by Dawn Raffel
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At Leipzig Maternity Hospital in Germany, the head obstetrician, fifty-eight-year-old Carl Credé, had already spent more than a decade saving weakling babies using a machine called a Wärmewanne. Similar “warming tubs” had been used even earlier in Russia. In these devices, the baby lay on a dry bed surrounded by a double-walled jacket of hot water. Lacking body fat, with sluggish circulation, underdeveloped nervous and respiratory systems, and improper metabolism, a premature infant was liable to freeze to death—especially at a time when “room temperature” in winter might have been 50 degrees Fahrenheit. Peasants would try to save their weakling babies by sticking them inside a jar of feathers. Another remedy was to slather the feeble one in olive oil, wrap it in cotton or sheepskin, set it by the hearth, and hope for the best. Most of the time, the best was not good.
The Wärmewanne wasn’t perfect. It required constant vigilance. But Credé had made significant advances over years of solid work. And Étienne Tarnier’s “epiphany” would irk him.
Carl Credé could tell you where that chicken-loving Frenchman had found his inspiration—and it wasn’t the Paris zoo. Tarnier’s ambitious intern, Pierre-Constant Budin, had examined the Wärmewanne on a recent trip to Moscow. What’s more, Tarnier had requested additional information about it from Leipzig right around the time he had his clever poultry moment. Tarnier’s proposed contraption was enclosed and Credé’s wasn’t, but the concept was the same.
This was a point that was hard to dispute. But Carl Credé’s rival would publish first.
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By 1880, Étienne Tarnier had his couveuse (translation: brooding hen) up and cooking at Maternité. To build it, he’d hired Odile Martin, the engineer who had made the chicken hatcheries. Why look farther than you had to? This “artificial hen” was a two-tiered device. The bottom held a reservoir of water, which was heated by an outside boiler called a thermosiphon, powered by an alcohol lamp. The upper deck held multiple newborns, poultry style.
One version of the Tarnier couveuse.
Tarnier reported that his couveuse cut the mortality rate of weakling infants by half. There was, however, a delicate situation. The couveuse was a closer relation to a pressure cooker than to a mother hen. The boiler was so potent and the flow of gas at the charity hospital so uneven that, left unchecked, it raised the possibility of boiling the water in its bowels—and stewing the patients above.
To skirt that gruesome risk, the nurses got in the habit of refilling the reservoir by hand, ditching the thermosiphon. Tarnier and another of his interns, Alfred Auvard, set to work retooling the machine. Instead of a reservoir, they used simple hot-water bottles, and they reconceived the upper deck to hold just one baby. By this point, it was not so automatic or impressive.
For his part, Pierre Budin, the man who’d first seen the Wärmewanne, must have had it in his mind not to let his fellow intern, Auvard, get too far ahead of him.
WILLIAM SILVERMAN AND THE COUNEY BUFFS CONVENE
New York City, 1970
Dr. William Silverman stood up to make a speech. The occasion was the Newborn Dinner, an annual gathering of pediatricians held near Atlantic City.
Two decades had passed since the ink had dried on Martin Couney’s obituary. At various times over the past twenty years, William Silverman had found people who’d known the incubator doctor, but his inner circle was gone. A couple of medical journals such as The Lancet referred to the sideshows, and a few historical archives offered photos. One of Silverman’s best finds was Evelyn Lundeen. She’d been the late Julius Hess’s head nurse for the run of his career, and had been dispatched (not entirely happily) to help at the Century of Progress. An expert herself, she had published articles and pamphlets on caring for premature infants, and had been honored as Illinois Nurse of the Year.
During an afternoon spent feeding martinis to the elderly Miss Lundeen, Dr. Silverman gathered that she’d found Madame’s diamond-ring-over-the-infant’s-wrist routine distasteful. Yet she had to concede that the Frenchwoman’s care of the preemies had been flawless.
