Zoo
I wondered why the people from the lab were in the NICU. "Oh, we just want to see the little babies," they said. For crying out loud, I thought, we're not a zoo.
At one time, though, premature babies were displayed as if they were zoo animals. A physician named Budin, one of the inventors of the incubator, displayed premature babies at the Berlin Exposition of 1896 and in subsequent exhibitions. A student of his, Dr. Martin Couney, also displayed premature neonates at exhibitions, including as late as the 1939 New York World's Fair. It sounds pretty trashy to use babies in such a way, but before we judge them too harshly, realize that Budin did studies showing that survival of premies weighing less than 2000 grams was improved if their rectal temperature was kept normal, a significant advance for the time, and Couney, although a showman, is said to have cared for 80,000 premature infants during a 40 year career.
Frankly, I think exhibits of premature neonates would still be popular at fairs, since it's not uncommon for hospital workers and visitors to want to see them. This is especially true if the babies are a set of multiples, like triplets or quadruplets, making them minor celebrities. It's also a problem if one of the parents is a hospital employee. I remember when an OB resident had her baby; there were OB residents making a steady stream into and out of the NICU.
Earlier in my career I wasn't sure how to handle requests from friends in the hospital who wanted to see the babies. I'd let them see them sometimes. I even took my mother around our NICU once, to show her the kids I worked with. (Not a medical person herself, she couldn't wait to get out of there.) But now I have an easier time refusing their requests. For one thing, I can claim that HIPAA doesn't allow it, although I'm not sure if that is really true, and for another thing, I'm just grumpier than I used to be and don't care if people are miffed at me for not letting them in. Also, I truly do worry about infections. The NICU is no place for extraneous people, people who might be incubating a cold and not know it.
I've never really asked parents how they feel about strangers looking at their kids. I suppose different people would have different thoughts. Most parents are proud to show off their baby, but if their kid is struggling for life on a ventilator, making him an exhibit isn't high on their list of priorities. The exception is if you ask the parents if you can show their baby to students as a teaching case. For example, a baby might have an omphalocoele, a defect where part of the abdominal contents are outside the baby instead of inside him, or some other unusual finding that students won't get to see often. If the parents aren't around, I simply show the baby to the students, but if the parents are there, it's only right to ask for their permission. They rarely refuse it.
At one time, though, premature babies were displayed as if they were zoo animals. A physician named Budin, one of the inventors of the incubator, displayed premature babies at the Berlin Exposition of 1896 and in subsequent exhibitions. A student of his, Dr. Martin Couney, also displayed premature neonates at exhibitions, including as late as the 1939 New York World's Fair. It sounds pretty trashy to use babies in such a way, but before we judge them too harshly, realize that Budin did studies showing that survival of premies weighing less than 2000 grams was improved if their rectal temperature was kept normal, a significant advance for the time, and Couney, although a showman, is said to have cared for 80,000 premature infants during a 40 year career.
Frankly, I think exhibits of premature neonates would still be popular at fairs, since it's not uncommon for hospital workers and visitors to want to see them. This is especially true if the babies are a set of multiples, like triplets or quadruplets, making them minor celebrities. It's also a problem if one of the parents is a hospital employee. I remember when an OB resident had her baby; there were OB residents making a steady stream into and out of the NICU.
Earlier in my career I wasn't sure how to handle requests from friends in the hospital who wanted to see the babies. I'd let them see them sometimes. I even took my mother around our NICU once, to show her the kids I worked with. (Not a medical person herself, she couldn't wait to get out of there.) But now I have an easier time refusing their requests. For one thing, I can claim that HIPAA doesn't allow it, although I'm not sure if that is really true, and for another thing, I'm just grumpier than I used to be and don't care if people are miffed at me for not letting them in. Also, I truly do worry about infections. The NICU is no place for extraneous people, people who might be incubating a cold and not know it.
I've never really asked parents how they feel about strangers looking at their kids. I suppose different people would have different thoughts. Most parents are proud to show off their baby, but if their kid is struggling for life on a ventilator, making him an exhibit isn't high on their list of priorities. The exception is if you ask the parents if you can show their baby to students as a teaching case. For example, a baby might have an omphalocoele, a defect where part of the abdominal contents are outside the baby instead of inside him, or some other unusual finding that students won't get to see often. If the parents aren't around, I simply show the baby to the students, but if the parents are there, it's only right to ask for their permission. They rarely refuse it.
posted by neonataldoc at 6:40 PM
81 Comments:
I was in the 'zoo' for 125 days with my daughter. During the first 10 days I was offended when people, including staff, wanted to peek in to see the 1 pound 5 oz baby on the warming table. Once she moved to the isolette and was 'stable' I felt more comfortable with onlookers. I even became one myself. I was always spying on the other babies trying to see and hear what was going on. I wanted to compare babies to see if mine was doing as well as I thought. I even befriended a cleaning lady who would tell me all about the other preemies.
I was a big time voyer. Although this behavior sounds scary, even to me, I know deep down it wasn't zoo like fascination I had but more a need to feel connected to something. The sad truth is knowing about other micropreemies, the good and the bad, helped ease my isolation and get me through those difficult days.
On a side note, my favorite movie is 'Rear Window' and I do love zoos but am saddened by their captivity....the NICU analogy really hits home on that one.
I got yelled at by a nurse for looking at another baby. They were taking an xray of Caitlyn's lungs (imagine that) and we had to go to the end of the aisle. Well, there was a baby that had been admitted a few days earlier, same gestation as Caitlyn, but much bigger. So my mother and I were oogling over her and comparing her "looks" to Caitlyn's. A nurse came rushing over and told me were weren't allowed to stare at other babies.
It really kind of made us laugh considering we were told to go down there in the first place. And in a NICU with upwards of 2 babies at any given time, how can you not look at other babies??
Not to mention, there were certainly nurses that we became close with that would tell us things about some of the other babies in there.
I wouldn't liken the desire to "see the babies" as a zoo though. I do think it's more truly just curiousity. For people who have never had or seen preemies, they want to see if they do in fact just look like a miniature version of a baby. For myself, I was always comparing how other babies looked at a particular age or gestation to what Caitlyn looked like at that same time.
