The Best Medicine: How Science and Public Health Gave Children a Future

by Perri Klass

Overview

The fight against child mortality that transformed parenting, doctoring, and the way we live.

Only one hundred years ago, in even the world’s wealthiest nations, children died in great numbers—of diarrhea, diphtheria, and measles, of scarlet fever and tuberculosis. Throughout history, culture has been shaped by these deaths; diaries and letters recorded them, and writers such as Louisa May Alcott, W. E. B. Du Bois, and Eugene O’Neill wrote about and mourned them. Not even the powerful and the wealthy could escape: of Abraham and Mary Lincoln’s four children, only one survived to adulthood, and the first billionaire in history, John D. Rockefeller, lost his beloved grandson to scarlet fever. For children of the poor, immigrants, enslaved people and their descendants, the chances of dying were far worse.

The steady beating back of infant and child mortality is one of our greatest human achievements. Interweaving her own experiences as a medical student and doctor, Perri Klass pays tribute to groundbreaking women doctors like Rebecca Lee Crumpler, Mary Putnam Jacobi, and Josephine Baker, and to the nurses, public health advocates, and scientists who brought new approaches and scientific ideas about sanitation and vaccination to families. These scientists, healers, reformers, and parents rewrote the human experience so that—for the first time in human memory—early death is now the exception rather than the rule, bringing about a fundamental transformation in society, culture, and family life.

Previously published in hardcover as A Good Time to Be Born.

Product Details

ISBN-13:	9780393882384
Publisher:	Norton, W. W. & Company, Inc.
Publication date:	04/19/2022
Pages:	400
Sales rank:	512,833
Product dimensions:	8.10(w) x 5.40(h) x 1.10(d)

About the Author

Perri Klass is professor of journalism and pediatrics at New York University, codirector of NYU Florence, and national medical director of Reach Out and Read. She writes the weekly column The Checkup for the New York Times.

Table of Contents

Introduction The Waning of Child Mortality and the New Expectations of Parenthood 1

Part I "The Desolation of that Empty Cradle"

Chapter 1 Postmortem Poetry and Comfort Books

Literary Echoes of Child Mortality 17

Chapter 2 "Ma'am, Have You Ever Lost a Child?"

Child Death in Civil War America 38

Part II "The Birth of a Great and New Idea"

Chapter 3 "We Might Rather Wonder That Any Survive"

Mortality, Miasmas, and Mother's Milk 71

Chapter 4 "Each Has a Right to Live"

Educating Mothers and Keeping Babies Alive 102

Chapter 5 "The Plague Among Children"

Diphtheria and the Doctors 135

Chapter 6 "Most Dreaded of All the Diseases"

Scarlet Fever, Strep, and Antibiotics 156

Part III "What Marvellous Days"

Chapter 7 "Strides of Modern Medical Science"

Preventing Polio, Treating Tuberculosis 191

Chapter 8 The Incubator Show

Life and Death in the Delivery Room and the Nursery 215

Chapter 9 "Something Children Always Have"

Measles and Chicken Pox 244

Chapter 10 "Safe to Sleep"

Postwar Parents, Postwar Pediatricians 272

Conclusion The Promise of Safety 298

Epilogue to the Paperback Edition 307

Acknowledgments 313

Notes 321

Further Reading 364

Index 368

Editorial Reviews

"Klass beautifully demonstrates how the fusion of medical science and public health led to the vaccines, antibiotics, safety measures, and self-help volumes that saved countless young lives while revolutionizing the ways in which we map our children’s future. Elegantly written, filled with memorable characters and events...the perfect prescription for the uncertainties of our time."

David Oshinsky

"Describes how the world—and with it, parenting—has been transformed by declining infant and child mortality over the past century."

Atlantic - Kate Julian

"All readers with an interest in the history of health care—and all parents who bite their nails over the relatively rare dangers facing their children now—will be riveted."

Anne Fadiman

"Not too long ago, parents lived with the near certainty of losing a child or two; Perri Klass captures the drama of science and society’s triumph over that abysmal reality. As we grapple with new and unimaginable scourges, the lessons in this gripping, personal and beautifully researched chronicle could not be more relevant."

Abraham Verghese

"With her broad pediatric knowledge and warm understanding of parental attachments, Perri Klass tells the dramatic story of how medical science transformed childhood in the twentieth century…An important contribution to the history of childhood that can provide comfort and insight to all of us."