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By now, Dr. Silverman had a few colleagues who shared his fascination. Dr. L. Joseph Butterfield, at Children’s Hospital in Denver, having learned that the incubator doctor spent one summer in his city, began to poke around. Dr. Lawrence Gartner, a professor of pediatrics and chief of neonatology at Albert Einstein College of Medicine in New York, discovered that a friend of his mother-in-law’s had been Martin Couney’s patient at Coney Island; his mother-in-law had seen Baby Gladys in the show.
Drs. Silverman, Gartner, and Butterfield began to call themselves the Couney buffs, and over time, more joined. Lawrence Gartner scoured New York and Atlantic City, looking for anyone who’d been associated with the showman—Gladys, of course, but also doctors, an Atlantic City ambulance driver, mothers of the children. These people strained to capture fraying threads of memory. If only they’d written it down, they said. But even if they had, it wouldn’t have mattered. Not even those who’d enjoyed a daily acquaintance knew much about Martin Couney, really. He was friendly. Elegant. The ambulance driver, Jerome Champion, remembered, “He wasn’t pretentious, he was real nice to you. He’d say, ‘How are you, Champion?’”
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Tapped to invite the speaker for the 1970 dinner—a festive event, with banquet and cocktails—Lawrence Gartner made the perfect choice.
The room was in high spirits as William Silverman approached the podium. “I’ve always felt a little bit concerned about the speakers at these neonatology dinners,” he began, warming up his audience. “The thought of facing several hundred drunken neonatologists always terrified me.” Already, he had the room laughing. “I remember once I was addressing a pediatric society in Virginia. And there was a very generous cocktail party and a grand dinner. And in the middle of the dinner, a barbershop quartet came in and sang. And everybody was feeling just grand. Then the chairman got up and said, ‘Dr. Silverman will now talk about twins!’ You can imagine how that went over,” he said, to more laughter. “Well, I’m not going to talk about twins today. I’m going to tell you about a story that began, for me, on the second of March, 1950 . . .” He acknowledged that some of them had already heard him speak about his favorite investigation, but the information kept changing.
“Martin Couney was born either on the thirtieth of December in 1870 in Alsace, or on the thirty-first of December, 1860, in Breslau,” he said, playing the lack of clarity for humor. “He was educated in Breslau, as near as we’re able to find out, and in Berlin, and received his M.D. degree, and then he went to Paris to study with the famous Pierre-Constant Budin. . . .”
Amid the clinking silverware, the atmosphere was one of delighted interest and amusement. Pity next year’s speaker. How could anyone top this?
MICHAEL COHN SEES AN ELEPHANT, AND THE LIGHT OF A NEW WORLD
SS Gellert, 1888
The passengers boarded at Hamburg, hopeful and wistful and nervy with fear, and already homesick, some of them. The journey to port had been wretched. Rattling on trains from hometowns all throughout Germany. Stopping at inns that robbed them for the privilege of tossing and scratching all night on a bug-infested mattress while thieves stuck sticky fingers in their pockets.
Those bunking in steerage went aboard with their few clothes, their last marks, the warmest blankets they could scrounge, despite its being August. They went clutching their family photographs, their neatly creased letters of recommendation, their handkerchiefs smelling of someone left behind. They brought aboard lemons for seasickness, and rough maps, and wild schemes, and lingering coughs that they tried to suppress.
The New World was their destination, but the old one they were leaving was in a transformative period. In Turin, forty-four-year-old opium-addicted Friedrich Nietzsche would en
ter his last productive months. The year before, he had completed On the Genealogy of Morals, a text that Benito Mussolini would later twist to his own ends. In Silesia, Gregor Mendel was dead, but the seeds of the science of genetics—and reposing within them, eugenics—had been planted. In Arles, Vincent van Gogh was ripping visual paradigms; in a year, he would sever his ear. In Paris, Gustave Eiffel was constructing something exceptional for the next Exposition Universelle. Elsewhere in the City of Light, Étienne Tarnier was tinkering while his interns, former and current, eyed succession. And at the port of Hamburg, an eighteen-year-old from Krotoschin was boarding the Gellert, steerage class. His name was Michael Cohn.
