The Strange Case of Dr. Couney

by Dawn Raffel

  Larry had laid out dozens of folders. I had seen some of the Couney buffs’ playful correspondence in the archives of the American Academy of Pediatrics. Now Larry gave me stacks more pages to take back home and copy. “The Couney Newsletter: A Journal Devoted to Making a Great Deal of the Very Little” was one of his own contributions. It was dated May 7, 1970, and marked “Vol. 1, No. 1.” Subjects included “Pictures I Have Seen” (including film footage of the incubator doctor shaking hands with a midget), “From the Underground” (Couney gossip currently under investigation), and “Evolutionary Speculations” (Cohen → Coney → Couney).

  Larry told me about the German physicians who’d done reconnaissance missions at the behest of the Couney buffs—they had discovered Lion’s patent and, further, confirmed that no one named Martin Cohn, Coney, or Couney had ever matriculated in Leipzig; despite two world wars, the city’s sole medical school had kept pristine records. A search in Berlin yielded the same result. We talked about Larry and Carol’s meeting with Martin Couney’s niece and her husband; about my visit to his grave; about Louise Recht’s superb care of the babies. The conversation continued back into the kitchen for lunch, and into and out of and through more files. Larry handed me papers in German and fragile cassettes and pages torn out of century-old publications, some with William Silverman’s handwriting scrawled in the margins (“Perhaps Couney ‘forgot’ he had a predecessor”). We talked about the babies. Larry and I both felt there was something wrong with the story of Hildegarde’s birth. Who was that child’s mother? Carol’s mother’s friend Gladys—the woman who’d sparked the Gartners’ quest—had sworn that Hildegarde was her stolen twin. Both Gladys and her sibling had been in Martin Couney incubators; he told the family the other child died. But the family couldn’t accept that. Once, as an adult, Gladys had gotten a glimpse of Hildegarde and saw her spitting image. The problem with this story was that their birth years didn’t match—it was a wish to believe in a theft less cruel than death. Eventually, I would come to suspect that Hildegarde’s mother was Louise—the physical resemblance is inconclusive—and her father possibly Solomon Fischel, of whom no photos remain. She was devoutly Catholic and he was an Orthodox Jew. In 1906, they would never have married. If something happened by accident during one of their many long summers together, why not give the baby to their childless dear friends? Martin would adore her. “Aunt Louise” would mostly raise her. And Maye would come to like her well enough. Still, Larry told me, there were occasional rumors of hidden dealings, babies—orphans—brokered to would-be parents who wanted to adopt them. Julius Hess and a New York pediatrician named Thurman Givan had investigated once, but found nothing.

  The Gartners and I also talked about Alfons and Annabelle Maye, as if these were people with whom we’d become acquainted, and about Martin Couney’s more endearing lapses in telling the truth.

  “So, Krotoschin,” Larry said.

  “Well, to be fair, Alfons was born in Alsace—”

  “So you think it suited Couney—”

  “To be kind of French rather than kind of Polish?”

  But beneath the amusement, it was clear that Lawrence Gartner held sincere appreciation. “Did you see that video of Louise Recht feeding a baby?” he asked. He was referring to a film at the pediatric academy archive, and yes, I had watched the dimly lit handheld footage three times. Louise Recht’s spoon-to-the-nose maneuver had astounded him and the other Couney buffs: How did that child not aspirate fluid? To me, it had looked like a nifty trick, captured in grainy silence; to someone who understood how hard it was to nourish a child this small, it was a display of skill that elicited a gasp.

  I had been smitten with the footage of Madame—sturdy, dark-haired, well into middle age by then—bathing a ribby child so small that its necklace of tiny beads resembles a chain. Her grip is muscular, no-nonsense, as she washes the baby with good old-fashioned soap and water. Squeaky-clean.

  From all Larry could gather, the incubator doctor didn’t cherry-pick the babies most likely to survive; in fact, he wanted them under three pounds, with some of them under two. Partly, he believed that hospitals could save the four-pounders; partly, he was putting on a show of extreme preemies.