And for the record, the baby I was "staring" at, her mother and I became close friends. And we have seen each other and keep in contact since discharge. You would think that it might even be encouraged to talk to the other parents and look at their babies. After all, when you have a micropreemie, you're there for the long haul, and when parents are in the same boat, there's always room for support.
"And in a NICU with upwards of 2 babies at any given time, how can you not look at other babies?? "
Should read 20 babies....must proofread more often!
Our NICU had a policy of only allowing visitors to see the babies with the express written permission of the parents or when accompanied by the parents. I really appreciated this policy because it gave me an excuse when friends and acquaintances wanted to "pop in and see the boys". I didn't want my boys being treated like freakshow exhibits! I particularly felt this way when the boys were very sick. When they were improving some of the nurses would ask if other parents could visit our boys when they were struggling with the early arrival of their babies too. This never bothered me because I knew that I got comfort from seeing other babies the same gestation and weight as my boys. It was strange though because just before the boys finally came home after 136 days in hospital I became very uptight each time someone came into their room, whether they were family, friends or staff. I suddenly was sick of "sharing" my boys.
Of course these days I am more than happy to show them off - and I even manage to (usually) answer the inevitable questions about their small size and premature appearance with a sense of humour.
Thanks for another interesting blog entry,
Hugs,
Lisa
mum to Mitch & Harry
ex 24.6 weekers
now 2 1/2 years old
As a mom to a 24 weeker I understand the curiosity factor of it all, but the very FIRST thing we were told upon entering the NICU was to not look at any of the other babies, we were never to go see one unless invited by another parent.... which in itself was a bit hard because they were all pretty close in there!
I enjoy your blog alot! Keep up the posts!
At the Chicago Century of Progress Exposition (1933-34), the premature baby exhibit was in the building next to the one in which Sally Rand, the fan dancer, performed. The two shows were the most popular of the Exposition.
When Sally Rand was arrested for indecent exposure, she protested to the police that she and her girls were wearing more clothes than the babies next door.
A permanent exhibit of premature babies was also set up on Coney Island. It featured "barkers" who would implore pedestrians "Don't pass the babies by!" One of these barkers, an unemployed actor named Archibald Leach, later rose to fame under his stage name "Cary Grant."
Silverman WA. Incubator-Baby Side Shows. _Pediatrics_1979;64:127-141.
I remember thinking "How Cruel" when I read of Dr. Couney's Coney Island preemie freak show. However, he was "exhibiting" his incubators which were a new practice. Where would we be without incubators/isolettes. I believe they used to call them a baby hatchery.
For the record, I don't think I would like random hospital staff looking at my baby like it was a zoo. But, I never did mind other parents looking.
I think views on this certainly vary from parent to parent and probably even differ in an individual parent depending on what day you catch them on. Our son was a 28 weeker that was IUGR at birth so weighed only 1.5 pounds. When we were hospitalized at 26 weeks there were no babies in the NICU that were Aidan's size whose mom's were ready to allow anyone to see them. This was a private room NICU so we had our own room.
I told the antepartum coordinator that whenever she was going to do a NICU tour, she could come ask me if the patient could see Aidan and visit with me.
Not only was this part of the healing process for me, but a chance to give a mom whose baby might be about this size at birth a visual conception of what her baby might look like. This was a way for me to pay it forward and make something positive of my experience to other moms.
Even today I visit the NICU from time to time and talk to new moms whose babies are about Aidan's birth size. We talk about the long NICU roller coaster and many other topics. They are also glad to view the pics of how Aidan is doing today.
I think one of the more helpful things that could happen in a NICU is to have former preemie parents willing to be involved with new parents.
Lori
While Moo was in special care, one of his nurses decided to bring in her neighbours to show them her "babies". I was disgusted and still am. They not only oogled my baby, but also stuck their faces right in his. My complaints were listened to and the head of the department agreed and the nurse was cautioned.
I used to have other visitors of other babies come and check Moo out. This used to annoy me no end as it was only because he was so tiny and we had been transferred to a hospital that didn't have a NICU, so he was the exception rather than the norm. At the time he was still on oxygen and fighting a CMV infection so I was always concerned about introducing more germs. And I noticed that visitors were never too concerned about coming into special care with a sniffly nose or cough.
We absolutely hated it when relatives of other children would come by and treat our kids like an exhibit. They'd come right up to the isolette and peer in and say something inane like "wow, your baby is really small; how old is it and why did you have it so soon." This of course was all happening when the twins were on oscillators, fighting for their lives, and we were emotional wrecks. Later on, after we lost Olivia and Hallie began to grow (but was still on the vent), we'd get parents wandering by. Sometimes they'd say things like "damn, I never knew there were babies born alive that are that small". They'd say this under their breaths, and to no one in particular, and I'd always think, looking at my still-vented surviving twin, "damn, you look big to me, kiddo." Anyway, I am very grateful to the ICN staff that attempted to minimize such intrusive voyeurism and whenever we had guests (frequently, during our 121 day stay), I'd warn them beforehand that they needed to respect the privacy of others.
Our son Ben has a rare genetic condition and has some unusual physical features. I wouldn't have liked having random hospital employees and other strangers gawking at him when we were only just coming to terms with his diagnosis ourselves. However, it wouldn't have bothered us if other NICU parents came by to see him. We also wouldn't have minded showing him off to students and residents for teaching purposes. (I rather suspect that did happen in our absence; one morning we found a Smith's textbook open to the page describing Ben's condition at his bedside).
This post brings back a very funny incident that happened at the tail end of my son's nicu stay. He had already been back-transported to a hospital closer to home, and had gone from being one of the most stable infants in the room(in a large teaching hospital) to being the smallest, most fragile infant in the nursery. One day I arrived and found a group of five or six people in business dress gathered around his isolette. They left shortly after I arrived, and I casually asked his nurse of the day who they were, as I had never seen them before. She was flustered, but answered that she thought they were on the hospital board. I was so used to having everyone and their next door neighbor examining my son, that I thought no more about it. The next morning I was met at my son's bedside by a very "important looking" person. She apologized profusely for invading our privacy the day before, and said that she understood from talking to the nursing staff that I was very upset. She then gave me a very large give basket stuffed to the brim with baby supplies, provided by the hospital auxillary. It was really rather strange, but for the two weeks remaining in my son's hospital stay he never again had unauthorized visitors.