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Michael would have done well to slip up to the open deck. The berths smelled of vomit, and worse. People were crying. And moaning. Bemoaning. Fourteen heaving, seasick days and nights of this—but soon they would be in New York. Michael’s mother, Fredericke, would miss him, but surely she knew there was nothing in Krotoschin for him. His father had died. And everyone young was packing up and moving westward, deeper into Germany or crossing the ocean. His brother Alfons emigrated first. He’d left for New York at barely fifteen. Jaunty, stylish Alfons had changed “Cohn” to “Coney,” and now he was a jockey at the races, at least when he wasn’t working as a clerk at a bank. Whatever the situation, Alfons seemed to finesse it.
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The immigrants were eager to see the Statue of Liberty, two years old, holding her torch aloft. But first they were going to see something else. It looked like . . . an artificial elephant? This was Coney Island in the distance. Sodom by the Sea, with its high jinks, its gamblers, its cabarets, its dancing girls, its houses of flagrant ill-repute. Apparently, the people on this island had completely lost their minds. The pachyderm-shaped building was the Elephant Hotel, a seven-story novelty colossus with telescopes embedded in its eyes. Someone from within the beast could have been watching the Germans at that very moment.
The Gellert rounded the horn at the base of New York, and the more auspicious sight of Lady Liberty appeared. Magnificent. She could make you cry, this time for joy.
Soon Michael Cohn would stride away from the cloyingly vomitous air of steerage and into the thrillingly filthy oxygen of New York City. First stop, Castle Garden, the immigrant intake center. Someone was going to peer inside his mouth, look down his throat, write down his name. Anything could happen in this strange new country. Alfons must have taken his name from that crazy Coney Island. Perhaps he would do the same, in time. Already, he had made a decision regarding “Michael.” Michael didn’t suit him. He preferred “Martin.” Martin Arthur. Yes, that had a ring to it.
THE COUNEY BUFFS ENCOUNTER THE MYSTERIOUS M. LION
New York City, 1979
After twenty-nine years, William Silverman was ready to lay his pet project to rest. His article about a “colorful (and bizarre!) chapter in medical history” was set to be published in Pediatrics, the peer-reviewed journal of his profession.
Certainly, William Silverman had more pressing concerns. Increasingly, he worried about the ethical implications of advanced technologies, of taking extraordinary measures to save barely viable infants who—if they survived, if their deaths weren’t being painfully prolonged—might suffer from catastrophic physical and intellectual disabilities. In the years ahead, he would publish probing essays under the not-so-secret pseudonym Malcontent. He would wonder “whether neonatal medicine’s enormous increase in technical power has allowed it to become coercive.” When is it cruel to force a heart to beat?
That question continues to haunt the beginning of life—as well as its end. What do we do with the means to keep someone alive in a near-vegetative state? To what extent does it matter if that someone is an infant or a nonagenarian? Technology, from life support to genetic testing and editing, keeps making the choices harder: Which lives are worth living? Who decides?
By contrast, this diverting business with the sideshows should have offered satisfaction, an itch well scratched.
In August of 1979, William Silverman’s article saw print. He acknowledged a few remaining “loose ends.” Nevertheless, this was a comprehensive reckoning, incorporating all the research from his fellow Couney buffs. Paris. Berlin. London. Omaha and Buffalo. New York, of course. Chicago. Photos of the incubator doctor, young and old, spiffy and staid, and later decidedly sad-eyed.
By the late 1930s, Martin had lowered the price of admission.
And so the matter was settled. For a minute.
And then the letter arrived in the mail. West German postmark. Its author, a credible-sounding reader named Felix Marx, begged to differ with a fact about the Industrial Exposition of Berlin. His quarrel wasn’t with the “child hatchery” or with the drinking hall songs it spawned. The problem was, the man who brought this show to Berlin was not named Martin Couney. It was someone named Lion.
And with the vibration of that tiny roar, the entire foundation of Martin Couney’s story began to fall apart.
