In The Strange Case of Dr. Couney: How a Mysterious European Showman Saved Thousands of American Babies (Blue Rider Press), author Dawn Raffel uncovers the fascinating story of an enigmatic Prussian-born immigrant who showcased  premature babies in incubators to early 20th century crowds on boardwalks and expositions across the United States. Without a medical degree, the self-promoting Couney saved about 7,000 premature babies who grew up to live long and healthy lives. In her review for The National Book Review, Laura Durnell explained how Raffel, with a “couturier’s skill,” relates the story of Couney’s theatrics and medical accomplishments. Now Raffel answers lingering questions from Durnell about eugenics, researching early 20th century America and the idea of a fake doctor displaying babies as little freaks, but ultimately saved their lives.

Q. Congratulations on The Strange Case of Dr. Couney, and thank you for doing this interview. Before your book, I had never heard of Dr. Couney, which, I am sure, is true of most Americans. I am glad you included your story of how you learned about him and brought the reader into your intensive research process. How did you decide to include that in Dr. Couney’s tale?

A: Thank you! I wanted to tell the story of Martin Couney during his lifetime, with the biographical “facts” he told the public. But I also wanted to tell the story of the “Couney buffs”—a group of leading neonatologists who spent decades trying to find out the truth about him after his death, as a sort of avocation. That logically led into my own investigations. I hoped to show the reader how carefully Couney’s fabrications were created and how difficult they were to unravel. It took all the work of the Couney buffs, plus the Internet, plus a whole lot of shoe leather and archival deep diving to get to the bottom of it. Plus, I wanted to share my meetings with the surviving “babies,” who are alive and well today. I think the story has a toehold in the present, as technology forces us to make harder and harder choices about which lives have value.

Q. I am sure the tapes Dr. Lawrence Gartner – one of the last living “Couney buffs” – made of people who had known Dr. Couney were a goldmine for you. What source or sources did you find the most revealing and challenging to obtain? Are there any you wished you had found?

A: The tapes were incredibly helpful. So were the probate files of Martin Couney’s wife, cousin, daughter, and the head nurse, Louise Recht. Couney himself died broke and didn’t have a will on file, but these other documents provided a lot of juicy leads. The hardest item to find was the original copy of his naturalization record because I did not know which name he was using (Coney, not Couney), or that he’d become a citizen in Omaha (not New York) during the time when he was supposedly earning medical degrees in Europe. The one thing I desperately wanted to find and couldn’t was the book he supposedly kept, in which he’d written down the names of all his patients. Sadly, I suspect that it was discarded.

Q. Dr. Couney was ahead of his time and practiced methods that are now commonplace for preemies as well as newborns born to term: breast milk feeding and loving touch. When I gave birth to my daughter in 2010, the nurses placed her on my chest immediately after birth, and I nursed her then and months afterward. Skin-to-skin and loving touch were also encouraged after we left the hospital. From your research, did anything in particular seem to be the tipping point for Dr. Couney’s “maverick” methods to finally be accepted in hospitals and by obstetricians and pediatricians?

A. I’m not sure there was a single tipping point. For instance, doctors during Couney’s time knew breast milk was ideal, especially for preemies, but if the mother wasn’t on hand, it was expensive. It had to be bought from a breast milk bank, and sometimes there wasn’t enough, and so they made do with formula. In contrast, Martin Couney paid to have wet nurses living on the premises—some of them had babies in the show. Later, of course, the formula companies made their push. Dr. Gartner was among the major voices stressing just how important breast milk is, and served as president of the Academy of Breastfeeding Medicine.

Q. You weave the history so well and construct a compelling non-fiction tale. Did Dr. Couney's mysterious life help your narration or did you find it made creating a dramatic story more challenging?

A: I loved following Dr. Couney through the decades. The fact that his show ran for so long, at so many venues, gave me the chance to create a cultural history of the midway.

Q. I had intellectually known about the harshness and cruelty of the late 19th and early 20th century – the anti-Semitism and racism, eugenics, freak shows, mistreating living animals – but one thing I was shocked by was how badly public records were kept. In the digital, social-media and 24-hour-news age, I don’t believe we will have the problem of finding information again -- we may even have too much of it. What element do you find missing from our present-day world that was around during Dr. Couney’s time that added to life instead of taking away from it?

A: On an intimate level, I enjoyed finding handwritten letters, even typewritten letters, which feel so much more expressive than emails, and are a lost art. In a broader sense, the Internet has made our world a place with nowhere to hide, and that’s not an entirely good thing.

Q. I found the most difficult parts of your book to read were when you addressed eugenics, how children who lived with disabilities and other anomalies were viewed and treated and when you addressed the disastrous “incubator infants” display at the Saint Louis fair, which Dr. Couney had no part in, where nearly all the premature infants died because money was prioritized over the preemies’ medical care. As a human being and a writer, how did you manage your own emotions when writing about events like this as well as the history of other preemies’ deaths before incubators became accepted and commonplace in hospitals?

A: Some of what I found was horrifying. The only way to manage emotions was to keep digging and keep writing; it strengthened my resolve to get those hidden and whitewashed histories onto the page.

Q. As much as Dr. Couney was a showman, his altruistic passion  for saving premature babies strongly comes through in your book. The same holds true for Dr. Couney’s wife Maye, his daughter Hildegard, and his lead nurse Louise Recht. In your acknowledgements, you mention you watched rare video footage of Dr. Couney. You physically describe him well, but how did that video add to you developing his character?

A: In the video, you really see more of Madame Recht, and I was in awe of the absolute confidence she exuded when she handled the babies. I felt I got more of a sense of Dr. Couney through his letters. He was elegant and witty, sometimes pugnacious, and he had the chutzpah to use letterhead stationery with all of his fabricated credentials!

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