dealt with her past, choosing instead to close the door and pretend it has no relevance.

All of us are impacted in our lives by many other people. Frequently we are unaware of how they were a part of our life, and sometimes even that they touched it. This story explores these relationships.

It's a great story, so if this sounds intriguing, give it a try!

[Erika · Rating 3 out of 5]

This book was given to me and I thought I would give it a chance. It had a good story, although predictable. I am very glad I read it after I had our children, it has a lot of obstetrics and a very bad and tragic situation...so many things went wrong with pregnancies and deliveries--it was tough to read. I would maybe give it 3.5? Lots of people confronting their pasts, past secrets, identities were surprising, certainly a formula I have read before.

[Caren Nelson · Rating 4 out of 5]

I really liked this book. It is more about horses actually than babies, but it did keep my interest because it switches between now and the past so I kept reading in order it find out "we" got to where we were.

[Erica · Rating 3 out of 5]

While the story line was good, there were parts of the plot that were a just a little "too much" for me. I mean, really.... a huge brush fire and a woman going into labor all at the same time?? But the rest of the story, the characters and the main themes were very well written.

[Allen Steele · Rating 2 out of 5]

Clara and Lydia were best friends in school, however they had lost touch. Clara becomes a doctor and come to her old friend for pre-natal care. Who coincendentally is expecting a baby with Clara's old flame..
Good medical descriptions here, but not very entertaining.

[Janet · Rating 4 out of 5]

I liked the story very much, with the exception of some crude language.

[Charlotte · Rating 3 out of 5]

A quick read with some fun twists, this is one you don't want to put down.

[Pauline · Rating 4 out of 5]

great read

[Pamela Reed · Rating 3 out of 5]

Interesting but found myself skimming at times as wasn't always holding my attention....but still a good story...

[Kelly Douglas · Rating 4 out of 5]

Great read

[Jane · Rating 3 out of 5]

Pretty predictable. Really just an okay summer read. Maybe better if you love horses.