The NICU where Ashton was had five different pods with about 8 babies in each. We were not allowed to wander around the pods, but only were allowed in the one that our child was in.
I remember always being curious about the other babies in there and never did I NOT look. I however never walked right up to the isolettes but viewed them from afar. I found it comforting as well.
Ashton spent 227 days in the NICU so he became "old" to everyone there. We knew every nurse and every doctor. Until this day (and he is almost 2) when we go to the hospital to visit or for appointments we can never go without seeing at least two or three people that know him.
I did have a few students come through near the end when Ashton was older as he was the exception. I never did mind. I even found comfort in talking to other moms who were nearby in the pod. Ashton was pretty much one of the youngest born at 24 weeks and parents always wanted to see him and hear about him b/c their children were 26, 28 weekers.
I have to say that this NICU had great standards for visitors and so on. People were ONLY allowed in with either me or dad, no exceptions. And only two of us at a time. I know I used to get frustrated with the "younger/immature" moms that were there and had all of their friends visiting constantly. There were many who were sick as well and had no respect for the sick babies.
I know since we have left that this NICU now only allows grandparents with the mom or dad. That is it. Now I know some people would complain and sure it would be hard, but at the same time you save these babies from being around so many more germs.
The NICU where my twins spent 77 days tried actively to discourage the zoo atmosphere asking all parents to only go directly to their own child's bedside, nowhere else in the unit.
The downside of this policy was that parents were kept artifically isolated when some of us (and I'm not claiming to speak for all parents, only some) would have liked a bit more contact. This was clear from the jam sessions we moms used to have in the breast-pumping room where we talked and laughed long and freely. A bit more of that could have helped on the NICU floor I think and I also think that we parents of preemies would be sensitive enough to know when parents wanted to be left alone.
I think privacy and reduction in noise is great, but if that is the aim, then why not also encourage nurses not to hold their daily gab sessions on car purchases, lunch menus, weekend plans right in earshot of those of us who craved more silence. It was a constant source of frustration to me, but I never said a peep, for fear of alienating one of these nurses who might one day be at my child's bedside.
I had a nephew in NICU....there were about 5 other babies in there. No one said anything about looking at the babies...and the sad thing was, a couple sets of parents were never around to even look at thier own child. My sister in law was there every single day, and when she'd leave my brother in law would be there. There were two sets of parents that they never saw visit, not even once. It's very sad:(......
For those who want to gawp, my response to this topic has usually been to ask the individual if they would go and wander around an adult ICU and whether they would go and have a peek there?
Or to lightly suggest that they strip down to a nappy, get hooked up and ask them if I can bring in a load of strangers to stare at them.
To balance this, my son was one of those long stayers in the unit, ( 6 months) and in times of sadness, death and stress in the NNU, on more than one occasion , we would go in and see the staff cuddling him - and we felt that was quite right and natural. The staff have a rough, stressful job and our son was a little one (560gms) they could gain hope from and we all need that when the days are dark.
Such a situation is a mile away from the " oh, I've never seen a baby so small' mentality. Move along folks please.
Dear Long Term listener,
Like you we found that the staff gained comfort from our boys and I suppose they realised that we were happy for them to give the boys cuddles (when they were stable). One day we discovered one of the doctors sitting in the boys' room with the lights off, her eyes closed and cuddling Mitchell- she quickly jumped up when we came in, but told us that she had spent so many nights struggling to keep the boys alive that she was just enjoying being with them now that they were stable. Another time one of the doctors encountered my parents as he carried Harry back into his room (Harry was close to going home)- he said he wanted to show Harry the hospital Xmas lights and show him there was more to this world than NICU.
Both memories are much treasured...
But the people who stared at my beautiful boys when walking through the NICU to see a baby were not endearing and caused me a great deal of distress...
Hugs,
Lisa
mum to Mitch & Harry
ex 24.6 weekers
now 2 1/2 years old
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ND:
I enjoy reading your blog - and the comments from other preemie moms. I do not, however, enjoy reading Helen (who I may not always agree with but heartily respect in so many ways)being attacked by this person posing as an 'ER Doc'.
This troll is jeopardizing your blog and ruining it for EVERYONE that reads it. Continuing to allow comments on your blog may bring unwanted attention to it and cause it to be halted all together when its undue fame brings more prying 'legal' eyes.
For the sake of everyone that reads please halt comments for a while - give this poser - 'ER doc'- a cooling off period and maybe they're go find some sewer to rot in.
We, preemie moms, need to read blogs like this but don't need to read his/her spew either.
If she has a personal vendetta with Helen she can be emailed - she has supplied her email address in various posts here.
When we lost our daughter, (she had some congenital anomalies,and had some very unusual features),the nurse came with our baby in the clear basinett but never made an attempt to cover her body up. She pushed our daughter from the morgue to the maternity ward through the hospital halls with our baby girl exposed for everyone to gawk at. Some of my visitors who had come by witnessed this. This woman was also the Nursing Supervisor.
I was so upset. I worked in a hospital before and had seen a lot of things but this was so wrong. When someone dies in the ER, you never see the sttendant just pushing the naked, deceased body down to the hospital morgue with no covering and put on display for everyone to see. However, this was exactly was this nurse did to my daughter.
I wonder how she would feel if in my position, and that was her daughter lying there. My husband and I were not surprised however, as the nursing staff had failed us on so many lavels.
As this was a teaching hospital, we would have consented for medical students to see the baby but never for passersby to gawk at her as they made their way to the snack machines.
Julie
I agree with Jennifer above. ND this personal attack on Helen has really gotten out of hand. This blog has been built over the months into something that is truly unique in that parents as well as professionals are able to have a good dialogue - of course not always agreeing with one-another, but at least being respectful. That appears to have ended on Saturday with the start of ERdoc's comments to Helen and others (including me) who agree with Helen. I can't help but wonder if your recent media coverage has caused some type of "it's time to bash any parent, etc that does not agree with us stance" so that we'll all go away.
