The New York Times
Is This a Good Time to Be Born? Comparatively Speaking, Yes
By Christie Watson
Oct. 13, 2020, 5:00 a.m. ET
A GOOD TIME TO BE BORN
How Science and Public Health Gave Children a Future
By Perri Klass
“A Good Time to Be Born” is an ambitious, elegant meditation on what the doctor-writer Perri Klass describes as one of our greatest human achievements: a reduction in child mortality. She begins by reminding us that “we are the luckiest parents in history”; for the first time in human memory, early death of children is now the exception, not the norm. Klass goes on to explore the toll taken in previous eras by measles, tuberculosis, diarrhea and other, now preventable, illnesses — and also the art that grew from such pain. She describes how scientific advances that led to the reduction of child mortality have shaped culture, transforming parenting, medicine and the way we live now.
The book is divided into three sections: “The Desolation of That Empty Cradle,” “The Birth of a Great and New Idea” and “What Marvelous Days” (from a 1902 speech by Mary Putnam Jacobi, a champion of women’s health, describing the birth of her first child). Chapters are punctuated with nursery rhymes, paintings, newspaper clippings, letters and photographs — all shining a light on advances in clinical medicine and science alongside the meaning of childhood. Klass also examines “Peter Pan,” “Jane Eyre,” “Little Women” and “Uncle Tom’s Cabin” through this lens.
The politics of health care are another undercurrent throughout “A Good Time to Be Born.” Klass describes inequality and racism with a quiet, powerful rage that underscores the shameful political truths that continue during our contemporary plague: “As we have watched the Covid-19 pandemic sweep the world, we have learned again the hard lesson that this new virus, like old infections, does more damage among the poor, among minorities, among immigrants and refugees, among people who are kept on the margins.” She reminds us that “racism continues to blight the health and growth of children in many different ways,” and then highlights continued disparities in medicine.
In the acknowledgments of this book is an almost apologetic disclaimer that Klass does not consider herself a historian or expert in any sense — yet she clearly is an expert in narrative and in medicine. In “A Good Time to Be Born,” she takes the most complex human patterns of all — history, medicine, politics, art — and knits them into something unique and beautiful.
I did find myself wanting more of Klass’s own story, both the sorrow and hope of a doctor’s work. But this is not a memoir, so she cedes her time to other trailblazing doctors like Rebecca Crumpler, Mary Putnam Jacobi and Josephine Baker. Klass also shows respect to the nurses, public health advocates and scientists who revolutionized medicine with vaccines, sanitation and antibiotics. This is an important book for many reasons, but that Klass has given voice to the voiceless is perhaps the most significant.
Good doctors — and good writers — understand the importance of what is not said. I fear the fallout of Covid-19 may change the landscape of child mortality, placing stress on the economy, international security and the state of mental health. We seem poised to fall backward — and, to this end, Klass’s conclusion, “The Promise of Safety,” feels like a warning. From start to finish, her book reminds us what it means to survive, and just how precious and precarious a state that is. With the long-term effects of the pandemic and current threats to democracy and climate change, whether or not it really is a good time to be born remains to be seen.
Christie Watson is a retired nurse and the author of “The Language of Kindness.” She is a professor of medical and ethical humanities at the University of East Anglia.
September 15, 2020
A GOOD TIME TO BE BORN
How Science and Public Health Gave Children a Future
Author: Perri Klass
Review Issue Date: September 15, 2020
Online Publish Date: September 1, 2020
Price ( Hardcover ): $28.95
Publication Date: October 13, 2020
ISBN ( Hardcover ): 978-0-393-60999-8
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.
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.)
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, “The Checkup” 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.
Reviewed by Margaret Henderson, Ramona, CA , Oct 01, 2020