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The
Death of Innocents:
by Jamie Talan and Richard Firstman OXOXOXOXOXOXOXOXOXOXOXOXOXOXOXOXOXOXOXOXOXO |
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It's the story of bad science and healthcare politics, how misconceptions about the cause of sudden infant death syndrome (SIDS) covered up a mother's murder of her own five children over a six-year span. It's an enormously frustrating real-life story, and not good bedtime reading. Each of Waneta Hoyt's infants died suddenly when they were home alone with her between 1965 and 1971, and it was assumed they all succumbed to SIDS. A Syracuse pediatric researcher, Alfred Steinschneider, MD, studied the last two infants and concluded that their deaths offered a possible answer to SIDS. He published a landmark paper in Pediatrics in 1972 that established a widely accepted theory of SIDS, launching multi-million dollar National Institutes of Health grants and the home apnea monitoring industry. The study's main message was that SIDS runs in families, and the only hope of prevention is to hook high-risk infants up to apnea monitoring systems at home. Only after a forensic pathologist in Dallas alerted a Syracuse prosecutor of her serious suspicions about the babies' deaths did an investigation begin. Yet there were others involved in the last two children's care who sensed something else was going on, but their opinions were not taken seriously. When Steinschneider was studying the fourth child, 2-month-old Molly Hoyt, she was hospitalized after her mother reported she had stopped breathing at home. Here's how the authors describe the situation: "The Hoyts' visits had trailed off to once every three or four days, and it seemed to the research clinic's head nurse, Thelma Schneider, that the baby was virtually motherless. In recent days, Thelma had been paying close attention to what she felt was a continuing divergence between Molly's physical condition and her emotional and mental development. She ate well, slept well, and gained weight on schedule. But her rosy cast was giving way to a certain dullness, and Thelma began entering these observations into the record. 'Child has little or no affect,' she wrote., 'Does not smile at people.'" Here is what Steinschneider entered into the medical record that day: "Does not appear to have much apnea during sleep and has continued to do well on ward. Will discharge today and plan on readmitting to CCRC in 2 weeks." Two days later, the baby was scheduled for discharge and the nurses were talking more openly, the authors say. "I just know something's going to happen," nurse Corrine Dower said to Schneider. "One of these times she's going to do it." Years later, Dower was scornful of Steinschneider. "If he had any brains at all, he would have seen that she didn't want the baby. You can tell in the grocery store if a person cares about their child. We were just disgusted with Steinschneider." Knowing that Molly would be going home in six hours, Thelma sat down at her desk and began to write her thoughts into the nursing record.' "I discussed my concerns for this baby with Dr. Steinschneider this a.m.," she wrote. "The interaction between mother and baby is almost nil in my opinion." The next morning, Waneta Hoyt called her mother-in-law. Molly was blue and not breathing. Twenty-five years later, in 1995, Schneider, Dower and another nurses testified for the prosecution in the Waneta Hoyt trial. Hoyt was convicted of murder and sentenced to 75 years to life in prison; Steinschneider is now president of the American SIDS Institute in Atlanta. It's a long book — 640 pages — but a riveting healthcare detective story. The lasting message is one every one of us should carry with us as we read research, news and theories, and as we observe patients and analyze symptoms. Even widely-accepted premises are sometimes dead wrong. Reviewed by Barbara Bronson Gray, MN, RN |
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