Fighting for Life by S. Josephine BakerMy rating: 5 of 5 stars
"It’s six times safer to be a soldier in the trenches of France than to be born a baby in the United States.”
Foul weather and cancelled plans allowed me time to finish this most remarkable memoir by a pioneering woman doctor.
Dr. Sara Josephine Baker (1873-1945) was, by any account, extraordinary. She was the first director of the New York City Bureau of Child Hygiene, the first one in the US. Her work with the poorest of the poor, women and children, helped bring down the terrible infant mortality rate by more than half. Later on, governments of other countries (even Japan and China) would send their representatives to learn from her.
"Public health education...meant altering the living habits of an entire population."
She observed that infants from well-to-do families, despite being born in cleaner surroundings, nearly had a 50% mortality rate compared with babies born to tenement mothers. The reasons, she says, are because of immunity to disease and the lack of motherly, affectionate care given to richer babies.
Of particular interest to this teacher were her efforts on preventing school diseases, especially during the flu pandemic during World War I.
"The schools were kept open. All of the inspectors and nurses were assigned solely to the care of this one disease. Every morning every school was visited by one of the doctors and the children were given a hurried inspection. The children went directly to their classrooms when they arrived at the school and directly home when the school was dismissed for the day. No class came into contact with any other class. So far as humanly possible, we watched those children."
In the wake of another rise in Covid cases in my country, it's worth remembering what works: keeping classes in bubbles, avoiding unnecessary leisure trips, and good air circulation (Dr. Baker wrote a doctorate thesis on "The Relation of Classroom Ventilation to Respiratory Diseases Among School Children").
"The rate of absence from school on account of respiratory diseases (which means bronchitis and pneumonia) was 32 percent higher in the mechanically ventilated 68-degree rooms than in the open-window rooms kept at the same temperature, and 40 percent higher than in the open-window rooms kept at 50 degrees. In the mechanically ventilated, 68-degree classrooms the incidence of common colds was 98 percent higher than in open-window 68-degree rooms and about 70 percent higher than in the 50-degree rooms."
This 1939 book fascinates, especially the chapter on her 1934 trip to the Soviet Union where she saw hospitals with many entrances, where patients entered via one of many doors leading to a possible isolation room and were examined before being allowed to walk in the main hallway. She also saw abortions being performed for free (this was before the state reversed its policy) and without anesthesia!
While much is outdated (medical techniques and medicines in vogue), a lot of her observations are strangely still relevant today.
On the perils of specialism: "Today, a patient has virtually to make his own diagnosis of his ailment before knowing what doctor to choose to treat him. Specialism is rampant."
On the dangers of labelling: "Ordinary child “badness” was not considered to be a pathological condition then. Nowadays if a child is anything but a little robot he is taken to a child psychologist to have the cause discovered. The net result is that mothers are unduly apprehensive and children are watched so closely that the tension is disastrous for both... Overanxiety on the part of mothers is extremely bad for children who find themselves the focus of this anxiety."
A lot of her work as a public health minister entailed working with government officials, corrupt and incorruptible alike. The evil apathy of some were simply appalling, as this transcript from a congressional hearing shows:
“We oppose this Bill because, if you are going to save the lives of all these women and children at public expense, what inducement will there be for young men to study medicine?”
“Perhaps I didn’t understand you correctly. You surely don’t mean you want women and children to die unnecessarily or live in constant danger of sickness so there will be something for young doctors to do?”
“Why not? That’s the will of God, isn’t it?”
I can't recommend this short read highly enough to anyone interested in children, public health, and the suffrage movement. Dr. Sara Josephine Baker is such an inspiration!
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