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Re:Chicago Has it changed since you were last there? Since the fire?
Dear Julie
Your experience is shocking and I am so saddened to read it. Why can't people think through these things and simply put themeslves in your shoes?
As someone else has said elsewhere, where is their humanity?
When my baby died, I carried him in a moses basket through the maternity unit, on my knee and I had to put a sheet over him, the midwife said that it would stop people from staring.
This upset me, I would much rather people would have been able to see him, than me having to hide him away, I was still a proud but very upset Mum.
I am fascinated by premature babies, and look in wonder at them, but then I am fascinated by all aspects of pregnancy and genetics, I look at pictures of babies from all different gestations and find it amazing that something so tiny can be so perfect.
Many 21st century accounts of the Chicago Fair describe the display of live preemies. In contrast, comtemporaneous newspaper stories describe them as being for "undernourished".
It is also ambiguous, in this story, whether there were babies present or not. The exhibit, in any case, was to demonstrate the incubators, not the babies, if present.
http://chicago.urban-history.org/evt/evt03/evt0342.shtml
"Next to this building is the Infant Incubator, another educational exhibit, showing how undernourished babies are restored to health."
Some consider whatever was done to be important in the adoption of the incubator and other tehcnologies.
http://www.people.cornell.edu/pages/ked42/Infant_Sideshow_Paper.pdf
Listing a citation doesn't make what the citer says true.
Another inaccuracy in the story that calls the credibility of this entire article into question: the location of the incubator exhibit. It colorfully claims that a stripper was the attraction next door.
However a map:
http://www.cityclicker.net/chicfair/34map.html
lists the incubators as being at #42. #40 is listed as The Mayflower Doughnut restaurant, its neighbor. To the other side is, somewhat distant is the Gennet Cigar Company, which is #53.
#43, which is very far to the other side and back, in spite of being the next number, is Neptune's Follies, which could have been the show mentioned.
But, it is hardly next door. Exhibits 40, 41, 128, 69, 39, and 38, are geographically in between.
Is any of this story true, besides the incubators?
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Sorry...I have no idea why that posted again...
I meant to ask if we could please try to keep this civil and directly on topic?
I am all for taking somebody to task if you have conflicting information, but can't we do so respectfully? It adds so much more to your argument if it can't be viewed by some as name calling.
The topic at hand is a very sensitive one to preemie moms and dads. Some moms have mentioned infant loss on this thread.
Please do try to be respectful. I am not suggesting that anybody not post...but on topic and civil would be nice.
These are important issues that we should all be able to discuss as adults even if we have differing viewpoints.
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ND,
Since I found your blog a while ago, it has been a great help and a great resource for me. I have learned alot through your posts and the comments, and have very much enjoyed the perspective you have been sharing. It very much saddens me to see people trolling on your blog and turning what was an excellent resource into a complete circus. I myself am posting anonymously today in order to protect myself from unwanted attention from those individuals. I hope that we can all find a way to return the quality of discourse here to it's previous level....and I thank you again for all that you do.
I've seen my favorite medical blogs taken down after unwanted attention... and I'm afraid this one may be added to that list.
In advance, I'm very grateful I had the opportunity to discuss preemie issues with the parents here and I'm very sad to see how a few trolls can ruin it for everyone.
If you have a problem with Helen Harrison or NAROF please discuss it off this blog with them - there are real people who benefit from this blog who have no other focus but to learn, not slander.
To Anon who said:
"It is also ambiguous, in this story, whether there were babies present or not. The exhibit, in any case, was to demonstrate the incubators, not the babies, if present."
Dr. Silverman interviewed one of the nurses who participated in this exhibit, Miss Evelyn Lundeen, and she discussed the exhibit with "some disdain."
"She was not happy about the 'showmanship' which was part of the daily routine. For example, Miss Lundeen related that the nurses were instructed to add more clothes as the babies grew larger to heighten the illusion of smallness of each of the infants on display. [Head nurse] Madame Recht wore an oversized diamond ring on her finger; she slipped this huge 'sparkler' over the babies' wrists periodically to demonstrate how tiny their hands were" [see Figure 14, pictured in Silverman's article, referenced above.]
Citing the more paasages of the same article doesn't do a thing at all to verify the what the article says.
The same author in the same article wrote detailed accounts with names of a strip show being next door. Detail gives the facade of authenticity, but does not authenicate it and could easily be fiction. The map of the exhibits clearly contradicts a key element of this story.
The author also claimed the babies were the attraction. It is clear the incubators, filled or not, were. Other people on the blog have pointed that out and there are many web references to that. So, another key element seems manipulated by this author.
The author's claim that a stripper is one of the top draws at a fair is plausible. That incubators were too stretches credulity. The below article gives an opinion on the popularity. It does not cite the incubators, as popular, simply shocking by today's standards (as it too claims they were filled with children).
http://www.bookrags.com/Century_of_Progress
"One of the more famous aspects of the fair were the performances of fan dancer Sally Rand. Other popular exhibits were the various auto manufacturers, the Midway, and a recreation of important scenes from Chicago's history"
There are many photographs of incubators with babies in them from that era.
http://www.neonatology.org/pinups/philly.html
One from a Fair, not a hospital would resolve the question. Certainly everything at that Fair was photographed. A newspaper article from the time that was less ambiguous would also do the same. Many medical museums have exhibits that "show how" we diagnose and treat things, but certainly don't have live patients on display.
There's so many contradictions, implausible ideas, and inaccuracies already. Are you sure you are not being sucked in to reposting an Urban Legend?
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Re: Chicago Century of Progress Exposition
"In 1933 infants ceased being brought to [Chicago's] Sarah Morris Hospital for the summer months; they went instead to the Chicago Century of Progress Exposition (1932-33). There Dr. Couney, the so-called incubator doctor, with [Dr.] Hess's full co-operation, ran the premature baby exhibit. Hess loaned [his chief nurse] Miss Lundeen to Couney for the two-season exhibit. Premature infants once more went on public display under the auspices of Dr. Couney's Infant Incubator Company."
