From 1898 to 1943, entertainment seekers from Coney Island to the Chicago World’s Fair could buy tickets to gawk at tiny premature infants in incubators. In our enlightened age we might wonder what kind of parents would put their newborns on that kind of display. The answer is they were parents who believed this was the only hope for their child. Rejected by the medical experts, they had turned to Martin Couney, the “Incubator Doctor,” who, while definitely not a physician, saved thousands of babies otherwise doomed to die.

The “Incubator Doctor” is the subject of a fascinating new book by Dawn Raffel, whose previous work includes a novel and two short-story collections. The Strange Case of Dr. Couney  can’t properly be called a biography—its subject misled many people about his past and his credentials, and published nothing but the occasional letter to the editor. Nor did he leave any papers. Yet Raffel is a terrific storyteller and has produced a fine history of a forgotten hero of the pro-life movement and a pioneer in the science of neonatology.

The story begins in 1920 in a Brooklyn hospital where a young married woman named Marion Conlin, having gone into premature labor, delivers twin girls. One is stillborn and doctors assure the parents that the other girl, named Lucille, would not last the day. The infant’s father tells the doctor about a sideshow with premature babies he had seen out at Coney Island. The doctor is dismissive. So Woolsey Conlin picks up his two-pound daughter, wraps her in a towel, and hurries outside, hailing a taxi to take them to Coney Island and Dr. Couney.

Like Lucille Conlin, the babies Couney took on generally weighed one or two pounds. Even the rare hospital with incubators to treat premature infants dismissed these tiniest newborns as hopeless, or as we say today, non-viable. But Couney was a believer.

Born Michael Cohn in Prussia to displaced Alsatian Jews, he arrived in New York at the age of eighteen. During the next ten years he changed his name and teamed up with another impresario, who invited him to exhibit incubators at important fairs in Europe, including one celebrating Queen Victoria’s Diamond Jubilee. Couney became the public face while his partner handled the finances. There were other doctors and inventors promoting their own versions of an incubator for preemies, but they lacked Couney’s messianic showmanship.

By 1898 Couney was back in the United States, stationed on the midway at the Trans-Mississippi Exposition in Omaha, not far from the Wild West Show and the camel ride. In 1901, he launched an ambitious campaign at the Pan-American Exposition in Buffalo, but the assassination of President McKinley turned the fair into a financial disaster. It was not a total loss, however, because he had hired Annabelle Maye Segner (Maye), a 25-year-old R.N. with a degree from Indiana University, to supervise the nursery. By 1903 he had married Maye and she began handling his business affairs. Setting up house in Brooklyn, they were joined by her widowed mother and Louise Recht, a nurse who had worked with Couney in Paris. In 1907 his only daughter was born at home, and Raffel hints at the likelihood that Hildegard Couney was in fact the unmarried Louise’s daughter. (The father being another Couney associate.)

Maye Couney and Louise Recht supervised the care of the infants, lifting them out of their incubators every two hours to be fed through the nose, one tiny drop of breast milk (obtained from the child’s mother or a wet nurse) at a time. These babies received finer care than they might have had in the best hospitals. For example, blindness has long been associated with incubators, but no Couney baby ever went blind. Raffel credits this to the fact that Couney’s machines never had enough oxygen to do that kind of damage and to his nurses having taken the babies out so regularly.

Although he was always referred to as Doctor, there is no evidence that Couney ever studied medicine or held a medical license. He was scrupulous about working under the supervision of local medical doctors. The committee behind the Louisiana Purchase Exposition (St. Louis, 1904) would have done well to accept Couney’s proposal to show at their fair, but instead they went with a licensed local physician who had no experience with preemies. This proved to be a disaster—at least 39 of the 43 babies on display died. An outraged Couney wrote to the New York Evening Journal, calling the deaths “the crime of the decade,” and charging that for political and other (read money) reasons, the exhibit had been placed in the hands of “people who did not know the difference between an incubator and a peanut roaster.”

Couney’s work paralleled the rise of the eugenics movement. In 1913, for example, while he was exhibiting at Denver’s Lakeside Amusement Park, Dr. Margaret Clark’s “Better Baby Campaign” was taken up by Women’s Home Companion, which promoted the contests at fairs across the country. Denver gynecologist Mary Bates wrote that such contests, “speed the day when we can have scientific elimination before birth of the unfit and someday the scientific culture of the fit.”

