"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.
Passengers on a domestic flight deplaning in New York were asked to present ID by Customs and Border Protection agents—a likely unenforceable demand that nevertheless diminishes freedom.
American citizens had their introduction to the Trump-era immigration machine Wednesday, when Customs and Border Protection agents met an airliner that had just landed at New York’s JFK airport after a flight from San Francisco. According to passenger accounts, a flight attendant announced that all passengers would have to show their “documents” as they deplaned, and they did. The reason for the search, Homeland Security officials said, was to assist Immigration and Customs Enforcement in a search for a specific immigrant who had received a deportation order after multiple criminal convictions. The target was not on the flight.
After days of research, I can find no legal authority for ICE or CBP to require passengers to show identification on an entirely domestic fight. The ICE authorizing statute, 8 U.S.C. § 1357, provides that agents can conduct warrantless searches of “any person seeking admission to the United States”—if, that is, the officer has “reasonable cause to suspect” that the individual searched may be deportable. CBP’s statute, 19 U.S.C. § 1467, grants search authority “whenever a vessel from a foreign port or place or from a port or place in any Territory or possession of the United States arrives at a port or place in the United States.” CBP regulations, set out at 19 C.F.R. § 162.6, allow agents to search “persons, baggage, and merchandise arriving in the Customs territory of the United States from places outside thereof.”
The president has long toyed with the media, but the stakes are much higher now.
American presidents have often clashed with the press. But for a long time, the chief executive had little choice but to interact with journalists anyway.
This was as much a logistical matter as it was a begrudging commitment to the underpinnings of Democracy: News organizations were the nation’s watchdogs, yes, but also stewards of the complex editorial and technological infrastructure necessary to reach the rest of the people. They had the printing presses, then the steel-latticed radio towers, and, eventually, the satellite TV trucks. The internet changed everything. Now, when Donald Trump wants to say something to the masses, he types a few lines onto his pocket-sized computer-phone and broadcasts it to an audience of 26 million people (and bots) with the tap of a button.
When President Obama left, I stayed on at the National Security Council in order to serve my country. I lasted eight days.
In 2011, I was hired, straight out of college, to work at the White House and eventually the National Security Council. My job there was to promote and protect the best of what my country stands for. I am a hijab-wearing Muslim woman––I was the only hijabi in the West Wing––and the Obama administration always made me feel welcome and included.
Like most of my fellow American Muslims, I spent much of 2016 watching with consternation as Donald Trump vilified our community. Despite this––or because of it––I thought I should try to stay on the NSC staff during the Trump Administration, in order to give the new president and his aides a more nuanced view of Islam, and of America's Muslim citizens.
Long after research contradicts common medical practices, patients continue to demand them and physicians continue to deliver. The result is an epidemic of unnecessary and unhelpful treatments.
First, listen to the story with the happy ending: At 61, the executive was in excellent health. His blood pressure was a bit high, but everything else looked good, and he exercised regularly. Then he had a scare. He went for a brisk post-lunch walk on a cool winter day, and his chest began to hurt. Back inside his office, he sat down, and the pain disappeared as quickly as it had come.
That night, he thought more about it: middle-aged man, high blood pressure, stressful job, chest discomfort. The next day, he went to a local emergency department. Doctors determined that the man had not suffered a heart attack and that the electrical activity of his heart was completely normal. All signs suggested that the executive had stable angina—chest pain that occurs when the heart muscle is getting less blood-borne oxygen than it needs, often because an artery is partially blocked.
John Krakaeur, a neuroscientist at Johns Hopkins Hospital, has been asked to BRAIN Initiative meetings before, and describes it like “Maleficent being invited to Sleeping Beauty’s birthday.” That’s because he and four like-minded friends have become increasingly disenchanted by their colleagues’ obsession with their toys. And in a new paper that’s part philosophical treatise and part shot across the bow, they argue that this technological fetish is leading the field astray. “People think technology + big data + machine learning = science,” says Krakauer. “And it’s not.”
Two of the world’s three richest people extol the virtue, and relevance, of optimism in the age of Trump—and predict a comeback for fact-based discourse.