See page 46 in _The History of the Care and Feeding of the Premature Infant_ by Thomas E Cone, Jr, MD.
Re: Chicago
There's many contemporary references to babies in the incubators. Every urban legend has multiple re-tellings.
Photographs or contemporaneous accounts in newspapers or the program would be needed to distinguish fact from fiction. If it really happened, why wouldn't these exist?
If definitive evidence doesn't exist, then say so. More people who fell for the urban legend is not evidence.
In an article with so many made-up story elements, it would not be surprising if this one was too.
Anon. 3:28. who said: "The author also claimed the babies were the attraction. It is clear the incubators, filled or not, were."
So were you are the Chicago fair then, to know what people were looking at and what the real 'attraction' was?
Further, the previous post you are alluding to contradicts your claim that the incubators not the babies were the attraction.
"Next to this building is the Infant Incubator, another educational exhibit, showing how undernourished babies are restored to health."
The undernourished babies are right there in the exhibit and clearly made the exhibit more attractive and lucrative. Otherwise, why not leave the incubators empty if if was all about the incubators.
More doubts? read Baby ER, by pulitzer prize winning journalist Edward Humes. It has a great chapter on the history of neonatology including the Chicago worlds fair and other 20th century exhibits.
Infants were also exhibited at the St. Louis World's fair in 1904. A history link summarizes the exhibit as follows. See: http://ftp.apci.net/~truax/1904wf/Pike%20US 20Attractions.htm#Incubators.
"Baby Incubators (Infant Incubators)
-- 25¢ adult admission (15¢ children)
Efforts of science to help humanity's struggle for life. One of the few fire-proof buildings on the Pike. Typically 20-30 infants, occupying 24 Incubators, 4 beds and a nursery. Also had a store with baby goods. Employed 3 doctors, ~10 nurses, used sanitary and scientific treatments to reduce chance of illness.
Had a 'problem' with sanitary conditions (many infants died) -- 'cleaned up' the facility, put in glass walls for separation of visitors, more attendants -- improved."
Interesting that the advancement of science and medicine came at the expense of sanitary conditions and the lives of those infants. ALso at teh same fair: an exhibit of 300 Native Americans Cliff Dwellers including Hopi and Zuni tribes.
The autobiograpy of John Saunders, who was head Physician of the Baby Incubators at the St. Louis World's Fair notes;
" The Imperial Concession Company, a company formed principally by some St. Louis businessmen, with Mr. E. M. Bayliss, manager, opened the incubators to the public about June 1, 1904. While the purpose of this company was simply to make money, the character of the men governing the institution precluded the entertainment of the notion that the infants would be neglected in any way. These businessmen did not claim to know anything about the care of infants prematurely born, but they were willing to do anything that science taught to be necessary. Miss Kelly, a highly trained nurse who had considerable experience with premature and normal babies, was put in charge; also, a physician was procured who had gone East especially to study the care of premature infants, and only trained nurses were employed to take care of the babies.
Everything went very well until the summer hot weather arrived, then, through some error, a very virulent disease-producing germ or virus was introduced, starting a catastrophic epidemic of contagious diarrhea. The loss of newly born infants was increased by the death of several "graduates" and the mortality was altogether higher than was desirable. On September first the death rate had risen to fifty per cent, the attending physician resigned, and thereupon, another physician was asked to take charge...
The great death rate of the infants was undoubtedly due to a sick, infected infant from one of the foundling homes. Such catastrophies are inevitable sooner or later, unless the most scrupulous attention is paid to every nursing detail. A rigid aseptic technic is essential and this can be carried out only at an enormous expense. It cost fifteen dollars a day to take care of each infant...Without boasting, our success at taking care of premature infants was very good indeed, our mortality rate dropped to less than twenty per cent, and most of the deaths occurred in infants weighing less than two pounds."
My question? Was it Dr. Saunders who agreed to spend the $15 to bring the mortality rate down from 50% to 20%? How generous of him.
See the full excerpt at: http://www.neonatology.org/classics/zahorsky/zahorsky.bio.html
So half the babies died. i wonder how much those lives "cost" in 25 and 15 cent admissions?
Finally, if there is any doubt about whether the babes or the incubators were the exhibit, here is another extract from the autobiography of Dr. John Saunders, who was in charge of the babies at the St. Louis World's Fair in 1904 and whose book was thus shunned by the medical community. The link is on my previous post.
"However, there was one cloud that obscured the professional acceptance of [my] book. Baby incubators for show purpose did not have the endorsement of the medical profession.
'What connection,' wrote the editor of the London Lancet, 'is there between the serious matter of saving life, and the bearded woman, the dog-faced man, the elephants, the performing horses and pigs, and the clowns and acrobats, that constitute the chief attraction of Olympia.' (London)
In another article the Lancet published a letter from a showman who felt it was his 'duty to warn members of the medical profession, also nurses, parents and public institutions not to entrust their children to any applicant whatsoever without first taking the precaution to assure themselves that they will not be made the victims of showmen, as well as inexperienced or irresponsible persons who seek to trade upon the established reputation of an invention (The Incubator) that has been recognized by both the medical and lay press.'"
Clearly there were more than a few showmen out there exhibiting babies.
In a nutshell, there's no proof of this story's basic premise. There's no photos. There's no unambiguous news accounts from the time.
There's more urban legend retellings. Most of the legends have some connection to neonatalogy.org. There's more stories from different places and different generations.
Pssttt: Infant Incubators means they are for infants (as opposed to chick eggs), it does not mean there were infants in there.
And multiple doses of steriods means....oh, nevermind.
There really is not an urban legend about how "attractive" the infant incubator exhibitions were.
Go to a library (I did) and find any book on the history of neonatology. The one I read was actually the 7th edition of Perinatal and Neonatal Practices (title may be off, I don't have it in front of me).
Perhaps one person's details don't agree with a map, but the fact that many, many people came to see the infants in the incubators doesn't change. Some estimations reach to 80,000 infants were raised(?) during the 40 years that Couney ran his exhibitions.
