In the days when Americans thronged to the carnivals of Coney Island and the Chicago World’s Fair, one exhibit always held a special power — the prematurely born babies gazing out from the incubators of Dr. Martin Arthur Couney.
Weighing under five pounds, the “preemies” were so tiny that some spectators tried to poke them to see if they were real.
Indeed they were. And the incubators were not just a carnival exhibit, but a lifesaving device that kept preemies warm, clean and nourished — exactly what they needed as they began life with the odds stacked against them.
The medical establishment of the era had a dim view of preemies’ prospects and downplayed the incubator’s effect, but the device was promoted by carnival showmen such as Couney — born a European Jew named Michael Cohn.
While Couney’s medical credentials were fabricated, his methods were proven correct. By the end of his career, this unlikely pioneer of American neonatology had saved an estimated 6,500 to 7,000 babies.
The story is detailed in a new book, “The Strange Case of Dr. Couney: How a Mysterious European Showman Saved Thousands of American Babies,” by journalist Dawn Raffel.
This September marks Neonatal Intensive Care Unit (NICU) Awareness Month.
Raffel describes a time when there was little awareness of how to help babies born prematurely — that is, earlier than the usual 40 weeks of gestation. In the early 20th century, parents’ best recourse was often not a hospital, but the carnival where Couney provided expert care on the midway, with admission fees paying for treatment.
A veteran journalist who helped launch O, The Oprah Magazine, Raffel recounts this story through a mixture of archival research and interviews with people who had connections to Couney — including some of the very preemies he had once saved, now grown up with children and grandchildren of their own.
“I had no idea how long a process it would be,” Raffel said.
It began in 2007, when Raffel was researching the Chicago World’s Fair and came across a photo of Couney and his incubators on the midway.
“It was an astonishing thing to me,” she said. “How could this be? It remained in my mind.”
As she discovered from a subsequent visit to the Coney Island Museum, Couney had exhibited his incubators at multiple venues across the US — including for four decades at Coney Island.
“I could not imagine how this went on for 40 years,” Raffel said. “I thought, ‘I have to get to the bottom of this.’”
Doing so meant sorting through sometimes contradictory records of how Michael Cohn became Dr. Martin Arthur Couney.
He was born in 1869 in Krotoszyn, a central-Polish town which was then part of the Prussian Empire and home to a Jewish community — including the Bar Loebel Monasch Press, a publisher of the Jerusalem Talmud. This is one of several ways in which Raffel sees Couney’s narrative as “a very Jewish story.”
“In time I came to view him as a strange embodiment of [the Talmudic adage,] ‘If one saves a single life, it is as if one has saved the whole world,’” Raffel explained.
Couney’s unlikely journey began when he left his homeland for England to pursue a career as a carnival showman. The latest hit at London sideshows was a revolutionary new device, the incubator, invented by French doctor and engineer Alexandre Lion, building upon previous technology meant to give preemies the warm temperatures they needed to survive.
“It was such a wonderful invention,” Raffel said. “It was practically automatic, it required no special care.”
Lion was also a showman who exhibited his creation to audiences. His incubators gained international attention as carnival attractions in England and America. Soon Couney had immigrated to the United States, where in 1899 he made his midway debut in Omaha, Nebraska.
“In general, I think, people are fascinated by babies,” Raffel said. “You can’t upstage a baby. They were dolled up really cute. The newborns, babies made people feel good.”
While other showmen staged incubator exhibits in the US, Raffel described Couney — who by this time had become an American citizen with an inflated resume while experimenting with several name changes, likely to avoid anti-Semitism — as “the only one who stayed with it.”
The midway could be a hazardous environment. The incubator exhibit at the 1903 St. Louis World’s Fair was run by one of Couney’s competitors whose carelessness tragically led to the deaths of babies. And the babies in Couney’s own incubators got a miraculous rescue from the devastating Dreamland fire at Coney Island in 1911.
But Couney did his best to account for all factors– including the fact that while the incubators ran smoothly, they also required round-the-clock care.
“For him, the secret sauce was really the nurses,” Raffel said.
They were the ones who “really understood how to take care of preemies, how to feed them, which was really difficult,” she said. “They nurtured them. The premises were immaculate, which you did not find in hospitals.”
