Customer Reviews

The Death of Innocents: A True Story of Murder, Medicine, and High-Stake Science

5 star:		(25)
4 star:		(3)
3 star:		(2)
2 star:		(1)
1 star:		(0)

 

 

This book was <<an epistemological adventure--how do we know what we know?--as well as a study of crippling ambition, a detective story, a courtroom drama, and a showcase for superb research and organization>> according to Frederick Busch, who reviewed it for The New York Times.

The quote above just about says it all. The book read like fiction and was carefully detailed. All of the medical terminology was easily understood and thoroughly explained. The authors stated that the theme of the book is "the emotionally-charged intersection of SIDS and infanticide."

Almost all of what we have known of Sudden Infant Death Syndrome (SIDS) for the last 20 years was based on work done by Dr. Alfred Steinschneider in upstate New York. His findings were based primarily on two children (Molly and Noah Hoyt) who died while under his care in the early 1970s, following the deaths of three of their siblings in previous years. Steinschneider thus "determined/concluded" that SIDS was familial and caused by apnea (pauses in breathing while sleeping). To combat these deaths, he pushed the use of home monitors for babies who were considered "at risk". His landmark paper in 1972 in The Journal of Pediatrics shaped medical thinking for the next 20 years. Yet he had used only a tiny sample and had no control group. This article and subsequent ones cleared peer review committees despite obvious flaws. He arranged facts to fit his theory over the next years. His fundamental deception/fabrication was that apnea episodes were documented in the hospital for the two children who died --but there was NO documentation!! In fact, Steinschneider had repeatedly ignored concerns of the pediatric nursing staff about the mother, Waneta Hoyt.

I found it incredible that a hypothesis was presented and accepted by the medical community based on only 5 cases and 2 deaths! I think this shows how desperate people were for a quick way to predict and prevent SIDS. Because of the prevalence and acceptance of this theory, Munchausen Syndrome by Prozy (when a parent, usually a mother, harms or kills a child, usually to get attention) was rarely considered when a very young child died.

In the next 20 years, the monitor business became a multi-million dollar business and many people got rich from it. Steinschneider himself never owned stock in any monitor company, but his research was underwritten by one of them, Healthdyne, whose fortunes then became dependent on the doctor's continuing research findings about apnea. A vicious circle! Also, leading SIDS researchers conducted seminars, which were funded by Healthdyne grants, then gave out information on monitors to the participants.

What particularly disturbed me was the fact that Dr. David Southall, from England, had refuted Steinschneider's theories and proven them to be false with very extensive research of his own But until the 1986 Apnea Consensus Conference, no one appeared to listen to him. This conference was the first time that Steinschneider's theory was formally investigated or questioned by an official group of his peers.

In the early 90s, a coincidental series of events led a district attorney in upstate NY to begin investigating the deaths of the Hoyt children. This led to the 1994 arrest and conviction of Waneta Hoyt for the murder of all five of her children. The authors make it clear that not only was the mother on trial for murder, but that Steinschneider's theory was also on trial.

The trial's outcome demonstrated that the entire premise for SIDS for the last 20 years was false. In the words of several prominent pediatric forensic specialists: if there is one infant death in a family, it is probably SIDS. Two deaths should be considered suspicious. Three deaths are homicide.

What was especially shocking to me was the information in this book about Massachusetts General Hospital's SIDS program. Mass General had positioned itself as "the" place to bring babies thought to be "at risk" for SIDS. Yet the program, run by Drs. Kelly and Shannon, disciples of Steinschneider, was governed by a false, 20- year-old theory. The pediatric department had had a long history of ignoring suggestions of child abuse, some of it fatal, when a young doctor named Tom Truman arrived for a research fellowship in pediatric critical care. Truman secretly investigated all of the deaths of children who were "at risk" and found that in 155 deaths which occurred after multiple "events" (instances of unconsciousness, etc.), Munchausen Syndrome by Proxy was never considered, even in one family when the "events" stopped after the children were placed in foster care.

The authors said: "In the Shannon-Kelly team, some [abusive] mothers found the allies they needed. In their babies, the doctors found the data they needed. Locked in this symbiosis, Mass General appears to have become a Munchausen haven, while contaminating the research of SIDS with highly dubious data."

I would highly recommend this book not only for its interesting subject matter but because it was so well done. The meticulous and documented research was presented in a scholarly yet easily-understood manner.

Pediatricians as well as clinical researchers will not only enjoy this book but will find that it will help them in their practice. Arrogance in the practice of medicine as well as research continues to be as much a problem today as it was during the 20 year span that events of the book were described. We as medical researchers must constantly question our own research as well as that of others. I have made this book required reading by the pediatric residents I work with. It has provoked great discussions with my peers as well as my students. It is a great narrative of a tragedy and easy to read by those in the field as well as the lay public.

Ron Sklar M.D. Portland, Oregon

I can't say enough how much I enjoyed this book. I came across a mention of the Hoyt family and this book while reading Michael Kelleher's "Murder Most Rare" (another really good read), and decided to order it. From page one, I was hooked.
It starts with a case of familial infanticide, then explores the earlier Hoyt case that was so important. The best part about the book is when the authors leave the Hoyt case and take us on a detailed tour of the history of SIDS and apnea. The very scientific and potentially dry discussion of research projects is told in a way that leaves you with the feeling that you really understand what is going on in the SIDS research arena, and you also feel like you know each player in this community. When the story turns back to the Hoyt case and its conclusion, the reader fully undertands the what, why, and how of the events. Without the exploration of the history of SIDS, the ending of the story would have much less impact. I didn't realize until I was finished just how personal the book had become for me. I went immediately online to Amazon and typed "Munchausen by Proxy" in the search bar.