Helen may interpret data with more pessimism than others, but she is not misrepresenting the facts regarding this issue.
And, she's gotten quite angry with my comments to her on other blogs, so I'm not always her supporter.
The treatment of premature infants can become a zoo and has in the past.
So the guy who does this in 1904 gets run out of town, pummeled in journals, shunned by the medical profession.
And this is proof that they still keep doing it until 1934.
A few images
And then this from the NY Times
As a NICU nurse I have experienced the "Zoo" phenomenon many times firsthand. Most visitors are just curious and mean no harm. When working with micropremies I frequently get asked by other parents how much they weigh. A light comment such as "not very much!" followed by a sincere apology that I cannot tell them anything about the baby without mom's permission is usually sufficient. Seeing premies and babies with various birth defects was a very important part of my training. When there is an opportunity to see a baby with a rare condition I always take it. I believe this allows me to be more compassionate with the family of the child, or with future families of children with the same condition.
Still no one can produce definitive evidence, evidence you should be able to find.
here in Chicago at the Museum of Science and Industry, there is an exhibit (a permanent one) showing the fetus as it develops in the womb. All of the fetuses are real in that they were at one time or another on the road to beig born.
http://www.msichicago.org/exhibit/body_prenatal/index.html
People are genuinely interested in fetal development, and seeing a preemie brings that interest to "life" if you will.
My daughter an ex 28 weeker who is now six has been asked to bring in a newborn photo. A ventilated 28 weeker with all the lines and equipment doesn't exactly make a Kodac moment that the other children will be bringing in. I am at odds at what to do. Her newborn photos are just plain sad. On the other hand I feel by not sending in a newborn photo I am not honoring her jorney and the incredible fight she has made. I just don't want her peers and teachers viewing those awful photos of her. I hate to think of how she would feel when she doesn't get the "how cute" commments that the other children get to their newborn photos.
"My daughter an ex 28 weeker who is now six has been asked to bring in a newborn photo. A ventilated 28 weeker with all the lines and equipment doesn't exactly make a Kodac moment that the other children will be bringing in. I am at odds at what to do. Her newborn photos are just plain sad. On the other hand I feel by not sending in a newborn photo I am not honoring her jorney and the incredible fight she has made. I just don't want her peers and teachers viewing those awful photos of her. I hate to think of how she would feel when she doesn't get the "how cute" commments that the other children get to their newborn photos."
Caitlyn was just the "Star of the Week" a couple weeks ago. Same task, make a poster board filled with pictures from infancy to current age.
Caitlyn is very aware of her beginning, as aware of it as she can be with a limited understanding of some things. She picked out all of the pictures that she wanted on the board. I was hesitant at first to allow her to take in pics of her on vents and with tubes in her nose. However, she is able to explain why she had those things. And to be perfectly honest, I am proud of the fact that she survived that and even more proud of the fact that she can accept it and explain it.
Is it nice for other kids to see? I'm sure it scared the hell out of them. But it is our reality. The other parents in the classroom know that Caitlyn was early, and if they have any questions regarding it, they are free to come and talk to me about it. I love nothing more than talking about my sweet girl ;]
Take a read at amazon.com of The Hatbox Baby. A work of fiction from which our our originally quoted Dr. Silverman seems to have "borrowed" from heavily.
"From Publishers Weekly
Chicago's 1933 World's Fair boasts both scientific marvels and carny-style showmanship in Barnes and Noble Discovery Award winner Brown's entrancing third novel, the two main attractions being fan dancer Caroline Day and the world-renowned premature baby doctor, Leo Hoffman, who exhibits his preemies in the "Infantorium." "
Instead of Ann Rand, who was really several doors down, getting arrested, we have Caroline Day, on page 9.
"...Caroline Day, the fan dancer, because she was the next exhibit over to the baby doctor and was very well know. Famous, in fact. His wife's sister had heard Caroline Day say once that babies wore fewer clothes than she did, and so what was all the fuss?"
One of the main character's names is "St. Louis". After the city not the saint, he explains. Wonder why?
I could go on, because it is not yet a smoking gun.
But, why bother. It is plain old plagarism. Not something to waste our time over. Mystery solved.
Anon 6:29,
Actually, you've got it backwards. Brown's novel was printed in 2000 and Silverman's article was published in 1979.
http://www.geocities.com/~jimlowe/sally/sr-who.html
"Sally Rand says she does 'exactly the same' dance ... that made her the sensation of the 1933 Chicago World's Fair because, "Why not? I'm the original."
"Actually, you've got it backwards. Brown's novel was printed in 2000 and Silverman's article was published in 1979."
Helen claims it was published in 1979. She oftens cites things so old that they are not on line. It is hard to check if the article really exists, if the passage is really from it.
The silverman/79 is supposed to be history. But, it doesn't match the historical facts from the time.
Some of the details seem to resemble what was posted about St. Louis in the early 1900s. Hence, the inspriation for the character's name.
Perhaps Silverman wrote the "first draft" by inventing this tale from bits from Chicago and old St. Louis and a little imagination. Then The Hatbox author ran with it.
In any case, we shouldn't be basing our discussion of real live babies on works of fiction. No matter who started the novel.
Stop feeding the troll, please. Ignore.
When we were in the hospital, pregnant women were brought through for a 'tour' of the ICN, perhaps so it wasn't as scary for them if they had to end up there. My daughter was front row right in the middle room. At 2lb 3oz, she was the biggest baby, and honestly I look back now and thank God she was the one they looked at and not the other littler babies in the room behind her. At the time though, I didn't care for it at all. As the weeks dragged by, I got to know the other parents and we often double checked each others kids if we were there and they weren't at any given time. This enabled a few of us to get decent time lines of things and find out what was going on when we couldn't be there.
One mother had to go home to her other children and upon leaving asked me to sit with her daughter some days, and just tell her that her mum was coming back soon. Living over 5 hours away with a large family to take care of, she couldn't stay to be there herself. It was heartbreaking for both of us.
