Eugenics and Preterm Infants at Coney Island

A Review of The Strange Case of Dr. Couney

The Strange Case of Dr. Couney: How a Mysterious European Showman Saved Thousands of American Babies
by Dawn Raffel
Blue Rider Press (2018), 304 pages


Should individuals resort to any means necessary to save the lives of children? Much controversy spins around this question, particularly when the definitions of “lives” and “children” remain fuzzy. It’s also one of the many questions that nestle at the heart of Dawn Raffel’s intriguing new book, The Strange Case of Dr. Couney. Repeatedly, individuals in the book resort to unorthodox means in order to keep babies from dying, and repeatedly, those means pay off. The book documents a cluster of human stories in the early 20th century that might easily have been lost forever, the lessons of which resonate today.

The subject of this book is Dr. Martin Couney, carnival exhibitor and incubation innovator. Couney emerges as a somewhat slippery figure, but also as an optimist of exceptional potency, possessing one of those rare minds which pushes against prevailing wisdom only to be proven right decades after his death. He created incubation chambers to house tiny premature babies, sparing no expense, and then charged carnival visitors to see them. Babies so small were on the order of “freaks,” attractions for gawkers accustomed to normal-sized infants. He exhibited preemies on Coney Island, in Atlantic City, and in multiple “World’s Fair” expositions in the United States between the turn of the 20th century and the beginning of the second World War. Prior to widespread incubator use, Raffel explains, premature babies were usually swaddled and set aside to die. Doctors had no hope for them because there existed no methodology to treat them. Some 90 percent of preemies died in those days.

Couney wanted to improve that figure, so he took in infants whose doctors had given up on them, and in exhibiting them, saved them. The story of Dr. Couney is the story of a man dedicated to saving lives. From this primary purpose came side benefits: money-making at expositions, the rejection of racism, classism, and eugenics, and the development of unheard-of technology and care for preemies (Couney’s incubator design is essentially the same one used today; his nurse fed newborns through the nose with a handmade spoon, astounding visiting doctors). But that primary purpose held: he did indeed save lives. Raffel reveals how many lives only in the book’s epilogue, and the figure is astonishing: between 6,500 and 7,000. While doctors failed to save 90 percent of preterm infants, Couney restored life to 90 percent of the babies in his care.

Before making a case for this book’s worth, I must point out some of its flaws. It reads as fairly disorganized, leaping frequently from one place, time, and perspective to another, and the chapters are often so short as to be jagged. As history, it’s potholed with missing information. Plus, it feels stretched over too many pages; the size of this story might have been better served by longform journalism rather than a book. However, in that form, it would not have had the reach and permanence that a book has. This history is obscure, unusual, and critically important; the book’s flaws fall away into insignificance when considering that without it, this information might otherwise go entirely unrecorded.

Besides, I have the sense that Raffel was doing her best to smooth and shape a story that exists mostly in memory and entirely in fragments. Records from carnivals and World’s Fairs from the early 1900s are not exactly the most complete primary sources. And Couney, an immigrant who changed his name repeatedly and left no direct heirs, appears to have a minimal paper trail. A great deal of this book relies on interviews and memories, stories passed from visitors of Coney Island to their children. Raffel’s skill as a researcher, and her determination to tell as much of the story as she can, shines through the cracks and missing bits.

The most compelling aspect of this book, though, aside from the sheer unlikeliness of it, is the tension it maintains between Dr. Couney and eugenics, a movement with a level of popularity in the United States that Americans would like to forget. At the 1933 Chicago World’s Fair, Couney showed his tiny babies in the same space as a eugenics exhibit, which “was devoted to the eugenicists’ second prong (preventing undesirable births).” Competitions purportedly held to judge babies’ health or beauty, known as Better Baby contests, in reality judged the measurements of a child against an Aryan standard. In one chapter, Raffel notes that “the eugenically perfect winner of the Better Baby competition died of tuberculosis a few months after the fair,” while an infant brought to Dr. Couney in a shoebox lived to age 80. It wasn’t just babies he saved; in the late 1930s, Couney fudged some paperwork and met strangers at the docks, personally helping between eight and 15 refugees from Germany find their way into the U.S. Meanwhile, “leaders of the American Eugenics movement were persuasive with the State Department: No flood of Jews. Not here.” Tucking the popularity and influence of eugenics out of the way for the better part of a century may be part of where we are now, as a nation, and Raffel’s pointed comparisons could not be more timely.

Couney put babies of all provenance into his incubators. (One of the book’s many delightful photos is of a tiny, extremely surprised African-American baby peering over a nurse’s shoulder.) When a doctor delivered a preemie in the greater New York area, sometimes he’d tell the parents about Couney and give them the option to take the infant there. Sometimes the parents would refuse, out of a sense of pride and dignity: they did not want their child to be exhibited to the public, a freak at a carnival. Those babies usually died. Other parents cared more for their children than their dignity, and their babies, under Couney’s care, usually lived and grew. At every opportunity, Raffel notes how many years of life Couney gave to his babies, and how many more lives, how many children and grandchildren, came from that sacrifice of dignity.

Dr. Martin Couney saved lives at any cost: dignity, financial ruin, family, reputation. It’s impossible to ignore his losses when reading The Strange Case of Dr. Couney, but it’s also impossible to ignore how much he gave to the world. His babies (mostly) did not die, they did not go blind, they did not suffer the same lifelong health problems as other preemies of the time (and even preemies of later decades, when doctors tried experiments with pure oxygen and cruder, less expensive incubators). And without this book, the wider public would never know about him. Raffel has done more than record a curiosity in the history of the American 20th century. She has offered up a lesson in the overriding value of life, and in the necessity of remembering the bad and bizarre parts of history as well as the palatable and good.



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Katharine Coldiron’s work has appeared in Ms., the Guardian, LARB, the Kenyon Review, and elsewhere. She lives in California and at