By Steven Jay Griffel
Queens, NY, USA

Historically, humankind has had a blind spot when it comes to the care and perpetuation of its own species. Consider: As many as 11.4 percent of all pregnancies end in early deliveries. Approximately one of ten babies around the world are born preterm. Even so, it wasn’t until the late twentieth century that the worldwide medical profession finally made a concerted effort to save those premature babies that had a good shot at survival.

What made humanity finally pay attention to its smallest, voiceless, and most vulnerable members?

Dawn Raffel’s fascinating and provocative new book, The Strange Case of Dr. Couney, tells a compelling story of how a European showman saved thousands of American babies and helped inspire the new science of neonatology.  

STEVEN JAY GRIFFEL: What first drew your interest to Chicago’s Century of Progress International Exposition?

DAWN RAFFEL: I was sorting out my father’s papers after he died, and he had written a sort of autobiography as a school assignment when he was 16. In it, he mentioned two visits to the Century of Progress. I had never heard of this world’s fair, but my mother, who grew up in Chicago, must have gone as well, and all four grandparents, and my uncles. Almost everyone I could have asked had died, except for an uncle who remembered a recreation of Fort Dearborn and little else. My interest was piqued and I began to do a little research.

The Century of Progress was Chicago’s second, less famous, Depression-era fair, not to be confused with the “White City” world’s fair of 1893, depicted in Erik Larson’s blockbuster, The Devil in the White City. The Century of Progress was predicated on the belief that technology would lift mankind to a higher plane, which was a disturbing notion from the opposite side of the Holocaust and the atom bomb.

STEVEN JAY GRIFFEL: What made you decide to write a book about Martin Couney?

DAWN RAFFEL: My fascination with the Century of Progress led me to sift through archival photographs in Chicago. I think I was half-hoping to stumble across a photo of my father or my mother in the world that shaped them before I was born—but then you have to ask, who among us would recognize one of our parents, pin-small, in a back-and-white crowd? What I did see that astounded me was a photo of an incubator exhibition smack in the middle of the midway. It seemed like the most bizarre commodification of human life—a mash-up of technology and voyeurism and commerce. When I later learned that the show was far from a one-time thing, and that the doctor in charge ran preemie sideshows on Coney Island and Atlantic City for 40 years, that did it—I had to get to the bottom of the story. The truth was far stranger than I imagined, and what initially appeared to be exploitation turned out to be quite the opposite.

The Strange Case of Dr. Couney

STEVEN JAY GRIFFEL: Why did you decide to tell your story using a multifocal narrative?

DAWN RAFFEL: You know, this is my fifth book, and I’ve never once written one in chronological order. I know that frustrates some readers, but I don’t believe we think or feel in chronological order, and it’s rarely the most interesting way to tell a story. For this book, I actually tried the straight-arrow-of-time in the first draft, and it felt flat. Allowing myself to move back and forth in time made it possible to bring the story into the present (introducing Martin Couney’s still-living patients) and it also made it possible to raise the curtain on how Martin Couney’s real identity was finally pieced together. NPR called it a mosaic, and I love that.

STEVEN JAY GRIFFEL: After you signed your contract, you experienced a change of publisher and editor. How did these changes affect your book’s final draft?

DAWN RAFFEL: At first it was extremely stressful to lose my editor, weeks after the third draft of the book had finally been accepted. It felt like running a marathon and then being told the finish line had moved. My new editor wanted another revision. Fortunately, having a fresh eye on the book made the whole thing much better. The structure stayed the same, but the final book was sharper. After that came a fifth draft, when I re-fact-checked everything.

STEVEN JAY GRIFFEL: What aspects in your personal life were particularly engaged in writing this book?

DAWN RAFFEL: I’ve been asked countless times whether I was a preemie or gave birth to one, and the answer is no. Yes, I am a mother, and yes, Martin Couney was Jewish and I am too—but how to explain obsession? Why invite this wily ghost to move into in my psyche and rattle around in there? I could cite several reasons: my curiosity about what initially looked like the commodification of infants; my fascination with early, twentieth-century midway culture; my utter confusion as to why a lifesaving technology went largely unused for decades. And I could cite the magnetic pull of a man whose deceptions were far surpassed by the good he did in the world. Each of these reasons is true. And yet our obsessions are rooted in the spaces reason fails to reach—like longing, like love.

STEVEN JAY GRIFFEL: Even though you had a great deal of information to work with, why was it so hard to find verifiable facts and corroborative evidence?

