This feels a little silly but

I think almost all of you know who I am, at this point? So any sort of big reveal feels silly. And furthermore, I don't think there are a whole bunch of folks left here since Google Reader died. But anyone who is: you've been here since the beginning, so I wanted to share.

Here are the recent events, bulletin-style:

1. I wrote a whole bunch of stuff in the outside world. 
2. I got an agent, and a book deal, and eventually I wrote a book. It came out pretty great, I think, and if you like this blog, it’s all that kind of stuff and more.
3. It's available everywhere (Amazon, IndieBooks, etc), or request at your local library. Easy links at my official author website www.chavikar.com
4. My publication day was last week, and I had a bunch of book events planned, and was scrambling to plan more. 
5. Then the world changed. All of....everything I planned is on hold, and my book is not going to get much attention. But it turns out that is just a small part of the larger sadness that we're all going through. As of now, as a health provider on the front lines, I feel like I’m mobilizing for war times. 
6. However, because I need to write, I've started posting a little from the front lines of coronavirus, as it starts up. I'm doing it on my author Facebook page but it feels a lot like the stuff I used to put here. 
7. MyFacebook page is: https://www.facebook.com/ChaviKarkowskyMD/. If that's of interest, feel to follow me there to see it; if that's too annoying a platform, I'll see if I can crosspost here - just let me know in the comments. 

Book Query

It's been a while since I've written here. In part because I've been writing elsewhere, but in part because I've been working hard on a book proposal. And it's done. 

But I don't have an agent. So I thought I'd ask you if you have any idea where I could/should send this, or who might be interested in representing me. 

My query letter is below; let me know if you have any suggestions on it, on the project, or any people in the publishing industry that would love to get this. Or the title! I don't like the title. 

Thank you, anyone who's still here. 

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I am seeking representation for my book, Every Little Thing’s Going to Happen: Stories from a High-Risk Obstetrician. I am reaching out to you because you represent other medically-oriented authors with similar works. My book includes death, sex, blood, and even joy; it is tentatively titled Every Little Thing’s Going to Happen: Stories from a High-Risk Obstetrician.

Every Little Thing’s Going to Happen goes behind the scenes of the high-stress, high-stakes drama inherent in my job, where every day I might be stewarding one woman through the worst day of her life, and one woman through the best day of her life.  The book begins with a chapter discussing the imminent delivery of a 23-week pregnancy: an age at the very limits of technology’s ability to keep a newborn alive. The baby will almost definitely die; if the baby lives, it will likely be severely impaired, a life full of limitations and pain.  In this situation, the laboring woman needs to tell us what to do. The medical team is emphatic that she needs to choose: are we caring for a miscarriage, a pregnancy that we will allow to deliver and die, and then we will mourn? Or are we caring for a patient in labor, with a newborn that we will surround with all of our medical power, in an attempt to wring a good outcome from terrible odds?  She has to decide, because what is good medical care in one situation is assault or malpractice in the other.  

In the remaining chapters, I unpack diverse scenarios, including the delivery of a woman who is sick enough to deliver in the Intensive Care Unit [ICU], and what the ICU team learns from having obstetric emergencies occur among their geriatric patients. I take the reader on a tour of the madness and chaos of a typical night on call on Labor & Delivery. I talk at length about the holiness and confusion of shepherding a woman and her family through a stillbirth -- and how that changes when I find out that I myself am pregnant.

I also spend chapters on what motivates me -- and medical providers in general -- to do a good job, in a job where doing just enough will never suffice to achieve good patient outcomes.  I talk about working in some of the poorest communities in the United States, with some of the most vulnerable women in the world: how medical staff works to make things better, and what happens when we inevitably fail. Other chapters include tales of how I progressed from an trainee to a mature health care provider who works with patients on the best and worst days of their lives.

Every Little Thing’s Going to Happen  will capitalize on the recent explosion of interest in medical literature, as demonstrated by the success of such titles such as Paul Kalanithi’s When Breath Becomes Air and Atul Gawande’s Being Mortal, and the interest in pregnancy evidenced in such works as Call the Midwife or Ariel Levy’s recent memoir Rules Do Not Apply. However, nobody has yet written an in-depth exploration of the medicine that surrounds women’s reproductive lives. Especially amidst current political upheaval, this book will also serve as in-depth look at the nuanced issues that surround pregnancy termination, contraception, and reproductive care, similar to the recently successful Life's Work by Dr. Willie Parker. Every Little Thing’s Going to Happen will also be a valuable resource for people interested in learning more about the complications and concerns of pregnancy, audiences that have made books like What to Expect When You’re Expecting into perennial bestsellers. I think this book will find an enthusiastic audience with both lay and medical readers.

I am a Maternal-Fetal Medicine doctor, a subspecialist in high-risk pregnancy, and I’ve been a provider of obstetric care for almost 15 years.  My writing has appeared in Slate, the Daily Beast, the Atlantic online, and other publications. I’m also a mom of four kids, so I’ve been on both sides of many (too many) reproductive and medical decision-making experiences.

May I send you the proposal?

Thank you,

This week. This everlovin' week

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Sipur Yisraeli

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Setbacks, nursing, Zika, failure

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Write a book

Would it be ok if it was just stories? Not stories linked together with trenchant analysis of what this means for Our Times, but just: this sad thing happened, or this happy thing happened, or lots of things occur and I have no other point than to show you that lives are hard but punctuated by great joy and great sorrow and here are some of those times that otherwise would be obscured from your view.

Is that a reasonable kind of book? Or does it need to be somehow More? (I have always thought it would need to be More. More makes me tired, so I just never get very far).

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Here's a possible title: "Every Little Thing Gonna Happen".

Because once I took care of a pregnant patient who had cardiac issues and renal failure and was in general very sick. Every time I took care of her in the office, I would talk about all the things we worried about, and she would say, very gently: "Hey, Dr. C. Hey. Ain't nothing gonna happen." When she got admitted to the hospital, I would tell her what we could, and couldn't do for her and her baby if things go worse, and she would say, very gently: "Hey, Dr. C. Ain't nothing gonna happen.".


And I would go tromping over to the nursing station to sit and write my note, and I would grumble: "That's her motto. We should make a t-shirt with that on it for our whole team. We could have hats, and wristbands: 'Ain't Nothing Gonna Happen'. "
"And I wish she was right, but I think I've been doing this for a while now, and you know what? Every little thing gonna happen. It just does, and it will. Every little thing."

That, to me is pregnancy, and L&D, and high risk and women's health and parentood. Eventually, around here, every little thing is going to happen: bad, good, in between. It's a whole world, over here.

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Anyway, is that a book? I thought so last night. Now I can't tell.
It's probably not, right? Probably not.

Cruel to be kind

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