One day at Ronald McDonald house, all the Mum's were out on the balcony chatting and one of the Mums came back from the ICN in tears...one of the twins that had been there for 12 weeks had just died (I'd seen the curtains drawn earlier in the day and wondered...). Even though the mother wasn't a RMH Mum, we were all devestated. Even though we didn't know Mum or baby very well, and we never 'looked', it came as a hard blow to much of the ICN.
We were all pretty much over being a 'zoo' at that stage, and the death of this baby was almost too much to bare.
I would also like to mention my dismay at seeing ND's blog comments sections turned into a free-for-all for immature trolls who apparantly have all the time in the world to do research to disprove anything Helen H has to say - if you're a Dr...why do you have so much time to spend in a dedicated vendetta again Helen...what about your patients? Or are you one of those Drs we all dread that really don't care after they're out of your hands; out of sight out of mind?
For what it's worth, I *am* a member of NAROF. It's a group that I am glad to be a member of. Having said that, I don't blindly follow our leader...although I have great respect for her. Helen has been nothing but good to me, giving me articles to read when I couldn't find them myself, NOT interpreting the evidence for me unless I asked for clarification. She has also been a good shoulder to lean on when I was going through rough patches with my ex-26 weeker.
I am at odds with most of the preemie community in some respects, but I am still a member and cherish the fact that such a community exists in relative harmony until someone comes in determined to stir the pot.
The women, and men, have been to hell and back and Helen has been there with them every step of the way. Along with some other very active community members who I've seen randomly attacked throughout the web. People who don't understand our battles, our opinions, and our mindsets need to back off. We disagree amongst ourselves and set each other straight...we don't need an outsider with no knowledge of our situation/s and with a vendetta against one of us to come in and pick petty fights.
ER Doc: You should be ashamed of yourself for casting such a dark shadow over such a wonderful blog. A blog that at one stage sparked honest and intense debate, and that didn't resort to the immaturity and nonsense of personal attacks and name-calling.
This comment has been removed by a blog administrator.
By now, all the readers of this blog are aware that it is being trolled.
Trolls are immune to shame.
They live to stir up argument and dissent.
The more folk they draw in to their conflict, the happier they are.
I'm sure tht when Neonatal Doc can get the time away from doctoring, this thread will be locked, or the trollish comments deleted.
In the meantime, best to ignore these dysfunctional souls.
Interms of the NICU zoo, both my kids spent time in the NICU as full-term infants, in the same pod as some what looked to me to be preterm, ill babies, but well away from the long-term growers, whose mums I only met in the pumping room.
I looked at the other babies, I'm sure, but I didn't really see them, if you know what I mean. Much too anxious about my own babies, and I imagine that most other parents are, too.
Some of the staff did come and ohh and ahh at how round my son's head was. (C-sec, 38.5 weeks)
It was a little weird at the time, but there was so much else going on.
kp, is there a support group/community available for NICU non-preemie graduates? I've never thought to look into it...but I hope there is because I would think that the preemie community can look awfully exclusive to someone with a situation so similar yet so far removed.
I imagine your son's round head would have looked odd to many of the staff that deal with the elongation of the preemie head. I always marvelled at the shape of my neice and nephew's heads when they were born (vaginally). So odd in comparison to Hannah's...but now I realise Hannah's head what the odd one!
I hope your kids are doing well now.
And you were right about the troll - sometimes I just can't stop myself from responding. I just had to say something, now that it's out of my system, I'm over it.
hannah's mum, both my kids have mild disabilities, but at least in my son's case, it is very unlikely related to time in the NICU.
I work in pediatric rehab, and I read some of the preemie blogs. I remember so clearly the worry and disorientation I felt in the isolated, almost underwater world of the NICU.
It takes a long time to get over even a relatively brief stay, doesn't it?
And no, I dont feel at all excluded. I'm moved by how much each parent loves his or her child, no matter his/her position on items of controversy.
this is what happens when you alienate your supporters,the nurses.callous indifference and brutal silence are THE most effective snubs there are.by ignoring all the nurses that support you,AND not addressing our concerns,theses trolls have hijacked your beautiful blog.we nurses brought a balance to your blog.but not anymore.yes,your brutal silence has effectively pushed us away.and we thought you cared about the nurses.yeahright. i am referring of course to your 'sick' post
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Neo Doc,
This bog is wonderful & should continue. Lets ignore the "trolls" and keep on blogging...
Thought this was of interest.
http://michellemalkin.com/archives/007191.htm
chiming in to say how nice it is to see another ex nicu mum of a non-preemie.
kp - you are so right - it is traumatic even if you have a short stay and a good outcome
and reading comments that are unqualified about nicus being dangerous, etc is disturbing
I posted on ND's last post about this and how i think narof should be called parof. Its nice to know i'm not alone. ND I'd love to see a post on term kids in nicus.
re the zoo thing, i became close to another mum and we watched out for each others' babies. when i saw they'd given her daughter a dummy (pacifier) despite mum's request i said something, when the cardiologist they'd been wanting to see for days showed up I asked one of the nurses to call them. The nurses seemed to understand that Julie and I were friends and had no worries with us looking out for each others babies.
Thirty years ago, grimly hanging on to a baby suffering from slowly worsening IUGR, I was shown the NICU, and, through the glass, a baby who was probably about 28-29 weeks. To this day, I can remember my feelings - horror, fascination and wonder. Without the layer of baby fat, I saw a human infant with arms and legs like pencils, a face that looked aged rather than premature - but a living, breathing fighting human being. Did it help me come to terms with my own baby's prematurity? No, it scared me. When my own babe was born, I thought she was absolutely beautiful - the full term infants suddenly seemed gross and too big. Funnily enough, I remember little about her three month stay. I remember it as an almost entirely negative experience - miserable, strained, terrifying. This wasn't my baby, she was the nurses', and I was a hapless spectator, powerless and inept. The idea that I could have made rational "decisions" at that time seems mad - I was just a bundle of instincts focused hard on survival. We were kept at arm's length from the other babies, making it difficult for mother's to support one another, and visitors were never allowed. When I read nowadays about the importance of "bonding" and immediate contact, it makes me smile. Our bond couldn't be stronger, despite a lousy start
ND,
This is your blog. But, is censorship what you are about?