I am a Crown Prosecutor (i.e. District Attorney) in Australia, and this is the best, the very best, true crime book that I have ever read. I couldn't put it down. I was so upset when I had finished it.

Death of Innocents is a compelling non-fiction that opens the eyes of the reader. The authors have painstakingly laid out the subject of infantcide by parent. They show the growth of SIDS in the medical community as SIDS becomes the answer for all deaths of infants under one year. We find out that some of our true doers of justice just cannot be convinced that particular cases after extreme and lengthy investigaton can be diagnosed as SIDS or of other organic causes. This book is a must read for anyone who is interested in finding out some of the history and causes behind death of infants.

You'll start reading this and get a tale of many cities - it's not a true crime story, it's a stunning cultural tour of science, emotions, fads, murder and self promotion. Like all the other reviews say, it's a lengthy book - the first 100 fly, then you'll slog through another 100 or so but then it will fly and rivet your attention. Read it and then think about the latest flaps about autism, gulf war syndrome, whatever - you'll really get a sea change in views. I'd give it five stars but for the following reasons - 1) the "sag" in the second 100 pages and 2) the authors seem give blank acceptance to some people and statements and partially reconstruct some conversations, 3)They question multiple SIDS deaths in one family (murder?) but shy hard away from the single death, and never challenge the emptiness of the either the SIDS diagnosis or murder presumption (i.e. calling a death SIDS simply because there's no explaination or calling multiple deaths in one family probable murder because SIDS "doesn't run in families"). But still an excellent book - highly recommended.

I recommend this book to true-crime enthusiasts; pediatricians, family physicians, nurses and anyone engaged in health care delivery; to health policy and health research technocrats; to social workers; to law enforcement professionals; and to anyone who wants to understand how mothers can smother their infant children ? and almost get away with it. It is a journalistic treatment of what has become to be know as "Munchhausen Syndrome by Proxy," where mothers surreptitiously inflict harm on their children to gain the comforting attention of their physicians and others. This story was the basis of a "Sixty Minutes" segment aired around 2001.

Story starts with the prosecution of Stephen Van Der Sluys for the death of his 16-month-old son in Upstate New York in 1977, asserting that the death was due to deliberate smothering by a parent and not the medically fashionable "Sudden Infant Death Syndrome." The "SIDS" Syndrome had considerable medical support. A National Sudden Infant Death Syndrome Foundation existed to increase general awareness, and the selling and use of breathing monitors for sleeping infants had become a big business. But prosecution expert Linda Morton, forensic pathologist from Dallas had seen many cases of child abuse that family physicians overlooked or attributed to SIDS. How many more cases of murder had been explained away by SIDS? And is SIDS something that can "run in a family"?

"Death Of Innocents" goes on to tell the disturbing story of the family of Waneta and Timothy Holt in which several infant children died SIDS-classifiable deaths occurred -- always privately when only Waneta Holt was alone with them. In 1994, Waneta Holt was tried for murders committed two decades earlier. The prosecution represents a case of law examining science. Alfred Steinschneider, M.D., Ph.D. had made a career out of SIDS and a portion of the data in one of his articles in a scientific journal had described the Holt family. Although the identity of the "SIDS" infant patients was masked, prosecutors were able to identify the cases from public health records. The discovery, case-building and trial make exciting reading. And beyond this, the story is fascinating because it is a case of Law correcting Science. Although many scientific experts had assumed that SIDS can "run in a family," there was no unimpeachable scientific evidence for this based on "near miss" SIDS episodes recorded be sleep/breathing monitors under controlled circumstances. The "scientific conclusion" of SIDS running in families was based more on assumption than on hard science or high epistemological standards. One expert's assumption became a mass of experts' unexamined opinions. The appearance of Dr. Steinschneider as a defense witness put his science on trial.

Firstman and Talan's "Death Of Innocents" is a truly momentous story. And like a mountain, their story can be viewed from its many aspects -- medical, scientific, legal and social. It is many stories -- of an attention-starved loser who kept killing her babies, of prosecutors who were not afraid to take on "medical scientists" and of the growth and modification of a medico- scientific theory. Firstman and Talan have produced an authoritative chronicle and encyclopedic work which will stand up to scrutiny from all directions.

The important take-home message from this book is that SIDS is, indeed, a natural and infrequent phenomenon. It can be a valid explanation for the loss of one infant in a family. But when a family loses a second infant to apnea (cessation of breathing), the circumstances must be examined very carefully.

This is a masterpiece -- possibly the finest true crime book I've ever read. One reads it with the sense of mounting horror that I usually associate with the Greek tragedies. Simply magnificent -- and devastating.

This book is a must for anyone interested in epidemiology, SIDS, junk science or public policy. It is thoughtful, interesting (even thrilling), and meticulously reported. I was so intrigued by this book that I went to the library and dug up the seminal article upon which much of SIDS junk science is based. It's amazing to me that an article that seems so scientific could be so misleading. That, I think, is one of the major points of this book: Don't be dazzled by fancy statistics and graphs. Ask the "stupid" questions. Use your common sense. Very highly recommended.

Truth certainly is more strange than fiction, and the authors have managed to capture an incredible story. Additionally, to their and their editor's credit, the book has not been 'dumb-downed' to be an easy read. Instead, it is a well-written, succinct yet thorough account of poor scientific method combined with the political and personal biases which we sometimes blindly pretend don't exist in the police, judicial, and our own social systems. The reader will be both outraged and satisfied. An eye-opener which won't insult your intelligence.