How does parenthood change when infant and child mortality affects all families in society? Recent history may provide an answer. Throughout the 19th century, infant mortality was ubiquitous. In 1880, nearly 35% of children born in the United States died within their first five years. The medical literature that explores common illnesses and public health inadequacies, while vast, often fails to answer the central humanistic questions surrounding such widespread death. How were these children mourned? How have bereaved families evolved? And how has this grief changed in the context of the last hundred years of medical progress?
These guiding questions prompted Dr. Perri Klass, professor of journalism and pediatrics at NYU, to write her recently published book, “The Best Medicine: How Science and Public Health Gave Children a Future.” A distinguished clinician, author, and medical historian, Klass explored leading artistic and literary works from this era of high infant and child mortality at the recent Trent Humanities in Medicine lecture at the Duke School of Medicine, titled “A Chair vacant: remembering the children”. .
Throughout the lecture, Klass guided the audience through famous portraits, poems and prose produced in the 18th century that commemorated children who died in infancy. Perhaps the most famous fictional account of infant death in the 19th century appeared in Uncle Tom’s Cabin by Harriet Beecher Stowe. The emotionally harrowing death scene of young Eva, who succumbed to tuberculosis, struck a chord with virtually everyone who read the novel. Published in 1852, Uncle Tom’s Cabin would continue to be replicated in theaters across the country for several decades, with the death scene becoming a ubiquitous anchor that often brought audiences to tears. Klass further described how Beecher Stowe drew on her personal experience, the death of her son Charlie from cholera just a few years before she wrote the book, to create this powerful literary scene.
Beecher Stowe was not the only author whose personal experience had an impact on his art. Charles Dickens, deeply touched by the deaths of his children, had created a multitude of sentimental but deadly child characters in his stories. One of the most prominent examples, the young Nell of “The Old Curiosity Shop”, was released in installments and developed a strong following. Dickens ended the series with the death of twelve-year-old Nell, much to the chagrin of international readers.
It is perhaps unsurprising that parents have chosen to commemorate their deceased children through literature and art. Wealthy families often hired famous portrait painters to portray their deceased children. Some, including the Rockefellers and the Stanfords, channeled the deaths of their children and grandchildren to well-resourced academic institutions.
That grief drives philanthropy and art is not a new phenomenon, but the sources of grief that drive such artistic and financial overtures today have changed significantly. Klass sought to bridge this knowledge gap and bring closer the history of which society is privileged to be unaware. Maybe it would even shed some light on how we deal with youth mortality today.
“How do we situate ourselves in a world where infant and child mortality is so low? Klass asked at the start of his presentation.
The past does not reveal a clear answer, but it does provide a tapestry of options, many of which are lost in our modern collective memory, for mourning, celebrating and commemorating.