Sometimes a book appears in your hands just when you need that author's words to speak to you. And that's primarily what made this book so special to me. Clara is a perfectionist driven obstetrician. When her long lost friend, now married to Clara's long ago boyfriend appears out of the blue in the L&D where Clara is on call, all seems to be well. She does a cursory (but not thorough) check, believes it's not a preterm issue & is then called into a imminent delivery. But while Clara is delivering the other infant, everything goes horribly wrong with Lydia. She starts hemorraghing everywhere, and when Clara reaches the bedside, she attempts to save the infant - but it's really pointless. The infant, which Grant names Clara, is brain dead and just being kept alive by machines. With her privileges suspended, she flees to her childhood hometown, determined to confront the woman that she believes ruptured her childhood family. Instead Eleanor, not recognizing her, gives her a job as a stable girl. In a twist of fate, the other stable girl is a pregnant teen. During her tenure of hiding out as a "stable girl", Lydia is forced to rethink what really happened during her teenage years, and what part her parents played in that drama....and maybe Eleanor is not where she needs to place the blame. The title is a key concept - "quality of care" does not equal "perfection" as Clara has always believed. It's doing the best that you can, and forgiving yourself if you fall short. ( )

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. ( )

Women's fiction about an obstetrician whose childhood best friend dies while under her care. well-written, but not my kind of book.

Life is full of pivotal moments--those moments when your life changes forever--even if you don't realize it until much later. Quality of Life is a story about those moments, and about an interconnectedness that goes beyond coincidence into the realm of fate.

Losing a patient is difficult for any doctor. But in Quality of Care, that patient is obstetrician Clara Raymond's childhood best friend. When Lydia and her husband Gordon, coincidentally an old boyfriend of Clara's, show up in Clara's hospital, it sets in motion a series of events that not only change Clara's life, they make her reexamine her past.

When Clara's hospital privileges are suspended pending an investigation of Lydia's death, she returns to the place where Lydia once saved her life, seeking answers to another pivotal moment, the disgrace & subsequent death of her father, and ends up incognito as a stable hand for an elderly woman who played a large part in her early life.

It's an emotional story, as you'd expect. The inexorable hand of fate is the driving force at the beginning of the book, as Clara merely reacts to events beyond her control. Those events change her, so by the end of the book she's no longer merely reacting, and fate's no longer in charge.

I can't do justice to all the levels in Quality of Care. The stories of Clara's past and her present are linked by her emotional growth and by the mysteries and people who affected her life. I was particularly fascinated, as I mentioned earlier, by the interconnectedness of the people and events, but without Clara's emotional and spiritual journey, it would have been a mere intellectual exercise--fun, but lacking the impact of the whole. ( )