Paula S. Fass

"An ambitious, elegant meditation...[Klass] takes the most complex human patterns of all — history, medicine, politics, art — and knits them into something unique and beautiful."

New York Times - Christie Watson

09/14/2020

Medicine’s campaign against child mortality has succeeded magnificently yet left parents more anxious than ever, according to this probing history. Pediatrician and novelist Klass (Treatment Kind and Fair) recaps the salient data—in 1900, 10% of American infants died before their first birthday; now 0.6% do—and the many breakthroughs responsible, including the pasteurization of milk; the development of vaccines and antibiotics; and the invention of incubators, pediatric surgical techniques, and neonatal intensive care units. She also explores the cultural impact of child mortality and the fight against it, from the preponderance of ailing and dying children in 19th-century literature (such as Little Women, which drew on Louisa May Alcott’s own sister’s death from scarlet fever), to the late 19th- and early-20th-century craze for incubator exhibitions, as seen at the World Exposition of 1896, where, before huge crowds, babies “borrowed” from the Berlin Charity Hospital were displayed inside a “child hatchery.” Ironically, Klass notes, as childhood became almost immune from serious health risks, doctors and parents responded not by relaxing but by shifting their concern to vanishingly unlikely risks, like vaccine-induced fatalities or strangulation by window-blind cords. The result of Klass’s erudition and nuance is a fascinating look at a seldom-sung but profound change in the human condition. (Oct.)

Publishers Weekly

★ 10/01/2020

Most parents of young children in the early 21st century have no experience with many of the deadly and rehabilitating diseases and conditions discussed in this latest work by Klass (journalism and pediatrics, New York Univ.) because public health practices and health care advances have decreased childhood mortality dramatically. Klass, "TheCheckup" columnist for the New York Times, brings exceptional and compassionate writing skills to an exploration of the hazards of early life, using stories of both rich and poor families before the 20th century to show how precarious children's lives were at that time. Gradually, writes Klass, public health practices such as better sanitation and medical advances such as vaccines and antibiotics, helped to decrease infant and child mortality, and continue to do so. The author provides insight into the importance of vaccinations and health checks along with touching upon vital subjects such as child rearing, child safety seats, breastfeeding, and other concerns of childhood that have seen changes over time. VERDICT Klass masterfully introduces readers to the people coming up with solutions for many of the dangers of childhood and shows how the pediatric specialty over time has worked to improve children's lives. Essential reading for parents.—Margaret Henderson, Ramona, CA

Library Journal

2020-09-01
A history of the scientific discoveries and public health mobilizations that made the world safer for children.

As late as the beginning of the 20th century, writes NYU journalism and pediatrics professor Klass, “childhood death was always there, in the shadows at the edge of the family landscape.” Children would die, “regularly and unsurprisingly,” from a host of contagions and infections, often in the forms of epidemics such as typhoid, cholera, polio, smallpox, and diphtheria. The author, a smooth storyteller, traces the arc of medical advancement targeted at that vulnerable population, suggesting that no segment of society was exempt. However, it was also clear that the poor, immigrants, Indigenous peoples, and African Americans would suffer the most. In a remarkable fusion of science, public health, private institutions, and medicine, a slow but steadily growing movement brought necessary sanitation upgrades to cities and advanced understanding of bacteriology, virology, nutrition, and pharmacology. Klass effectively situates childhood deaths and the growth of pediatric medicine in both social and cultural contexts; one interesting section examines the subject via literature, including “sentimental poetry” and even gallows humor. “In that lost world in which dead children and mourning parents were routine and regular parts of life,” writes Klass, “morbid humor clearly had its place.” With steady narrative momentum, the author follows the long road that led to germ theory and the growing belief that it was “not just a parental obligation to prevent [childhood death] but a social responsibility.” Klass also chronicles the egregious missteps: eugenics, social Darwinism, and the racist, classist beliefs that hampered treatment for the poor and people of color. The author completes the picture with a range of subjects, including the dangers of childbirth; ethical issues in the neonatal unit; parents who don’t believe in vaccinations; psychosocial problems, including the shaming of “refrigerator mothers”; and the scourges of measles, chickenpox, polio, and tuberculosis.

A powerful story of the right of children to live and thrive from birth.

Kirkus Reviews