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The Death of Innocents: A True Story of Murder, Medicine, and High-Stake Science Paperback – October 6, 1998

4.5 out of 5 stars 76 customer reviews

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Editorial Reviews

Amazon.com Review

A rule of thumb in forensics: one dead baby is Sudden Infant Death Syndrome(SIDS); two dead babies is suspicious; three dead babies is murder. The Death of Innocents starts off a bit slow, but as soon as a new district attorney decides to pursue an old case of five siblings whose deaths were attributed to SIDS, the story kicks into high gear. There are two villains: the quietly furious mother who admitted to smothering her children--one of whom was 2 years old, and kicked and flailed as he died--and the arrogant medical researcher who was so eager to make a name for himself that he was willfully blind to the warnings of danger. Richard Firstman and Jamie Talan, a husband-wife team, write about abuse of the scientific method as suspensefully as they write about parental abuse of babies. The Death of Innocents was named a 1997 Notable Book of the Year by the New York Times. The NYT writes, The Death of Innocents "...seamlessly weaves the tales of the earlier and later murder cases, separated by two decades, with the complicated scientific and social issues, the many disparate personalities, documents, interviews and dramatic moments. The book is paced like a thriller, and it will be read like one." --This text refers to an out of print or unavailable edition of this title.

From The New England Journal of Medicine

So starts the 1961 Journal article "Slaughter of the Innocents: A Study of Forty-Six Homicides in Which the Victims Were Children" (L. Adelson. 1961;264:1345-49). This classical theme echoes throughout the accompanying grim editorial, "Murder in the Tower" (1961;264:1368-69). Thirty-seven years later, the same themes of passion, corruption, and the death of sweet children reverberate through the pages of The Death of Innocents: A True Story of Murder, Medicine, and High-Stakes Science.

The book opens with a gripping tale of the investigation into the deaths of the three Van Der Sluys siblings -- deaths that had been written off as due to accidental choking or the sudden infant death syndrome (SIDS). Ten years, three exhumations, and a dramatic trial later, the dogged determination of a group of tenacious law-enforcement officials was rewarded when a judge found the father of the children guilty of murder. He had suffocated the children for the life-insurance money. If the book had ended there, it would have been a better-than-average true-crime story, but it would not have been reviewed in the Journal. What makes this book appropriate for review in these pages is a piece of the medical literature itself.

In 1972, Pediatrics published an article that described five patients with abnormally prolonged periods of apnea, two of whom were siblings who eventually died of SIDS (A. Steinschneider. "Prolonged Apnea and the Sudden Infant Death Syndrome: Clinical and Laboratory Observations." 1972;50:646). In fact, those two children had three older siblings who had died. This paper provided support for the theory that prolonged apnea and SIDS are linked and hereditary, and it was carefully studied by the attorneys in the Van Der Sluys case. Just as they had been suspicious of the three deaths in the Van Der Sluys family, the prosecutors suspected foul play in the deaths of the five siblings. By coincidence, the Pediatrics paper originated from upstate New York, close to where the Van Der Sluys murders had occurred. After some clever detective work, the investigators identified the second family in the article as the Hoyts, and Mrs. Hoyt was eventually convicted of murder. She was a pathetic murderer, suffering from Munchausen syndrome by proxy. Contrary to the conclusions of the Pediatrics article, the children were victims of a serial killer, not a genetic disease.

Although they are the only murderers in the book, Mr. Van Der Sluys and Mrs. Hoyt are not the only villains. The authors, former reporters at Newsday, paint an ugly picture of the clinical investigators in the SIDS field. Starting with the 1972 Pediatrics paper, we are given a detailed description of scientists whose arrogance, ruthlessness, and lust for success prevented them from viewing either their data or their patients objectively. They are shown denigrating colleagues who criticized their interpretation of the data, ignoring the nurses who confronted them because of concern about the research subjects, and marginalizing members of the house staff who questioned the diagnosis and management of familial SIDS. As one of the investigators admits, "When you do research, you can easily be seduced into believing what you want to."

It is hard to judge how accurate this gruesome portrait is, although the authors are careful to document much of what they report in a very creditable fashion. I must admit that as a house officer in the early days of the familial SIDS flurry, I was too beleaguered to insist that the emperor did not seem to be wearing anything.

This book is a most absorbing way to be reminded of the pitfalls of clinical investigation and how to avoid them by involving a diverse research team and listening to their conclusions.

Reviewed by Orah Platt, M.D.
Copyright © 1998 Massachusetts Medical Society. All rights reserved. The New England Journal of Medicine is a registered trademark of the MMS. --This text refers to an out of print or unavailable edition of this title.


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Product Details

  • Paperback: 640 pages
  • Publisher: Bantam (October 6, 1998)
  • Language: English
  • ISBN-10: 0553379771
  • ISBN-13: 978-0553379778
  • Product Dimensions: 6.1 x 1.4 x 9.2 inches
  • Shipping Weight: 1.6 pounds
  • Average Customer Review: 4.5 out of 5 stars  See all reviews (76 customer reviews)
  • Amazon Best Sellers Rank: #905,272 in Books (See Top 100 in Books)

Customer Reviews

Top Customer Reviews

Format: Paperback
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.
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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
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When I first read this book some fifteen years ago, I threw it against the wall more times than I could count. Yes, because a woman had viciously killed her children, but also because of the malicious way in which Dr. Steinschneider was viewed. You see, I worked for Dr. Steinschneider in the late '80s and knew him as a kind and wonderful man who cared deeply about the children we were trying to help. Our offices weren't much--we could only see two children a day due to the time needed to perform a sleep study on the child and home care training for the parents. As one of two nurses on staff, we followed up with every patient(over 200 for the two years I worked there) every week as well as received calls from frantic parents terrified when the apnea monitor would alarm in the middle of the night.

It was a difficult job emotionally. And while I agree that Al was a proud man, he truly cared for those children. He didn't have much in the way of material things--his home was nice but nothing like the homes of ninety-nine percent of the doctors I knew. He drove an older model car and gave every appearance of the rumpled research doctor, rolled up sleeves and lop-sided tie. His wife volunteered in the office, helping wherever she could and making us lunch at least once a week. But we ran on a shoe-string budget--a far cry from the 'success' that's implied in the book.

Healtydyne's involvement in funding our research was widely known-- one of the founders of Healthdyne lost a son to SIDS in the early '70s and as a Ga. Tech graduate, came up with the apnea monitor to keep other babies from dying like his son. And the company did DONATE every monitor and recorder we supplied to the families who visited the clinic with their babies.
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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.
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