In the first half of the twentieth century, thousands of tiny babies lived their first few weeks among the smell of hotdogs and the sound of carnival music as they desperately fought for their lives.
Dismissed as ‘weaklings’ and given little chance of survival, many were simply left to die.
But one man, Dr Martin Couney, had the technology, the know-how and the motivation to save them. So, with parents’ permission, he took pre-term babies from their homes and hospitals and admitted them to his child hatchery – a precursor to today’s neo-natal unit.
It was through his own experience of having a premature baby with his wife, who was a nurse, that Dr Couney recognised the need for sustenance, human contact and warmth to survive, and decided to set up rooms full of incubators where they could be kept alive.
However, these rooms weren’t in hospitals – they were in fairs and expositions around the world.
But it was an expensive operation and the doctor controversially decided to charge people money to come from the streets and ogle at the 2lb infants under the catchline ‘all the world loves a baby’.
He soon became known as ‘The Incubator Doctor’, but his work riled the establishment. The New York Society for the Prevention of Cruelty to Children accused Dr Couney of exploiting children, while an editorial in the Lancet warned the show exhibited babies “just as they might have exhibited marionettes, fat women, or any sort of catch-penny monstrosity”.
Dr Couney told reporters at the time that he had trained in medicine in Leipzig, and Paris, however, author Dawn Raffel, has since discovered there was no record of him at German medical schools, no German doctoral thesis in the National Library of Medicine’s holdings and no US medical licence for him.
Explaining the reason behind the man’s extreme circus show, Dawn, who has written The Strange Case of Dr Couney, tells Metro: ‘Infant mortality at the time was extremely high, hospitals were terrible and most people would have preferred to give birth at home. There weren’t a lot of resources for newborns in general and there wasn’t the dedicated nursing needed to keep a baby alive in an incubator.
‘He was begging for money all the time. But it was hard to convince people because of the eugenics movement in the United States at the time. They were focused on building better babies.’
That meant tiny weak ones were simply left to die – until Dr Couney stepped in and made a career with his hatchery in expositions, world fairs and amusement parks both here in the UK and the US, with shows in London in 1897 and Nebraska in 1888. The doctor then set up his spectacle on the Atlantic City boardwalk and Coney Island – alongside other circus ‘freak show’ acts.
It was a huge success. At the 1933 to 1934 Chicago World’s Fair, the incubator pavilion drew in 1,250,000 visitors. At Coney Island, The New Yorker described Dr Couney watching “the crowds flocking into his concession” and noted the loyal “repeaters” who picked a favourite baby and came back weekly. One woman returned once a week for thirty-six seasons.
Medically, Dr Couney’s results were miraculous. While the babies had a 90% mortality rate in hospital, when housed in the incubator exhibit, they had an 85% to 90% survival rate. And the families didn’t have to pay a penny for their babies’ care.
‘He was a visionary. But a lot of the smarts came from the nurses who were doing most of the work’, Dawn explains. As well as clinical nurses, Dr Couney hired wet nurses to breastfeed the newborns – sometimes a mother of one of the babies in the show – and a cook to feed them three square meals a day. If he caught one of them eating a hotdog or drinking a soda, he would fire them on the spot. (He was keen that their diet should be wholesome.) The doctor also kept the rooms spotless and practiced excellent hygiene across the premises.
While the preemies that were treated in hospitals in the 1940s and early 1950s frequently went blind, babies treated in Martin Couney’s sideshows retained their eyesight. It wasn’t until the mid 1950s, after the showman’s death, that doctors discovered the reason – overuse of oxygen. (It was oxygen toxicity that caused blindness in singer Stevie Wonder, who was born six weeks early in 1950.)
Dr Couney was undeniably a controversial character. Child protection charities accused him of exploiting the babies and detractors said he was a mercenary, because he made a good living from the work. Meanwhile, as Dawn discovered, his credentials were questionable.
‘He made the medical profession uncomfortable at the time, because he was a showman, a carnival guy. He didn’t see any conflict between his own self interests and saving babies,’ she explains.
‘In researching the book, I went through a lot of old newspaper articles and there were so many inconsistencies. He said he invented the incubator, which he did not. He said he was trained in Leipzig and Paris. But he wasn’t even in Europe at that time. So a lot of that stuff he made up.’
However, without doubt, his work was both vital and revolutionary. Dr Couney’s incubator shows saved the lives of an estimated 6,500-7000 babies, many of whom are still alive today and have spoken to Dawn about their unconventional start in life.
‘It can make you uneasy to think about. It’s as if there were a cure for breast cancer but you have to be in a circus to receive it. Some of the surviving patients who I talked to said their parents were extremely embarrassed by it, or hesitant or appalled by having to do this, and yet, he saved their lives. So how do you weigh those two things?’ asks Dawn. ‘At the same time, there wasn’t another way to do it at the time. You could think of it as medical crowdfunding.’
Dr Couney’s legacy continues today. Dr Julius Hess, a paediatrician from Chicago who worked with him, took what he’d learned back into hospitals who then started to invest in incubators and neonatal care, earning Dr Hess the reputation of being the father of American neonatology.
So was Dr Couney an exploitative showman or inspirational visionary? Surely the final say should go to those tiny babies now grown, parents and grandparents themselves.
‘Some of them felt it was really cool, and some felt kind of proud of it,’ says Dawn. ‘They felt special, because they were in his show as a baby. But most of all, they felt they survived because of this guy.’