English Literature

Dr. Bergman in his book The Discovery of Sudden Infant Death Syndrome Lessons in the Practice of Political Medicine discusses and explains why it took so long for the public and the medical community to accept Sudden Infant Death Syndrome as a legitimate disease rather than as an unknown type of accident.  Historically, this type of death has had three main characteristics.  These characteristics were that the infant deaths were not expected because there were no prior health warnings, the deaths happened quickly, and there seemed to be no valid medical reasons for the deaths.  Somewhat morbidly, these types of deaths were often referred to in the past as crib deaths because they typically involved infants younger than one year of age and many actually occurred in a babys crib.  The most frightening aspect of this type of death was the fact that it constituted the second most common cause of death among infants an additional frightening aspect was the simple fact that there existed no verifiable medical explanations.  Worse, because there were no medical explanations, these numerous deaths were effectively classified and treated as accidents rather than the result of specific causes that might be identified and addressed to prevent more deaths.  This is the main topic of Dr. Bergmans book about discovering Sudden Infant Death Syndrome.  More specifically, he details the lengthy academic and political battles waged by doctors and public health professionals to classify these infant deaths as a real medical condition rather than as accidents that could not be prevented.  This battle was important because it made available public and private funds for education programs and further research.  This battle to recognize crib deaths as a legitimate medical condition has yielded some positive results.  While many infants still die in unexpected and sudden ways, these types of deaths are no longer completely unexplained as was true in the past.  Instead, recent research studies have identified potential causes that might lead to prevention techniques and pre-death interventions. 

    Statistically, as Dr. Bergman notes, these deaths are truly a public health crisis worthy of further attention and public funding for research.  He states, for example, that
Sudden infant death syndrome (SIDS), commonly known as crib death, claims between 6,000 and 7,000 babies a year in the United States. It is responsible for between 2 and 3 deaths out of every 1,000 live births. After the first week of life, where deaths associated with prematurity predominate, SIDS is the most important single cause of death of infants under 1 year of age
 
    Given these statistics, and the fact that these deaths involved the most vulnerable population among human beings, one would guess that finding the causes would have been a public health priority.  Sadly, as Dr. Bergman points out throughout the book, this was not the case.  More puzzling, both politicians and policy makers did not seem very interested in these crib death statistics.  As a consequence, and Dr. Bergman details a series of public education campaigns and government lobbying efforts, it was left to a few dedicated academics, public health professionals, and grieving parents to fight in order to get these deaths recognized as a legitimate disease and public assistance.  The author implies that these deaths were not as profitable as diseases such as cancer or AIDs and that this cynical profit orientation may have been one reason why politicians neglected these infant deaths.  Drug companies, after all, could not sell drugs for a disease for which there were no known causes and they had little economic incentive to press politicians to fund research for a disease that many deemed a series of tragic accidents.  This is the ironic nature of the books title, suggesting a discovery of Sudden Infant Death Syndrome, because there was no discovery but a push for public officials to discover this disease in the form of a formal acknowledgement that would open up funding and support for public health professionals and families. 

    In many ways, in addition to explaining the scope and the nature of the problem, this book provides an interesting historical account of the lobbying efforts that eventually resulted in formal recognition and funding.  The author provides an interesting overview about how this started out as a small grassroots campaign than eventually became an important national public health issue.  He notes, referring to the grassroots origins of this campaign, that

First and foremost a research effort had to be launched. Research support had been the exclusive interest of the tiny Roe Foundation. A few small grants were awarded, but the Foundation lacked the capacity for any sort of substantial campaign. Money was not the only problem. Few scientists with potential talent even knew of the existence of crib death they had to be recruited to work in the field.     
After much effort, the biggest break came when a famous consumer rights advocate named Ralph Nader decided to help the group present its concern to state and federal lawmakers.  Naders group prepared a report together with the group advocating recognition of Sudden Infant Death Syndrome and this report would eventually receive much media attention and political interest.  It was mostly through this report that the public learned about these infant deaths more thoroughly and they began asking there political representatives to increase funding for this important family health issue.  In fact, the author was so appreciative of Naders help that he writes in his book that When the list of the most important Americans of the twentieth century is compiled, Ralph Nader should surely rank high. By word and deed he has shown how citizens without money or position can alter the status quo.

This book, in addition to being about Sudden Infant Death Syndrome, is also about how a few concerned citizens can help to change their societies by becoming knowledgeable, involved, and persistent.  A few groups of individuals can make the world a better place.   Indeed, since the time that Sudden Infant Death Syndrome was formally acknowledged as a legitimate disease, several potential causes have been identified.  Many deal with irritants which affect an infants lungs, such as chemicals and second-hand smoke.  Other studies suggest that a low birth-rate and male babies are risk factors for this type of infant death.  Without the dedication of people like Dr. Bergman and Ralph Nader, these causes might never have been found.  They are truly heroic people.

In conclusion, this book demonstrates that disease and public health are sometimes too narrowly defined.  People cannot view deaths with a pattern as accidents and therefore ignore them as if they are inevitable.  Instead, people who suffer such personal losses should exercise their rights as citizens.  They should educate themselves and become involved in the political process.  These are the books main messages and they are hopeful messages.  Anyone can change the world.