How the Coney Island Sideshow Saved Thousands of Babies
Before Neonatal Care in Hospitals, There Were Incubators at the Carnival
In 1920, a two–pound baby was deemed a “weakling” by the hospital and expected to die—hospitals did not have neonatal facilities. The story goes: the baby’s father wrapped the baby—her name was Lucille Horn—in a blanket, hailed a taxi outside the hospital, and headed to the sideshow at Coney Island. The baby’s twin had died at birth, and Mr. Horn was not willing to lose both of his children.
I learned this story three years after a season with America’s last traveling sideshow, the World of Wonders, is over. We had no babies in our sideshow—no cases of tiny infants beneath glass, no babies born with anatomical abnormalities floating in jars. We had knife-throwers, fire-eaters, and the world’s shortest daredevil. Though the specifics of the baby story were new to me, the fact that the sideshow provided a place where people who were not accepted elsewhere were taken in was not new to me at all.
When Lucille’s father arrived at Coney Island, a sign charging 25 cents admission was up over the door. Inside, all along the walls, preemie, teensy babies of every race and class were on display in steel and glass incubators. Some cried, others slept in a swaddle. The exhibit was run by Dr. Martin Couney. The medical community was more than skeptical. Along with the scientific skepticism was an unspoken ethical question: What lengths should we go to keep someone alive?
In the 19th century, babies that were born preterm, small, diseased, or seeming to lack energy were termed “weaklings.” Many physicians believed premature babies were the body’s way of expelling fetuses that weren’t up to snuff. In the late 19th century, 15 to 20 percent of babies did not reach 12 months. Many of those deaths were newborns.
French obstetrician Stéphan Tarnier built the first incubator, modeled after a chicken incubator he observed at the zoo. Though his design didn’t vary greatly from methods mothers were using at home—tucking hot water bottles into blankets surrounding their new baby—the very fact of paying attention to newborn mortality was a cultural shift, according to Dr. Jeffrey P. Baker in his article “The Incubator and the Medical Discovery of the Premature Infant.” Neonatal care simply didn’t exist; keeping a newborn alive, regardless of its health, was the responsibility of the mother. The first incubators were put into a Paris maternity ward in 1880. But it took 50 years before an incubator was a widely accepted component of neonatal care—and 50 years before hospitals would adopt them in the US. The first neonatal ICU wasn’t established until 1960 in the US. How did the medical community shift so drastically from a complete dismissal of incubators to a belief in their necessity? The public fell in love with the babies on display in a sideshow.
Dr. Martin Couney, who was born in France or Poland around 1860, studied with a disciple of Dr. Tarnier. Sent to the World Exposition in Berlin in 1896 to exhibit their latest incubator model, Dr. Couney first had the idea of displaying live babies in the incubators to ramp up the drama. The exhibit, know as the “child hatchery,” was wildly popular—though intended to be a serious scientific display, it soon turned into a massive crowd draw with great financial success. From there, Dr. Couney was invited to display his child hatchery in other fairs, exhibits, and amusement parks around the world, from South Africa to South America, with traveling wet nurses and a rotation of babies moving great distances. Eventually the exhibit found a permanent home at the Coney Island Sideshow. The show there ran continuously each summer from 1903 until 1943.
Dr. Couney adopted some of the principles P.T. Barnum had recently been using in his museum and touring shows. A key to sideshow success depended upon how an exhibit was framed—how the audience’s emotions were manipulated. Barnum, for example, cast public doubt on his own exhibits from time to time in order to encourage people to come find out for themselves whether something was authentic. For Dr. Couney and the Coney Island baby show, the celebration of innovative technology was as much on display as the fragile babies inside—too small for regular baby clothes, and wearing those meant for dolls. Like any good sideshow act, the person on display was fascinating to watch, and also inspired something else—a tinge of fear, in this case, that one’s own child might be so delicately on the precipice between life and death. Historically there were many people exploited in sideshows, but in the Coney Island baby show, the babies only survived because they were there. Painted on the outside of Coney Island’s exhibit was an explicit part of its framing device: All the World Loves Babies.
In 2016, the tiny baby girl who’d been rushed from the hospital to the sideshow, Lucille Horn, sat with her daughter to record their conversation for NPR’s Story Corps.
“How did your parents know about the incubators?” Lucille’s daughter asked her.
