"Over all the years that followed, I found myself thinking from time to time of that picture, my hand over the baby's mouth. I knew then, and I still think now, that the right thing to do would have been to kill that baby."
Like a morbid time capsule from the mind of an elder New York psychiatrist, a report surfaced this week in which Dr. Fredric Neuman essentially confesses to criminal breaches of medical ethics. His essay "The Cyclops Child," which appeared on the website of the journal Psychology Today, recounts the dishonesty and cruelty surrounding the brief existence of a child with severe birth defects. Compounding the offenses detailed in the story itself, Dr. Neuman uses dehumanizing terminology -- referring to the infant as a "monster" -- and focuses disproportionately on the hardship endured by hospital staff, as opposed to the dying child (or "it," according to the author). An anachronism of some unadulterated views from a voice of the medicinal community circa 1960, "The Cyclops Child" is an offending document in itself.
I will summarize here the critical facts resurrected by Dr. Neuman, but please do read his entire essay as well. While he withheld the specifics, I estimate that the hospital was St. Vincent's (now closed), and the year was 1959 or 1960 (based on my review of his curriculum vitae). The essay -- which catalogues what would today be considered kidnapping, assault and possibly murder -- shocks our modern sensibilities. "As a person with disabilities, I find this entire post chilling," one of Dr. Neuman's readers wrote. "I hope the NY state medical board investigates the physicians involved and takes appropriate action," chimed in another.
Here's what happened. A mother gave birth to an infant with a fatal developmental defect called holoprosencephaly. Infants born today with this condition are almost unheard of, as most women will opt to abort the pregnancy when the condition is identified on an early ultrasound. Fifty years ago, women didn't have this option. They were treated by obstetricians who felt that they operated on a higher plane than the rest of us, paternalistically keeping information from patients and limiting options however they saw fit. In this case, the obstetrician decided the parents should not know that the baby was born with the condition. Instead, he and the rest of the team lied to the parents, telling them their baby was dead.
A word about this baby's condition, holoprosencephaly. As humans develop in the womb from a bundle of cells into distinct tissues and organs, the nervous system emerges from a structure called the "neural tube." In rare instances that doesn't form appropriately. In the case of holoprosencephaly, a defect in the neural tube occurs at the head, and various midline structures like the brain, eyes, and mouth may not fully form. In this case, Dr. Neuman describes the deformity using "cyclops" -- which is actually a valid medical term, but is used here outside of the appropriate pathological context -- in describing eye tissue that did not separate into two distinct eyes. It is disturbing that the term holoprosencephaly never occurs in his essay.
The baby is treated as an object and given no gender, referred to as "it." In the events that followed there is no indication that he received any palliative treatment, as would be the standard today (comfort care, including pain management).
The hospital staff expected and hoped that the newborn would soon pass away, but he did not. They left the child ignored in the back of the hospital nursery. Doctors and nurses waited for him to starve. An excruciating death watch followed that dragged on for about 13 days, as Dr. Neuman notes in the comments section of his piece. The child's cries anguished nursery staff who kept the dark secret. Dr. Neuman wrote:
"There was a price to be paid. Dying though it might be, the staff still had to tend to it, to change it, to clean it, to hold it in repeated attempts to comfort it. The baby was suffering, and so was everyone else. Earlier, I had caught an aide crying. A couple of nurses had stayed home that day. It was at that point that I began to think about killing the baby."
Dr. Neuman did not kill the baby. But he did torture him at the direction of his senior resident, who asked him to practice a finger amputation procedure on the child:
"The way you treat a baby's extra fingers is to tie a ligature, a string, as tight as you can around the base of the finger. The blood supply is cut off, and after a while the finger falls off.
When I went over to the baby, it was lying quietly in its bed. It did not object when I picked up its hand. But when I tied the ligature around its finger and pulled tightly, it screamed."