  In contrast, Larry told me that when he was a young medical student at Johns Hopkins in the 1950s, if a child was born terribly small, the obstetrician wouldn’t even call in a pediatrician. They would lay the baby aside in a warm bin in the delivery room, where it would die. “It was terrible,” he said. “And because it was warm they would gasp longer.” Perhaps, he said, in what sounded like generosity, the babies had been so small that there would have been no hope. But all these years later, it still ate at him.

  Martin Couney’s nurses, with Hildegarde at center.

  * * *

  —

  On April 29, 1971, Lawrence Gartner had stood in front of a Holiday Inn in Atlantic City. This was the former site of Martin Couney’s show, and Dr. Gartner had come to dedicate a bronze plaque on behalf of the Newborn Dinner group. According to the press release, the plaque was to honor “the first person in the United States to offer specialized care for premature infants.”

  I had seen the undated, handwritten text for a different presentation Dr. Gartner had given, which read, “If Dr. Pierre C. Budin is the world father of neonatology, then Martin A. Couney must be considered the ‘American’ father of neonatology.” In 1970, his fellow Couney buff Dr. L. Joseph Butterfield had captioned a photo of Dr. Couney, identifying him as an “extraordinary progenitor of a new field in the science of medicine” and elsewhere had called the shows “the forerunners of the modern premature nursery.” And I had run across written testimony from several pediatricians who were Martin Couney’s contemporaries, including Thurman Givan, who said they’d been inspired by him. Givan had organized the Child Health Committee of Kings County in New York, which began to study mortality and morbidity in preemies in Brooklyn hospitals. In light of everything I had heard and read, I couldn’t quite grasp the conclusion of William Silverman’s original article in Pediatrics: “It would be fatuous to attach deep significance to this odd chapter in medical history, especially since the incubator-showman phenomenon was largely the result of the activities of one man.” Subsequent academic writings had echoed this sentiment. Why? William Silverman had spent years engaged with his subject, and his article had seemed—to me, at least—to be heading toward the opposite conclusion. Was there something I had misunderstood? Was it simply impossible to credit such an unorthodox, unscientific practitioner in the rigorous world of peer-reviewed publications? Why would the fact that he was alone among showmen have taken away from what he did?

  Before the nine-hour Day of Couney ended, at a rib joint down the road, I asked Lawrence Gartner why he thought William Silverman had ultimately dismissed the importance of the incubator doctor. He told me, “I don’t know.”

  * * *

  —

  The thin spools of tape held the voices of people who’d long ago gone to their graves—their diction, their pauses, their accents, their laughter. The portal to their world. But like that world, Lawrence Gartner’s tapes were old. They stalled and snagged, tangled and hissed, and slithered off their spindles. Some were stubbornly blank. A professional restorer said no dice. After multiple tries, I managed to digitize most of them.

  One day, a German accent came pouring through my laptop. Ilsa Ephraim was Martin Couney’s niece, the daughter of his sister, Rebecca, known as Betty. On the seven minutes of tape that survived, she recalled a tantalizing story about a German exposition in 1898, as her uncle had told it to her. Which didn’t make it true.

  Ship manifests confirm that Martin Coney—new citizen, fresh off Omaha—left New York at the end of that year and returned in 1899, but Ilsa’s is the only remaining account of what he was doing there, three years after the famous child hatchery. “There was a big exposition in Berlin, where, after gre
at difficulties, Dr. Couney finally got the permission to show live babies,” she said.* In order to make that happen, he’d met with Professor Vincenz Czerny, a gynecological surgeon and professor at Heidelberg, who was a friend of the Cohns. “He told [Czerny] about his plight, that he brought all his stuff along from America and was not permitted to exhibit. And Czerny arranged for an interview with the German empress because he treated the children of the empress’s house.”

