Jan. 8, 2023

Martin Couney // 145 // The incubator doctor

Martin Couney // 145 // The incubator doctor

Martin Couney was an advocate and pioneer of neonatal technology, and he was also known as the incubator doctor.  He displayed prematurely born babies in incubators at expositions and fairgrounds and ended up saving thousands of lives.

Website: https://www.drinkingthecoolaid.com/

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Transcript

Martin Couney is known as the incubator doctor who was shunned by many doctors, but he never stopped trying to save babies, and eventually changed the course of American medical science. Parents could bring their preemies to a sideshow featured on Coney Island which was known for death-defying roller coasters and incubators. 


Dr. Couney's story is a mystery. His records are full of inconsistencies and some are probably clerical errors, but others are lies. His census records start in 1910 and he could have been German or French. He arrived in the US in 1884 when he was about 14 years old or it could have been 1888. His name at that time was COURSEY and his daughter was listed as his wife. His immigration records were missing and so was his naturalization records. The New York State Medical licensing archive doesn't have any information on him and his last name was later changed between CONEY and COUNEY and his funeral was held at Kirschenbaum's Westminster Chapel which is a Jewish funeral home, but it was later discovered that his real name was MICHAEL COHN, not Martin Couney.



He claimed to have obtained a European medical license after studying medicine in Leipzig (lipe-zig) and Berlin, but there aren't any records of this. He said he studied under Dr. Pierre-Constant Budin who is considered the founder of modern neonatal medicine. He was researching groundbreaking concepts such as the umbilical cord blood, benefits of breastfeeding, and perinatal care.



Martin Couney says he was Pierre's intermediary at the 1896 Berlin Great Industrial Exposition and the two of them exhibited Pierre's child hatchery. There is no evidence that the two of them actually knew each other, but Martin Couney could have made it up all together or he may have been a technician at the exhibition. Pierre's hatchery was used with chickens on farms. The crowd loved it, but it was never something he used on humans. The child incubators were exhibited in 1897 at Queen Victoria's Diamond Jubilee Celebration, in 1898 at the Trans-Mississippi Exposition in Omaha, Nebraska, and in 1901 at the Buffalo, New York Pan-American Exposition. Around 3,600 people visited the show on opening day alone. Martin's medical credentials were made up or self-awarded, yet he saved between 6500 and 7000 babies over the course of 40 years. Crowds paid a quarter to see the preemies and parents were never charged a penny for their care.



At one point, Martin Couney wasn't attracting much attention with the babies, so he did a beer advertisement and it's the worst. This was advertised as a special to young mothers and it read “Dr. Martin Couney, the physician in charge of the Infant Incubators at the Exposition, who has had a wide experience, says, after using several other beers: “We take pleasure in stating we have used Krug Cabinet bottled beer constantly and for milk producing qualities. We can cheerfully recommend it to all nursing mothers” it has less acid in it and is much more healthful; it is used by every nurse in the Infant Incubators building. This is certainly convincing proof and every mother should at least try it.” He may endorsed this, but he NEVER allowed his nurses to actually drink alcohol.



The author of the book, Dawn Raffel said, “hospitals were under-resourced. There was a high rate of infant mortality. Women were dying in childbirth. And he was working in the shadow of eugenics, which was beginning to rear its head.” 


Eugenics was the pseudo-science of improving the human race by breeding out undesirable characteristics. Eugenics is also referred to as racial hygiene and it was a movement during the late nineteenth and early twentieth centuries. It's the selection of desired characteristics in order to improve future generations. You would basically reduce disease, disabilities, or so-called undesirable characteristics in the human population. Early on, it was believed that people inherited mental illness, criminal tendencies, or even poverty and this could be bread out of the gene pool. Eugenics encouraged healthy people to reproduce and anyone that was deemed to have anything outside of the “norm” shouldn't reproduce. This idea is typically associated with Adolf Hitler, but it was also being used with babies. If a baby was born premature, it was believed that they were too weak and hospitals would just let them die. 


The knowledge, expertise, and technology necessary to help the infants wasn't available. Preemies who survived more than a day or two were labeled “weaklings” because they were genetically inferior and the survival rate was low. By 1910, there were “better baby contests” happening all over the country. Prizes were awarded to babies for having the best shaped eyes or noses. Babies that were the cutest were celebrated, while the weak or disabled were tossed to the side to die. The eugenics movement wasn't meant to specifically target preemies, but the idea was certainly applied. Dr. Couney had a different vision. He didn't care what a babies background was, what their race was, or even if they came from a poor or wealthy household. He felt that every baby deserved a chance to live. He wrote a slogan that was on every door of the show and it said: All the world loves a baby!