Bill Gates, the world’s richest man, and Warren Buffett, the third richest, are—not entirely coincidentally—two of the most unremittingly optimistic men on the planet. So when I met the two of them in New York recently to talk about the state of humankind, and about the future of American democracy, I had a clear understanding of my mission, which was to pressure-test their sanguinity at every turn.
I tried, and failed, though not completely. Both men appear to doubt some of President Trump’s innovations in rhetoric and policy. Both men have warm feelings about immigrants, and also about facts, and so are predisposed to react skeptically to recent developments in the capital. When I asked whether they believed America needed to be made great again, Buffett nearly jumped out of his chair: “We are great! We are great!” And when I asked about the Trump Administration’s problematic relationship with empiricism, Gates said, “I predict a comeback for the truth.” He went on to say, “To the degree that certain solutions are created not based on facts, I believe these won’t be as successful as those that are based on facts. Democracy is a self-correcting thing.”
Some data gathered from travelers going through customs can stay in a Homeland Security database for 75 years.
When you cross into or out of the United States, whether in a car or at an airport, you enter a special zone where federal agents have unusual powers to search your belongings—powers they don’t have elsewhere in the country. The high standard set by the Fourth Amendment, which protects people against unreasonable searches, is lowered, and the Fifth Amendment, which guards against self-incrimination and prevents the government from demanding computer passwords or smartphone PINs, is rendered less effective.
These special rules allowed a customs officer at the Houston airport to ask a NASA engineer to give up the passcode to his smartphone last month. The engineer, Sidd Bikkannavar, was reentering the U.S. after a two-week vacation in Chile, but the device he had on him belonged to his employer, NASA’s Jet Propulsion Laboratory. He routinely used the smartphone for sensitive work, so losing sight of it for a half hour was a “huge, huge violation of work policy,” Bikkannavar told me.
In an era when audiences are so sure about so much, the mistake—simple, dramatic, human—can be a wonderful thing.
Last year, the comedian Marc Maron brought the author Chuck Klosterman on as a guest on his WTF podcast. The two discussed many things (including Klosterman’s then-new book, But What If We’re Wrong?, which he was there to promote), but one of them was sports—and the particular thrill that they offer to audiences. Sporting events, Klosterman argued, promise that most dramatic of things: an unknown outcome. Unlike other widely watched events—the Super Bowl halftime show, the Grammys, the Oscars—the primary selling point of sporting events is that their endings are, by definition, unpredictable. Within them, anything can happen.
Well. While you can say a lot about the Oscars on Sunday, you can’t say that the glitzy awards show was boringly predictable. The 89th Annual Academy Awards ceremony, right at its conclusion, brought a mixture of confusion and shock and full, deep delight to its viewers as Warren Beatty and Faye Dunaway teamed up to announce the Best Picture winner and proceeded to, because of a backstage flub, announce the wrong movie. Chaos—and really, really good TV—ensued. Tired East Coasters were summoned back to their living rooms from their bedrooms, on the grounds that “ohmyGodyou’veGOTtoseethis.” Twitter erupted with jokes—about Bonnie and Clyde being at it again, about Schrödinger’s envelope, about “Dewey Defeats Truman” getting an Oscars-friendly update. It was late on a Sunday evening, and the unexpected had happened in the most unexpected of ways, and the whole thing was, as my colleague Adam Serwer perfectly summed it up, Moon-lit.
Did the prank with “Gary from Chicago” and his band of tourists humble Hollywood—or just condescend?
If the last-minute twist at the Oscars was seen to echo all the last-minute twists in American culture lately—the Super Bowl, the election—a silly five-minute segment earlier in the night should be noted for what it captured about the country’s ongoing tensions and tastes in iPhone peripherals.
Host Jimmy Kimmel’s team arranged for a sightseeing bus of supposedly “real” tourists to walk into the room, expecting a museum exhibit about the Oscars but instead finding themselves in the middle of the actual thing. “Welcome to the Dolby Theater,” Kimmel announced. “This is the home of the Academy Awards, which are, in fact, happening right now.”