“THE GREATEST NOVELTY OF THE AGE!”
London, 1897
What was not to love? London, with its carbonated energy, the babies being saved, the attention Martin and Sam—Messrs. Coney and Schenkein—were receiving with the marvelous invention they were showing! The Diamond Jubilee for Queen Victoria’s sixty years on the throne was a wonderland of arts and entertainments, yet they—two American immigrants—were singled out for notice.
This was more than worth the nasty transatlantic crossing. Sam—born in Kraków—had the money and Martin had the charm. Together, they had a winning proposition. Already, these incubator shows were a hit in France. And just last summer in Berlin, the crowd had been ecstatic. More than one hundred thousand people saw the exhibit at the Industrial Exposition. Six thousand women came to look in three days alone.
Messrs. Coney and Schenkein had secured exclusive rights for London for this summer. How could those fellows over at Barnum & Bailey help envying them? But this was not a silly entertainment. It was educational, important. Top-of-the-line: the gleaming machines with their handsome German imprint, the French nurse who knew what to do with the babies, their spot across from the exposition’s welcome center at Earl’s Court, guaranteeing traffic.
Martin’s job was host, shaking hands, greeting guests, answering endless questions. Every day, with something like 3,600 people. The spiel might go like this: Yes, the tiny babies you are looking at are real. Yes, most of them will live. No, they can’t hear you. The heat comes from these coils, you see. It’s all automatic. Did you say you’re a physician? Martin was a natural. Diminutive yet stylish, genial yet eloquent in just the right measure. He could talk to anyone, workers with faces ragged from hardship, delicate ladies, men with callused hands, and those who held a surgeon’s knife. And they were saving lives! Where Sam saw shillings, Martin saw babies’ faces.
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The gentlemen at The Lancet saw a step in the right direction. On May 29, 1897, before the show even opened, the editors had noted, “The employment of incubators as a means of saving the lives of prematurely born or of very weakly infants has not yet become general in England. Yet it is notorious and obvious that the best, almost the only, means of saving such infants is to protect them absolutely from change of temperature and from cold.” In just the past year in England, 2,534 infant deaths had been attributed to prematurity. The Lancet mentioned previous inventions, by Carl Credé and Étienne Tarnier, but those machines were extremely difficult to maintain. “The main feature of this new incubator,” the editors wrote, “is the fact that it requires no constant and skilled care. It works automatically; both ventilation and heat are maintained without any fluctuations whatsoever, not only for hours, but even for days. The incubator need not be touched for these purposes, and the only attendance necessary is that needed for feeding and washing the infant.”
Martin was in no position to disabuse them of that notion. But from where he stood, he must have seen that the feeding (every two hours during the day, with the watchman waking the nurses every three hours at night) and the cleaning (not just bathing the babies but keeping the whole place spotless) mattered as much as the heat. The French nurse, Mlle. Louise Recht, worked harder than he did, sometimes feeding the weakest through the nose with those funneled spoons she had. When anyone asked, he and Sam explained that she was specially trained at Paris Maternité. That commanded respect. They had wet nurses, too, and British physicians checked on the infants daily. But Louise was the person they couldn’t do without.
Late at night, after everyone else had left and the grounds had fallen quiet, with only the watchman and the nurses stirring, Martin might have stayed and talked with her, in French. Perhaps it was she, perspiring in the heat of the feeding room, who showed him—the baby of the family—how to hold a newborn.
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Across the channel in France, M. Alexandre Lion was doubtless satisfied by his invention’s success, though it couldn’t have been a surprise. After Berlin, nobody would have expected anything less. All one had to do was take a look at what passed for competition—the tricky couveuse, the clunky Wärmewanne. The awkward, wheeled brooder that the American doctor Thomas Morgan Rotch rolled out at Chicago’s White City exposition in 1893. Dr. Rotch laid claim to being Harvard University’s first professor of pediatrics, but his invention was doomed. Besides the poor design (even aided by a technical expert), the doctor didn’t have the wit to display the machines with babies inside. Typical academic.