The newborn finally died. The parents of the child never knew of the suffering or the needless procedure. Dr. Neuman still believes he should have euthanized the child:
Over all the years that followed, I found myself thinking from time to time of that picture, my hand over the baby's mouth. I knew then, and I still think now, that the right thing to do would have been to kill that baby. It wasn't really a baby; it just sounded like a baby--that's what I tell myself. But I would like to stop thinking about it. After all, the whole thing happened over fifty years ago.
I'd compare Dr. Neuman's sickening tale to the work of Edgar Allen Poe, except that Dr. Neuman has not written a piece of creative fiction. This is the truth, we're told. So, has Psychology Today just published potential evidence in a trial for murder?
That's possible, but in no way probable, says Professor Martin Guggenheim of the New York University School of Law. Despite the fact that the statute of limitations doesn't run out on homicide, Guggenheim can't imagine a city prosecutor being interested in the case today. "Particularly because St. Vincent's is no more, I'd be more than a bit surprised if a prosecutor would do anything about this," Guggenheim says. All the other crimes - the kidnapping, the assault, the lies - are far too dated to be actionable.
Disability scholar Rebecca Garden, who teaches medical bioethics at Upstate Medical University, points out that despite the prevailing 1960's attitudes in this essay, deciding when life is worth living is still a contested issue. Disability rights advocates are still dealing with this on a daily basis. In this context, she feels Dr. Neuman's blog post is "distressing on many levels."
"This piece seems to be a complex and conflicted mix of confession, provocation, and defense or apologia," Professor Garden told me. Parts of "The Cylops Child" are written in the present tense. There is a passage where Dr. Neuman suggests that an obstetrician could smother such a baby. His observation that "such things happen" isn't confined to the past, Garden observes.
How can we fathom Dr. Neuman repeatedly describing this child as a monster? According to Laurence McCullough of the Center for Medical Ethics and Health Policy at Baylor College of Medicine, we're merely witnessing equally valid discourse from another era. Our modern scientific understanding that such developmental anomalies are errors of reproductive development derived from our evolutionary biology carries little human meaning, Prof. McCullough points out. A monster was considered "a portent sent by the Gods to punish transgression."
At least that's something people can somehow grasp and justify. "What may, at first, strike us as a wrong-headed or even repellent discourse of the past... turns out to have a distinct advantage over our own," McCullough says.
Though I would like to think of "The Cyclops Child" as a dusty artifact, it nonetheless appeared on my computer in 2012, from the mind of person living contemporaneously. I find myself trying to construct a narrative around it, to explain and contain it. Maybe Professor McCullough is right that "human scale" explanations at least offer us a framework to comprehend the things that distress us.
Alright, then. I'll believe the essay is a monstrosity published by the Gods to punish one doctor's fifty-year-old transgression.
Hillary Clinton’s realistic attitude is the only thing that can effect change in today’s political climate.
Bernie Sanders and Ted Cruz have something in common. Both have an electoral strategy predicated on the ability of a purist candidate to revolutionize the electorate—bringing droves of chronic non-voters to the polls because at last they have a choice, not an echo—and along the way transforming the political system. Sanders can point to his large crowds and impressive, even astonishing, success at tapping into a small-donor base that exceeds, in breadth and depth, the remarkable one built in 2008 by Barack Obama. Cruz points to his extraordinarily sophisticated voter-identification operation, one that certainly seemed to do the trick in Iowa.
But is there any real evidence that there is a hidden “sleeper cell” of potential voters who are waiting for the signal to emerge and transform the electorate? No. Small-donor contributions are meaningful and a sign of underlying enthusiasm among a slice of the electorate, but they represent a tiny sliver even of that slice; Ron Paul’s success at fundraising (and his big crowds at rallies) misled many analysts into believing that he would make a strong showing in Republican primaries when he ran for president. He flopped.
Thenew Daily Show host, Trevor Noah, is smooth and charming, but he hasn’t found his edge.