Martin Couney's own daughter was born 6 weeks early. He sent a friend of his to fetch an incubator from Coney Island and it was an hour drive each way. When the baby was born, Martin plunged her into ice-cold water to shock her into breathing. Hildegarde was mainly raised by aunt Louise, a nurse who worked for Martin, and no one filed her birth certificate until 1926 and she was born in 1907.



Martin was wildly advanced, like decades ahead of the medical establishment. Each incubator was more than 5 ft tall, made of steel and glass, and stood on legs. A water boiler on the outside supplied hot water to a pipe running underneath a bed of fine mesh where the baby slept and a thermostat regulated the temperature. Another pipe carried fresh air from outside the building into the incubator, first passing through absorbent wool suspended in antiseptic or medicated water, then through dry wool, to filter out impurities. On top, a chimney-like device with a revolving fan blew the exhausted air upwards and out of the incubators.



In 1903, it cost about $15 a day to care for each baby in Martin Couney's facility, so that's a little over $500 today. He gave many speeches to advocate for saving the lives of premature babies and he recited the names of men who were born early and lived to achieve great things, such as Mark Twain, Napolean, Victor Hugo, Charles Darwin, and Sir Isaac Newton.



He maintained his facility at Coney Island for 40 years and also set up a similar one at Atlantic City in 1905 and that ran until 1943. Through the years, he took his show to other amusement parks and to World's Fairs and Expositions across America.


He insisted on feeding the babies breast milk and paid wet nurses to feed them on a constant schedule. There are testimonies from doctors who worked with him and they said they had never seen a hospital as calm as the one in the side shows. Some of the babies in Martin's care didn't make it, but his survival rate was somewhere between 85 and 90 percent. Most babies stayed in the show for a few months and they were allowed to be discharged once they weighed 5 pounds.


Patients received diplomas that read

This is to certify that baby received its start in life at the Baby Incubators Institution at the New York Worlds Fair.

We the undersigned are proud and happy to present this certificate to the above named baby with our best wishes for its continued good health and success in life.”


Martin Couney used a very different approach. Doctors were masked and gloved at hospitals and had a no touch protocol when it came to the preemies. Most doctors believed that there shouldn't be contact with premature babies due to risk of infection, but Martin encouraged his nurses to take the babies out of the incubators to hug and kiss them because he believed they responded to affection.



When a baby arrived, they were bathed in “synized” water and mustard. There wasn't an explanation for this in the book, but a Google search says that a Mustard bath can soothe muscle aches and detoxify the body. If the baby could swallow, they got two drops of brandy, then they were rubbed with alcohol, swaddled tight, given a pink or blue ribbon and placed in an incubator that was kept around 96 degrees. The babies were given show names for confidentiality and every two hours they were fed by a wet nurse.


If a preemie was born in the summer, they could be featured in the sideshow, but if they were born in the winter, they were pretty much out of luck. Martin Couney desperately wanted to change this, but he was having a difficult time with funds. In 1909, he held a competition for the best preemie. More than 500 babies had passed through the incubators by this time. Families from all over arrived with their children and they were dressed to the nines. The judges selected 3 year old Burton Douglas Stevens as the healthiest and best developed, so he was presented with a red wagon as his prize. Martin used this opportunity to mention that he wanted to set up a permanent incubator station in Chicago and he needed government help to make this happen.



Physicians and health officials kind of hated Dr. Couney and felt that he was exploiting babies and endangering their lives by putting them on display, so they regularly tried to get him shut down.


Even though it was referred to as a sideshow, Martin did try to distance himself from the freak show aspect of it. He really stressed that the preemies were in a miniature hospital, not a sideshow attraction and he dressed his nursed in white uniforms and the doctors wore suits that were topped with white physicians coats. The facility was always scrubbed spotless and he hired a cook to prepare meals for the wet nurses. If any of them were caught smoking, drinking alcohol, or even snacking on a hot dog, they were immediately fired.


It was Memorial day weekend and only a few people were awake at Dreamland which is an amusement park at Coney Island. A worker knocked over a bucket of tar and it hit the lights which sizzled and Hell Gate burst into flames. The breeze carried the flames quickly and the fire was heading straight for the incubators. The New York Times reported that all of the babies had died, but they didn't. That night, the wet nurse was just getting up for the 2 AM feeding when a police sergeant came rushing through the door followed by smoke. The doctor grabbed two babies and covered their heads in blankets and the nurses each grabbed a baby and they all ran. They had 5 babies at the time and they all survived. The paper reported that three babies were carried out, but suffocated and at least 3 other infants had been trapped inside. The next day, they had to run a correction and it said, “All Well with the Babies”


The five babies had been rushed to the home of a doctor named John Pierce and the nurses continued their feedings and care on schedule. When the false story was originally printed, it ignited outrage. John D. Lindsay, the president of the New York Society of Prevention of Cruelty to Children sent an angry letter to the editor stating this violated every principle of medical or professional ethics. He said the Society had previously investigated the incubators and attempted to have them shut down in 1906 and this work should only be conducted in hospitals. 