  Word arrived that he was to have an audience with the Empress Augusta Victoria the next morning at eleven o’clock in a castle near Potsdam. “Czerny told him how to dress,” Ilsa Ephraim said. “He had to wear striped pants, tuxedo cutaway, and high hat and gloves.”

  According to the story, Dr. Couney hurried to get all the necessary clothing, had the audience, and convinced the empress, who served as the protectress of baby care in Germany. “The show was a tremendous success for him,” Ilsa said, despite the fact that “hospitals were only willing to give him the sickest, weakest babies because, when they saw any chance to bring them up themselves, they didn’t give them to a showman.”

  She continued her story: “One year later, his only sister was getting married. They had a very big party for the wedding and as Dr. Couney was still in Europe, he certainly attended this affair and met all the new relatives on his brother-in-law’s side. And during the conversation, this exhibit was mentioned. An aunt, very close to the family of his new brother-in-law, said she was there and that a man came, grabbed her, lifted her off her feet and personally threw her out of the exhibit. And Uncle just told her, ‘I remember you. And I threw you out myself because you were poking with your finger into the incubators and insisting that these babies were not alive.’

  “So it was not a very good introduction to the new part of the family,” his niece concluded.

  Ilsa and Alfred Ephraim.

  I listened again and again, as if repetition would force this belated story to make sense. It has the ring (however thin) of truth; Vincenz Czerny was real. But aside from Betty’s wedding, none of the facts add up—nor does the story match any of Martin Couney’s well-known tales. It was filtered through time, shaped by retelling and memory, ungraspable yet redolent of the confounding essence of this man.

  Breath on glass.

  LET’S PRETEND I WASN’T THERE

  Denver, 1913

  By the summer of 1913, Martin was growing stout. Marriage and fatherhood clearly suited him, and business was robust. With Solomon Fischel manning the East for the final summer of his life, Martin and Maye went west.

  Lakeside Amusement Park was the Mile High City’s playground. It boasted all the usual frenetic, base-of-the-spine concessions, plus—this once—a show of teeny preemies. His slender young red-haired “assistant”—a newly licensed pediatrician—did such a competent job that Martin had plenty of time to walk the grounds. Back and forth. To and fro. Killing time. Because, sadly, there weren’t any medical eminences to wine and dine. After the debacle in St. Louis, physicians turned away. Most of the city’s doctors weren’t even aware of his show at Lakeside. Those who knew of it viewed it as vulgar quackery, in league with charging admission to see a two-headed calf.

  Meanwhile, at the eugenic section of the National Western Stock Show in Denver that summer, on Dr. Mary Bates’s turf, the city’s esteemed physicians awarded prizes to children with optimal flesh, with perfect ears and toes and noses.

  * * *

  —

  In time, Martin’s slender red-haired assistant would become an established pediatrician in Colorado. In the 1960s, Dr. L. Joseph Butterfield tracked him down. The man did not wish to discuss that summer at Lakeside, and given that Dr. Butterfield didn’t disclose his name, presumably he asked that it be kept confidential. He found it difficult, he said, “to understand an interest in such a brief event so long ago.” When pressed, he conceded that Martin Couney was serious and earnest, and truly desired to demonstrate that preemies could be saved. But the redhead’s larger message was, Don’t tar me with that brush. Whatever knowledge he had absorbed would go uncredited.

  KEEP THE INCUBATORS, PLEASE

  San Francisco, 1915

  Martin had a problem. He had won the concession for the Panama-Pacific International Exposition in San Francisco, but this meant that someone from the Infant Incubator Company was going to have to move west for the better part of a year before the show even opened.

  Every conceivable species of minutiae would need to be hammered into submission. Mind-numbing meetings. Memos that flew to and fro in a fever dream of herewiths and we beg to acknowledge receipts. Ceiling joists and standpipes, water connections, electric work, telephone service, paint colors, gas and contingency gas, suggested protective coating for the temporary building, meter readings, points of egress, fractions of inches between this and that, ad nauseam, ad infinitum.