The fascist, cult-like responses from this organization needs to be left up and seen by the public. People need to know what they are really like and about. For that reason, I ask you NOT to delete posts that slamming mine and other critics of them, no matter how repugnant.
This is the real face of this group. Not some nice soundbite about parental choice.
They are useful idiots to the more marginal neonatologists. Their calls for non-resusitication are both against the law, but also relieve the docs from treating the most difficult, challenging, high-risk patients. If the mid and small hospitals' docs start telling parents early preemies are hopeless, than their workload and malpractice will be much less. The difficulty level of patients will be more in line with their expertise and experience. Revenue, slightly less. But, overall it is more bang for your buck on a purely personal level for the docs and hospital. Is that what you are about?
They are all about not feeling guilty about not wanting their children. They are all about pretending like these kids are too difficult for everyone to hide that they are too difficult for them.
They try to dress it up in a medical futilty argument. They put a bunch of unsubstaniated and unrelated footnotes after it and pretend it is evidence-based.
And when one points out the obvious about them, they even have more hidden agenda tactics.
You are not pointing out their hypocrisy, you are threatening them!! You are not pointing out that they frequently post malarky as science, you have a vendetta against them!!!! You cannot disagree with them or you are uncivil, a troll, or destroying the community!!!!
And they are going to call the police, their lawyer, the state medical board, and the Coast Guard out on you unless you stop.
People need to see this kind of reaction they have and what they are reacting to.
I challenge all of those to cut and paste posts which contained "threats" and "slander or libel" and any violations of other laws.
This comment has been removed by a blog administrator.
"Neo Doc,
This bog is wonderful & should continue. Lets ignore the "trolls" and keep on blogging...
Thought this was of interest.
http://michellemalkin.com/archives/007191.htm "
FOAD is not a death threat.
Stupid.
"(we are anonymous to avoid unwanted attention)"
Just to play devil's advocate here...this group is so desperate to get the "true" image of prematurity out, then why don't you want the attention? I thought your whole intent was to attract people to listen to the message that you want to get out there?
If that's the case, then anonymity defeats that purpose right? How can people accept what you say as truth if you can't stand behind it with your name?
Our NICU had strict rules (thank goodness) about this. You weren't allowed to wander around, you weren't allowed to look at the other babies without those babies' parents invitation. Only immediate family allowed (parents, grandparents, and siblings of the infant - nobody under the age of 12) and only 2 people at once and one of them had to be a parent. I was super grateful for the rules since Mr. Man was septic and the thought of recurring infections was unacceptable to me. Even after we brought him home, for the first 6m we made everyone wash their hands before touching him and no sick visitors allowed.
My sister's NICU (different hospital), however, let in anyone the parents wanted. I was aghast when I heard it. A NICU is not for companionable visitations. I have the hardest time explaining to people that ICU's are life and death, and not for social calls.
" Nancy said...
"(we are anonymous to avoid unwanted attention)"
Just to play devil's"
Hon, read the whole thread. It's a joke. It is a reference to an earlier post.
(satire)
(I am anonymous to avoid unwanted attention....to my bank account, or maybe to agree with myself, whichever) (/satire) Closed captioning for the humor impaired.
"Hon, read the whole thread. It's a joke. It is a reference to an earlier post."
Easy there now...no need to get all snarky on me. I have read the whole thread...must have confused one of the comments along the way. it's early yet and I was in the ER with my daughter all night. But thanks for the clarification. :]
Nancy said...
"If that's the case, then anonymity defeats that purpose right? How can people accept what you say as truth if you can't stand behind it with your name?"
It has been explained before. It is ironic that you post on a blog where the doctor is anonymous, but then question it.
The unemployed losers online can extort money out of the successful people they cross paths with on line by making up frivilous charges of slander or libel. This has actually been done here.
Also, the doctors have to worry that they might be sued for malpratice and that the patients' lawyer would twist whatever they posted and use it against them.
Finally, you might run into distubed people who might stalk you. And I mean that for real. Not this They-made-fun-of-me-and- I-am-mad, I-can't-get-revenge-by-being-honest-so-I-will-make-up-a capital-murder-offense business seen here.
Those are the reasons.
"Easy there now...no need to get all snarky on me."
No offense intended. I guess it sounded harsher than I meant.
Hope you got a chuckle out of it.
Hope the ER visit went OK.
"Hope you got a chuckle out of it.
Hope the ER visit went OK. "
It did give me a good chuckle, hence my response...matter of fact, lots of these comments are giving me a good chuckle.
The visit went as well as could be expected. Thanks for asking :]
But Anon, can't you make up a name or a number so we can tell which Anon is which? I'm quite enjoying SOME of your jokes and SOME of your points, which seem a bit better than your average troll - so I hope that isn't your purpose. Your actual troll is a real pain, destructive for the fun of it, but the kind of comments section that only says "I love your blog and I agree with every word" gets a bit boring too!
You know, I was thinking about this recently as well. The other night I was taking care of a 24 weeker that was IUGR. Vented, umbilical lines, double photo, the cigarette paper skin, and dusky abdomen made the kid a sad sight to look at. Around 4 am 3 young nurses were walking around and were standing at my babies bedside. I was surprised by how protective I felt. Why are you looking at my baby? Does anyone know who these people are? I bit my tongue and assumed that they were new to the nicu and learning what was there. Afterall that IS the only way to learn. I remember when I was new in the nicu walking up to babies that I was definitely not ready to take care and just taking it all in.
Out of respect though if I am observing another baby it is never while the parents are there. We need to learn from each other and from every baby and I think that is understood, especially in a teaching hospital (as I am in). However, I think there are proper ways to learn and observe. The parents are overwhelmed enough without having the feeling that people are fascinated and need to learn from their baby. ("Ut oh, why is everyone looking at him? Haven't they seen this much? Is this that weird?") The babies are there to cared for not to be put on display as if in the zoo. That being said, I have found in my short experience that more sets of eyes are better. People notice different things, so the more people the better (when saying this I mean nurses/doctors). It is very inappropriate and a violation of privacy for parents to walk around and gawk at other babies and on our unit we feel very strongly about that.
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