The problem was, not only were incubators not being used in hospitals, but pregnant women didn't even want to give birth in a hospital because the protocol was extremely harsh. Kerosene and ether (ee-ther) were applied to the woman's head, and her hair was washed with ammonia, then braided. Her nipples were cleaned with ether and Albolene. Her pubic hair was shaved or clipped and after giving birth, she had to lie flat for 24 hours and was not allowed to sit up for the first 5 days. She was only able to consume milk, no food for the first two days.


Some of the children that were preemies came from poor families, so when the show was over, no one came to claim them and they ended up being sent to an orphanage. At one point, Martin wanted to donate the incubators to the city when the San Francisco show ended in December of 1915, but he literally couldn't give them away. No one would take the expensive machines. He didn't want to tear down a fully equipped facility that could save lives, but he received memos saying the building was going to be demolished because it sat on private property and the owner wanted it back. 


There were many rumors that Martin was making money off rehoming children. Someone didn't claim their baby and instead of sending them to an orphanage, he found a family to take them instead. There isn't proof of this though. He did run into a little trouble with the IRS because he was filing as a personal service corporation which is a charity. Even though he charged admission to view the babies, he never sent a bill for his patients, but the IRS didn't agree with this and he took the case to the US Board of Tax Appeals and the board ruled against him, so he had to pay. 



Later on, there was an infant incubator reunion which was broadcast live. Prominent doctors and members of the Infant Aid Society showed up to watch and the speech kicked off with “All the world loves a baby.” Julius Hess was an American physician who is often considered as the father of American neonatology. He published the first textbook in 1922 which focuses on the care of prematurity and birth defects in infants. Julius Hess attended this event and he was also a speaker. He said, “I should like to emphasize the fact that we believe that those premature infants who have normal physiological development for their fetal age and show no inherited disease do not differ significantly as they grow older in weight or in mental development from their brothers or sisters or from other children.” He said this is a perfect example of why he needed assistance from a showman.


Martin was thrilled to have forty of his preemie graduates attending the show and he was equally happy with the leading doctors “who have come here for the purpose of convincing themselves that these babies are actually worth saving.” 


Martin struggled to get people to accept his skills in caring for preemies. He eventually got Julius Hess and Morris Fishbein on board. Even though he had well-known physicians endorsing him in New York and the American Medical Association had honored him with a platinum watch, people only saw him as an amusement man. In 1937, he expressed interest in exhibiting and he found doctors that were willing to take over the project if he passed away because he was about 70 at the time. One committee member objected to the exhibit and Martin still had another issue to deal with and that was money. 


He wanted this show to be bigger...grander. And he was going to finance it by himself. After the fair, he planned to give the equipment to the City of New York, a permanent hospital. Unfortunately, Martin was never the best at finances, He originally estimated that he would need $80k, but that amount soon jumped to $100k. The committee sent Martin a request for his financial report because they wanted to know where this money was coming from, but he ignored that. The committee attempted to fish for the information on their own by visiting local banks, but they all confirmed that Martin didn't borrow any money. The committee assumed this meant he had enough liquid assets, but they were wrong, Martin was way over budget. 


Skidmore and Owings was hired to design the building. In addition to the nursery, there would be a U-shaped structure with 9 rooms so Martin, his nurses, the wet nurses, housekeeper, and chauffeur had living quarters. There would be a garden and a glass-bricked area where the babies who gained enough weight could be in the sunlight, a presentation room, and a doctors visiting room. They were behind schedule on the project and Martin had to sell stocks so he could afford the labor, but it was a bad market. He tried to get around everything and was cutting corners and he even got upset about the fire alarm requirement. He had a close call years earlier when there was a fire and he had to get the babies out in time, but he just couldn't afford another dime.


He typed up a two page letter arguing that a fire alarm was “absolutely unnecessary”. He said the building was semi-fireproof; he had 6 extinguishers and a hose-reel connection inside. Three or four nurses were always awake and they had a telephone with four extensions. They had nightly fire drills and set up baskets with hot-water bottles and blankets in case they needed to evacuate. He also had a special ambulance parked nearby and he always slept on the premises. In his conclusion he wrote, “my nurses are strictly prohibited to smoke in the building and my babies do not play with matches. I hope you will see the justice of my claim and relieve me of the unnecessary expense.”