  Solomon Fischel had intended to make his way out to San Francisco as soon as his honeymoon ended. Instead, he died in his wedding bed.* His wife of several hours might have been consoling herself with a hefty inheritance, but Martin was in a fix.

  With Solomon gone, Martin would pick up his family and move to San Francisco, but where was he going to find a physician to deal with the board of health? He could always get someone in New York with Louise. But all the way out West? And this was a major world’s fair, not a summer stroll in a theme park, where any slender red-headed novice would do. With millions of visitors coming, he wouldn’t want Maye to have to train a doctor who’d never touched a baby’s bottom. He needed someone suitably impressive. But who?

  * * *

  —

  Julius Hess was mired in aggravation. Yes, his achievements were notable: a pediatric practice in Chicago’s Michael Reese Hospital, well on his way to full professorship at the University of Illinois College of Medicine, and soon to be chief of staff at Cook County Community Hospital as well.

  He had also invented his own incubator—really, a heated bed. It wasn’t pretty like Martin’s. It looked like a metal wash bin, a semi-covered bucket on four legs, with a thermometer stuck on top. The view of the baby was lousy; you had to bend over to see it. But Julius wasn’t running a show. He was trying to counter objections from his colleagues—that is, among those few who were trying to save preemies at all. The new machine was easier to clean than the incubators Martin used, and its top was open.

  Martin’s machines were ventilated via a pipeline, through to the outdoors. No matter how nasty and leopard-scented that outside air might be, it was better than regurgitating the nursery’s germs into enclosed machines. Infant wards in hospitals, lacking this venting system, were still relying on less effective “warm rooms.” Julius Hess was offering the ugly-but-functional best of both worlds: open air, easy care, and individual temperature control.

  But no one was taking him up on it.

  Martin, his improbable co-agitator, believed in the power of public perception. And after Solomon’s death, he must have asked Julius for a favor—a large one. Among the records of his many accolades, Julius Hess would save his certificate of participation in the incubator exposition at the San Francisco World’s Fair.

  * * *

  —

  All through the spring and summer and fall of 1914, as plans were grindingly drawn and redrawn for the incubator concession, as a shot was fired, killing an archduke and starting a world war, Martin lived on San Francisco’s Pierce Street. With him were Maye and Hildegarde, and Maye’s ailing mother.

  And then there was Alfons, who’d been living in the city for more than a decade. Time had done its work on him. Now in his late forties and childless, Alfons had settled into a salesman’s life with his wife, Mary. The Dipsea Race he had accidentally started was now an institution in its tenth year, with teammates who called themselves Indians—complete with chief and grand chief. Destined never to win, Alfons enjoyed his status on the committee and walked the t
rail two or three times a week. Whether from inattention or from the pleasure of poking in the needle, he persisted in calling his little brother “Dr. Coney.”

  Frederic Thompson was also in town, and desperate for a comeback. A decade before, with Dundy, he had wowed the crowds not only at Coney Island but also with the mind-bending spectacle of Manhattan’s Hippodrome Theatre: elephants and spaceships, clowns and explosions, the id on a bender. Then Dundy died and Thompson drank. And drank. Most of his fortune was gone by the time he lost the last of it in a flammable marriage to an actress. In 1912, bankrupt, he surrendered Luna Park—named for Dundy’s sister and not, as everyone thought, for the famous moon ride. Thompson’s creditors claimed it. The Panama-Pacific Exposition was his golden chance to redeem himself, with a show called The Grand Toyland. But the magic failed. Thompson fell ill, and never regained his health.

  * * *

  —

  In February of 1915, three days after the fair finally opened for business, a premature baby named Anna was born to parents who rarely caught a break. Anna’s mother, Karen Steinicke, had come over from Denmark as a nanny. Her father, Peter Rasmussen, was a stowaway. They met at a Danish dance, and by the time their first child was born—weighing, they thought, barely more than a pound—they were scraping by as a cleaning woman and a carpenter.