The Strange Case of Dr. Couney: How a Mysterious European Showman Saved Thousands of American Babies by Dawn Raffel (Blue Rider Press, 284 pp.)

By Laura Durnell

With a couturier’s skill, Dawn Raffel’s The Strange Case of Dr. Couney: How a Mysterious European Showman Saved Thousands of American Babies threads facts and education into a dramatic and highly unusual narrative. The enigmatic showman Martin Couney showcased premature babies in incubators to early 20th century crowds on the Coney Island and Atlantic City boardwalks, and at expositions across the United States. A Prussian-born immigrant based on the East coast, Couney had no medical degree but called himself a physician, and his self-promoting carnival-barking incubator display exhibits actually ended up saving the lives of about 7,000 premature babies. These tiny infants would have died without Couney’s theatrics, but instead they grew into adulthood, had children, grandchildren, great grandchildren and lived into their 70s, 80s, and 90s. This extraordinary story reveals a great deal about neonatology, and about life.

Raffel, a journalist, memoirist and short story writer, brings her literary sensibilities and great curiosity, to Couney’s fascinating tale. Drawing on extraordinary archival research as well as interviews, her narrative is enhanced by her own reflections as she balanced her shock over how Couney saved these premature infants and also managed to make a living by displaying them like little freaks to the vast crowds who came to see them. Couney’s work with premature infants began in Europe as a carnival barker at an incubator exposition. It was there he fell in love with preemies and met his head nurse Louise Recht. Still, even allowing for his evident affection, making the preemies incubation a public show seems exploitative.

But was it? In the 21st century, hospital incubators and NICUs are taken for granted, but over a hundred years ago, incubators were rarely used in hospitals, and sometimes they did far more harm than good. Premature infants often went blind because of too much oxygen pumped into the incubators (Raffel notes that Stevie Wonder, himself a preemie, lost his sight this way). Yet the preemies Couney and his nurses -- his wife Maye, his daughter Hildegard, and lead nurse Louise, known in the show as “Madame Recht” -- cared for retained their vision. The reason? Couney was worried enough about this problem to use incubators developed by M. Alexandre Lion in France, which regulated oxygen flow.

Today it is widely accept that every baby – premature or ones born to term – should be saved. Not so in Couney’s time. Preemies were referred to as “weaklings,” and even some doctors believed their lives were not worth saving. While Raffel’s tale is inspiring, it is also horrific. She does not shy away from people like Dr. Harry Haiselden who, unlike Couney, was an actual M.D., but “denied lifesaving treatment to infants he deemed ‘defective,’ deliberately watching them die even when they could have lived.”

Haiselden’s behavior and philosophy did not develop in a vacuum. Nazi Germany’s shadow looms large in Raffel’s book. Just as they did with America’s Jim Crow laws, Raffel acknowledges the Nazis took America’s late nineteenth and early twentieth century fascination with eugenics and applied it to monstrous ends in the T4 euthanasia program and the Holocaust. To better understand Haiselden’s attitude, Raffel explains the role eugenics played throughout Couney’s lifetime. She dispassionately explains the theory of eugenics, how its propaganda worked and how belief in eugenics manifested itself in 20th century America.

Ultimately, Couney’s compassion, advocacy, resilience, and careful maintenance of his self-created narrative to the public rose above this ignorant cruelty. True, he was a showman, and during most of his career, he earned a good living from his incubator babies show, but Couney, an elegant man who fluently spoke German, French and English, didn’t exploit his preemies (Hildegard was a preemie too). He gave them a chance at the lives they might not have been allowed to live. Couney used his showmanship to support all of this life-saving. He put on shows for boardwalk crowds, but he also, despite not having a medical degree, maintained his incubators according to high medical standards.

In many ways, Couney’s practices were incredibly advanced. Babies were fed with breast milk exclusively, nurses provided loving touches frequently, and the babies were held, changed and bathed. “Every two hours, those who could suckle were carried upstairs on a tiny elevator and fed by breast by wet nurses who lived in the building,” Raffel writes. “The rest got the funneled spoon.”

Yet the efforts of Dr. Couney’s his nurses went largely ignored by the medical profession and were only mentioned once in a medical journal. As Raffel writes in her book’s final page, “There is nothing at his grave to indicate that [Martin Couney] did anything of note.” The same goes for Maye, Louise and Hildegard. Louise’s name was misspelled on her shared tombstone (Louise’s remains are interred in another family’s crypt), and Hildegard, whose remains are interred with Louise’s, did not even have her own name engraved on the shared tombstone.

With the exception of Chicago’s Dr. Julius Hess, who is considered the father of neonatology, the majority of the medical establishment patronized and excluded Couney. Hess, though, respected Couney’s work and built on it with his own scientific approach and research; in the preface to his book Premature and Congenitally Diseased Infants, Hess acknowledges Couney “‘for his many helpful suggestions in the preparation of the material for this book.’” But Couney cared more about the babies than professional respect. His was a single-minded focus: even when it financially devastated him to do so, he persisted, so his preemies could live.

A Talmud verse Raffel cites early in her book sums up Martin Couney: “If one saves a single life, it is as if one has saved the world.” The Strange Case of Dr. Couney gives Couney his due as a remarkable human being who used his promotional ability for the betterment of premature infants, and for, 7,000 times over, saving the world.

Laura Durnell’s work has appeared in The Huffington Post, Fifth Wednesday Journal, Room, The Antigonish Review, Women’s Media Center, Garnet News, others. She currently teaches at DePaul University, tutors at Wilbur Wright College, one of the City Colleges of Chicago, and is working on her first novel. Twitter handle: @lauradurnell