When they first discovered retrolental fibroplasia, Martin said he just didn't understand because he took care of thousands of babies and none of his babies ever went blind later in life. He didn't live to see the answer, but this was later solved. His machines didn't have enough oxygen to do that kind of damage, especially when the nurses were taking them out on a consistent basis. So, this was something that was happening to preemies that were in the hospital. Martin gave everything he had to saving the babies and there was nothing left for him financially. He did receive some checks in the mail from Julius Hess or Thurman Givan, or other medical friends that could afford to send him gifts.


In 1943, Cornell New York Hospital opened the city's first dedicated premature infant station and that was the year that Martin Couney closed his show for the final time and he said his work was done. He died on March 1st of 1950 and was buried with his wife, Maye, at Cypress Hills Cemetery in Brooklyn. Record keeping was shoddy, so we don't have an exact number, but it's estimated that Martin saved between 6500 and 7000 babies, but there is nothing indicating this at his grave. Dr. Julius Hess continued the fight for preemies until his death in 1955. Martin's daughter, Hildegarde, continued to work as a nurse until her death in 1956.



The records about the incubator babies weren't great either. In fact, some of them wanted to meet the others once they were adults, but they had a difficult time finding anything. Harold S. Musselwhite Jr. wrote a letter to the research librarian at the New York Public Library dated Thursday, June 27th, 1996 and he requested any possible information about Martin Couney, including his obituary. He wrote a second letter on June 6th, 1998 where he provided some details about his life. 


He was born in Brooklyn on April 24th, 1921. The letter said, “My parents and several others were preparing to go the the Statue of Liberty when my mother paused to go to the bathroom. She suddenly called out, 'The baby's here' and I was saved from going down the toilet...It was my maternal grandmother who conceived the idea of keeping me in a cotton filled shoebox placed in a warm oven as a makeshift incubator until they made contact with Dr. Couney. No hospital had the means to care for me. The how and when is unknown to me as was my means of transportation to Coney Island. Unfortunately, all persons concerned are now deceased and most of the records destroyed.”


Harold was looking to connect with his other incubator-mates. He had lived a fulfilling life. He was married, had 3 children and 7 grandchildren, but he always felt like something was missing. He passed away at age 83 and it looks like he was never able to locate any of the people that were in incubators at the same time. 


June and Jean were incubator twins who also wanted to know if there were other incubuator-mates out there. They tried writing to several media outlets, but no one responded. The twins were born on August 17th, 1934 and they weighed a combined total of 7 pounds, 10 ounces. Their aunt was a nurse and she got them into the show. Their father stopped at the fair daily on his way to work and he would deliver his wife's breast milk to the nursery next door. There was also a 4-year-old boy who would visit the babies and he later became Jean's husband. Nineteen years later, Jean and June had a double wedding.


Beth Bernstein weighed one pound, ten ounces when she was born in 1941. Her twin only lived for two days and she never even knew about her until she overheard her family talking about it when she was 11. She asked her father about this and he confirmed that she had a twin, but told her she wasn't allowed to say anything about it to her mother because it was too painful for her. The couple never had any other children and they were overly protective of Beth. When she came home from the incubator, her mother wanted to get a nurse for her because she was so scared, but Martin Couney told her she had already had a long vacation and she needed to take care of her child.



On the day of Beth's birth, her mother called the doctor because she knew something was wrong. The hospital didn't have anyone trained in treating a baby under two pounds and they didn't have enough machines to keep a baby for long. The doctors wanted to send Beth to Dr. Couney, but her mom got upset and said her baby wasn't a freak, she didn't want her in the sideshow, but they got Martin Couney to persuade her himself. Her mother couldn't bear to visit her while she was in the show, but her cousins went to Coney Island every day to check on her. Many people chastised Beth's mother for putting her child on display and this made her feel super embarrassed and ashamed, but she was trying to give her baby a chance at life. 



The last baby homecoming was held in 1940 at the World of Tomorrow and it was for the class of '39. It came with stories of everyone saying that they weren't supposed to be alive. The doctors gave up on them. Their parents were told they wouldn't make it. Martin was the only one that gave them a chance. Some of them had been rushed to the sideshow in a warm towel or in a shoe box. Martin may have been a very controversial figure, who wasn't even a licensed doctor, but he's also someone who put everything into changing the world and saving children.


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