It’s a psychic law of the American workplace: By the time you give your notice, you’ve already left. You’ve checked out, and for the days or weeks that remain, a kind of placeholder-you, a you-cipher, will be doing your job. It’s a law that applies equally to dog walkers, accountants, and spoof TV anchormen. Jon Stewart announced that he was quitting The Daily Show in February 2015, but he stuck around until early August, and those last months had a restless, frazzled, long-lingering feel. A smell of ashes was in the air. The host himself suddenly looked quite old: beaky, pique-y, hollow-cheeky. For 16 years he had shaken his bells, jumped and jangled in his little host’s chair, the only man on TV who could caper while sitting behind a desk. Flash back to his first episode as the Daily Show host, succeeding Craig Kilborn: January 11, 1999, Stewart with floppy, luscious black hair, twitching in a new suit (“I feel like this is my bar mitzvah … I have a rash like you wouldn’t believe.”) while he interviews Michael J. Fox.
The championship game descends on a city failing to deal with questions of affordability and inclusion.
SAN FRANCISCO—The protest kicked off just a few feet from Super Bowl City, the commercial playground behind security fences on the Embarcadero, where football fans were milling about drinking beer, noshing on $18 bacon cheeseburgers, and lining up for a ride on a zip line down Market Street.
The protesters held up big green camping tents painted with slogans such as “End the Class War” and “Stop Stealing Our Homes,” and chanted phrases blaming San Francisco Mayor Ed Lee for a whole range of problems, including the catchy “Hey Hey, Mayor Lee, No Penalty for Poverty.” They blocked the sidewalk, battling with tourists, joggers, and city workers, some of whom were trying to wheel their bikes through the crowd to get to the ferries that would take them home.
I coined the term—now I’ve come back to fix what I started.
O reader, hear my plea: I am the victim of semantic drift.
Four months ago, I coined the term “Berniebro” to describe a phenomenon I saw on Facebook: Men, mostly my age, mostly of my background, mostly with my political beliefs, were hectoring their friends about how great Bernie was even when their friends wanted to do something else, like talk about the NBA.
In the post, I tried to gently suggest that maybe there were other ways to advance Sanders’s beliefs, many of which I share. I hinted, too, that I was not talking about every Sanders supporter. I did this subtly, by writing: “The Berniebro is not every Sanders supporter.”
Then, 28,000 people shared the story on Facebook. The Berniebro was alive! Immediately, I started getting emails: Why did I hate progressivism? Why did I joke about politics? And how dare I generalize about every Bernie Sanders supporter?
The country has experienced nursing shortages for decades, but an aging population means the problem is about to get much worse.
Five years ago, my mother was rushed to the hospital for an aneurysm. For the next two weeks, my family and I sat huddled around her bed in the intensive-care unit, oscillating between panic, fear, uncertainty, and exhaustion.
It was nurses that got us through that time with our sanity intact. Nurses checked on my mother—and us—multiple times an hour. They ran tests, updated charts, and changed IVs; they made us laugh, allayed our concerns, and thought about our comfort. The doctors came in every now and then, but the calm dedication of the nurses was what kept us together. Without them, we would have fallen apart.
Which is just one reason why the prospect of a national nursing shortage is so alarming. The U.S. has been dealing with a nursing deficit of varying degrees for decades, but today—due to an aging population, the rising incidence of chronic disease, an aging nursing workforce, and the limited capacity of nursing schools—this shortage is on the cusp of becoming a crisis, one with worrying implications for patients and health-care providers alike.
U.S. presidential candidates are steering the country toward a terror trap.
For close to a decade, the trauma of the Iraq War left Americans wary of launching new wars in the Middle East. That caution is largely gone. Most of the leading presidential candidates demand that the United States escalate its air war in Iraq and Syria, send additional Special Forces, or enforce a buffer zone, which the head of Central Command, General Lloyd Austin, has said would require deploying U.S. ground troops. Most Americans now favor doing just that.