In 1934 Couney was at the Chicago World’s Fair, “A Century of Progress,” where the Hall of Science featured eugenics exhibits promising “improvement in the breed of man.” (This would be the first and last eugenics exhibit at a World’s Fair.) Couney, consigned to the midway, promoted his “Infant Incubators with Living Babies” using his perennial slogan, “All the World Loves a Baby.” He also appeared on radio with Dr. Julius Hess, director of a children’s hospital and president of the Chicago Medical Society, who became a lifelong supporter.

The rise of the eugenics movement, Raffel writes, “Would cast a shadow over the perception of premature infants and dim their prospects for decades to come.” In Chicago, Dr. Harry J. Haiselden denied lifesaving treatments to infants he deemed “defective,” deliberately watching them die even when they could have lived. Haiselden wasn’t the first or only doctor to intentionally allow a child to die, but he was the first to call in the press. He eagerly displayed dying babies to journalists, in addition to writing his own articles for the Chicago American. The Chicago Medical Society finally stripped Haiselden of membership—not for letting his tiny patients die, but for publicizing his cases.

Maye’s death in 1936 marked the beginning of difficult years for Couney. He had relied on his wife to handle his business and control his free spending—he never billed any of his patients a nickel.

New York’s 1939-40 World’s Fair, showcasing the “World of Tomorrow,” was a financial disaster for everyone involved, including Couney. The onset of World War II also took a toll on his personal finances as he assisted many relatives who were fleeing Hitler’s Germany. Business fell off as the lure of resorts like Atlantic City and Coney Island faded and young men were being called up for the draft. In 1943, Cornell New York Hospital opened the city’s first dedicated premature infant station. That same year Couney closed his Coney Island show for good. His work was done.

Couney died in 1950 at the age of 80, but his story goes on. His obituary in the New York Times, headlined “Martin A. Couney, ‘Incubator Doctor,’” caught the eye of Dr. William Silverman. A pioneering neonatologist, Silverman would later become director of neonatal intensive care at Babies Hospital of Columbia-Presbyterian in New York. As a sort of hobby, he sought to learn more about the “Incubator Doctor,” and his hunt brought him in touch with fellow Couney buffs in Paris, Berlin, London, Omaha, Buffalo, New York, and Chicago who shared his obsession. They became an informal Couney Circle. But the fact was that most of the details of Couney’s early years were clouded or conflicted. The more they learned, the more they wondered. In 1979, Silverman published an article based on his years of research in Pediatrics, a peer-reviewed journal. (Silverman died in 2005.)

The best part of Raffel’s book may be her interviews with people who owed their life to the “Incubator Doctor.” They all ask for information about the man who saved them. But Couney himself remains elusive.

Jane Umbarger and Jean Harrison, a pair of twins born in 1934, were delighted to talk about their time with Couney at the Chicago World’s Fair, but were surprised to learn that they had been exhibited on the midway. All those years, they had assumed that Couney’s display was in the Science Hall. Lucille Conlin recalled visiting Couney in 1939, while she was a nursing student at St. John’s Episcopal Hospital in Brooklyn. When she earned her nurse’s cap the next year, Couney sent her a corsage.

Beth Bernstein Allen was born in 1934, weighing one pound, 10 ounces. Her twin survived for two days, and doctors did not expect Beth to last much longer. The hospital where she was born, now Maimonides Medical Center, had a few incubators, but no one trained to treat an infant who weighed under two pounds. Doctors suggested Couney, but Beth’s mother resisted the idea of putting her baby in a sideshow. She only agreed when Couney came in person to plead his case. For years after, Beth’s parents would bring her to Couney’s home in Brooklyn on Father’s Day. It was Beth Allen who directed Raffel to Dr. Lawrence Gartner, the last surviving member of Silverman’s Couney Circle, who turned his own research materials over to her. Gartner assured her that in spite of his lack of credentials, “Martin A. Couney must be considered the ‘American father of neonatology.’”

In 2015, Raffel even managed to put together a reunion of five Couney babies, all women. Lucille Conlin was the oldest, a married mother of five. These are real people who were once real newborns struggling to survive. They were never non-viable fetuses.

Raffel writes, “He moved in the ephemeral, flash-and-dazzle world of the midway, surrounded by flaneurs who left little but pixie dust behind.” The Couney babies and their descendants would no doubt agree that the Incubator Doctor left far more than pixie dust behind.

(Blue Rider Press, 2018, 278 pages, hardcover, $27)