One particular nurse, Annabelle Maye Segner of Lafayette, Indiana, would become Couney’s wife in 1903. Raffel described her as “all-American” and “thoroughly lovely.”
Segner did the bookkeeping for her husband, and their daughter, Hildegarde, grew up to become a nurse herself — even managing one of her father’s incubator exhibits, in Atlantic City. The family prospered.
“He made a lot of money doing it,” Raffel said. “People were endlessly fascinated. The public was willing to come and pay to see the babies.”
Raffel noted that “the model of charging admission” was what supported the show. “It was not a nonprofit,” she said. “He was a complicated guy.”
Yet Couney did not charge the preemies’ parents.
“The parents [represented] all classes of people,” Raffel said. “Some had a fortune — one family owned the biggest hotel in Atlantic City. Some [preemies] were orphans. They were from all races, all classes.”
In general, the preemies he cared for had a “very high” survival rate, Raffel said.
“Towards the beginning, there were no statistics to back up his claims, but as the years went by, the 1930s and 1940s, doctors were documenting this,” she said, citing a 90 percent survival rate at the New York World’s Fair in 1939-40. (She noted that this excluded babies who had died in the first 24 hours after birth, “the most dangerous period.”)
Some hospitals experimented with incubators and other ways to keep preemies warm, Raffel said, but made errors such as not using breast milk. Couney’s methods did win some support — including from renowned Chicago pediatrician Dr. Julius Hess.
“They had a very unusual friendship,” Raffel said. “Dr. Hess was everything Couney wasn’t. He had real medical degrees, medical affiliations. He had a considerable impact.”
Hess designed three separate models of incubator technology and published a pioneering work in the US, Premature and Congenitally Diseased Infants. He was also unafraid of assisting Couney at the 1933-34 Chicago World’s Fair in an exhibit that “started national attention [towards the] care of premature children,” Raffel said.
In contrast, much of the American medical establishment of the era viewed preemies as unworthy of care. The book quotes a doctor writing in The Journal of the American Medical Association in 1916 that “incubators are passe,” proclaiming “It is a fact that practically all prematures entrusted to institution care die.”
An ominous shadow in the background was the pseudoscience of eugenics.
Raffel said that “eugenics never directly [addressed] preemies,” but rather represented “sort of an attitude — survival of the fittest, propagation of the superior, will these children be worth it? They were not a priority.”
She characterized the climate as “a bit hostile to babies who needed a little extra help and maybe would never grow up to be productive citizens,” noting that “eugenics were very well-funded in the US.”
And, she said, “The idea of a ‘degenerate’ family, maybe [that makes] you think of the Nazis. There’s a pretty clear link there. Many of the eugenicists were friendly with the Nazis. The Nazis were inspired by them.”
When World War II broke out, the Nazis brought their murderous methods and genocidal policy to Couney’s ancestral home. Krotoszyn’s 17 remaining Jews were deported to the Lodz ghetto in September 1939, the month in which the war erupted. Couney worked tirelessly to save members of his family from the Holocaust.
“Better than most, he understood what was about to happen, and he intended to rescue as many Jews as he could,” Raffel writes in the book.
Couney rescued between eight to 15 relatives — including his niece, Ilsa, who escaped Berlin in 1937 with her husband, Dr. Alfred Ephraim. Their daughter, Couney’s grand-niece Ruth Freudenthal, was interviewed by Raffel for the book.
As Couney helped relatives, he was also dealing with the tragedy of his beloved wife’s death during surgery. He would face financial ruin as well; having to do his own bookkeeping, he would incur staggering debts for his exhibit at the New York World’s Fair of 1939-40.
“Looking through the correspondence of the New York World’s Fair committee, the whole tone is of resentment, really, that he did not control his finances,” Raffel said. “He had no investors. It was all his own money.”
When Couney died a decade later, in 1950, his grave at Cypress Hills Cemetery in Brooklyn made no indication of his achievements. Today he is vindicated by the variety of resources available for preemies — and by the thousands of babies he helped save.
“They lived rich, full lives,” Raffel said. “Not anybody felt any resentment they were placed in a sideshow. They were grateful.”