The primary justification for this new hawkishness is stopping the Islamic State, or isis, from striking the United States. Which is ironic, because at least in the short term, America’s intervention will likely spark more terrorism against the United States, thus fueling demands for yet greater military action. After a period of relative restraint, the United States is heading back into the terror trap.
What happened when 11 exiles armed themselves for a violent night in the Gambia
In the dark hours of the morning on December 30, 2014, eight men gathered in a graveyard a mile down the road from the official residence of Yahya Jammeh, the president of the Gambia. The State House overlooks the Atlantic Ocean from the capital city of Banjul, on an island at the mouth of the Gambia River. It was built in the 1820s and served as the governor’s mansion through the end of British colonialism, in 1965. Trees and high walls separate the house from the road, obscuring any light inside.
The men were dressed in boots and dark pants, and as two of them stood guard, the rest donned Kevlar helmets and leather gloves, strapped on body armor and CamelBaks, and loaded their guns. Their plan was to storm the presidential compound, win over the military, and install their own civilian leader. They hoped to gain control of the country by New Year’s Day.
Bernie Sanders doggedly pursued his one big idea about reforming American politics, while Hillary Clinton detailed her many proposals for change.
With the New Hampshire primaries just days away, Democrats Hillary Clinton and Bernie Sanders met on a debate stage in Durham on Thursday. In their first one-on-one matchup, the duo seemed determined to illustrate Archilochus’s classic binary between the fox, who knows many things, and the hedgehog, who knows one important thing. Sanders knows that what the country needs—the only thing it needs—is a political and economic revolution. Clinton knows the country needs progressive policies on a range of matters and a pragmatic, realistic strategy to implement them.
That divide was clear from their opening statements, with Sanders immediately jumping to his familiar mantra about a rigged economy and a corrupt campaign-finance scheme. Clinton’s answer was not so laser focused, discussing a general need for the nation to “live up to our values in the 21st century,” and checking off not just the economy, but racism, sexism, and more. This split is not new, of course, but with Martin O’Malley off the stage and out of the race, and the Democratic contest tighter than ever, the division has never been so clear. It led to an unusually interesting debate, with the two candidates frequently addressing each other directly and delving into detail.
The Islamic State is no mere collection of psychopaths. It is a religious group with carefully considered beliefs, among them that it is a key agent of the coming apocalypse. Here’s what that means for its strategy—and for how to stop it.
What is the Islamic State?
Where did it come from, and what are its intentions? The simplicity of these questions can be deceiving, and few Western leaders seem to know the answers. In December, The New York Times published confidential comments by Major General Michael K. Nagata, the Special Operations commander for the United States in the Middle East, admitting that he had hardly begun figuring out the Islamic State’s appeal. “We have not defeated the idea,” he said. “We do not even understand the idea.” In the past year, President Obama has referred to the Islamic State, variously, as “not Islamic” and as al-Qaeda’s “jayvee team,” statements that reflected confusion about the group, and may have contributed to significant strategic errors.
A series of experiments in mice has led to what some are calling “one of the more important aging discoveries ever."
I'm looking at a picture of two mice. The one on the right looks healthy. The one on the left has graying fur, a hunched back, and an eye that's been whitened by cataracts. “People ask: What the hell did you do to the mouse on the left?” says Nathaniel David. “We didn't do anything.” Time did that. The left mouse is just old. The one on the right was born at the same time and is genetically identical. It looks spry because scientists have been subjecting it to an unusual treatment: For several months, they cleared retired cells from its body.
Throughout our lives, our cells accumulate damage in their DNA, which could potentially turn them into tumors. Some successfully fix the damage, while others self-destruct. The third option is to retire—to stop growing or dividing, and enter a state called senescence. These senescent cells accumulate as we get older, and they have been implicated in the health problems that accompany the aging process.