DAWN RAFFEL: For starters, Martin Couney did his work at amusement parks and on midways—not the kind of institutions that keep records. He never published his work, nor did he leave a journal, or memoirs, or letters; in fact, he had cleverly fabricated key components of his identity. I knew from the beginning that Couney wasn’t the name he was born with—a quick look on will show you there’s no one else with that name, spelled that way, except for his wife and daughter. But what was his original name, and when and where did he change it? The answer to that question lay in his daughter’s will, in the King’s County Surrogate Court probate archives. Under pages and pages of legalese in triplicate, someone had tucked in a slip of paper that was her father’s certificate of name change. There was absolutely no legal or financial reason for that piece of paper to be in the file. Whoever placed it there 60 years earlier was hoping that someone would find it some day.

Another enormous break was discovering that a group of leading neonatologists from the second half of the twentieth century had spent quite a bit of time sleuthing out the story. They called themselves the Couney buffs and over time their numbers grew. The last of the original Couney buffs, Dr. Lawrence Gartner, very generously offered me the use of unpublished research and never-transcribed cassette recordings of people who were long gone. It took the Couney buffs’ research plus my pavement-pounding (looking for wills, marriage, birth and death certificates, property deeds, immigration, naturalization, census records … and, of course, the surviving “babies” and relatives) plus intensive archival deep-diving to put the story together. And honestly, without the internet making it possible to access, say, the one random copy of a publication that went defunct a hundred years ago, or identify the one archive where a librarian could locate a 90-year-old transcript of a concession committee debate, Martin Couney’s story would have remained a mystery.

Dawn Raffel

STEVEN JAY GRIFFEL: Which of your research challenges were the most satisfying?

DAWN RAFFEL: I loved finding the living Couney babies and introducing them to one another. I also found the brother of a baby Martin Couney couldn’t save, despite exorbitant efforts, and I think that is one of the most moving stories in the book. The baby died in 1934, but the family had lovingly held onto his baby cap and bracelet.

STEVEN JAY GRIFFEL: Please explain why the subject of eugenics is so important to your book and why it remains an important issue.

DAWN RAFFEL: The American eugenics movement created a culture of “survival of the fittest.” In time, it would decide not only that some people were unfit to “breed” (including African Americans, Mexican Americans, people with intellectual disabilities, people who’d committed petty crimes) but also who was fit to survive. At Chicago’s German hospital, Dr. Harry Haiselden famously advocated for withholding care to infants with severe disabilities, instead letting them die. He invited the press to watch infants breathe their last. Later he starred in his own movie, The Black Stork, a piece of propaganda showing why “unfit” infants were better off dead. Preemies were called “weaklings” in the medical literature, and while eugenics did not directly target them, it did make people question whether they were worth going to the trouble to save. Some would have disabilities and people wondered whether they would ever be “productive citizens.”

Many American eugenicists were Nazi sympathizers, and the Nazis were in turn inspired by American eugenics. American eugenicists were persuasive in their arguments with the State Department not to allow “a flood of Jews” into the U.S. before the Holocaust.

Today we no longer have something called eugenics, but technology continues to force us to make decisions about which lives we will save. Medical advances make those questions harder to answer. Where do we allocate resources? Which lives have value? When do we use extreme lifesaving measures and how does the equation change when the patient is not a newborn but, say, a nonagenarian? Who decides who lives?

STEVEN JAY GRIFFEL: Which modern advances in neonatal care impress you the most?

DAWN RAFFEL: The best neonatal care, at institutions such as Morgan Stanley Children’s Hospital in Manhattan, makes it possible to save ever smaller and more fragile infants, using sophisticated equipment that Martin Couney could only dream of. Some of the fundamental principles remain the same: heat, cleanliness, breast milk, loving touch. It’s also worth noting that among impoverished populations prematurity remains a leading cause of infant death.

STEVEN JAY GRIFFEL: When you are lecturing about the book, what questions have surprised or intrigued you most?

DAWN RAFFEL: I’m often asked why people paid to see the show. To me it seems obvious—we’re endlessly captivated by newborns (“you can’t upstage a baby”) and these infants were smaller than any most people had ever seen. Initially, people could not believe a child that small—two or three ponds—could survive. Some visitors became regulars, rooting for a favorite baby until it went home, and then choosing another favorite—a precursor to reality TV. 

STEVEN JAY GRIFFEL: Bottom line: Was Martin Couney more of a savior or a showman? 

DAWN RAFFEL: He was both, and that is a compelling paradox of this story. His showmanship was crucial to what he called “making propaganda for preemies.” To get the public’s attention, he had to entertain them. One of the medical ethicists I interviewed told me that in a sense, all public health policy is a form of propaganda—in a good way. Yes, Martin Couney fabricated his credentials, and he enjoyed getting rich, but I don’t know how you weigh that against saving 6,500-7,000 lives and being one of the major inspirations for American neonatology. He died broke and largely forgotten, and I would like to see him get his due.

Dawn Raffel


Steven Jay Griffel is an Amazon bestselling novelist, an editor, and a publisher. His latest novel, The Ishi Affair, was released in March 2017.

All opinions expressed are solely those of its author and do not reflect the opinions of Stay Thirsty Media, Inc.