“They saw the exhibit on their honeymoon. You had to pay to go in. And the babies were all lined up . . . My father said I was so tiny he could hold me in his hand. [The hospital] didn’t have any help for me at all. It was just: you died because you didn’t belong in the world.”
After six months, Lucille had grown strong enough to leave the incubator and go home to her parents.
Dr. Couney funded his research by charging admission. Over his long career displaying the babies— from 1896 to 1940—they were shown anywhere he could find an audience. The money enabled Dr. Couney to keep the babies alive without cost to their parents. Hospital stays then, as now, were prohibitively expensive for some families, so even as the first few hospital-based options became available, many families couldn’t afford it. The New York Society for the Prevention of Cruelty to Children had repeatedly accused Couney of exploiting the babies and endangering their lives by putting them on show. But it was precisely the “putting them on show” that allowed for audience members to foot the cost of keeping the babies—6,500 of the 8,000 who came into his care—alive.
“How did the medical community shift so drastically from a complete dismissal of incubators to a belief in their necessity? The public fell in love with the babies on display in a sideshow.”
After a series of massive strokes left my mom paralyzed on one side and unable to communicate, we watched her physical, speech, and occupational therapy sessions like watching would manifest a miracle. A miracle was what we needed, what we were flailing and desperate for. Insurance would only pay for these therapies, for care in a facility, if she made measurable, consistent progress. If she couldn’t live in a hospital, she would have to live at home. Could she survive at home? Was she making progress? No. Yes. No. A little. Who knows.
When should we keep a person alive? How do we measure improvement?
An occupational therapist set a checkers board in front of my mom. Red and black tiles, red and black plastic pieces, sticky, smudged. “Oops, looks like we’re missing a few,” she said. “Shall we play anyway?” she asked my mom, who met her eyes a moment later. My mom opened her mouth, parted her lips and stretched them thin, then O’d her lips as if around a carrot, before closing her mouth again. She could not talk, but she tried and tried and tried.
“You go first,” the therapist said. My mom looked at her. The therapist mimicked the movement, sliding a black piece diagonally. My mom waited. Then, she picked the same piece up and put it back where it began. She liked order these days. She had been a painter, a little messy, a little wild, a hater of symmetry, bored by the obvious ways people patterned their lives. But in her new brain, order reigned. Perhaps it was to control the only thing it seemed she could control.
My mom set her finger on a checker and looked up at me. Her eyes were wide, blinking slowly, set in concentration. Then, she relaxed her brow and gave me her sweet, small, left-half smile. She couldn’t play checkers, but here it still was: her tenderness. She could stroke the side of my face when I lay down beside her in her hospital bed. She could hum.
My mom would not have survived her strokes and months of continued emergencies without aggressive, continued medical intervention. There is no direct equivalency between looking at a newborn baby, my 64-year-old mother, or my fellow sideshow performers. It is easy now to cast moral judgment on a society that didn’t fight for all babies to live, easy, too, for me to hold moments of sweetness with my mom after her stroke as perfect evidence of her right to life, but, of course, it’s never that simple. Before her stroke, she had written on her advanced directives “Do Not Resuscitate.” A few months after her first stroke, an infection in her brain led to septic shock. She died. She was resuscitated. I am wildly grateful. I am angry.
Sometimes we take the fire inside in order to be amazing, and sometimes a fire inside has already taken us. Sometimes the boundary between entertainment and injury is as fragile as new skin. Sometimes we look to make ourselves feel better about the fate that has befallen someone else, as a way to understand our bodies by defining what they are not.
Lucille Horn was not a baby who should have lived. She died at 96.
“The Care of Premature Infants: Historical Perspective,” Dr. Lawrence M. Gartner, Dr. Carol B. Gartner. Neonatal Intensive Care: A History of Excellence. A Symposium Commemorating Child Health Day. Sponsored by the National Institute of Child Health and Human Development. Originally presented October 7, 1985.
“Historical Perspective: The Incubator and the Medical Discovery of the Premature Infant,” Jeffrey P. Baker, MD, PhD. Journal of Perinatology 2000; 5:321–328 © 2000.
“The Man Who Ran a Carnival Attraction That Saved Thousands of Premature Babies Wasn’t a Doctor at All.” By Claire Prentice. Smithsonian.com. August 19, 2016.
“You had to pay to go in and the babies would be all lined up.” Lucille Horn and Barbara Horn. Story Corps, NPR. Originally aired July 10, 2015, on NPR’s Morning Edition.